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Cake day: January 21st, 2025

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  • To be clear i am not the person who downvoted you

    It’s not like I get paid extra to do ABA. I get paid to do therapy regardless of who shows up and thanks to the shitshow of the world there’s no shortage of people. Mental health isn’t really like physical health. We can’t really “pad” billing with a ton of codes in outpatient settings most of the time. We bill in units, not services. So you come in and I bill more like you would expect from a worker, essentially by the hour. This is not like a surgeon that tacks on a complexity billing code and an extra code because you took a $300 Tylenol. Of course not all mental health is like this (especially crisis, which has more modifier codes)

    But clearly you think regardless of how the billing works it doesn’t matter. So anyone who charges for their services is invalidated from speaking on issues? Got it. That is a viewpoint entirely incompatible with modern society. How do you reconcile such a thing?

    Do you distrust vaccination because the evidence is sponsored by companies with a vested financial interest? Do you distrust the providers who recommend your flu shot because they have a vested financial interest in being able to bill for the service in rendering it? Do you distrust the evidence based treatments for your TN-2? There is a vested financial interest behind every treatment if you are that cynical.

    A financial interest is absolutely something to investigate. That’s why they’re required to be disclosed in research. But it’s not inherently an issue if there is valid evidence of efficacy

    I am criticizing their bias because their bias allows them to present a one sided inflammatory and misleading argument that masks the true issue of what the problem is here.

    When someone comes into my job I give them the associated risks and rewards with ABA or any other therapy. They are allowed to weigh that risk and either consent or leave. Obviously my bias is that I think it is good. Like all people I have bias. But my bias is supported by a base of evidence supporting the efficacy of treatment

    Again I think the issue here is consent and I think the article obfuscates that. If a parent comes in and says “my autistic child flaps their hands and that is weird, make them stop” it is my responsibility to say no. That is where I take offense to your point. If I was purely working from financial interest why wouldn’t I be like “fuck that kid?”. Granted there are practitioners out there who do this. I am sure of it. I am sure some of them are malicious even, knowing this is bad but doing it because they can bill. But I am betting the majority of them are more naive. They believe they are being helpful. They believe they are making this child’s life easier because it will help avoid social stigma, rather than think of ways to address causal factors of social stigma.

    And to their credit they at least have an argument. I have worked with clients who wished they could suppress their stereotypy early in life to avoid bullying. I would argue these clients need work on self esteem and self advocacy rather than finding themselves in a position where they feel the need to be subservient to an abusive system only to make the abuse stop, but on the other hand it is not my right to tell someone how to interpret the world and this is starting to get away from the point.

    But there is a very difficult ethical debate here. Where is the line for clients that cannot actively consent? A moral gray area exists, obviously. It’s easy to say that using ABA to extinguish non harmful stereotypy is fucked up. It’s somewhat easy to make the argument that someone who is physically harming themselves to the point of hospitalization would likely consent to changing their behavior (though obviously some will steadfastly disagree no matter what the risk is and regardless of the lack of viable alternatives). But where is the middle? What about doing homework? Chores? Moderating access to games and such? Far more interpretable

    But we can’t have these nuanced discussions because of misleading articles like this and hardline stances like yours that reject any nuanced discussion on the topic whatsoever.

    Edit: and that blog absolutely has a financial interest, they literally have a fucking shop link in their top bar. I have no idea if they run Adsense because I have Adblock. Their financial interest is more nefarious if anything! At least mine is upfront! I will tell you my hourly rate beforehand!


  • I never claimed to not have bias. Everyone has bias. But I run my practice with a fairly extreme sliding scale, I take Medicaid, and I work with several clients for no money at all. I make a livable wage but I don’t make as much as you think. And the reason I do is because I do literally everything myself to cut as many middlemen and overheads as possible.

    Additionally ABA is only a part of my practice. I do a lot of gender affirming care, CBT, etc. frankly if you removed ABA from my practice I would be fine, financially.

