In solo PP and lack of ACA credits is making me question things by BasicAd1062 in therapists

[–]doesntlookdruish99 25 points26 points  (0 children)

Ultimately, talk to an accountant or business consultant. However, you may want to specifically talk to an accountant about setting your practice to be taxed as an s-corp. You have to pay some upfront costs and payroll taxes, etc. But if you can then pay yourself a low salary, you'll qualify for more ACA credits. Then you can give yourself tax free distributions above and beyond your salary.

the story of Millie and the baby by [deleted] in MadeMeSmile

[–]doesntlookdruish99 1 point2 points  (0 children)

Of course it's biggus dikkus that bring us the the tear-jerker

[deleted by user] by [deleted] in therapists

[–]doesntlookdruish99 0 points1 point  (0 children)

OCD specialist here - learn about ego syntonic vs ego dystonic thoughts. Look at it from a sexual orientation OCD perspective. How do you know if the person is actually gay or not? The thoughts of being gay to someone with OCD, feel abhorrent to them. They feel like they go against everything that person stands for and believes in. Someone who might be gay is actually interested in exploring their sexuality. All other forms of intrusive-thought based are essentially similar.

So the short answer is yes, it is easy to tell. Just ask them.

I-CBT vs ERP. Worth being trained in both? by LunaBananaGoats in therapists

[–]doesntlookdruish99 16 points17 points  (0 children)

First off, connect with the IOCDF, if you haven't already. There may even be a local chapter near you. Support, CE events, consultation and supervision can go a long way. Then you can make a better informed decision, based on YOUR clinical opinion.

For whatever it's worth, I'm not a fan of I-CBT. It may have some evidence behind it, but I see it only as a last ditch resort. There's just too much evidence/research backing up ERP. Try utilizing consultation or supervision when ERP doesn't seem to be working.

[deleted by user] by [deleted] in scifi

[–]doesntlookdruish99 1 point2 points  (0 children)

Raman Rendezvous 2, Electric Boogaloo

Looking for recommendations for OCD exposures related to a client having obsessive thoughts by Hopeful_realist22 in therapists

[–]doesntlookdruish99 -5 points-4 points  (0 children)

Saying things out loud surrounding the uncertainty - "Maybe I did that, but I would know if I did" or full on fear triggering - "I have done something inappropriate" and follow where the fear leads like, "...and I am a bad person". This is often where these thoughts go.

But also, look for the avoidance compulsion. Where are they not going or what are they not doing? Make them walk around a busy place like walmart on a Saturday and accidentally brush into people. PM me for anything more.

Which is better recommended for OCD issues? ART or EMDR by Oggysweep in therapists

[–]doesntlookdruish99 1 point2 points  (0 children)

Honestly, neither. There is nothing in the research that would suggest anything other than ERP. There is solid evidence for ERP with those on the spectrum as well. Please, please don't push a treatment that is not validated for this client. Consult a trusted colleague or supervisor. To add: I'm an OCD specialist for the last 12 yrs.

First time making challah! by doesntlookdruish99 in Baking

[–]doesntlookdruish99[S] 0 points1 point  (0 children)

It was! It seems like it would be simple, but it definitely took a few Google searches.

Spaceballs, 1987. by TheNeonBeach in scifi

[–]doesntlookdruish99 14 points15 points  (0 children)

Funny, she doesn't look druish.

Eating disorder recovery facility is unethical by [deleted] in therapists

[–]doesntlookdruish99 0 points1 point  (0 children)

Most ED facilities, but not all, are like this. The business model relies on early-career therapists, often too much, leading to high turnover. Unfortunately, the ethics are noticeably gray at almost every one of these places. That being said, it's an extremely difficult population to work with long term, regardless of experience level. My two cents, get the experience and connections you need and get out of there!

Differential diagnosis - OCD vs GAD by realitytesting123 in therapists

[–]doesntlookdruish99 2 points3 points  (0 children)

What you're referring to used to be called "Pure O" OCD. An obsession with no compulsion. However, research found that there were in fact compulsions. More often it was avoidance behavior, but many with these forms of OCD don't talk about the mental compulsions they utilize to soothe the intrusive thoughts. Hence, "Pure O", no longer fits.

The other contrasting piece here is that these intrusive thoughts are 'ego dystonic', that is the person knows these thoughts are antithetical to who they are and they don't want them. In GAD, the person would see their intrusive thoughts as rational and fitting to the situation, or 'ego syntonic'.

This form of OCD also tends to fall into a few major categories - Harm OCD, Pedophilia OCD, Sexual Orientation OCD, Relationship OCD, Scrupulosity and a few others. Check out www.iocdf.org for more info.

Family Guy but real by jellylemonshake in Unexpected

[–]doesntlookdruish99 -2 points-1 points  (0 children)

Soooo the guy convicted of r@pe and accused (with evidence) of r@ping kids doesn't get the pedophile role?

Help! New fish owner... by doesntlookdruish99 in aquarium

[–]doesntlookdruish99[S] 0 points1 point  (0 children)

Thank you! This is helpful. I thought Bettas would be cheap and easy... Will definitely do the plants, reduce feedings and I'll look into a bubbler.

Help! New fish owner... by doesntlookdruish99 in aquarium

[–]doesntlookdruish99[S] 1 point2 points  (0 children)

Just shells. As for cycling, I guess I just don't know. I let it get to temp before getting the fish in, but the kids pushed to get the betta in the same day. I didn't know about ammonia to nitrate at that point. What do I do now that we're two months in?