- [Voiceover] Truly, thank you for that. As you guys are thinking about what is going on in the DSM-5, let's pause before we jump into this slide and let's put up the next polling question, polling question number two, please. And let's see where you guys are at with DSM-IV-TR or DSM-5 in your agency, your private practice or wherever you're working right now Casinoslots New Zealand .
Give it a minute for everybody to jump into that polling question. Are you just using DSM-IV or are you just using DSM-5? Neither or some of you are using both. And then in a few seconds we'll broadcast the results, if we haven't already.
Let's see those results. Okay, one person is still just using DSM-IV and I want Denise E. to kind of address that and eight people are using DSM-5 already, that's shown some progression, more people than I expected are using DSM-5. There are zero agencies that are using neither. That gives me hope that you're using good materials out there, because, of course, there's controversy around DSM, but at least it's a springboard and it's something that we generally have to use if we're trying to get insurance and other reimbursement.
And some people, two people, are using both. Denise if you could spend a minute, Denise E., talking about your experience with Medicaid and billing and what's happening with your use of the DSM-IV and five. - [Voiceover] Actually, the results were actually interesting to me too, because we are using primarily the four because of Medicaid. They have told us that they are not going to be moving to actually DSM-5 at all, now the reason for that is currently, we use the DSM-IV plus ICD-9 because the language in the two is not the same, so we need to use both for diagnosis and billing. When we move to ICD-10, after the the first of the year, is my understanding, it keeps being moved back, the language in the ICD-10 encompasses the language from the DSM-5, so there's no point in using two different documents, so we're gonna be only using the one document when that kicks into place, but for the time being, to get reimbursed by Medicaid and many insurance companies, we're still... (silence) trained in those kinds of things, so my staff is slowly getting trained in the DSM-5 because we will be using it as part of our Medicaid reimbursement in the ICD-10 just not necessarily separate and then I also wanted you, Denise Q., to address the issues around if you're going to be sitting for your alcohol, your licensure or certification in front of the oral board.
- [Voiceover] Absolutely. When you are preparing to take the oral, well, first of all, the written, you have to certainly do a lot of book learning to get ready for the written and I know right now that the written exams for the alcohol and drug counselor for the state of Nevada test are all coming off DSM-IV and ASAM, so let me talk a minute about ASAM. The ASAM Criteria, it used to be ASAM PPC-2R, where we would do patient placement and use the... - [Voiceover] Crosswalk. - [Voiceover] Crosswalk, I wanna call it boardwalk, I knew it was a walk of some kind, we'd use all that crosswalk stuff for placement of our alcoholics and drug addicts. There was nothing like that for gamblers and that was the genesis of creating the Gambling Patient Placement Criteria because we wanted something specific for gamblers, so those of us who created that started noticing that as the ASAM criteria was being written over the last couple of years, my colleague, Colin Hodgen, and I had the privilege of being one of the field reviewers, two of the field reviewers out west here, and we got to see comments being made about what was necessary and what they wanted to have in the ASAM Criteria, so we even got our names in the back of the book, it's pretty exciting.
Are they're lying to themselves or others about their gambling or are the amounts of their bets increasing. That Lie-Bet Screen is a perfect segue of any conversation that you're having with one of your clients that you're assessing about money and financial stress and as soon as you catch a whiff of any financial problems, if you simply ask, "Hey, are you lying to yourself or anybody about your gambling," and you can assume if they're having financial problems that there may be a gambler hiding in the closet somewhere, if it's not them, it might be somebody else. And if they say yes to that one, "Oh, well have you noticed the amounts of your bets increasing." Boom, you've got the perfect segue to do more screening and more assessment on the gambling problem. So that's a little gift, you can use that any time. And then a few words about DSM-5.
