Category: Writing

Posts on writing by a writer Jano Klimas, primarily on books, poetry, slams and science writing.

Building research leaders and supervisors with Hugh Kearns

Are you sometimes worried about the progress of your research students and what happens with them?

Hugh Kearns, a Sligo-born research coach from Australia, ran two courses on this topic in the last week of January in Dublin: Building research leaders and Research supervisor support& development workshop. Hugh gave us best-practice tips, some of which I bring in this post.

Figure 1. The long road to project completion
  1. Supervisor vs advisor
    Language matters. While both of the above terms imply a person who ‘sees’ more than the other person, nobody’s view is really super-ior in science. A more experienced researcher can provide an add-itional perspective on student’s work only.
  2. PhD students never die; they just fade away
    Proper supervision perfects students. Busy advisors often overlook this simple truth. A PhD research project is a long-distance run that requires a lot of motivation and support. The former can be instilled by the latter. Think about your time before you take on a research student.
  3. Give them small victories
    Midway through the project, many students fade away simply because of the time that it takes to complete it. Breaking the bigger task into smaller steps creates opportunities for instilling a sense of mastery when students complete a smaller step, for example, a paper on a related subject.
  4. That’s enough – stop now
    The advisor’s perspective and experience is most valuable here. Data collection can go on forever. The literature review can reveal new and interesting studies all the time. This way, the research project won’t end. The golden rule applies to this problem perfectly: Less is more.
  5. GYO PhDs…
    Mentoring relationship and quality of the mentor are the most important factors of a successful student project. If the student and mentor have a chance to work together on a smaller project first, they can better decide whether they want to continue working on a PhD. A great way to start growing your own PhDs is to advertise your research topics on your website or notice board: “Here are the topics that I’m interested in supervising”
  6. Listen to your tummy
    Our research intuition is often the best indicator when deciding about a new student or when the progress is slow. If your tummy tells you something’s wrong, step back and take a moment to think about what caused it.
  7. Meetings build structure into a relationship
    Each mentoring meeting should have an agenda. Ask to student to take the ownership of agendas and meeting minutes, e.g., send in advance, remind me of what I’m supposed to do? Where’s the agenda?
  8. Airtime?
    If your speech takes too much of the meeting airtime, the student might not learn anything. Good questions for prompting students are:
    Tell me what you’ve been doing? Tell me what you think we’ve agreed? Tell me what you’re going to do next.
  9. Quick sneak peek at your results
    Some students might find it intimidating to send whole chapters for review by their mentor. To make it easier for them, you could ask then to send you an outline, a draft or bring a copy to the meeting. The key is to instill hope that the review won’t be shredded their work into pieces.
  10. Grains of sand on the beach
    Some PhD projects lead to Nobel prizes, but most don’t. Most graduate students understand the impact they can make on the world, but it’s no harm to emphasize that however small, their work counts.

The second workshop was part of the new Research support and supervisor development programme at the University College Dublin. This programme is targeted at both new, inexperienced research supervisors and those more experienced staff who would like to refresh their knowledge in the area. The 6 last-Friday workshops will be based on sharing of practices with experienced supervisors and students, case studies, open forum discussions and knowledge sharing with colleagues on policy in the research supervisory field. Watch this space for my observations from these workshops.

Retention versus continuity of care?

Retention in treatment has been traditionally regarded as a key outcome measure of addiction treatment. Thinking about this indicator brings us to fundamental questions of what a success in treatment is and how it can be measured.
The longer drug users stay in treatment, the higher their chances of success. Their health improves; they commit less crime and have more stable daily routine. Early identification and treatment of drug problems is also associated with better outcomes. NIATx, for instance, is an easy to use model of process improvement designed specifically for behavioral health. It helps substance abuse and mental health treatment organizations improve user access to and retention in treatment, defined as “attendance at the second, third, or fourth outpatient treatment sessions”. Others regard 12-month retention in care as success.
Rowdy Yates said, at the INEF conference in Dublin, 2011 that drug users seeking treatment want to give up drugs and what they get from us? Methadone [a replacement opioid]. This statement reflects the inability of many treatment systems to offer a menu of options and tailor them to individual needs of drug users. Medicating drug problem is one of the solutions that work for a large population of treatment seekers. Other options should be offered too.
Dr Okruhlica, in Slovakia, agrees with the diagnosis of addiction by the International Classification of Disorders (ICD) or Diagnostic and Statistical Manual DSM. This definition lists several symptoms of addiction. If somebody has certain number of these symptoms, they receive the diagnosis. If the person doesn’t have symptoms for a year, they cannot be regarded as ill any longer. Harm reduction experts believe that while the medical diagnosis of addiction could be helpful in understanding the problem, even the most dependent users have control over their drug use and choice plays an important role in their life. Dr Zinbergwas a pioneer of this approach with his monograph The Basis for Controlled Intoxicant Use. Studies on uncontrolled drug use followed. These views are regarded as extreme by many. Their believability is further undermined by the fact that non-problem drug users live in anonymity. For example, very few scientific studies manage to engage with non-problematic heroin users.
On the other hand, the recovery-oriented movements, especially AA, maintain that once a person “gets” addiction, they will become ill forever. This opinion can be very helpful for people in treatment, but can actually harm people out of treatment. Ex-users seeking re-integration into job markets are viewed as irresponsible and incapable of holding jobs for long time – result of a society stigmatization.
Because retention in treatment, as a robust outcome indicator, is highly esteemed in the drug addiction field, most professionals working in the addiction are able to place them somewhere on the continuum delineated by the two extremes – illness for life vs. uncontrolled drug use. See figure 1 below.
Figure 1 Continuum of opinions
Alongside the controversy around medicalization of drug use runs another debate about language. For many, language doesn’t matter too much and is a matter of political correctness. Opposite to them, I would like to hope, stand the language-believers. For them, the words we use shape and influence the world we live in. If we call drug users “junkies” they will become “junkies” – whatever that word represents to those who use it. Similarly, the term retention could be too close to detention; people are not kept in treatment to help them regain life, but to help sustain the treatment centre. Just like in the prison, where the inmates have little control over their length of stay, the people detained or retained in treatment have little control over length of their treatment. Opponents of the word retention propose continuity of care as an alternative, more humane, term to describe this golden-standard treatment outcome indicator. For them, it incorporates also the individual willingness to receivecare. But, are patients aware of it? I ask.

