Author Archives: Susan

“Psychiatric Collaborative Care Model” Passes House 98 to 0

HB 278 by Rep. Echols passed the House on April 27 with a vote of the 98 to 0. It was received in the Senate and placed on the calendar.

The measure provides requirements for the Psychiatric Collaborative Care Model and requires mental health or substance abuse benefits for services delivered through the model. The bill is pending in the Insurance Committee.

The proposed law requires a health coverage plan delivered or issued for delivery in this state  that provides mental health and substance abuse benefits to reimburse for such benefits that  are delivered through the psychiatric Collaborative Care Model. The model includes the current  procedural terminology (CPT) billing codes 99492, 99493, and 99494.

The new proposed law requires the commissioner of insurance to update the CPT codes if there are any alterations or additions to the billing codes for the Collaborative Care Model.

Proposed law authorizes a health coverage plan to deny reimbursement of any CPT code  provided in proposed law on the grounds of medical necessity, provided that such medical  necessity determinations are in compliance with certain federal and state law.

Defined are: (2) “Mental health or substance abuse benefits” means benefits for the treatment  of any condition or disorder that involves a mental health condition or substance use disorder  that falls under any of the diagnostic categories listed in the mental disorders section of the  current edition of the International Classification of Diseases or that is listed in the mental  disorders section of the most recent version of the Diagnostic and Statistical Manual of Mental  Disorders. (3) “Psychiatric Collaborative Care Model” means the evidence-based, integrated  behavioral health service delivery method described in 81 FR 80230. 

 

 

 

 

Cow

A Review

by Alvin G. Burstein, PhD

From Ida Tarbell’s exposé of Standard Oil, to Upton Sinclair’s critical exploration of the plight of  packing house workers, to Ralph Naders’ blistering attack on automakers, America has a rich  tradition of what has become called “muckraking.” Some will see Andrea Arnold’s documentary  debut, the 2021 movie Cow as in that genre, but I would think that a mistake. It has a visceral  punch and evokes a  strong reaction, but it is not a protest film. It is a tour de force, however,  on many levels. Just released to movie houses, I watched it on Amazon Prime.

Strikingly, there is almost no dialogue in this film. It is a biography of a cow, Luma, centered on  the birth of two of her seven calves. We hear only scraps of conversation among the employees  of the English dairy farm housing Luma. They address their bovine charges as “good girl,” and  manage their comings and goings without the electric cattle prods seen in some settings. But  Arnold gives us an unsparing, honest look at the muck and mud and blood of the setting.

We watch Luma’s strenuous birth labor, and the tug of war winching out of her calves. We see  her placenta dangling afterwards. We watch her next impregnation, the climax of which,  jarringly, is accompanied by a pictorial burst of fireworks.

Most viewers will resonate to Luma’s tender ministrations to her newborn calves, and be  harmed by the offspring’s’ tottering responses and nuzzling of her mother. They will also feel  stirred by Luma’s lowing when the calf and her mother are separated by the need for Luma to  be returned to the cycle of artificial machine milking. That highlights one of the major contrasts  of this documentary, that between living flesh and blood and the clangor and efficiency of  machines on the other: incompatibles inextricably interwoven in Luma’s story and in human  lives.

Another element of the film that seemed important was the British pop music soundtrack. It  struck me at times like an ironic comment on the action. But I came to regret my lack of  familiarity with that material.

An intriguing issue posed by this film is its documentary “fly on the wall” self-presentation. The  dairy workers give no evidence of being aware of the process of filming, of interacting in any  way with the filming crew. And yet the cameras and crew must have been making an  impression on the workers, and, indeed, of influencing in some way their behavior.

As a biography of Luma it must end with her death, the details of which I will not reveal. There  is, however, an afterword. We watch Luma’s second calf going down a path that will echo Luma’s.

Andrea Arnold’s first two feature films, Fish Tank and American Honey, earned awards at Cannes. Cow will further burnish her reputation.

Stress Solutions

What do Jazz Fest and Stress Have in Common?

Do you like music? To New Orleanians, Jazz Fest means good music, and lots of it. So, you might  ask what could Jazz Fest and Stress possibly have in common? My answer is “MUSIC!” The reason is that one of the best ways to relax and reduce built-up stress is music.

Why is music such a good way to relax? There are many answers, but the key answer is also the  key to stress. It is simple really. Music is a great way to relax and reduce stress because it can stop you from thinking. And, thinking is the #1 trigger for stress.

Thinking generally produces cortisol. To reduce the buildup of cortisol, you have to stop  thinking. That is why focusing on your breathing, mindfulness, meditation, or exercise are great  stress relievers. Most of the time if you are practicing mindfulness or meditation, you are not  thinking and trying to solve a problem. You are burning cortisol when exercising so maybe it  does not belong in the same group. My point is that music can stop you from thinking.

There are major advantages to using music as your primary means of stress reduction. For one  thing, it is much more fun and pleasant and easy to do than most of the other things you can do to reduce cortisol. Music is usually easy to set up. Any type of music, well – almost – any type of  music will work. It can be playing in the background while working. Then you can take regular  breaks by sitting back and focusing on the music and clearing your mind of whatever you are  working on for a few minutes.

Music uses almost all the brain areas. I’m not sure if this is a fair statement, but music like good  jazz or classical seems to balance the nervous system. The more you can take a moment to pay attention to, focus on the music, the more it will work to relax you.

If at the same time, you  practice a little breathing while listening actively, you will be surprised how much 5 minutes like  that can do for you. You will feel ready to re-attack that stack of files on your desk.

So, how about putting on something you like to listen to, take a few deep breaths and then  maybe move a bit to the rhythm. Shrug those shoulders. Relax your neck and shut your eyes for a minute. When you catch yourself in that big yawn, then you know you were successful. You  reduced the cortisol. I think I will take some of my own advice right now.

Gov. Edwards Signals Veto of Mizell’s SB 44

Senator Beth Mizell’s “Fairness in Women’s Sports Act,” was reported out of committee with amendments and voted on by the full Senate on April 19. The measure passed by a vote of 29  to 6. The proposed law, SB 44, will have the effect of prohibiting transgender females, those  assigned as male at birth, from competing in traditional women’s sports.

Gov. Edwards vetoed the same measure last year and foiled the Legislature’s attempt at an  override in a special session. Regarding this new effort, the Governor said, “I don’t think you all  have ever heard me announce from this podium before a bill gets to my desk that I’m going to  veto it because I always think that there’s an opportunity and a path forward to working things  out,” he said. “So that may not be necessary, but I will tell you that my views haven’t changed.”