I want you to get a good look at the cartoon, because I think it is a good humorous rendition of what's going on in our day. This is a snapshot of the DSM-5, the Diagnostic Statistic Manual of Mental Disorders and I want to advise you that if you are about to take a DSM-5 class from anyone, you've been looking online, you wanna take a cheap, quick and dirty, get something off the internet, DSM-5 class, which I think everyone should do in their push for time. Do not take a class that says it's about DSM-V because that person did not pay attention to the fact that the new DSM-5 is using Arabic numerals, not Roman numerals anymore, (laughs) so if you wanna be on top of things, it's DSM Arabic numeral five, not Roman numeral V. It's kinda cute that the idea behind the cartoon there is that anything that could go wrong in any of our lives could possibly be mentioned (laughs) in the DSM as a mental disorder. Thus we are having more and more discussions about process addiction and behavioral addiction and gambling made the cut in the DSM-5 with all the 15 years of planning and discussion about what should go in DSM-5, we, I consider it we because I take some ownership having some expertise in this area, we were very happy when we saw that gambling disorder is the first of the behavioral addictions listed in the DSM-5.
We know that there are others that didn't quite make the cut because they didn't have enough research or enough of whatever it was that the committee decided they needed and, frankly, many of us were disappointed about that. I know Denise and I were talking yesterday about it's stunning to me that food addiction did not make the cut because there's so much research and clients behind it. - [Voiceover] This is Denise E. There's a lot of research, I was just reading an article very recently about process addictions and there are several that are still on the drawing board and one of the interesting things about changing to the Arabic numbering system is that my understanding is from Denise Q., is that in the future, rather than rewriting the entire manual, they're going to adapt different sections and so it'll be 5.1, 5.2, 5.3, so they won't be waiting several years before we come out again with another manual because they're behind the times almost before the ink is dry.
- [Voiceover] Absolutely. - [Voiceover] And so I think that's going to be extremely valuable and in the future, it might even be helpful if they did it in, kind of a three-ring binder kind of format, rather than having it hardbound and that way you can add in whatever the revisions are. All of the articles that I've been reading recently have talked about how there's a real movement afoot to include food issues, sex addiction and a variety of things, there's people who have problems with overspending, underspending, the financial recovery issues, debt, over and under earners, you know, those kinds of things, so it will be really interesting to see how the field evolves over the next few years.
It's been my experience that some of my clients who have had horribly negative experiences with gambling, if I should use the term gaming, they will stop me and say, "That is not what it is." (laughs) And we're gonna talk more in a few minutes about how gamers, if you are talking about gamers now in this year, 2014, you need to differentiate between what kind of game they're playing, are they playing an interactive video game, a multiplayer game, are they just two little boys playing on their XBox and they've got their headset on and they're talking to their three other friends down the block, you know, those are gamers, or are they actually people playing some kind of a game of chance where the risk is involved and money is involved or something of value is involved. So the reason I'm giving you my favorite definition of gambling from Gamblers Anonymous, it's because I trust that since 1957 when Gamblers Anonymous was founded, piggybacking off the 12 Steps of Alcoholics Anonymous, gamblers know what problem gambling is, so you can have a definition of gambling, or you can have this definition of a gambling problem from the viewpoint of an addictive gambler and you'll see that the key components are any betting or wagering, for yourself or for others, because I know plenty of codependent or non-codependent concerned family who think they're doing a fun thing going across state lines to buy lottery tickets and that is gambling, that is going out and doing the act of gambling, whether for money or not, as Denise mentioned earlier, it can be for something of value, no matter what, no matter how slight or insignificant where the outcome is uncertain or depends on chance or skill and lovingly, I think, GA put quotation marks around the word skill, because there are some games I would have no idea how to play, you could not convince me that there is a way to learn how to play craps in five minutes. I've seen people talk about it endlessly and the science behind it and I think, uh, it's just throwing dice, I don't get where the skill is, but some people say that there's skill involved and also the outcome being uncertain, that risky part, Denise E. is gonna be talking about adolescents in a little while, and boy, high-risk behavior with adolescents is all over who they are and what they do, so it doesn't become an addiction until all of these elements combine and loss of control, as you well know from the diagnostic criteria, has to be going on.
