What happened:
Meta announced last week a new Instagram feature that notifies parents if their teen repeatedly searches for suicide or self-harm content.

Alerts (via email, text, WhatsApp, or in-app) are rolling out this week in the U.S., U.K., Australia, and Canada for families using supervision tools.

The stated goal:
Earlier visibility. Earlier support.

The timing:
Not neutral.

The legal backdrop:

On the same day Meta made their announcement, a 20-year-old plaintiff testified in a lawsuit alleging that Instagram and YouTube’s design features contributed to her anxiety, depression, and self-harm.

The case centers on:

The clincher:

Meta and Google deny liability, arguing that many factors contribute to teen mental health outcomes and that parents ultimately bear responsibility for monitoring use.

In response, the plaintiff’s attorney pointed to a recent internal Meta study indicating that teens facing difficult life circumstances were more likely to use Instagram habitually or unintentionally.

In other words, the teens most vulnerable offline may also be the ones most drawn to social media

Why this matters for clinicians:

This week has been an absolute circus. And it’s only Tuesday.

At full council, I took the mic to clap back at the opposition after they decided to invoke a Ronald Reagan quote in a debate about our budget – most of which goes on social care, hence the council tax rise to protect it. The idea that they were holding Reagan up as some sort of patron saint of fiscal virtue in that context was more than I could tolerate. So there I was, calmly schooling them on Reaganomics while simultaneously watching myself do it and thinking, is this really my life now? The patriarchy was on fine form across the chamber – but I am not there to smile politely and take notes while the opposition mansplains over social care.

The “local politician” part of me has been fully online: ringing round our group at all hours to make the case for why we should do X (which I can’t spell out here, but rest assured I had Opinions™). At the weekend I took my seven- and five-year-old nieces out for Chinese to our friend’s restaurant– their first time in a proper Chinese restaurant. The joy of watching them lose their minds over the décor, the food and the napkins was ridiculous. It was the five-year-old’s birthday, so I went full Aunty Mode and cleared the shop of Minecraft merch. In reality, I probably could have just bought the plush Steve and Dennis and saved myself the “you spent how much?” from Max, but where’s the fun in that?

First thing on Monday, I joined a walk-to-school initiative with our MP, who is also my friend and the Secretary of State for Transport. In the current state of the world that is… not a small job. Repatriation, protests, press. And yet there she was, on a grey morning in Swindon, walking to school with a load of kids and chatting to parents about crossings and pavements. It was lovely seeing so many young people walking in together; disorientating watching them turn down free croissants. At their age, I was firmly committed to the concept of double breakfast. All of this rolling within a system of global uncertainty that sits like a low-pressure system over everything. It makes the small, local stuff feel more valuable.

I then rolled straight into delivering my webinar for AFSP. Ninety minutes of non-stop talking and a live interactive ‘ChatGPT plays Therapist’ has left my voice slightly shredded, but it reminded me of the other pieces of myself outside the NHS – the bit that loves writing this newsletter, banging on about digital life, and insisting that therapists are not left behind in tech. If you came along or subscribed to Therapist Brief afterwards, thank you – you’re fuelling my ongoing crusade against “I don’t really get all that online stuff” as a clinical position.

Today we had our QNCC reaccreditation for my eating disorder service. The process has been necessarily exhausting, forensic and, at points, deeply……I’ll say no more. But to hear all the good stuff reflected back – the feedback from parents and young people, the sheer volume of work our teams are doing across bases, the hundreds of young people we see- it made my heart jump a bit. Every single emergent referral is seen within 24 hours. That is not normal. It is a big deal. So yes, it’s been a week- it’s a good job I am going on leave…..my colleagues said I look ‘very smiley today’, translation = mildly feral.

Money stress is real in this field. We navigate unpredictable income, insurance delays, seasonal slowdowns, and the strange math of relationships that are both transactional and transformational. And layered underneath all of that are our own money stories, fears, and early experiences that shaped how we relate to earning, charging, and our sense of worth.

This is why Ann is facilitating a free workshop through Mental Health Match called Money Narratives & Therapist Realities.

When: Friday, March 6, from 12:00–1:00 PM PT.

This isn’t financial planning advice. It’s about connection and normalization.

Register here: https://luma.com/e4xavs32

If you’re like me, setting boundaries around late-cancellation fees and repeatedly missed appointments brings up a kind of assertiveness that makes me want to crawl into a hole and never come out.

For a long time, charging a fee felt like I was doing something to someone, instead of simply upholding the structure of my practice.

Here are the reframes that have helped me lean in more comfortably over the years:

I don’t auto-charge the second a cancellation happens. If someone’s child wakes up sick or there’s a genuine emergency, I use clinical judgment and the Golden Rule. Life happens.

Prolonged Grief Disorder (PGD) – the diagnosis given to bereaved people whose grief doesn’t gradually soften over time but stays intense, preoccupying and life-shrinking long after the loss. The DSM-5-TR and ICD-11 now both include PGD, with core symptoms of persistent yearning or preoccupation plus accessory symptoms (identity disruption, disbelief, emotional pain, avoidance, etc.) for at least 12 months post-loss in adults, with functional impairment.

Meta-analytic estimates suggest around 1 in 10 bereaved adults meet criteria at some point, with higher rates in suddenly bereaved, violent loss and refugee populations. (PubMed, T&F, Frontiers)

Recent neuroimaging work suggests PGD is not just “more depression” but a partially distinct pattern: reminders of the deceased trigger reward circuitry, especially the nucleus accumbens, alongside differences in amygdala, anterior cingulate and insula activity. (PubMed, ScienceDirect)

The working hypothesis: In PGD, neural systems built to maintain close bonds don’t fully update to the reality of the loss, so the attachment system keeps firing as if reunion were still possible – more “craving” than simple sadness. (Research Gate)

The treatment signal is actually one of the clearer bits of this literature:

Complicated/Prolonged Grief Therapy (CGT/PGT) – a structured, grief-specific therapy combining revisiting, exposure, attachment work and restoration-of-life goals – consistently outperforms interpersonal therapy and supportive treatments, including in older adults. (JAMA, PubMed, PMC, OUP)

Antidepressants may help co-morbid depression or anxiety, but do not reliably resolve PGD alone; the main line is targeted psychotherapy.

I know, I know. I put Bridgerton last week, but truly, Part 2 did not disappoint. My favorite season yet!!!

I’m going on holiday tomorrow (today if you’re reading this when it drops) and my internal clock is so far gone it’s got no hands, no battery, and is probably face down in a drawer under old lanyards.

No podcasts to “catch up on,” no CPD on the plane, no noble intentions. Just sun, sleep and ‘out of office ‘on . That’s it. That’s the pick.

Stories from the community

Here’s how it shook out:

No turf wars here. We appreciate the different training pathways that can all lead us to the same high level of overthinking about whether handing someone a tissue communicates attunement, avoidance, rescue, or subtle emotional shutdown.