According to the SB 44 digest, the “Fairness in Women’s Sports Act” requires an athletic team or sporting event sponsored by an elementary, secondary, or postsecondary educational institution to be designated, based upon the biological sex of team members, as only one of the following: (1) A males’, boys’, or men’s team or event only for students who are biological males.
(2) A females’, girls’, or women’s team or event only for students who are biological females. (3)  A coeducational or mixed team or event for students who are biological males or biological females.

Among other provisions, the proposed law provides that certain persons are entitled  to legal causes of action and legal remedies under proposed law. A biological female student  who is deprived of an athletic opportunity or suffers or is likely to suffer from any direct or  indirect harm as a result of a violation of proposed law.

The proposed law provides that requiring a biological female to compete against a biological male on a team that is designated as a “female”, “girls'”, or “women’s” team is inherently discriminatory to biological females and is a cognizable harm under proposed law.

In the 2021 Session, Senator Mizell’s SB 156, easily passed both the Senate (29–6–4) and the House (78–19–8).

But on June 22, 2021, Gov. Edwards announced he had vetoed the bill, stating “… discrimination  is not a Louisiana value, and this bill was a solution in search of a problem that simply does not  exist in Louisiana.” And, “Further, it would make life more difficult for transgender children, who are some of the most vulnerable Louisianans when it comes to issues of mental health.”

On July 20 the Legislature convened a veto override session for the first time since the 1974 constitution. Sources report a primarily reason for the session was to override the veto on  Mizell’s SB 156.

The Senate narrowly overcame the veto with a 26–12–1 vote. However, the House vote, 68–30- 6, fell two votes short of the super majority needed to override the Governor’s veto.

The text of the currently proposed law states: “A recent study of female and male Olympic performances found that, although athletes from both sexes improved over the time span, the athletic gender performance gap between female and male performances remained stable.  These studies suggest that women’s performances at a high level will never match those of  men.”

Mizell’s bill highlights the crossroads of transgender individuals’ rights and the rights of biological female athletes. The issue has galvanized both the political left and right across the  country.

The American Psychological Association opposes these measures, stating, “Transgender  children vary in athletic ability, just as other youth do. There is no evidence to support claims  that allowing transgender student athletes to play on the team that fits their gender identity  would affect the nature of the sport or competition.”

The Louisiana Psychological Association opposed the 2021 SB 156 and the Louisiana School 
Psychological Association labeled the bill as discriminatory.

 

 

 

 

 

 

 

Dr. Slaton Named 2022 Distinguished Psychologist by LPA

Dr. Karen Slaton, who has been at the forefront of psychology’s transition to integrated health care for most if not all of her career, and engaged in practice, research, and teaching, has been named the 2022 Distinguished Psychologist by the Louisiana Psychological Association.

Dr. Slaton is the Program Manager of Behavioral Medicine/Health Psychology/Primary Care  Mental Health Integration at the Southeast Louisiana Veterans Health Care System. She developed and manages the Primary Care Mental Health Integration Program at the Care  System. She implements the Veterans Administration mandated effort to fully integrate  behavioral health as part of the extended Patient Aligned Care Team. This team consists of  psychiatry, social work, nursing and psychology, and is essential in assuring veteran access to same-day care.

Dr. Slaton also coordinates behavioral medicine services, such as services for pain, palliative  care, cardiology, physical medicine & rehabilitation, and integrated health services (including  yoga and hypnosis).

Dr. Slaton also serves in additional roles including Health Behavior Coordinator, Pain Psychologist, Complimentary Integrated Health VISN lead and Lead Tobacco Cessation Clinician.  She provides health promotion and disease prevention services to veterans such as tobacco cessation and weight loss coaching.

She trains other clinicians in the Interdisciplinary Pain Program, Bariatric Treatment Team, and  Controlled Substances Oversite Board. She collaborates in other teams and committees  including Health Promotion and Disease Prevention Committee, Women’s Health Committee,  Employee Wellness Committee, and the Opioid Safety Initiative.

Dr. Slaton is Clinical Assistant Professor of Behavioral Sciences at Tulane University School of  Medicine and Clinical Assistant Professor of Medicine at Louisiana State University Health  Sciences Center School of Medicine. She provides invited lectures to trainees in the Tulane  School of Medicine Clinical Psychology Internship Training Program and the LSU School of  Medicine Physical Medicine and Rehabilitation Residency Program.

Dr. Slaton is an APA accredited clinical psychology internship and postdoctoral fellowship  Training Committee Member, providing didactic training and supervision to interns and post- doctoral fellows in the areas of primary care mental health and behavioral medicine.

Dr. Slaton is a nationally Approved Consultant in Clinical Hypnosis and a Registered Yoga  teacher.

Dr. Slaton has also owned and operated her own private practice through Northshore  Psychological Services, LLC, Covington, and the Center for Wellness and Peak Performance, LLC,  Covington. She provides a wide range of psychological services including psychotherapy, assessment and evaluation, consultation, and professional training. Her areas include posttraumatic stress disorder, marriage, couples and relationship counseling, food, weight and  body image issues including eating disorders and bariatric psychology, depression, anxiety,  sport and performance psychology, clinical and sports hypnosis, personal growth and  development and counseling patients with medical illness.

Dr. Amanda Raines announced the award in April, at the annual meeting of the Louisiana  Psychological Association. “This award is given to an individual who has made significant  contributions to psychology research, practice, or both, during the course of their career,” said Raines. “This year we are recognizing Dr. Karen Slaton. Dr. Slaton currently serves as the  Program Manager for Primary-Care Mental Health Integration and the Health Behavior  coordinator at the New Orleans VA. She is actively involved in more local and regional committees within the VA than I can count,” Raines said.

“She maintains academic appointments at Tulane and LSU and actively stays involved in both  training and research related endeavors. Dr. Slaton is certified by the American College of  Sports Medicine as an Exercise Physiologist and by the American Society of Clinical Hypnosis. She is also a certified & registered yoga teacher and somehow manages to incorporate all of  these skills into her integrative practice at the New Orleans VA.”

Dr. Slaton’s research includes:

Slaton, K. (2000). An investigation of the relationship between  parental bonding and body image disturbance among male and female college students. Dissertation.

Slaton, K. & Lyddon, W. (2000). Cognitive-experiential reprocessing and rape: A case study.  Journal of Cognitive Psychotherapy, 14, 189-200.

Slaton, K. & Westphal, J. (1999). The Slaton-Westphal functional assessment inventory for adults  with serious mental illness: Development of an instrument to measure functional status and psychiatric rehabilitation outcome. Psychiatric Rehabilitation Journal, 23, 119-126

Raines, A. M.,  Primeaux, S. J., Ennis, C. R., Walton, J. L., Slaton, K. D., Vigil, J. O., Allan, N. P., Zvolensky, M. J.,  Schmidt, N. B., & Franklin, C. L. (2021). Posttraumatic stress disorder and pain
in veterans: Indirect association through anxiety sensitivity. Manuscript submitted for publication.