I put the little Yellow Combo Book picture at the bottom of this slide. If any of you are working with gamblers, whether it's children, adults, relatives, friends and somebody has a gambling disorder, or gambling problem or used to have a gambling problem, I heartily recommend you spend 50 cents and order this online through the Gamblers Anonymous website or get one at the nearest GA meeting because this little Yellow Combo Book, which is literally only about three or four inches tall, 17 pages long, has everything that you need to know for a basic GA meeting and for any gambler who wants to not gamble today. The essential information is on page 17 and they will tell you in a meeting, if you don't wanna gamble today, do everything that's on page 17. That is treasure for somebody who's brand new in recovery and is mortified that they have to live in this town where they're surrounded by gambling things and for the family who need to understand what the essence of Gamblers Anonymous is about. So if you don't have one, please get one. The Lie-Bet Screen is a two question screen that anybody can do, if you would like to use this... (silence) determining, with science to back it up, because you've got a 90% reliability that there's a gambling problem if they answer yes to either or both of these.
Ladies and gentlemen, the captain has turned on the fasten seatbelt sign. We're currently experiencing a loss of altitude, and we'll be making an unscheduled landing at a crafty and cooperative survival card game. On behalf of all of us here at Treetop Airlines, welcome to Ravine.
In the event of a Ravine landing, you and up to five of your friends will need to collaborate to survive the night, and avoid falling into madness. All survivors will start with six heart tokens, and a wreckage card. Your wreckage card could be a valuable resource, left over from the crash, like a tarp, a flare gun, or a bottle of vodka. If you've survived our emergency landing, there's a good chance your bags and your limbs have been badly damaged.
Take three of your six heart tokens, shake them in your hands like dice, and release them to see how strong your karma is. Rolled three full hearts? Congrats!
You're Chuck Norris! Rolled zero hearts? Sorry! We're probably gonna eat you first navigate to this website.
During the day, you and the other survivors can choose to risk as many hearts as you wish to leave the camp and forage for food and supplies. For every heart you risk, you can collect one forage card. You can replenish your hearts with any food you've found on your forage, or by playing nice with the other survivors. Please be advised, any survivor with only one remaining heart, must draw a madness card and then, go completely *BEEPING* insane. Symptoms of madness include, but are not limited to, blindness, uncontrollable singing, fits of rage, growing obsessions with 80's trivia, compulsion to wrestle nearby neighbors, delusions of grandeur, cannibalism, the need to be held constantly, intense existential fear of robots, pyromania and compulsive dancing.
Before sunset, craft fire, shelter or eat the food you've discovered, in an attempt to prepare for the wolves, winds and blistering rains that come with the night. Some of you won't make it. But don't worry, we'll split up your stuff. *scary animal noises* Lose all of your hearts to risk or the elements, and you lose the game. Survive all of the night cards in your deck, and you win! That completes our safety demonstration.
Please feel free to move about the Ravine, and try not to die now, okay? Buh bye, now! Okay, buh bye, now! Safe travels!
Title: ぼくたちと駐在さんの７００日戦争 (Bokutachi to Chuuzai-san no 700 nichi Sensou)
English Title: 700 Days of Battle: Us vs. the Police
Release Date: April 5th, 2008 (Japan)
This is a sweet story about a group of highschool friends and the silly, mostly harmless, pranks that they play, especially on a particular traffic cop.
The movie remains mostly in the realm of comedy, while becoming a bit more serious and heartfelt at the end.
An especially funny scene: one of the main characters, Mama chari, is caught in the act of decorating the police office with dirty posters and smutty magazines. He is caught by none other than the lady from the café, who he has a crush on. Moreover, he then discovers that she is the police officer’s wife. Mama chari, pleads that he found the magazines outside school and was must coming to turn them in. The police officer knows this is a lie and so, in order to take record of the “found” goods, he makes Mama-chari read the titles of the books out loud as he writes them down. Meanwhile his wife, to Mama chari’s ever growing embarrassment, watches the whole scene.
Apart from the mostly juvenile, slapstick humor (which I found to be hilarious) the movie touches on the importance of friendship along with being role models for those younger than us.
