Geries Shaheen • May 13, 2017
The Mental Frontier: Hope for Common Ground
Over the weekend, I learned something new from an unlikely character. She was familiar, somewhat monotone, and sat in the passenger seat of my car as I drove to meet a client.
I was bored. I wanted new information , something to fill my mind, something inspirational. So I asked her:
“Hey Siri, how many stars are in our galaxy?”
“Hummm..let me think about that,” she replied. “It looks like the answer is 200 billion to 400 billion.”
The environment we live in is truly changing . Our technology is beginning to grow on us. It is beginning to move from being something external to something internal, not so much something we use, but something that is part of us.
This can be more easily understood by our movement toward wearable technology. For example the Galaxy Gear, Apple Watch, Pebble, Google Glass, Oculus Rift, Fitbit, etc. These devices do not offer accessibility, but rather dimension.
Augmented reality apps create for us a space to utilize and live within this dimension. A theater to be ourselves, but in an extended manner. Avatars, forums, blogs, video teleconferencing, privacy settings, status updates, social networking platforms , we are beginning to find meaning and purpose in these keywords. It is not merely our ‘ digital ’ lives, but rather another aspect of our ‘ actual ’ lives.
Yet even in this new space, in our extended selves , we still experience ancient truths. These ancient truths withstand progress, time, and desire. They have no barrier. They are called hurt, fear, identity, and belonging .
As humanity evolves in its role, while our technological advancements continue to shape our cognitive and physical experiences, we must continue to seek wisdom in ways that surpass our own self-driven ambition. Just as we always have sought wisdom and counsel, we must continue to do so no matter what theater of life.
The counseling world is beginning to more readily learn about the environment in which it exits. It’s beginning to understand that Suzy , who has an open spine, has little chance of seeing a counselor in person.
Or that Jake , a college freshman, would benefit more from continuing to see his therapist back home via webcam rather than starting from square one.
Perhaps its Lindsey , who can barely handle stepping outside of her home due to struggling with Body Dismorphic Disorder.
Or maybe Steven , who just received word that he will be stationed clear across the world.
While people naturally feel uncomfortable with these gray areas, they are realities. Our world, relationships, and people are more complicated than the clear cut lines we desire our identities to reflect.
There are people out there who give praise to a proposed evolutionary millstone for humanity termed ‘Singularity’. This prophetic calling states that within a few decades, technology will reach a point where it and the human race will be one and the same. The creator and the creation will be a singular existence. No longer will there be a need for aid, because our future ability to create will outweigh our ability to need. This is a scary notion, one I disagree with. No matter the time or ability, we will always lack wisdom, always need counsel.
I think back to Scripture: James 1:5
If any of you lacks wisdom, let him ask God, who gives generously to all without reproach, and it will be given him.
Perhaps in this new environment, t here could exist a common ground. A way to seek counsel, to seek wisdom. A way to meet people where they are.
Here’s the good news:
I have been working hard to make a place like this possible. It may not be for everyone, but it exists for anyone.
If you, or anyone you know would benefit let me know!
Geries Shaheen is a Provisionally Licensed Professional Counselor operating in and around St. Louis Missouri. Geries teaches psych classes as an Adjunct at Saint Louis Christian College and offers Adolescent/ Family Therapy through Preferred Family Healthcare . Geries holds his BA in Intercultural Studies from Lincoln Christian University, and his MA in Professional Counseling from Lindenwood University. Holding a certificate in Life Coaching, Geries provides life coaching services to clients online throughout the nation.