Vigil, J.O., Slaton, K.D., Raines, A.M., & Franklin, C.L. (2018, September). Examining the Effects of a Comprehensive Pain Rehabilitation Program among Veterans. Poster presented at the annual meeting of the Southern Pain Society, Atlanta, GA.

Lyddon, W., & Slaton, K. (2001). Promoting healthy body image and the prevention of eating disorders among adolescent women. In C. Juntunen & D. Atkinson (Eds.), Counseling strategies  for developmental concerns. Thousand Oaks, CA: Sage Publications.

Her training lectures are  numerous, and include: Use of Hypnotic Language in Non-hypnosis Clinical Encounters.  Presented at 6th Dabney Ewin, MD FACS Hypnosis Lecture. 2022 Tulane Brain and Behavior Conference.

Primary Care Psychology. Presented to Psychology Interns at Tulane University School of Medicine and Southeast Louisiana Veteran Health Care System.

Motivational Interviewing: Effective Communication with Veterans. Presented at the Southeast  Louisiana Veterans Health Care System 2020 Fall Women’s Health Summit.

Motivational Interviewing Skills for Dealing with Challenging Patient Encounters. Presented at LSUMC PM&R Pain Conference.

Behavioral Intervention for Chronic Pain. Presented at LSUMC Physical Medicine and Rehabilitation Resident Didactic Lecture.

Motivational Interviewing. Presented to the LEND program staff at Louisiana State University  School of Medicine.

Motivational Interviewing Skills for Dealing with Challenging Patient Encounters. Presented at LSUMC PM&R Pain Conference.

“My career as occurred in phases,” Dr. Slaton said, “I started in academic medicine at Tulane School of Medicine and like many of my Tulane colleagues, left after hurricane Katrina for  private practice. I enjoyed a thriving practice in Covington for almost a decade before joining  the New Orleans VA 10 years ago. I always say I have the best job ever! I work as a clinical health psychologist in various medicine services and have the privilege of serving Veterans in honor of my grandfather who was awarded the Medal of Honor for his service in WWII,” she said.

“I’m lucky to be able to provide clinical hypnosis to Veterans and to teach hypnosis at the National level for the VA, teach a weekly yoga class to Veterans, lead the Primary Care Mental  Health Integration team, and serve the facility as a consultant for patient education. However,  my favorite part of all is training the next generations of psychologists in our APA accredited  internship and fellowship programs,” Dr. Slaton said

 

 

Discrimination Complaint Rejected by LSBEP

A Request for Investigation, stating that members of the Louisiana State Board of Examiners of Psychologists are operating outside of their area of competence in regard to selection-testing  and racial discrimination, was rejected by the Board. In a letter dated March 7, Ms. Jaime Monic, the Executive Director, said that the members do not have jurisdiction over themselves. Also,  she said, they are not engaged in the practice of psychology as board members. However, they  are open to reviewing this issue, Ms. Monic wrote.

The psychologists who submitted the request, Drs. William Costelloe, Julie Nelson, and Marc Zimmermann, are all business psychologists who have extensive experience with high stakes  selection testing in the private sector. In their request for an investigation submitted in January,  the three said, “There is evidence that confirms that the EPPP has adverse impact against  African-Americans and Hispanics. […]

“Once adverse impact has been shown for a test it is improper to ignore the selection problems.
Furthermore, the way in which the test is used by the Board members drives up adverse  impact. As just one example, the use of a hard cut off, and one that sets a higher bar  considering the restricted sample, on a test with proven adverse impact, is an error in  professional selection testing design.”

The March 7 letter noted:

“Dear Dr. Nelson, Dr. Costello and Dr. Zimmermann, On January 11, 2022, the office of the  Louisiana State Board of Examiners of Psychologists (LSBEP) received your Request for  Investigation form and a statement of complaint against current LSBEP Board Members. Please  be advised that individual members of the LSBEP in their capacity as board members do not  have jurisdiction to initiate a formal investigation or action against themselves under the  authority of La. R. S. 37:2351 et al. All current Board Members meet the requisite requirements  established by the Louisiana Legislature under Chapter 28 of Title 37 of the La. Revised Statutes  to serve the LSBEP and are uniquely qualified to carry out this authority by way of their service,  teaching, training, or research in psychology, degree and licensure as outlined under the  provisions of La. R. S. 37:2353 et al. However, Board Members are not engaged in that which is defined as the ‘practice of psychology’ in their work as a Board Member.

“In consideration of the above, your Request for Investigation of the Board Members is rejected. However, the LSBEP will consider your concerns, “…that the EPPP has adverse impact against African-American and Hispanic populations“, including your concerns regarding LSBEP‘s continued use of the EPPP (Part I – Knowledge) as a tool to assess professional knowledge as  required under R. S. 37:2356. (A)(7). This review is consistent with LSBEP’s statutory authority  and its ongoing endeavors to increase multicultural awareness through assessment of  candidates for licensure and continuing education offerings provided to all licensees who are  involved in direct client services to ensure public protection.

“You will be notified in writing of the final disposition of this matter on completion of the review. If you have any documentation, including peer reviewed articles, valid documentation or studies to support your claims, and/or alternate valid assessments that measure entry level  professional knowledge that should otherwise be considered, please forward that information  directly to the office of the Louisiana State Board of Examiners of Psychologists at 4334 S. Sherwood Forest Blvd., Suite C – 150, Baton Rouge, LA 70816. Due to security and resources,  emails or email attachments will not be accepted or downloaded for consideration in this  matter.

“Thank you for calling our attention to any practices that raise concern regarding the practice of the profession. Sincerely, Jaime T. Monic, Executive Director”

According to Dr. Zimmerman,  copies of Dr. Sharpless’ two articles on the adverse impact of the EPPP have been sent by US  mail to the Board and more information will be sent to them for their study of the issue.

 

 

 

 

 

 

 

Rep. Firment Seeks to Prohibit Gender Change Procedures on Those Under 18 Years of Age

HB 570 by Rep. Firment prohibits certain procedures to alter the sex of a minor child and to  designate this act as the Save Adolescents from Experimentation (SAFE) Act. The bill is pending  in Committee on Health and Welfare.

Proposed law states that the risks associated with the allowance of irreversible, permanently  sterilizing genital gender reassignment surgery outweigh the scientific benefits.

The author notes “It is a grave concern to the Legislature of Louisiana that the medical  community is allowing individuals who experience distress at identifying with their biological  sex to be subjects of irreversible, and drastic non-genital gender reassignment surgery and  irreversible, permanently sterilizing genital gender reassignment surgery, despite the lack of studies showing that the benefits of such extreme interventions outweigh the risks.