This was so incredibly entertaining, light, funny movie and a really enjoyable watch that I decided to write an essay.
Das Experiment (The Experiment)
Chilling in many of its implications about human nature, director Oliver Hirschbiegel’s The Experiment is a film which contains imagery that may remain long after you have seen the film.
A group of males are assembled by the lure of big money, into participating in a behavioural experiment. The group is divided into two groups, a division which the participants see as totally arbitrary. For the purposes of the experiment, one group will be warders in a simulated prison. The second group will be prisoners.
Into this mix is added Prisoner 77, Moritz Bleibtreu’s character, Tarek Fahd, who has secretly done a deal for a newspaper which he has worked for, to deliver an article about his experiences after the experiment has concluded.
The warders are informed that no violence is to be used in their relations with the prisoners but gradually their use of humiliation as a means of controlling those who are the prisoners becomes itself an extreme form of violence and in the face of resistance by prisoners like 77, they become increasingly obsessed with their own power and control.
At one point in the film, one of the prisoners accuses the warders of being “Nazis” but the frightening reality of the film’s message is that any group of people, given sufficient incentive and sufficient leeway to exert power over others, will do so and often do so both ruthlessly and with violence.
Admittedly all involved in the experiment are male and the only female character with a close association with the experiment, herself becomes victim despite her status at the beginning of the film. There may be as much testosterone in the reactions of the warders as there is test.
There is an interesting quote from one of the cast members on the extras features which come with the DVD. Oliver Stokowski who plays Schutte in the film, says when discussing his role and its similarity to certain exercises that he was subjected to in acting school: “somehow I never liked the psycho-pathological ring-a-round-the-rosey where someone eventually freaks out.”
Like many experiments where human behaviour is observed, this film indicates that the animal part of humanity is brought closer than are those values which we think elevates us from beasts.
Title: 空気人形 (Kuuki Ningyou)
English Title: Air Doll
Release Date: 2009
“Everybody in this town is empty, it’s not just you.”
One day, a blow up doll comes to life. A very pretty blow up doll, by the way, played by the Korean actress Doona Bae. She moves about, slowly at first, then leaves the house while her owner is gone. In the outside world, she experiences everything with joy and wonderment for the first time. Except for some faint lines and the fact that she is full of air, she looks entirely human.
Her explorations in the outside world are cute and harmless at first, but a trip into a video rental store change things; here she falls in love with one of the employees.
Hirokazu Koreeda, director of Nobody Knows and After Life, uses the life of this one doll to represent many of the things that we often deal with and encounter in life. Although the doll’s life is short, she covers a lot of ground – from child-like wonderment, to love, to heartbreak. The themes represented in the movie as well, are ones that are meant to be universal; those of love, desire, and loneliness. Some of the sweetest moments from this movie, are lines spoken by the main character, Nozomi, and the man she falls in love with Junichi, played by Arata. These are made even more powerful because they are firsts for Nozomi; “I told a lie,” she says in one scene, “Because I have a heart, I told a lie.”
The soundtrack to this movie was really pretty and one of the first things that helped rope me in. There is very little dialogue in many parts; instead we are left to experience the world through the eyes of a doll, with the help of the music playing in the background. Something of a combination of tracks from Amelie and 28 Days Later – sweet, yet heavy at the same time – the movie is filled out with the help of simple keyboard melodies, accordion, and a few strings.
As the movie gets further along, the parallels between Nozomi, a blow up doll, and the people she is surrounded by start to become clearer. “Everybody in this town is empty, it’s not just you,” an old man tells her, and we begin to understand one of Koreeda’s messages: everyone is fragile and weak on the inside; we can’t survive without supporting and being supported by others.
Koreeda also returns to some themes that were at the center of After Life. Nozomi’s creator, a doll maker, asks her, “The world that you’re born into…is it all pain and suffering? Or is there anything…beautiful?” To this Nozomi faintly smiles and nods, her maker and the audience receiving confirmation that, although life is full of hardships and suffering, there are beautiful moments too.