It’s good that you’re looking to expand your food repertoire

If you’re dealing with arfid though you should consider a desensitization protocol to help deal with sensory or phobic response driving the arfid. What this looks like varies because it depends on what drives your arfid: is it a fear of aversive reaction, is it sensory, disinterest, etc.

That said building on what you have can be helpful. Changing the burritos slightly - change the protein, add a new vegetable, add guacamole, etc. try a new flavor of protein bar, etc.

If you’re looking for something in the healthy/low prep side of things I tend to make one big meal on sundays for the week and portion it out. It takes about 30-60 minutes depending on what I make. Japanese curry, various pastas, salads, soups, etc. how healthy these are varies. I am vegan so they tend to be a little bit better than the typical recipe you’d see online but some are still not the most healthy (Japanese curry for example is fairly high in fat but portioned correctly with rice is still filling and a reasonable amount of calories)

I used to send out my reminders by hand and made it very clear, pretty much what you wrote

I don’t know why you would emulate a script

I’m sorry, but I don’t think the answer is to be dishonest to you about the reality of the situation

I do believe our government has failed us here and that therapy should be protected communication the same as speaking to a lawyer, for what it’s worth

I am a therapist, at least in America you should know that your therapy records are not fully confidential and are subject to subpoena. They are confidential in the way that if a cop asks for them I will tell them to fuck off, or if a random person does the same thing applies.

But you should be fully aware that psychiatric and medical records do not have the same rights that you would have with a lawyer or a clergy member during confessional. If I see you, my records are eventually subpoenaed, and I refuse to release them I can be held in contempt and potentially jailed. I can also be compelled to testify but this is extremely uncommon, basically unheard of.

This is absolute bullshit and a good therapist should do two things: they should make this clear to you and they should document in a way that skirts the line between “enough to pass an insurance audit” and “as vague as humanly possible”. There are many ways to go about this.

Additionally if records are subpoenaed I can push back against the subpoena. However, this can be difficult and very expensive. In my experience subpoenas will essentially request everything. “Records including patient notes, assessments, treatment plans, billing information, medical imaging, etc etc etc for the entire duration of treatment”. Stuff that doesn’t even make sense for my scope of practice. This makes sense for them; might as well grab everything you can and avoid potentially missing some juicy detail.

Pushing back is tough though. In some instances I don’t have to; the client is aware of the subpoena and is fine with me releasing records. In instances where I can’t I need to retain counsel. My malpractice insurance provides counsel for this but they tend to provide super cheap lawyers from lawyer mills who are just making sure I’m not fucking up anything that would get myself sued. If I tell them I want to push back and avoid releasing they generally heavily discourage this and if really pressed will flat out refuse.

My only option at this point is to fire them and retain counsel at my own expense. Lawyers are goddamn thieves so this can easily cost 2-5,000 assuming it doesn’t end up in some huge battle where I need to retain counsel for weeks. Like many outpatient therapists I’m self employed so I have to just eat that cost (I think technically I can bill the client for it but that’s kind of fucked up so I’ve never looked into it). If they’re not independent like me and work for a larger agency they don’t have to eat the cost but they also usually don’t have the option to do this; most agencies are run by capitalistic cowards who will bend at the knee to avoid conflict and do not have any interest in principles or ethics

On the electronic medical record(EMR) front documentation management systems are fairly secure, or at least as secure as healthcare management systems can be. Psychiatric management systems are a double edged sword; we tend to have smaller boutique solutions tailored to meet our needs. Hospital networks and large medical agencies will generally have something by Epic or Oracle health.

These companies don’t bother with software packages for small practices like mine though, which make up the bulk of outpatient psychological care in America. They want the huge medical networks that will pay contracts of 150k/month. That makes them huge targets though. My software solution is niche and mostly unknown so hackers targeting it is far less likely. On the other hand the resources involved in securing it are far less.

A growing concern with all software solutions is integration of LLM nonsense to streamline writing progress notes. Generally they want us billing as much as possible so this is being pushed hard to raise utilization rates. Some software guarantees the models are sanitized and that once deployed data fed into the model isn’t used for refinement or reinforcement learning but not all guarantee this. This is concerning from a privacy standpoint. Some more intrusive versions record and process the audio of the entire session and spit out a progress note, which is real gross

As for a cellphone being present, I don’t know how to get around that. Normally I would say I don’t think there’s much risk from a cellphone simply being present in the office but I stopped bringing mine in because i noticed the voice assistant would be accidentally invoked at times. I bring it in now because I have a cellphone that no longer runs a voice assistant. This is gonna be a tall order though. Everyone in the world has a phone on them all the time and they very rarely degoogle or disable siri

I don’t tell you this to discourage you from therapy. I tell you this to encourage you to make an educated decision when you select a practitioner. If confidentiality and privacy are meaningful issues to you (and they should be) when you do your consult or first visit ask about how the therapist handles subpoenas, ask about how they handle documentation knowing subpoenas are a risk, ask if they use AI summarization tools.

Good fucking luck

Service manuals often aren’t even made anymore let alone wiring diagrams. This is a bigger discussion of things being made to be repairable. It’s one thing if you’re discussing a car (which are increasingly being built like hostile tech, thanks tesla), but your phone/console/laptop/appliance/etc?

Best case scenario it’s made with a few sub assemblies that are designed to be swapped out instead of fixing them. why diagnose the 1 cent capacitor that’s shorting on your phone motherboard and swap it out? That would create skilled labor, save your data, create opportunities for local small businesses, and prevent e waste. Instead let’s just swap the motherboard, or more likely just junk the phone altogether and make it a parts phone so it can be used for someone who needs a new lcd/battery/casing down the line. As a result apple will buy it off of you for $100 (only if you buy a new phone too though, store credit) as a result even though you paid 800 2 years ago and the remaining parts are worth $400 second hand easily

That’s why even when you can get these docs they’re largely worthless. Apple shares their support docs with their self repair program (though you need a current model serial number to access, not freely available). But it’s what’s described above. If you want to change the lcd? Helpful. If you want to fix a boot loop and persevere your flash? Go fuck yourself unless you have backups

back up

https://blog.4chan.org/post/781845918774394880/still-standing