Pioneer Counseling Blog
For a new client (and therapist), the first session can carry plenty of unspoken questions: What am I expected to share? Who will hear about it? What if I’m not ready to talk? Before exploring what brought someone through the door, therapists have an opportunity to make the process clearer, and invite the client into a working partnership. A thoughtful introduction brings together warmth, informed consent, professional boundaries, and client choice. For provisionally licensed counselors, it also means explaining supervision in a way that feels transparent and reassuring. The template below offers a starting point for that conversation. Adapt it to your voice, your practice’s policies, and the person sitting across from you, leaving room for questions along the way. “Hi, I’m _____, a provisional licensed professional counselor in Missouri. I’m glad we could find a time to meet. “You mentioned _____ in your intake paperwork. Today, I’d like to understand those concerns in your own words, learn what you hope will change, and talk together about how I can help. “Before we begin, I want to review a few things about counseling. I practice under the clinical supervision of _____, LPC. My supervisor reviews my clinical work, and we may discuss your care and review relevant records as part of that supervision. “Counseling can help you understand patterns, develop skills, and work toward changes that matter to you. Sometimes discussing difficult experiences brings up uncomfortable feelings. You can tell me when something feels overwhelming, ask to pause, or let me know when an approach is not helping. “Your privacy matters. What you share is confidential, with certain limits explained in our consent paperwork. These include legally required reports of suspected abuse or neglect, situations involving serious safety concerns that may require protective action, and disclosures required by applicable law or a court order. If a legal request for information comes in, we review the requirements before responding. Whenever possible and appropriate, I will discuss a necessary disclosure with you first. “You can talk openly about thoughts of suicide or harming yourself. Having those thoughts does not automatically mean hospitalization; I will ask questions so we can understand your safety needs and determine the appropriate support. “I use _____ approaches. I’ll explain what I recommend, why it may help, and any relevant risks or alternatives. You can ask questions, decline an intervention, and give me feedback. “You’re in the captain’s chair when it comes to your goals and choices. My role is to bring structure, clinical guidance, and attention to safety. We’ll develop a treatment plan together and revisit it as your needs change. If we find that another therapist or service would better meet your needs, we can discuss that and appropriate referrals. “[Review session arrangements, fees, communication boundaries, emergency procedures, and any setting-specific confidentiality policies.] “What questions or concerns do you have about what we’ve reviewed? Are you comfortable proceeding? “What brings you here at this point in your life, and what would you most like help with?” Additional checkboxes: For the remaining first-session checklist, I would add: ☐ Session length, frequency, fees, insurance, and cancellation expectations. ☐ How to contact the therapist, expected response times, and what to do during an emergency or outside office hours. ☐ How records are maintained, who can access them, and any applicable billing disclosures. ☐ Questions, understanding, and documented consent to proceed. ☐ When applicable: telehealth location/privacy/disconnection procedures; guardian involvement and minor confidentiality; couples/group confidentiality policies; mandated treatment and what gets reported to the referring party. ☐ Separate explanation and consent for recording or observation, if used. A clear introduction sets the stage. How you manage the rest of the session helps turn those words into a therapeutic experience. Here are ten practical tips for keeping initial sessions welcoming, purposeful, and within the allotted time. Set a flexible agenda together. Briefly explain what today will include: introductions, informed consent, understanding the client’s concerns, and identifying next steps. Ask what the client most wants to make sure you address. Maintain a steady cadence. Give clients room to think, feel, and respond while keeping an eye on the clock. Use gentle transitions rather than rushing through questions or allowing the opening discussion to consume the entire session. Make time checks collaborative. Try, “We