“Studies consistently demonstrate that the vast majority of children who are gender non-conforming or experience distress at identifying with their biological sex come to identify with  their biological sex in adolescence or adulthood, thereby rendering most medical healthcare  interventions unnecessary.

“Scientific studies show that individuals struggling with distress at identifying with their  biological sex often have already experienced psychopathology, which indicates these individuals should be encouraged to seek mental healthcare services before undertaking any  hormonal or surgical intervention.”

Rep. Firment’s proposed law prohibits any physician or other medical healthcare professional  from performing any gender transition procedures on any person under 18 years of age or referring any person under 18 years of age to any medical doctor for gender transition  procedures.

The proposed law prohibits school personnel from encouraging or coercing a minor to withhold from the minor’s parent or legal guardian the fact that the minor’s perception of his gender is  inconsistent with his sex.

“Only a tiny percent of the American population experiences distress at identifying with their  biological sex. According to the American Psychiatric Association, prevalence ranges from five  thousandths of a percent to fourteen thousandths of a percent for natal adult males and from  two thousandths of a percent to four thousandths of a percent for natal females.”

 

 

 

 

 

 

 

Cybersecurity Expert Offers Essential Ideas for Defending Yourself and Your Clients

by Leslie Todd, LCSW, ACSW
AFCC Correspondent

Those of us who work with victims of intimate partner violence or vengeful ex-partners have  seen how badly technology can be misused to harm our clients. And we also know that just as  private citizens, we have to be on guard against cyber shenanigans. Then there’s our offices, our
electronics files, our phones….it’s pretty daunting, right?

Fortunately, there are folks who specialize in educating us so we can keep our clients and ourselves safe. 

Steven Bradley began his career with the FBI, starting a task force which investigated  technology and cyber-related crimes. Later, he worked with state coalitions and local domestic  violence/sexual assault center as a liaison between law enforcement and community partners  to better support survivors and victims. Today, he works with Our Family Wizard to promote  healthy communication between co- parents via technology. He has been an international  trainer for over 25 years, and recently presented at the AFCC-LA State Conference on March  18th on this subject. He agreed to share further information with The Psychology Times regarding handling the very difficult cyber abuse issues our clients may bring in—and tips for  protecting ourselves as well.

First, let’s start with Bradley’s pet peeve: people who don’t use passwords, or use them poorly.  Your first defense against hacking is to have a complex password, and to keep it private. Too  many of us still use lazy and highly guessable ones like “12345” or “password”– and many  people don’t even put a password on their smartphones. If you worry about not being able to  keep up with all your passwords (and no, you should not use one password for everything),  then allow your device to generate a complex password which will then be stored for you. And  do NOT tape it to your laptop or otherwise leave it handy for others to discover.

So—sloppy security starts with sloppy passcode management. If you have a client who is  endangered or may be at risk of being stalked, have them list ALL their social media and other  sensitive sites and discuss changing their passwords and security questions to things the stalker could not possibly know. That means no birthdays, pet or child names, or any other easily-guessed information. Remember to have them check medical portals as well.

Thanks to “the internet of things,” it is possible that your client is being monitored via a car’s nav system or some other device. Make sure you discuss with your clients what technologies are being used such as Bluetooth, GPS, On-Star, etc.

Bradley stresses that we should all keep our Bluetooth OFF unless we are actively using it,  because it is easily hacked. Also public access internet, such as in hotels or cafes, is highly  vulnerable to hacking. Malicious software can be installed, including tracking devices. And  remember to check the location services in a phone’s settings to be sure you or your client is  not giving away your location. Bradley noted that when he was to meet an abused client at  court, he would first meet with them near the courthouse in a fast-food place, where they  would both then turn off their location and Bluetooth settings. After court, they would return to  the same fast-food place or gas station and turn them back on. That way, anyone monitoring  would only track them to the innocuous site and not know about Court or other more sensitive destination.

Also, check with your vulnerable client to see if they have devices that were provided by the  suspected person. If a cellphone has been provided by the abusive party, ask your client to  consider using a donated or new cell phone. Same for a computer. If the client is looking for a  new place to live or making travel plans, ask them to use a computer at a public library.

The client should also update all privacy settings on any dating sites and social media sites  (Twitter, Facebook, LinkedIn, Pinterest, TikTok, etc.) and be very wary of what they post. Remember that pictures and images can be searched as well as names and words.

Another way to safeguard a phone is to choose an optional service, like Google Voice, to keep a  personal number safe. Some of these services will let you forward calls and messages to up to five different phones while you simple have one phone number. That way, if the client’s number is compromised, they can log in and change one phone number instead of having to contact the phone company to change many.

Other than tracking people, cyber-hacking can allow the bad guys to “spoof” your phone. This  means that you may answer a call which looks like it’s coming from your mom, but it is really  the hacker. Spoofing allows threatening texts to show up from anonymous numbers (or  highjacked ones, like Mom’s.) In one of my high-conflict divorce cases, each of the spouses was  spoofing their OWN phones with threats ostensibly from their ex.

As a mental health professional, you may have tried to secure your office space and your files— but your cellphone and your car may betray you. Bradley points out that a judge may feel safe  in her courtroom, but once she gets in her car, she is as vulnerable as the next person unless  she takes cyber precautions to safeguard her devices (including her car). In a world where our  clients can Google images of our home and family, we need to keep this in mind.

If you do work with court systems or government agencies, you should know that they often  publish records online. Ask them how they protect or publish your records and request that access to your files is sealed or restrict to protect you and your client’s safety.

Bradley lives in this cyberworld everyday, but understands that we are far less aware than he is. He notes that he most common mistake he sees professionals make is to brush off a client’s suspicion that someone may be monitoring them. Since abusers love to make their clients feel  or look crazy, we should be wary not to add to the gaslighting. Abusers can use highly subtle  methods that will make your client sound paranoid. For instance, I had a client who would frequently find she had a flat tire in the morning. She assumed she was hitting nails around a  construction site—until her mechanic pointed out the frequency and types of punctures and boldly asked her if she was going through a divorce. Bingo. She ended up seeking counseling,  and we discovered many more dangerous indications of stalking.

Bradley’s talk was such a hit at our AFCC-LA State Conference that we are going to have him  return to do a half-day training later in the year, specifically for mental health and legal  professionals. We’ll be sure to publicize that event. Meanwhile, if you’d like a handout from  Bradley on this basic information, email me at Leslie.todd@leslietodd.com and I’ll pass it along to you.