    While it is valid and important to expose a vested financial interest I think it’s also important to look at the overall content of what is being displayed as well. Of course you have no obligation to do so and can always tell me to go fuck myself


  • I mean see the much more involved reply I gave to the to other person but in addition to that the difference here is that ABA does work. It’s evidenced based to do so. It is not kooky bullshit of people stealing your money with snake oil.

    The issue surrounding it is one of consent, which is a very worthwhile discussion to have. This is another issue with the way the article is presented. It confounds the actual issue! Now you are conflating it with snake oil when there is an astoundingly large body of evidence in support of its efficacy. To be clear, this is not a flimsy “it works sometimes under some scenarios maybe” thing. This is decades of evidence

    So when you come into my practice and say you want to change a behavior that bothers you and negatively impacts your quality of life I can present you with operant conditioning. You want to change something about yourself, which is sometimes a thing that people do. It will likely be effective if done correctly. If I present it to you clearly and you consent to it, what’s the problem? But the moment I call it ABA you are far more likely to simply reject it now. That’s your right of course, but it’s sad

    Now we can discuss the ethics of treating those who cannot reliably consent, children, people who cannot reliably communicate, etc. but frankly is ABA the issue here? Again I argue your issue is with programming direction being forced upon someone who cannot advocate for themselves. This is not ABAs fault. But it is an easier thing to scapegoat


  • Well you’re obviously being sarcastic but to expound on the point

    ABA is a difficult thing because of consent issues, obviously. But the article portrays it solely as torture, as do you. I have worked with children who literally bash their head into the wall until they give themselves concussions. One kid did it so hard he detached a fucking retina. I have worked with people that have done so much property damage to their homes their houses are condemnable. I have worked with people that become violent when presented with stimuli that they consider aversive, like a song comes on the radio they don’t like. And when I say violent I don’t mean they are “mean”, I mean they fuck people up, they send people to the hospital.

    To further confound things research shows the absolute best thing that can be done to avoid the above scenarios is early intervention to work on issues like frustration tolerance and toleration of denied access.

    What do we do in these cases? Contingent reinforcement is evidenced, effective, and when applied effectively can be balanced against the cost. These people have serious quality of life issues and ABA can alleviate that when not much else, if anything, can, aside from just giving them what they want all the time and creating a sterile environment free from any stressor, which is unrealistic and foolish.

    The article is presenting it in terms of “ABA is bad because people implementing it have misused it”. This is why I say it’s one sided. I should have elaborated this in my first comment probably. But so many people, you included, seem to have no interest in having a more nuanced discussion on this. It’s demonized because of practitioner misuse. This is understandable. But I will continue to make the point that all ABA is is the science of operant conditioning, nothing more, nothing less. How it is implemented is up to the practitioner. It is up to the social norms surrounding to dictate that

    To that point I would argue your real beef is with capitalistic systems. These practitioners are generally well intentioned but they are misguided. They are doing what they and the parents of the individual often think is “right”, to make you “work” within such frameworks. This is where the article starts to come into play and this is where bad application of ABA comes in.

    Utilizing ABA to encourage a child to stay seated, to discourage stereotypy, etc. of note is that this application is generally discouraged although to your point there is nothing strictly disallowing it. Parents and education environments ultimately have the most power here although many practitioners, myself included, will refuse to “work” on behaviors that don’t need to be worked on when they can be accommodated instead or simply just ignored, eg hand flapping doesn’t bother anyone so who cares? And getting up from their seat during class may be disruptive but can we possibly accommodate somehow, like changing seating or directing to the back of classroom so they can pace freely?

    Further the article completely glosses over things like functional communication training. So never mind that utilization of ABA has led to me giving communication skills to many clients who otherwise had either none at all or very limited skills. And never mind that it’s not just contingent reinforcement in a bubble, it’s generally operant conditioning paired with functional communication.