have about twenty minutes left. What feels most important to spend that time on?” This helps clients participate in prioritizing the conversation. Prepare the client for the ending. Offer a reminder about ten minutes before the session ends, then begin closing with enough time to summarize, check emotional readiness, and discuss next steps. A predictable ending helps prevent the client from feeling abruptly cut off. Be thoughtful about opening difficult material late in the session. If a significant concern emerges near the end, acknowledge its importance and assess immediate needs. Collaborate on what can be addressed today and what needs dedicated time next session. Safety concerns require appropriate assessment and action regardless of the clock. Take concise, precise working notes. Capture clinically relevant themes, meaningful changes, interventions provided, the client’s response, and follow-up needs. Brief phrases can support accurate progress-note writing later without turning the session into a transcription exercise. Store all notes according to practice policy and privacy requirements. Keep your attention with the client. Explain why you may jot down a few notes, maintain natural eye contact, and pause writing during emotionally significant moments. Your notes should support your presence in the room. Check understanding in small pieces. Pause during the introduction and informed-consent discussion. “What questions does that bring up?” often invites more conversation than “Does that make sense?” Give the client space to clarify concerns before moving on. Reflect before moving to solutions. Summarize what you understand and ask whether you have it right. Initial sessions can feel crowded with assessment tasks; a brief reflection helps the client feel heard and keeps your clinical understanding grounded in their experience. Close with a shared summary and a clear next step. Identify the main themes, ask what felt useful or difficult, and agree on the next focus. Confirm scheduling and any between-session plan. Complete the progress note promptly afterward, while your recollection is fresh. Use OARS to keep the conversation collaborative. Incorporate open-ended questions, affirmations, reflections, and summaries throughout the session. Balance questions with reflections so the client feels heard rather than interviewed. Affirm specific strengths and efforts, and use summaries to check your understanding and transition between topics. Maintain an ongoing mental status lens. Quietly observe the client’s presentation throughout the session, including appearance, behavior, speech, mood and affect, thought process, attention, and orientation. Integrate these observations naturally rather than treating the Mental Status Examination (MSE) as a separate interrogation. Ask direct questions when clarification is needed, and document only what you observed or assessed; areas such as thought content, perception, and safety cannot be established through observation alone. Begin developing a diagnostic formulation. Organize the information gathered into possible explanations for the client’s concerns. Consider symptom duration, severity, functional impact, history, cultural context, and potential medical or substance-related contributors. Keep early impressions tentative, distinguish the client’s report from your observations, and identify what additional assessment is needed. Bring diagnostic questions and competing explanations to supervision rather than rushing to a conclusion. The first session does not need to answer every question or uncover every part of a client’s story. It should give the client a clearer understanding of counseling, an opportunity to feel heard, and a voice in what happens next. For developing therapists, balancing connection, assessment, documentation, and time takes practice. Use this introduction and these tips as a flexible guide, then bring your questions and observations to supervision. Notice what helped the conversation flow, where you felt rushed, and what you want to approach differently next time. Aim to end the session with the client knowing three things: what to expect, how they can participate, and that their concerns have been taken seriously. Geries Shaheen is a Licensed Professional Counselor and Nationally Certified Counselor operating in and around St. Louis Missouri. Geries holds his MA in Professional Counseling from Lindenwood University, BA in Intercultural Studies from Lincoln Christian University, and holds a certificate in Life Coaching, Geries provides life coaching services to clients online globally. Geries is EMDR trained and DBT Certified, practicing from a TIC lens.