[Editor’s Note: Leslie Todd served as the founding President of the Louisiana Chapter of the  Association of Family and Conciliation Courts (AFCC). Her contributions were acknowledged by AFCC  when they named her an “AFCC Ambassador,” a designation exemplifying the collegial and  collaborative spirit of AFCC membership.]

 

 

 

 

Gov. Edwards Budgets More for Higher Education

The Louisiana Legislature convened March 14 for the 2022 Regular Session, and hundred bills have been filed and are under review by Legislators. See our report starting on page 8.

The Governor’s proposed budget includes: $31.7 million for faculty pay raises in higher education; $10.5 million for the MJ Foster Promise Program Fund; $97.2 million for higher education, which includes $5 million for Title IX offices across the state, $15 million increase
in GO Grants, and $25 million into the Higher Education Initiatives fund.

In his opening remarks Gov. Edwards said the state is in a much better place then when he took office six years ago. “At my first state of the state, I had just inherited a billion dollar budget deficit to close out that fiscal year, and a two-billion-dollar deficit for the year that started July 1,  2016. Today, as I stand here before you, we have hundreds of millions in surplus, even more in current year excess, and billions in federal funding through the American Rescue Plan and the Infrastructure Investment and Jobs Act.”

The proposed budget also includes $43.4 million for early childhood education, with more than  $17 million for the LA-4 Early Childhood program; $148.4 million for teacher and support staff  pay raises, which is at least a $1,500 raise for teachers and $750 for support staff; a $12 per  diem increase for intermediate care facilities for people living with intellectual disabilities; and more than $1.1 billion in funding for critical infrastructure, such as $500 million for a new Mississippi River Bridge in Baton Rouge, an additional $100 million for the bridge in Lake Charles, and $500 million for water and sewer improvements statewide.

“This is a balanced budget that is responsible, transformational, and continues my administration’s practice of only using one-time dollars for one-time expenses. It’s a promise I  made six years ago and one that I have not deviated from. We are not going back to the days of  deficits, fiscal cliffs and one-time dollars for recurring expenditures. And we will continue to be  focused on empowering families and communities for the future,” Gov. Edwards said.

“My legislative package includes a number of bills focused on hurricane deductibles, claim  transparency, enforcing insurance fraud laws against bad actors, revamping the adjuster  registry so that policyholders can verify their adjusters, and stopping mortgage companies from withholding insurance money from homeowners without good reason.

He noted his Climate Initiatives Task Force had set a goal of reaching net zero by 2050. “This  taskforce, which includes scientists, academics, industry leaders and environmentalists, has  adopted a Statewide Climate Action Plan,” the Gov. said. “What makes Louisiana’s plan special,  and the most attainable in my opinion, is that instead of working against oil and gas companies,
we are working with them.”

He made an appeal to raise the minimum wage and reduce the gender pay gap. Gov. Edwards  began his address by saying, “All too often, our world is filled with unrest, and right now our  prayers are especially with the people of Ukraine as they defend their homes, their families, and their freedom. We are joined today by Eddy Hayes who is the Honorary Consul of Ukraine. He  represents the economic and cultural interests of the country here in Louisiana. I asked him to  be here today in hopes that he will relay our unified support to his colleagues in Ukraine.” 

 

 

 

 

 

 

 

Stress Solutions

Acute Stress is Helpful…
Chronic Stress is Harmful

Of course, the key to successful management of stress is recognizing acute stress from chronic  stress. So many things stress us during the average day that it is hard to be aware of when  acute stress becomes chronic stress. Webster defines acute in this context as “characterized by  sudden onset…and lasting a short time.” Webster gives 136 synonyms and antonyms of acute. The word, acute, comes from the Latin word, acutus, meaning sharpened, pointed, having a  violent onset, and less than a 90-degree angle. If your nervous system is healthy, it redresses  itself when the acute stress is over and is better off for the process in many cases.

On the other hand, the meaning of chronic according to Mr. Webster is “continuing for a long  time or returning often.” Of interest, there are only 41 synonyms of the word, chronic. In medical care, an illness that lasts more than 90 days is considered chronic. The Greek root of  chronic is time. The psychological context of chronic stress is more like habitual, returning  often.

The difference between Helpful and Harmful is based on how successful the person is at  managing their stress. If a person is in a chronically stressful situation, good management has  to include frequent breaks during which you can clear your mind, think, and do something  relaxing and happy-making before returning to the stressful situation either in your mind or in  action.

So, there really are two important keys involved in keeping stress from becoming harmful: 1)  Learn how to recognize when you are in stress. 2) Learn how to best manage your stress to  keep it acute (i.e., by taking frequent breaks) and finding things you can do that are relaxing. Or, if your stress primarily comes from your mind and the fact that you have a busy mind and your  mind seldom or never shuts off, then finding a way to clear your mind long enough to reduce  the body’s stress reaction.

Sadly, many of us tend to deny that we are under stress, therefore failing to recognize it. There  are so many triggers and situations that produce the stress hormones, but none are as present  as our mind and thinking. Do you remember those childhood years when an adult might have  said: “What were you thinking?” And, the response was truthfully, “Nothing!”

Well, for most of us, those days are long gone. That is why the technique that is now called,  Mindfulness, is sweeping the world. It is easy to do for anyone and if done often enough it will  produce the desired result of a peaceful, quiet mind. Mindfulness only takes a minute or two to  do and the only thing most people have to do is sit back, close your eyes, focus on your  breathing, and spend a quiet, mindful minute or two. Try it right now. It only takes a minute.  Your To Do List can wait a moment.

I’m Your Man

A Review

by Alvin G. Burstein, PhD

This self-described Rom Com surprises with its wit, and its depth. The frothy wit with which it  abounds is contrasted by flashes of tragic despair.

German written and acted, with subtitles, directed by Maria Schrader, it more than merits its many awards. The female lead, Maria Egert, won Best Acting Award in the 2021 Berlin International Film Festival. At the 2021 German Film Awards, Egert was named Best Actress; the  male lead, Dan Stevens, Best Male Actor; and Schrader, Best Director.

Egert plays the role of  Alma, a career-focused archeologist, seeking evidence of poetic writing in ancient relics. In  pursuit of funding for her research team, she reluctantly agrees to serve as a subject in another  study, one that explores the feasibility of using humanoid robots programed to adaptively modify their behavior, as humans’ companions. She is to cohabit with a robot, Tom, for an  extended period of time, and to evaluate the experience.

At a fanciful party where many of the attendees are holograms, Alma, while giddily brushing  through hologramed guests, literally bumps into her proposed companion, whose appearance  is that of an attractive young man. Tom invites Alma to dance, leading her in a hilariously  extravagant tango, in the midst of which he begins to malfunction and is carried off for repairs.