    And never mind that operant conditioning is in many ways naturalized consequences of real world conditions made safer and more artificial so that they can be practiced and learned without more serious cost

    The issue I ultimately take here is that yes, there are issues with ABA. I outlined them above but will explicitly say them again: it’s in the application. Contingent reinforcement is a powerful tool and misusing it means you can attempt to shape behavior in flawed ways that are harmful. Conversion therapy is not ABA but is based in somewhat similar principles of behavior conditioning (classical vs operant conditioning), and yet I still don’t think the gross misuse by those clinicians nullifies the applicability of classical conditioning based therapies for similar reasons.

    But to respond in such an obviously biased way steers people away without providing a balanced view. It reeks of tactics that anti science zealots utilize. it puts families in a position that makes the susceptible to dangerous treatment options. Etc






  • Oh I didn’t mean larger like that, I meant width wise. Standard rack width is 19 inches so if it’s one of those specialty racks that’s narrower that thing I said about repurposing an old 1u/2u is pointless because it won’t fit. Doesn’t mean you can’t or shouldn’t use this rack, just that that idea is no good.

    4u is fine unless you want to expand down the line. Networking gear and stuff. However if it’s a narrow rack I don’t think there will be much to put in it for those purposes? Depends on your goals. I have a larger rack but I also have my whole networking stack in it, switch, poe switch, ups, router, nas, etc.

    I would consider posting on the unraid forums. There may be someone who has used similar hardware and can give guidance on how they approached the setup. The benefit of unraid is ultimately that the support community is very solid


  • How do you connect the drives? Looking at specs there’s only one sata port (which I don’t actually see anywhere, but it says it is there, although using it slows the second nvme lane)

    USB connected drives in a raid array are not ideal. USB connectivity is not as solid as a direct sata connection and a drive suddenly disappearing from your area, especially parity, is quite a headache

    No pci slot so you can’t add an hba for more sata lanes either. You could do one of those nvme to sata things but I’ve heard bad things about the reliability of those.

    If it’s free though I def think it’s worth finding a way to make it work. The specs are more than enough for unraid and usually those tiny pcs are pretty power efficient, which is nice. But that’s the issue to work around, connecting the hard drives reliably.

    WRT what to put them in it could be anything really. You could get a cheap broken 1 or 2u server case where someone’s pulled the motherboard and powersupply, rig something in there to hold them all. Should be more than enough space for 5 drives and will probably have cages for at least 2-3, maybe all 5 if you get lucky. Might even have hot swap ones. Dunno if this would fit though, that rack looks small and I couldn’t get the specs to load, is it full sized or a tiny one?

    Could also see if there’s some kind of 3d print thing. There’s probably a 3d print thing to rack mount that mini pc.


  • Not shocking to hear, he’s a scumbag at heart. But now if you say that people will be like “uhhh how can you say that he’s donated so much money”

    Then when you point out he’s donated literally 0% of his overall current net worth, his past (and current, apparently) behavior has arguably as much humanity if not more than he has offset, etc you’ll get whataboutism. “What have you done??”

    I don’t want philanthropy to be contingent on the whims of billionaires. Gates has done a lot but it still has major issues, there is no real transparency, and it’s still authoritatively controlled because he has a great deal of influence over his foundation. The even bigger issue is that he is by far the exception. Other billionaires donate minimally only to maximize tax benefits and only to issues they have been personally impacted by.

    The other day I was with people who were watching a football game. The eagles won and I asked why the owner gets to speak first at the trophy ceremony, let alone at all, given it was the teams effort. This led to a whole discussion but one thing that came up was how he donates so much money to autism research because he has a grandson with autism. This was meant to appeal to me because I have a background working in autism research and I work with people with autism a lot.

    all I could think is “how fucked up is it that we have to hope that an obscenely rich person personally experiences the issue for them to decide to bequeath funding?” This inherently means that things with a much higher rate of prevalence, like autism (1 in 36, roughly) or dementia (prevalence varies widely by age range (2% to 13%) but ~10 million cases per year), will get tons of money. But what about far less common things? I’ve worked with people who have extremely rare conditions. Angelmans syndrome, prader willi, chromosomal deletions, (rates of 1-2 per 10,000) or extremely rare things like hellers syndrome (rates of 1-2 per 100,000).