Conversations about DSM-6 are growing louder in professional spaces . Industry leaders, researchers, and clinicians are sharing insights about what the next revision of the Diagnostic and Statistical Manual of Mental Disorders may look like. Some projections suggest a potential release window around 2029 to 2030 , though the American Psychiatric Association has not formally confirmed a publication date. For Licensed Professional Counselors, it is important to distinguish between confirmed information and thoughtful speculation. What follows is a grounded overview of both. What Is Officially Confirmed There has been talks of the next DSM potentially being names something totally different, as well as potentially being a living breathing document housed online rather than a printed material. This has led to thoughts that it will include a full structural overhaul as it aims to find a balance between psychiatric insight as well as lived experience data. At the moment, there has been no official announcement of: A finalized DSM-6 release date A confirmed structural overhaul A change in name Adoption of biomarkers as diagnostic requirements The APA has historically used multi-year committee processes for revision, as documented during the development of DSM-5 (Regier et al., 2013, American Journal of Psychiatry). Any specific timeline, including projections of 2029 to 2030, remains speculative unless formally announced by the APA. Documented Criticisms of the DSM Many of the concerns you listed are well documented in peer-reviewed literature, including in the American Journal of Psychiatry. Historically cited critiques include: • The DSM uses a categorical model, which may not fully capture dimensional or nuanced symptom presentations. • Emphasis on diagnostic reliability has sometimes been prioritized over diagnostic validity. • Limited integration of biological markers despite advances in neuroscience. • Heavy reliance on expert consensus panels. • Concerns about Western cultural bias in diagnostic framing. These critiques have appeared in academic discussions surrounding DSM-5 and broader psychiatric nosology debates (Hyman, 2010; Regier et al., 2013). What is important to note is that these criticisms are part of ongoing scholarly dialogue. They do not automatically predict specific DSM-6 changes. Themes Being Discussed in Professional Circles While not formally confirmed, several themes are widely discussed among researchers and leaders: 1. Greater Dimensional Integration DSM-5 already introduced cross-cutting symptom measures and severity scales. Continued movement toward dimensional models is supported in academic literature (Krueger & Markon, 2014). A future DSM may further integrate dimensional frameworks alongside categorical diagnoses. 2. Stronger Alignment with ICD There has been ongoing effort to harmonize DSM diagnostic codes with the International Classification of Diseases, maintained by the World Health Organization. Future revisions may continue this integration to improve global diagnostic consistency. 3. Inclusion of Biomarkers Despite significant neuroscience research, no current psychiatric diagnosis relies on validated biomarkers. The National Institute of Mental Health developed the Research Domain Criteria (RDoC) framework to explore biologically informed models. However, RDoC remains a research framework and is not a diagnostic manual. Any integration of biomarkers into DSM-6 would require strong empirical validation, and no official confirmation currently exists that biomarkers will be required for diagnosis. 4. Cultural and Social Determinants DSM-5-TR expanded cultural formulation tools and updated language related to gender and diversity. Ongoing discourse suggests future editions may further incorporate cultural, socioeconomic, and environmental determinants of mental health. 5. Lived Experience Input There is broader movement in healthcare toward incorporating lived experience perspectives. While stakeholder feedback has been part of past revisions, there has been no formal announcement detailing the extent of lived experience integration for DSM-6. The direction of greater inclusivity aligns with contemporary healthcare standards but remains under development. Autism and Potential Diagnostic Shifts Speculation regarding updates to Autism Spectrum Disorder criteria reflects ongoing research around gender differences, masking, and underdiagnosis in women and people of color. Research literature supports the idea that autism presentations may differ across populations. However, there is currently no official confirmation that DSM-6 criteria changes will create a diagnostic surge. Any future criteria updates would require field trials and empirical validation before implementation. Committee Structures The APA historically forms workgroups and task forces organized by diagnostic categories and thematic areas. Planned improvement committees include the "Structure and Dimensions committee", "Functioning and Quality of life committee" "Biomarkers and Biological factors committee" " Socioeconomic, cultural, and environmental determinants of mental health committee". What LPCs Should Do Now Continue practicing under DSM-5-TR standards. Strengthen dimensional assessment skills and measurement-based care. Stay informed through official APA channels and peer-reviewed publications. Approach social media claims with professional caution. :) It is reasonable to expect that DSM-6 will aim to reflect scientific advances, cultural responsiveness, and improved diagnostic validity. However, until the American Psychiatric Association releases formal statements, timelines, or draft criteria, any detailed structural predictions remain speculative. For Licensed Professional Counselors, preparation is less about anticipating dramatic changes and more about maintaining strong assessment practices, cultural competence, and evidence-based treatment planning. Geries Shaheen is a Licensed Professional Counselor and Nationally Certified Counselor operating in and around St. Louis Missouri. Geries holds his MA in Professional Counseling from Lindenwood University, BA in Intercultural Studies from Lincoln Christian University, and holds a certificate in Life Coaching, Geries provides life coaching services to clients online globally. Geries is EMDR trained and DBT Certified, practicing from a TIC lens.