Once Tom is refitted, Alma drives him and his baggage to her apartment. The drive is the  occasion for an awkward conversation during which Tom assures Alma that he is programmed  to modify his behavior in the light of her preferences. Alma makes it clear that the relationship  is to be more formal than intimate. As he explores his new setting, Tom notes a painting that  Alma says was a gift from a friend. As the story unfolds, the “friend” is the father of Alma’s still- born child. Tom also notes a photo of Alma as a youngster, radiating happiness as she sits next to a male  companion, coincidentally also named Tom. Alma tells Tom that the delightful male companion  of her youth drifted away from her long ago.

Tom, in the hope of helping, speed-reads all the literature on the topic Alma and her team is  researching, and discovers that a competitor has already published proof of the thesis Alma was seeking to confirm. Crushed, in an alcoholic daze, Alma has sex with Tom.

She suffers a second blow, learning that the partner that had given her the painting and  fathered the unsuccessful pregnancy, has married another woman who is now pregnant.

Tom tries to comfort Alma and she begins to feel drawn to him, but ultimately despairs, telling  Tom, “I’m acting in a play. But there’s no audience. All the seats are empty. I’m only acting for myself. Even right now, I’m only talking to myself. It’s not a dialogue,” a rueful acknowledgement of the psychological truth that without the gap of otherness, real love cannot exist. This confession becomes the framework of a second confession that closes the film.

Alma tells Tom to return to his factory. When she learns that Tom has not returned there but has disappeared, Alma becomes concerned. Looking for him, she returns to the site where she  had last seen her childhood companion. She finds her robot companion waiting for her. The  film ends with Alma confessing anguished feelings of loss and loneliness to Tom.

The movie is available on Hulu, Amazon and Netflix.

Stress Solutions

Some Benefits of Keeping Indoor Plants Around

Nature walks and the beauty of nature have long been identified by philosophers and  researchers alike as a good method to reduce stress. So many of us do not live next to a  beautiful park or serene lake around which to walk or take a meditation break. The next best thing is keeping plants around your workplace.

Plants not only provide an oxygen-carbon dioxide exchange, but also, they are natural things of  beauty. Plants capture the carbon dioxide in their environment and release oxygen into the  atmosphere. The process is called photosynthesis. The more carbon dioxide, the better the  plants thrive. A recent study indicates that as global warming increases, plants will actually take  in more carbon dioxide. Science backs up more benefits to keeping indoor plants around you. Indoor plants improve our mental health. And stress reduction just happens to be one of the  ways that indoor plants improve our mental health. Dr. Leonard Perry, Horticulture Professor  Emeritus at the University of Vermont, has research that shows visual exposure (just seeing  plants) helps reduce stress in only five minutes.

An interesting study conducted at Washington State University (Lohr, et al. 1996. J. Environmental Horticulture) found that the presence of plants in a workplace helped reduce  stress levels of employees. The research was conducted in two computer labs, identical except for the plants present in one lab. The subjects in the lab with plants were 12% faster in reaction  time and their systolic blood pressure was lower (measure of stress). The subjects also reported feeling more attentive when surrounded by plants.

Plants in the same room while working increases a person’s ability to pay attention and stay  focused (J. Environmental Psychology). Flowers are even more impressive. Research at Rutgers  showed an immediate impact on happiness. One hundred percent of the people in the study  immediately responded with a smile.

Even more impressive is that a study published in 2010  that was performed in 101 Michigan high schools strongly supported the positive effects of  nature on students’ performance on standardized test scores. More students were planning to  attend college. The long-term implication for teachers is offer more lessons outside and keep plants in your classrooms. It will pay off in students grades and attention.

So, treat that forgotten Boston fern in the corner of your office or therapy room with a little  more respect! Plants are not just fluff for the decorator; having plants around us is improves  our lives in so many ways.

Experts Point to Alarming Trend of Increased Opioid Related Overdose Fatalities

A new report warns of soaring overdose deaths from the opioid crisis. Authors from the  Lancet’s, “Responding to the Opioid Crisis in North America and Beyond: Recommendations of  the Stanford-Lancet Commission,” published in February, said that in the USA and Canada, 2020 was the worst year on record for fatal opioid overdoses. The US overdoses rose 37%.

The Centers for Disease Control and Prevention (CDC) said that provisional data analysis  estimates for the 12 months ending in May 2021, there were 75,387 deaths from opioid toxicity.

Opioids—mainly synthetic opioids (other than methadone)—are currently the main driver of  drug overdose deaths, said the CDC, with 72.9% of opioid-involved overdose deaths involving  synthetic opioids. And, overdose deaths involving psychostimulants such as methamphetamine  are increasing with and without synthetic opioid involvement.

Also in February, Medscape reported a surge in the rate of Black Americans dying from a  combination of opioids and cocaine, an increase of 575%. The rate for White Americans  increased by 184%.

A recent analysis in the American Journal of Epidemiology, found that in the South, deaths from  cocaine and opioids increased 26% per year among Black people, 27% per year among Latinx  people, and 12% per year among non-Hispanic Whites.

Dr. Marc Zimmermann is a neuropsychologist and medical psychologist in Baton Rouge, with over 30 years experience. He  is noted for his work in forensic psychology having testified in multiple states and jurisdictions, and he has been a consultant to many chemical dependency programs such as the Serenity Center and Lane Recovery Solutions. He is also a staff member at PTI in Baton Rouge.

Dr.  Zimmermann said that according to the Louisiana Department of Health, the bulk of all  recorded opioid overdose deaths occurred in the parishes of Southeast Louisiana. St. Tammany Parish experienced an average of over 47 opioid overdoses a year and Jefferson Parish  averaged over 71 opioid overdoses a year.

While their age-adjusted rates are not as high as St. Tammany and Jefferson Parishes, Orleans  and East Baton Rouge Parish experienced high average numbers of deaths from opioid  overdoses during the same time period.

Dr. Tiffany Jennings is a Louisiana native who is the Rural Health Coordinator for the Louisiana  Psychological Association and in full time private practice. Dr. Jennings has worked in a variety  of settings, including outpatient, inpatient, state and Federal agencies. She was previously an  Assistant Professor, Department of Neurology, at Ochsner LSU Health Shreveport and a Neuropsychologist at Overton Brooks VAMC in Shreveport, and for the US Army’s Traumatic  Brain Injury Clinic at Fort Polk in Leesville.

How serious does she feel the opioid crisis is in rural settings for Louisiana? “The opioid crisis  continues to be a serious crisis that has not shown any signs of abating,” Dr. Jennings said.

“The COIVD-19 may have exacerbated the crisis. The Louisiana Dept of Health’s website notes  an increase in fatal and nonfatal opioid overdoses as people are ‘cut off from services and  disconnected from support systems, have made it difficult for individuals to seek help.’

