Press Release: New Zealand Association of Psychotherapists

Tuesday 15^th April, 2014

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Yesterday’s District Court ruling, that the standard ACC release of information form the “ACC 167” is illegal, has been welcomed by psychotherapists and clinicians working with sexual abuse survivors.

“The Disley Independent Clincial review of the ACC’s treatment of Sensitive Claimants, undertaken in 2010, outlined serious concerns about this form and the ACC’s approach to the gathering of health information.  This decision is welcomed, but long overdue” says Kyle MacDonald, New Zealand Association of Psychotherapists Public Issues spokesperson.

The Disley review included a legal opinion, which noted concerns about the ACC 167, and explained the limitations that apply to the collection of health information.  Those working with all ACC claimants, and specifically in the sexual violence sector, have long expressed these concerns.

“We’ve known for a long time that this form, and it’s implementation, has caused specific problems for sensitive claimants”  says Kyle MacDonald, “it has been common practice for the ACC to request ALL of a claimants GP or Mental Health notes, and not accept a health professional acting in accordance with the Privacy act by providing only those parts of the record relevant to the claim.  Furthermore the ACC have quite explicitly declined to advance a claim if individuals refuse to sign the waiver due to quite legitimate privacy concerns.”

This has set up a perception that ACC have gone on “fishing expeditions” for reasons to decline claims, rather than sticking to the limits of the Privacy Act, like all other health professionals are required to do.

“Hopefully this decision allows people who have had their claim declined due to the illegal acquisition of health information to have their claim revisited.  It should also allow those who have had their claim declined due to their refusal to sign this form to also re-apply for cover and treatment.”

The following article appeared in the Sunday Star Times on 8/12/13 (Click here for the original article…)

To view the full judgement this story is reporting on click here…

“A judge has ruled in favour of an ACC claimant in a case expected to have “enormous” ramifications for the way mental health patients are treated.

In the decision, released recently, Judge Grant Powell in the Wellington District Court agreed with a psychiatrist who said a man’s schizophrenia had been caused by trauma from sexual abuse in childhood.

Two ACC-employed psychiatrists had earlier said there was no evidence schizophrenia was anything other than a biological condition passed down through families and so the man’s abuse had nothing to do with his condition.

However, the judge agreed with a growing body of research that says traumatic events can cause psychosis.

The research includes the work of clinical psychologist John Read, who has been at the forefront of research to show a relationship between childhood sexual and physical abuse and psychotic symptoms, including schizophrenia.

Read said the ramifications of the decision were “enormous”.

“It is gratifying that years of research on this issue is impacting the judicial system. These rulings will also make it harder for psychiatrists to ignore disclosures of sexual abuse by severely disturbed patients, or to dismiss them as either irrelevant or imagined.

“This is a significant victory for all those patients and researchers who have been saying for many years that the experiences which biological psychiatry believes are symptoms of a brain disease called schizophrenia are best understood as responses to adverse life events.

“Very often the voices abused people hear are the actual voices of the perpetrator of the abuse.”

Read said it was “alarming” that the two ACC psychiatrists “either knew nothing about the many studies documenting the relationship between child abuse and psychosis or were trying to mislead the judge”.

The man referred to in the finding had been covered by ACC for his history of sexual abuse but it was schizophrenia that had stopped him from working. He had sought to gain an independence allowance from ACC in December 2010. An independence allowance covers people who are permanently impaired as a result of an injury. The maximum weekly allowance is $84.97.

In 2011, ACC decided it would not cover the allowance because it said his schizophrenia was not linked to his covered injury – a significant history of sexual abuse between five and 13.

He was assessed by a psychiatrist who prepared three reports but concluded sexual abuse “is not likely to be the material cause of the current condition. There is no evidence of sexual abuse as an etiological factor [cause] in schizophrenia.”

His claim was declined and despite an appeal and subsequent reviews it was again found his incapacity related to his schizophrenia, which ACC said was a health issue unrelated to the sexual abuse.

