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Solution Focused Coaching
Rabbi Joshua Ritchie MD • November 23, 2014
Woman 6: I was just going back a little towards to what the woman before was asking. You keep saying how you’re able to help people coming out of a depression quickly. I’m just wondering would you ever recommend someone to, let’s say, go to a psychiatrist or a psychologist. Is there room for someone to be clinically depressed who’s on medication or would you say everything is solvable through your coaching program?
Ritchie: Maybe you missed the first part of it. I did address that question, and I will answer briefly again.
Woman 6: Oh ok, I’m sorry, I did come on a bit late.
Ritchie: Ok, the studies have shown, many well-documented studies by experts, scientific published articles show that about 70% or more of people who are depressed can come out of their depression relatively quickly with cognitive behavioral or solution-focused or whatever you want to call it, approach. Whatever you want to call it. The type that we’re teaching. There’s an additional, about 10-15%, that will respond when you add medication, so if the cognitive approach, coaching, the cognitive behavioral approach doesn’t solve the problem, then they probably would benefit from a trial of anti-depressants but I feel it should be tried in that process, first. If you start, first, with medication, you’re providing a crutch that has side effects then when they come off of it, they often relapse and it only works about 50% of the cases, maybe 60% at most. I’d rather try it with the cognitive approach, which works at a bigger percentage, and if that doesn’t help, you can always try it with medication later, and that will add a little bit to those who weren’t helped with the cognitive.
Whereas if you start with medication, some of them stay on it for years, and in a certain sense, it’s not desirable to stay on anti-depressants for years and it’s hard for them to come out of it and they often relapse when they get off of it or become symptomatic again so the method of choice is to first try cognitive coaching and then, if that doesn’t work, they probably should be evaluated by the one who can prescribe who is a psychiatrist or some MDs who aren’t psychiatrists will sometimes prescribe medication, maybe they’re skillful enough in it, but I would probably prefer a psychiatrist be the one because they’re more an expert at prescribing anti-depressants than a GP.
So if someone hasn’t responded to cognitive coaching, then they should probably be seen by a psychiatrist who can skillfully choose the anti-depressant because there are dozens, probably almost a hundred different anti-depressants and they are all in about half a dozen to a dozen categories of medication so one medication might work for on person and another medication might work for another and to know which one to use for which client, I’d rather have the more skillful psychiatrist rather than just a GP prescribe it and there might be another problem. If they’re not responding to cognitive coaching, it might be more than just depression; there might be some more issues. They might be bipolar or manic depressant or there might be some other issues involved, there might be really a medical issue. So if they’ve been evaluated and it’s not a health problem, if it’s situational, cognitive coaching would be the first approach then the medication.
Woman 6: So you wouldn’t do it side by side?
Ritchie: Yeah, they’re often together but why start the medication if you can start, first, with the cognitive, and if it will work within the few weeks, why would you start with the medication? The medication always takes almost a month to kick in. They always say anti-depressants take almost a month to two months to work. Cognitive coaching will also work within a month, so why not try the cognitive coaching first, so you’ll know if it works or not. Why do you have to start the medication? Then they become addicted to it. They actually do become tolerant to it, and then if they stay on it too long, it’s hard to get them off. They’re actually addicted to it and they often relapse. Both get symptoms of withdraw and then they begin to relapse, so I’d rather not start those on medication if they don’t need it.
Woman 6: Right. Thank you.
Sandy: Hello, it’s me again, Sandy. About this person who’s having this whole packet of problems that it’s ok to grieve their loved ones, we know that this is already a busy year.
Ritchie: I’m not sure if I want to answer this right now. I don’t want to get into a specific case right now. We’re talking about coaching in general and I’d rather not try to solve a specific difficult problem. If you do join our training program, we can bring this up in the training program. We can discuss it in the practicum and the discussions, and if you want to talk to me personally about it, I’ll talk to you about it further, but this is not the time or place to deal with this now.
Sandy: Ok, thank you.
Ritchie: I’m sorry, but reach out to us and we’ll try to help you. Ok, it’s getting late. If anybody has a sort of general question or query, I would enjoy you all to be in touch with us. We’ll be happy, if you don’t have our informational package, to send it to you, we’ll be happy to speak to you. You can speak to our director of admissions, Dan Gruen, or you can speak to me if you set up an appointment, Dan will set you up an appointment, and you can speak directly to me, if you’d like. The program is starting in exactly a week, and there’s still time for you to join, and we would like to help you get enrolled and get your training materials, so there is plenty of time to join us. We encourage for you to being in touch, and we look forward to getting you enrolled. I hope this has been helpful to everybody in sort of a general way.
Thank you, students and graduates who have joined us, and thank you newcomers and thank you for the new students. We appreciate your getting a running start by hearing these two sessions, and hope that some of you who have joined us for the first time will pursue us and talk to us. We’ll be glad to answer any more specific questions and help you get enrolled. So please, be in touch, email or phone us, and we look forward to hearing from you. Yishai? Did you want to say hello? Yishai has been providing all of our technical support. He’s a graduate, he’s also trained in all of our training programs, he’s also on the faculty as a practicum supervisor, and he’s also a master technician and he manages these broadcasts and he makes it look simple when it’s really quite a masterful art to connect all of these Internet and phone calls. If you’ll be joining the program, Yishai will be helping you access a huge audio/video library on box.com where there’s printed material, there’s audio material, and there’s video material that’s a powerful large library that’s very resource rich for helping you grow and acquire more and more information and training. Yishai manages that big library and will help you access it, and he’s putting together quite a directory of it. It’s there on thebox but we’ll be providing you with a sort of index to that library soon.
Yishai, do you want to say hello? Do you have a microphone?
Yishai: People might have heard my voice trying to get connected to different things. It’s nice to hear from everyone and to hear from our new students who are joining the course next week and to hear from everyone’s questions and comments. It was very informative, so it was nice to reconnect with old students and new students. It is quite a journey learning coaching. I have now been learning it and growing over six years now, and every time I learn and gain something new, insightful from Professor Ritchie from all the different lectures from all the different students, I’m looking forward to meeting you each one of you individually either through the phone or online, maybe in person if you’re ever here in Jerusalem. I hope to continue to keep growing and learning together. Thank you so much.
Ritchie: Very nice, thank you, Yishai. Yishai is really very helpful and you’ll appreciate being able to work with him. Ok, alright, so we’ll say good night and wish you well and look forward to your joining us and look forward to working with you and happy to hear your questions. All the best. May this be a very light filled month of Kislev.