“The Louisiana Opioid Surveillance Program has noted an increase in deaths from overdose,”  she said. “This was noted to be in part due to availability of synthetic opioid drugs, which are  much more powerful than morphine. This results in a higher chance of death from use –– such  as fentanyl.”

Has she seen any changes over the last couple of years? “There’s been several high-profile  lawsuits against drug manufacturers for their alleged role in the opioid crisis,” Dr. Jennings said. “I believe there currently four US companies in the process of settling, to the tune of  approximately $26 billion. This has certainly brought attention to the extent of the current  opioid epidemic.

“Many insurance agencies, including Medicaid, expanded telehealth access due to the ongoing  COVID-19 pandemic. Unfortunately, I have not seen much change with regard to access to service for rural health settings in Louisiana. There continues to be a wait list to see Medicaid providers. Reimbursement remains an issue. Also, those in rural areas may not have the  technology to fully utilize telehealth services,” Dr. Jennings said.

The Lancet Commission Report pointed to the lack of accessible, high-quality, non-stigmatising, integrated health and social care services for people with opioid use disorder in the USA. The  authors recommended reforming public and private health insurance systems to address this issue, including cutting off funding for care that is likely to be harmful.

Dr. Geralyn Datz is a licensed Clinical Health and Medical Psychologist and a national educator  of healthcare providers, attorneys and the public. Dr. Datz is licensed in Louisiana, Alabama, and Mississippi, and specializes in pain psychology, forensic assessments, and public speaking. She is President and Clinical Director of Southern Behavioral Medicine Associates PLLC, in Hattiesburg, Mississippi, a group specialty practice devoted to treating patients with chronic  pain, She is a past president of the Southern Pain Society, and previously with New Orleans Veteran Affairs Medical Center and Pennington Biomedical Research Center

We asked Dr. Datz if there is adequate treatment available? “No there is not,” she said. “The  treatment of opioid use disorder is a very large, systems based issue that right now is in dire  straits and vastly underfunded. The short answer is that we need more insurance reimbursed  programs, and the treatment needs to extend well beyond ‘rehab’ as it is traditionally defined. Private treatment centers are one component of treatment, but cannot meet the needs of this  diverse population, which often has serious mental health issues and/or comorbid pain  conditions. There are effective treatment models like Pain Rehabiliation Programs, that help
people with medical conditions come off of opioids, but sadly these are no longer reimbursed  by insurance.

In addition, the treatment of opioid misuse is ideally multidisciplinary and  requires medical and mental health follow up, which frequently does not occur. The Commissions comment on using the Chronic Disease Model for treatment, and in healthcare, is exactly on point.”

Is treatment covered by funding such as insurance for those who need help? “.Again…no. There  are wide ranges in what insurance will and will not cover in treating opioid overuse and addiction. Often, comorbidities, such as pain or severe or even mild mental illness, are left  untreated. In addition, there are variations between what private addiction centers will accept which insurances if any at all. As a result, care ends up being parsed out for opioid-dependent  individuals and not as effective. Furthermore, many individuals do not have insurance coverage at all, further complicating the problem,” Dr. Datz said.

“The 2008 Mental Health Parity and Addiction Equity Act was designed to make treatment of  mental health and substance abuse conditions as easily and fairly reimbursed as medical conditions. This Act was a step in the right direction but is still not fully realized. A recent report  showed that many insurances are non compliant, and showed wide disparities between  behavioral health care and medical/ surgical healthcare. Mental health parity needs increased  attention, and enforcement, in order to address the public health needs that we are now facing.”

Dr. Jennings agrees. “Given the number of deaths from opioid overdose, I would say there is not nearly enough treatment, recovery and support systems in place for this population. This is especially true of those in rural settings,” she said.

“The state has enacted laws in an attempt to better regulate prescriptions and to reduce the chance of ‘doctor shopping’ for those addicted or who have developed a tolerance to their pain medication. Government agencies on federal and state levels are holding providers accountable for illegal prescriptions for opioids,” said Dr. Jennings.

“Louisiana is expecting to receive approximately $325 million from a national settlement of  opioid lawsuits. The intention is to divide monies into addiction treatment, response and recovery services. The goal is to send the monies–divided up over a 20-year period–to local  agencies that directly work with those suffering from opioid addiction,” she said.

“For some patients, education into the nature of chronic pain and their ability to manage pain  can be helpful. There are evidence based psychotherapy treatments (such as Cognitive  Behavioral Therapy for Chronic Pain) that can be used to help a patient manage pain. For  patients in need of an increase in structure or level of care, there is certainly a need for  agencies that provide this care. Again, insurance and location can often be a barrier to treatment.”

Pain costs society up to $635 billion annually, according to the CDC, and is the number one  reason for disability. Pain is becoming better understood as a multifaceted phenomenon with  psychological factors.

In 2016, CDC authors published Guidelines and said that there was no evidence for a long-term  benefit of opioid pain medications. The authors found strong evidence for serious risks, including overdose, opioid use disorder, and motor vehicle injuries. The CDC said that other  treatments, including psychological approaches, had long-term benefits, without the high risks of opioids.

“It is now widely accepted that pain is a biopsychosocial phenomenon,” Dr. Datz, told the Times  in a previous interview. “The Guidelines are really exciting because they explicitly state that  physicians should be using nonpharmacological strategies including cognitive behavioral  therapy as well as exercise for patients with pain,” Datz said.

“This is a departure from the traditional belief that pain was primarily physical, and to be only  treated by medical means, which was the biomedical model,” Datz said.

“The benefits of pain psychology are that the person experiencing chronic pain ultimately has more control over their pain process, their reaction to it, and their life,” Datz said. “This is  accomplished by teaching patients about how their expectations, their attention, and their  stress levels interact with chronic pain and can greatly exacerbated.”

“A large body of research,” said Datz, “has shown that use of structured cognitive behavioral  therapy, and in particular cognitive behavioral therapy combined with physical therapy, as happens in functional restoration programs, are extremely effective ways of dramatically  improving physical function, mental health, and overall well-being in patients with chronic pain,” she said.

“Unfortunately, these methods have been sorely underused, partly due to insurance coverage  issues. With the advent of the ACA however, this is getting a lot better. Also, I think providers and patients are more open to these ideas now that the opioid epidemic has become such a  hot topic nationally,” she said. Among the key messages of the Lancet Commission report, the authors noted that “The profit motives of actors inside and outside the health-care system will  continue to generate harmful over-provision of addictive pharmaceuticals unless regulatory systems are fundamentally reformed.”