After another appeal, psychiatrist David Codyre provided a report that completely disagreed with the previous psychiatrists.

“With due respect to my colleagues who undertook the prior psychiatric reports . . . their opinion that sexual abuse is not causally related to schizophrenia is not evidence based.”

Judge Powell said ultimately he found Codyre’s analysis “a more compelling and inherently more credible cause of the appellant’s schizophrenia”.

Read said the finding would reduce the frequency with which psychiatrists dismissed abuse disclosures as irrelevant or imagined and increased the probability of people being offered trauma-based psychological therapy instead of anti-psychotic medication.

New Zealand Association of Psychotherapists public issues spokesman Kyle MacDonald said the judgement was encouraging and could mean entitlements for many other people.

“The reality is there a lot of people who would be in the mental health system who would have a diagnosis of a psychotic disorder who may now be entitled to access some treatment under the ACC.

“For a long time there has been a mindset of how schizophrenia and psychotic disorders are treated, which is that it is a biological disorder which needs to be medicated and managed.

“The reality is that actually these people are underserviced in terms of therapy and psychological intervention. This is a way to get people more therapy and more psychological help.”

ACC said it would consider whether this decision “has any wider impact” but took the view it would have “limited” value as a precedent and it would “continue to carefully consider each person’s unique situation and circumstances”.

– © Fairfax NZ News”

On Sunday morning Wallace Chapman on Radio Live spent an hour talking with various people about the victims perspective of the recent “Roast Busters” rape cases.

Here’s a link to my chat with him about the psychological effects of sexual violence, and what we can do as a community to stand up and not allow this sort of crime to take place.

Click here for a link to the audio….

Ever since the so called “Roast busters” case broke this week, I’ve had a few men say to me that they feel sickened by the actions of these young men, and wonder what voice do we have as men?  Can we as men talk about Rape Culture?

Of course we can, but more than that we need to.  There have been a number of  intelligent voices online who have talked eloquently and with real passion about how we as a nation need to now acknowledge that New Zealand has a serious problem.  (Click here, here and here for more.)

But sadly the voices that have disturbed me has been the voices of other men.

Whether it’s John Tamihere and Willie Jackson’s bizarre and seemingly in-sightless harassment of a young woman on air, John Key’s off the cuff remark that the Roastbusters need to “grow up”, or the apparent lack of understanding of the psychological effects of rape and abuse shown in the Police’s remarks that the girls attacked have not been “brave enough” to come forward.

As a man, at these moments I feel ashamed and let down by my own gender.

And as understandable as it is, forming a lynch mob and beating the crap out of these young men in retribution for their actions achieves little but a perverse sense of satisfaction.  That’s not how we need to respond as men.

We need to recognize that these young boys who have so horribly lost their way, were surrounded by other boys and men.  It’s too easy to stand by and let the sexist remarks slide, the objectification occur, stand by when a mate “targets” someone who’s been drinking at a party.  It’s just what happens right?

Well to do so is to turn a blind eye to what is rightly labelled “rape culture.”

Sexual violence doesn’t happen in a vacuum, it happens in a context where the degradation of women and children, the privileging of masculine power and the celebration of sexual conquest takes precedence over human decency and respecting others.

As men we all have a role to play.  As much as it is difficult to talk openly about sex and consent, teaching our sons how to use condoms and what a cross section of a uterus looks like is woefully inadequate preparation for the world of sexuality.

Not only do we as a nation need to thoroughly investigate the actions of the Police, and prosecute these young men to the full extent of the law, we also need to stand up and stop standing by as our friends, brothers, colleagues and team mates behave towards women in ways we feel uncomfortable about.

Mates don’t let mates abuse women and children.

From: Herald on Sunday, 5:30 AM Sunday Jul 28, 2013, By Sally Webster

Psychotherapists anxious as Govt, insurers redirect funds for depression
Funding for talk therapy is drying up just as increasing numbers of New Zealanders are feeling comfortable talking about their problems.