Language shapes and influences the drug treatment systems that we study or work for. It is important to recognize that even though retention and continuity of care could be the same thing – looked at from different angles – we have to choose the words we use in treatment carefully and make sure people who use our services are aware of it.

Alcohol: poets’ love affair

Spoken word events often take place in bars. Poets who perform at and attend these events are over the legal limit for drinking. But what if an underage poet wants to join them? Their chances to avoid the alcohol culture are grim.

Poetry slam at Accent’s drink-free venue


Young talented poets are forced to perform in alcohol temples. There, they listen to the established artists talking about their drinking. They watch older poets drink one beer after another, which is nothing new in the poetry art. Poetry has a long-established love affair with alcohol, not only in Ireland. For example, W. B. Yeats, an Irish poet and playwright, would have had experiences with the drinking culture. Perhaps they contributed to his Drinking Song:

“Wine comes in at the mouth
And love comes in at the eye;
That’s all we shall know for truth
Before we grow old and die.
I lift the glass to my mouth,
I look at you, and I sigh.”
Being open about alcohol is good – we live in an alcohol-soaked society after all. Denial and silence doesn’t work. Harm reduction approaches to drug use works. Adolescence is a period of experimentation which includes drugs and other risky behaviors. Parents of teen poets could use, for example, Marsha Rosenbaum’s Safety First reality based approach. This approach helps teenagers to make responsible decisions by honest, science-based information, encouraging moderation, understanding consequences and putting safety first.
In addition to education, drink-free venues for arts and poetry events should be promoted. For example, Accents Coffee & Tea Lounge is an alcohol-free place in Dublin City centre. It was created by Anna Young as a cozy environment for people to meet and as an alternative to a pub. Before they opened, there weren’t many places where you could buy coffee late at night in Dublin. It is the only café in Dublin opened till 11 pm. Accents is the home to two poetry events, a poetry slam competition on the first Sunday of the month (See picture), and A-Musing gig, Stand-up comedy and poetry night on the last Sunday of every month.
I hope that there will be more venues like this for aspiring poets. In the meantime, support a poet by “buying him or her beer”.

The mystery of change (-ing others): article in the Irish Psychologist

How may I help you– change you?* 

“Change is the Law of Life. And those who look only to the past or present are certain to miss the future.” – John F. Kennedy


Trying to help somebody to change their bad habits is an admirable act of kindness. It shows our compassion and care for the less fortunate. The best is when it comes from the person’s own initiative. Motivated helpers are assumed to be good helpers. Some of us help others pro bono, while others do it as part of their job description. But what if the professional helper doesn’t want to help? How do you help the helper with change in others?