Dr. Datz will be presenting “Forced Opioid Tapers and the Culture of the Opioid Crisis: Time to revisit pain psychology” at the American Academy of Pain Medicine in Scottsdale Arizona on  March 19. She will speak about how the approach of using pain psychology during opioid  therapy is not new, but is enjoying a renewed urgency in the context of rising rates of opioid  tapers and the safety issues surrounding preventable side effect from forced opioid tapers.

Lancet Commission authors warned that pharmaceutical companies based in the USA are  actively expanding opioid prescribing worldwide, and are using fraudulent and corrupting tactics that have now been banned domestically.

Discrimination Complaint about LSBEP Discussed in Private

A Request for Investigation, stating that board members at Louisiana State Board of Examiners  of Psychologists are operating outside of their area of competence in regard to selection testing and racial discrimination, was reviewed in an executive session of the Board last month

The psychologists, Drs. William Costelloe, Julie Nelson, and Marc Zimmermann, are all business psychologists who have extensive experience with high stakes selection testing in the private  sector.

On February 15, Dr. Zimmerman emailed Executive Director Ms. Jamie Monic asking her, “It has  been in excess of 30 days since this was sent. We have not received any response. I am writing  to be sure the Request was received and if there has been any action on this matter.”

Ms. Monic replied, “Your Request for Investigation was received on January 11, 2022. I will send you a formal acknowledgment of receipt and response following the Board Meeting on  February 18, 2022.

“The agenda for the February meeting of the board included the Executive  Session item “Legal Issues and Strategy [LSA-R.S.42.17.A(4), 44:4.1] – AttorneyClient Privilege”  and numbered “P21-22-09P Received 1/11/2022.”

No additional information has been received as of publication.

In their Request for Investigation, Costelloe, Nelson, and Zimmermann wrote: “We submit this  request for investigation because we believe that the psychologists serving on the board (Drs.  Gibson, Gormanus, Moore, Harness, and Sam) are currently in violation of ethical principle  §1305, A.1., 2., 5., & 6. This is because the board members do not have the specific competences to develop an  anti-discriminatory selection program, then members are in violation of the ethics code.

“There is evidence that confirms that the EPPP has adverse impact against African-Americans  and Hispanics. Dr. Brian Sharpless proved adverse impact for the EPPP in New York. He studied  4,892 New York applicants and first-time EPPP takers over 25 years. He found that Blacks had a  failure rate of 38.50% and Hispanics had a failure rate of 35.60%. Whereas, Whites had a failure rate of 14.07%. Dr. Sharpless also studied 642 applicants to the Connecticut State Board of Examiners of Psychologists with similar results. Whites had a 5.75% failure rate, Blacks had a 23.33% failure rate, and Hispanics had a 18.6% failure rate.

“Once adverse impact has been shown for a test it is improper to ignore the selection problems.
Furthermore, the way in which the test is used by the Board members drives up adverse  impact. As just one example, the use of a hard cut off, and one that sets a higher bar  considering the restricted sample, on a test with proven adverse impact, is an error in  professional selection testing design.

[…] “Finally, we are sympathetic to the situation that very few psychologists have developed  expertise in this subspecialty of selection testing, and in particular, ways to reduce or totally  avoid discriminatory practices. To that point, we are open to a resolution in concert with the  aspirational goal of working closely with colleagues when we perceive an ethics code violation  regarding area of competence.

“Summary We submit our complaint that the psychologists who are serving on the Board are unwittingly authorizing an inadequately designed selection program and therefore participated in unfairly denying African-American and Hispanic individuals licenses. This process may also be
harming the public by restricting the number of minority psychologists who serve the diverse  citizens of our state.

“We request an investigation and make ourselves available for additional questions and a collaborative review of the matter.”

 

 

 

 

 

The Tinder Swindler

A Review

by Alvin G. Burstein, PhD

This very recent Netflix documentary’s popularity exploded during the first week of its release,  drawing my attention to a genre that has not previously interested me: true crime accounts. The Tinder Swindler turned out to be interesting, and, to make a pun, even arresting, in  unexpected ways. It features accounts by three young women who describe their becoming  enmeshed in a web of exploitative lies woven by a con man who rivals Frank Abagnale, Jr.,  played by Leonardo DiCaprio in the 2002 biopic, Catch Me If You Can. The villain of the Netflix  documentary, Simon Leviev, neè Shimon Hayut, seeks out targets different from those of  Abagnale, and the documentary has an ironic element that the biopic lacked. Moreover, as  documentary, the Netflix piece, unlike a biopic, is not emplotted, with an ending that provides  narrative closure.

The documentary opens with an interview of Cecilie Fjellhoy telling of her addiction to the Tinder site in her search for love. When her swipe-right on a posting by Leviev is matched, she accepts his invitation to join him for dinner, and she is awed by lavish arrangements. He tells  her that he is the son of the “King of Diamonds,” Lev Leviev, a billionaire Israeli Hasidic Jew. Simon, styling himself “The Prince of Diamonds,” flies her around the world, wooing her with  expensive gifts and protestations of love. Soon, however, he tells her of complex business  affairs requiring elaborate security arrangements that make it necessary for him to avoid using  his credit cards requiring him to ask her to do him a favor: a loan of a few thousand dollars.  Over time, Cecilie is lured into massive debt. Terrified and ashamed, she cannot find a way out  of her predicament. In an effort to deter others from getting scammed she asks a newspaper to tell her story.

We next hear from a second victim, Pernilla Sjoholm. Leviev, using money from Cecillie, in  tandem with his relationship with her, is regaling—and courting—Pernilla, employing the same  tactics, making the same protestations, and ultimately requiring the same financial assistance.

Finally, we see an interview with Ayleen Koeleman, a long term flame of Leviev. Enraged by the  newspaper accounts of Cecilie’s predicament and Liviev’s carryings on, she relishes describing how she scammed the scammer. Employed in the fashion industry, she deals with Leviev’s on-going pleas for financial assistance by offering to sell much of his extensive high-end wardrobe.  But she keeps the proceeds for herself rather than remitting them to Liviev.

Ayleen also reaches out to the other two victims. Taking advantage of the publicity afforded by  the newspaper coverage, the three open a Kickstarter account, hoping to recover some of the  money they lost.

In a final twist, the newspaper’s ongoing efforts to track Leviev’s evasive peregrinations result in  is arrest by the Israeli police, and an all too brief incarceration. He is said to be currently  offering his services as a financial advisor.

The documentary closes with Cecilie’s telling us that  she is still looking for love on Tinder. The irony is her failure to consider that the kind of  intimacy she yearns for might require more effort and time than swiping right on potential Prince Charmings.

There is a report that Netflix may have a movie in the works. If we accept Aristotle’s definition of comedy as emplotted narratives in which the characters are such that the audience looks down  on them and can relish rather than regret their discomfitures, that film will be a comedy