The country’s biggest income protection insurer, Sovereign, says claims for depression have reached a crippling 40 per cent and the cost of counsellors it sends clients to “out of the goodness of our hearts” can’t be sustained.

It will recommend more clients do exercise and take medication.

Government departments have also reduced the counselling services they have offered for years.

Free relationship counselling services offered by the Family Court are about to be axed; the Ministry of Social Development is tightening up on the extensive counselling it offers the mentally ill on the disability allowance; and ACC is doing a major review of how it handles those who come to it with sexual abuse and assault trauma.

The ceiling on therapy sessions may be cut from 16 to as low as four.

Some of the cutbacks, particularly Sovereign’s, have alarmed the Association of Psychotherapists’ chair of public issues, Kyle MacDonald.

He says they are being done simply to save money.

“We are up against the massively funded model of the drug companies who convince people that medication is the best treatment, despite evidence to the contrary for mild to moderate depression.”

Sovereign’s chief medical officer, John Mayhew, says it has decided that where antidepressants have been proven to work well, it is “efficacious” for them to be used.

“In the past we’ve had, say, a 50-year-old stockbroker with an income protection product who’s become severely depressed.

“The first thing we’d do is get him seen by a psychiatrist, get a diagnosis and then start treatment. That might be a mixture of psychotherapy, medication and an exercise programme. But now we’ve decided a talk therapist isn’t necessary for everyone.

“A guy whose wife has just left him might be depressed and struggling to cope but it doesn’t mean he necessarily has to see a counsellor.

“Anti-depressants like SSRIs (selective serotonin re-uptake inhibitors) are proven to work.”

The Ministry of Justice is gutting its free relationship counselling. The Court Proceedings Reform Bill before Parliament will kill off the remaining three hours’ free relationship counselling for couples. That was halved from six in 2012.

Justice Minister Judith Collins says the ministry has no idea of the outcomes of counselling sessions.

These will be replaced with six separation mediation sessions, free to 60 per cent of users who fall under the civil legal aid threshold. Those above it will pay about $780 + GST a couple, or $390 a person.

The squeeze on therapy has angered comedian and Nutters Club founder Mike King, who has had well-documented battles with addiction and mental illness.

“The reason I had talk therapy was because I was overwhelmed with suicidal thoughts.

“As much as the whole therapy thing went against everything I stood for, I was faced with death as the only option – I had to try it for my family’s sake.

“I can say from experience that talk therapy absolutely works. But few people can afford it.

“We don’t need less talk therapy. We need to be working with the Government and insurance companies to find ways for more people to get affordable or free therapy.”

MacDonald of the psychotherapists association says that at its most basic, the choice is coming down to the cost of a pill versus $120-plus for a session of talk therapy.

“People are given medication as the frontline treatment – usually SSRIs – after just 15 minutes of consultation,” MacDonald says.

“It is often not an effective form of treatment but people are getting this as the only option.

“We must find the reasons people are depressed and this is what therapy is for, otherwise it is likely to recur.”

Mid-week I had a chat with Sean Plunket on Radio Live about the Jesse Ryder assault, men, violence and fighting.  Here’s the link in case you missed it:

Click here for the audio of the interview

When I was reading some articles and blog posts in preparation for my Radio Live bit this week (click here to listen to the interview) I came across a survey figure stating 50{1b812f7ed7a77644fff58caf46676f6948311bf403a3d395b7a7f87010507f87} of people in the USA describe themselves as”shy.”  Apparently that figure is rising, as is the number of people being diagnosed with social phobia or anxiety, now the third most common psychiatric diagnosis in the States after depression and alcohol dependence.

Shyness seems to be more related to upbringing than genetics and the key difference with social anxiety is the degree of impact on one’s life.  For more details see this excellent blog (click here).  You can also click here to read more about the differences between shyness and social phobia.

Mindfulness is a really effective treatment for social anxiety and social phobia, as I said in the interview, and this article outlines some of the research (click here).

Lastly if you’re interested in the body language research and techniques I mentioned check out this video clip from www.ted.com.  And thanks for listening.