Encouraging professional helpers to address excessive drinking is a complex problem. It’s so complex and resistant to change, that their unwillingness to adopt these new practices can be viewed as a bad habit. Many experts called for complex strategies to persuade their clinician colleagues to address alcohol. But complex strategies did not help.
Professors Anderson, Laurant, Kaner, Wensing and Grol reviewed available scientific evidence and claimed it was possible to increase the engagement of doctors in screening and advice-giving for excessive drinking. They saw a potential in programs which were specifically focussed on alcohol and that were multi-component. Later, some of the original team tested this theory by doing a clinical trial, which is a type of study considered as a golden-standard by many experts. Their Swedish experiment “failed to show an effect and proved difficult to implement”. Are the Swedish too stubborn to embrace change? Let’s not be harsh by accepting this cultural stereotype as a plausible explanation for their negative findings, before we look at more perplexing findings from other countries.
When scientists ask doctors and other professional helpers about what’s so difficult in talking alcohol with their patients, they give the same reasons all over the world. The World Health Organisation (WHO) commissioned a multi-state study, at the beginning of the millennium, which documented all of these reasons – the myths about alcohol care. The myths were lack of time, inadequate training, a view that alcohol is not a matter that needs to be addressed by medical doctors, conviction that doctors’ advice won’t work and fear of talking about such sensitive issue. It seems that the next twist in the story of change brings us to helpers’ beliefs.
Recent research at the University of Michigan, cardiovascular centre demonstrated how doctors’ confidence in their ability to advise patients on diet and exercise correspond with their own personal health and fitness levels. Could this apply to alcohol too? Would it help if we use some evidence-based strategy to boost their confidence or ambivalence about drinking behaviours?
Motivational enhancement therapy (MET) is an evidence-based treatment which targets person’s ambivalence about unwanted behaviours including their attitudes and beliefs. A team supervised by Professors Hettema and Sorensen used this Swiss-army knife of addiction counselling to help doctors-to-be to resolve their ambivalence around managing alcohol and drug problems. They’ve put a group of nine medical residents through a brief MET therapy before they learned more about alcohol consulting and advice-giving. Five weeks later, their consulting and advice-giving went up, but due to the small numbers, the researchers called for caution with interpretation of their results.
Resident education was combined with a team-based approach to systems change in the Richmond clinic – a busy family practice in the south-east Portland, Oregon. Dr Muench led his team to change the way they deal with drinking issues – from receptionists, through medical assistants to physicians.
Dr Muench is a slim, middle-aged physician with a passion for teaching young doctors and helping patients from difficult backgrounds. Explaining their approach to practice change, he points out, ‘we’ve strengthened our practice systems, but the system leaks at three points. They are at the front desk, in the consultation room and in the teaching modules.’ In making these comments, Dr Muench argues that while their project led to many improvements, there are things that can be improved. Ultimately, Muench conveys a positive message about systems change being possible, although not without some obstacles. In the Richmond team-based approach, the receptionists should give patients alcohol check-ups while they wait for the consultation, but they often forget because the PC fails to remind them of this. When the receptionist doesn’t forget to hand out the form, and the patient brings it to a medical assistant, she frequently forgets to complete the full assessment. It is no surprise then that the next ‘cog in the machine’ – the doctors – ‘forget’ to discuss alcohol with patients.
What science tells us about implementing change is reassuringly similar to the traditional knowledge of common folk. If you can’t change others, change yourself. “We must become the change we want to see”, said Gandhi. Richmond truly became the change they wanted to see in others. And yet, the project’s 75% yardstick of engaging patients into alcohol discussions wasn’t met. Why was Richmond below targets? Embracing change in healthcare requires system changes and education on several levels – multi-level changes.

*This is a shortened version of my article published in the Irish Psychologist, Volume 40, Issue 2/3. Dennis McCarty, PhD gave me feedback on drafts of this blog post.

Citation for the full version of this article:

Klimas, J. (2013). The mystery of change(ing) others. Irish Psychologist, 40(2-3), 78-79. http://www.psihq.ie/irish-psychologist-journal-of-psychology

Facing the fear: alcohol and mental health conference in Ireland (#facingthefear)

On Wednesday, 20 November 2013, I’ve attended this conference in the Royal College of Physicians in Dublin, Ireland. The conference was organized by alcohol action Ireland. What were the fears that the presenters encouraged us to face? Read about them below

Dr Bobby Smyth started his talk with a brief intro into the ways by which culture and language shape attitudes about drinking – a cultural learning to drink. He saw teens as apprentice adults, learning by observation. The age when they start to drink has gradually lowered during the Irish boom. Who’s fault is that? The alcohol industry and crazy sports sponsorships play a role. Also, “our culture encourages us to drink to overcome low mood”.

Teens learn to wipe on the shoulder of vodka. If they continue to “bathe” their brain in alcohol soup, they are rolling the dice – can we stop it rolling or roll it safely? Dr Smyth provided their book as a guide for dealing with some of these issues (see Fig 1).

One of the key drinking motives is the social motive – alcohol is a social lubricant. This is reflected in the language too. Eskimos are surrounded by snow all year round and have 100 words for it. There are 120 words for the state of alcohol intoxication in Ireland. People have stopped having fun sober. Moral language of industry-sponsored sites is often substituted for more effective strategies. Slogans like drink sensibly can hardly foster behavior change.

Prof Ella Arensman spoke about the focused on health& women, especially on the seasonal patterns of self-harm and public holidays.

Dr Conor Farren addressed the relationship between alcohol and mental health issues, including depression. He also showcased his book (see Fig 2).

Dr Philip McGarry spoke about alcohol’s impact on mental health in Northern Ireland.

After lunch, the delegates came back for a panel discussion featuring Dr Claire Hayes, John Higgins and Fr Pat Seaver.

Watch the speakers’ presentations here