Issue archive

We spent two years debating whether AI therapy chatbots cross ethical lines. Brown University counted the crossings. The number is 15, across 5 categories, in a patterned and predictable way.

Closing hospital beds without opening community services is not deinstitutionalisation. It is abandonment with better optics.

We assess the child's trauma and the child's symptoms. But the parent's ACE score may determine whether the child finishes treatment.

Eating disorders have the highest mortality of any psychiatric illness. And 90% of people who have them never receive treatment. This is not a clinical failure — it is a system designed to deny care.

Depression does not just cost quality of life. It costs $477.5 billion a year in one country. That is not a health statistic — it is an economic emergency.

The profession is losing people faster than it trains them. That is not a staffing problem — it is a system failure.

"HIPAA-compliant" is not the same as "your data stays yours" — and APA wants psychologists to know the difference.

Most clinicians have one lecture on dissociation from graduate school. This program replaces that with a structured clinical competency.

One in three people who attempt suicide receives any outpatient follow-up. Brief contact — even a single session — reduces re-attempt odds by 28%. The intervention works; the gap is implementation.

Nine years of illness, and a 12-week digital protocol still produced clinically meaningful change — the barrier was access, not treatability.

The National Council report reframes therapist burnout from an individual self-care problem to an organizational systems problem — and prescribes specific structural interventions: competitive pay, reduced documentation burden via measurement-based care, protected supervision, and career pathways beyond "stay or leave."

Across 36 studies spanning Holocaust, Rwandan, Cambodian, and other genocide contexts, parenting disruption, attachment insecurity, and impaired family communication emerge as the same three transmission mechanisms — structurally identical across cultures, differing only in expression.

Alliance and cohesion each predict group therapy outcome at b=.12, uniquely and independently — statistically indistinguishable from each other. If you track only alliance in your groups, you are measuring half the relational mechanism. The bonds among members matter as much as the bond with the therapist.

The MHPAEA 2024 Final Rule, effective January 2025, requires insurers to prove — in writing, on request within 10 days — that prior authorization and step therapy requirements for mental health treatment are no more restrictive than for comparable medical conditions. For anxiety treatment providers, this creates the first enforceable documentation standard for parity compliance.

NICE has moved MBCT from niche relapse prevention tool to first-line treatment for depression. Mindfulness is now mainstream clinical policy in the UK. The question is whether the implementation will match the evidence — or whether we will fund the brand while losing the therapy.

Prolonged grief disorder is now recognized in both ICD-11 and DSM-5-TR, affecting roughly 10% of bereaved individuals — yet the majority are never screened, never identified, and receive generic treatment for depression rather than grief-specific intervention. Killikelly and colleagues provide the definitive clinical catch-up.

1.46 million people in isolation. The crisis was framed as adolescent. It is now midlife. Japan is learning what happens when withdrawal becomes permanent — and redesigning intervention to meet people in the spaces they can tolerate.

In 2000, autism prevalence was 1 in 150. In 2022, it is 1 in 31. Every clinician in general mental health practice — not just specialists — will encounter autistic clients regularly. The workforce is not ready.

Overdose deaths dropped 30% from the 2022 peak. But the system that produced that drop is losing the people who made it happen — 114,000 addiction counselors short by 2037.

After the FDA rejected MDMA therapy and the largest psilocybin trial showed mixed results, the evidence for psychedelic-assisted treatment is promising but incomplete — clinicians should inform, not recommend.

Three years after the joint emergency declaration, pediatric mental health ED visits remain at crisis levels, children board for 24-48 hours, and child psychiatrists cover only 47% of national need.

250+ episodes featuring Porges, Siegel, Schore, and Johnson — Therapist Uncensored translates attachment neuroscience into clinical language that therapists can use in the room, not just in case notes.

15-20% of the workforce is neurodivergent, but most workplaces are designed for neurotypical processing — effective accommodations are low-cost but rarely implemented without advocacy.

100 million Americans in mental health shortage areas, 60% annual therapist turnover, 77% working sick — this is not a burnout problem, it is a systems design failure.

The $95B behavioral health market is shifting from "are you growing?" to "can you prove your patients get better?" — making measurement-based care a survival requirement, not a best practice.

California's SB 243 is the first law requiring AI companion chatbots to implement self-harm prevention, crisis referrals, and transparency — a template other jurisdictions will follow.

Two-thirds of UK adults using AI for mental health choose ChatGPT over purpose-built tools — creating a governance gap no regulation can fully close.

AI has moved from hypothetical to routine in clinical practice — but the regulatory framework remains a blank page, leaving practitioners to navigate adoption without guardrails.