    This is why we fund things like NIMH, so that money can be fairly dispersed to ensure that all things are researched. Teams of people research what needs to be researched. This isn’t even just about equity; sometimes researching lesser known disorders leads to discoveries that are applicable in a broader context

    But instead we let a few oligarchs hoard money. Most of them don’t bother to fund this stuff at all and they few that do only bother to do so when it’s something personally relevant to them. We have no say in the matter.


  • 80s, 90s, and a few years into early 2000s. Gates ruthlessness lasted decades, destroyed many businesses and lives, and is mostly whitewashed thanks to his philanthropic efforts and a few reddit amas and some secret santa participation

    Not to mention the destruction he did to computing as a whole. The nightmare of proprietary bullshit is something that he did not architect but he pushed heavily and lobbied for constantly. He had the position to push for interoperability from an early stake in computing, to set the stage for computers to have a strong precedent to work together. Instead he and microsoft made every effort to work against open standards. They would adopt open standards and extend them with proprietary extensions to intentionally ruin them. A lot of what is infuriating about modern tech can be traced back to precedent that microsoft set at his direction

    Reminder despite every donation he has made his net worth is higher now than it ever was and this has essentially always been the case. His philanthropy, while objectively good, is a measured pr effort that does not impact his overall obscene wealth and basically never has


  • You bring up a good point. I ultimately oversimplified my post to illustrate the point which upon reflection was probably not the best idea

    Your presentation is not uncommon at all. It is totally a thing to fear the needle and not fear the pain. Ultimately the strategies remain the same (which is why I kind of glossed over this but it was still a bad idea to do so, my bad)

    In addition to desensitization you can also try diversion in the short term. Create sensations in other areas of your body to divert your focus away from the needle. Put an ice pack on your thigh or something similar that’s not harmful but mildly uncomfortable to pull focus. Similarly you can just go with good old distractions if possible like watching a video while looking away. This isn’t the best strategy, especially long term because in some cases it can worsen the stimulus you’re anxious about, but in a pinch it can be helpful. And of course if your phobia is trauma related processing said trauma is helpful (although that in and of itself is often a desensitization process fyi)



  • On device isn’t always ideal. I don’t use immich because i don’t have a large photo library. But I do use komga. Nextcloud can sort and manage epub/pdf like komga but as poVoq said, the specialized solution is superior

    This point is where on device app is not the ideal situation, for me at least. These apps exist. Tachiyomi and the resultant forks can import a local library. And frankly even a somewhat massive local library can fit on a cheap SD card

    The point of the server is portability. With this I have portability across my devices. My library, reading status, metadata, etc is available on all devices. I can read a book on my ereader, close it, the status is synced. I can pick up from my laptop and the same thing occurs. I can pick up from my phone, download the book to my device, and keep reading while I’m away from home. If I wanted to I could open remote access to my server and avoid the need for downloading the books but that’s a whole thing

    I don’t think it would make sense to run a server solely for this but it’s a service that doesn’t take much in terms of resources and I read a lot.


  • Yeah there are plenty of apps that can rip from tidal, apple music, etc. noteburner, deemix, deezloader, musify, notecable, and noteburner are all ones that I tried where they successfully ripped audio from streams to flac but spectrals showed the flac was transcoded from lossy source.

    Granted this is basically inaudible and super nitpicky, like honestly show me the person who can truly hear the difference between a modern 320 mp3 and a 16bit flac in a double blind situation. But if you’re using these rippers to upload to a private tracker, especially a popular release, guarantee someone will check

    That said streamrip can get deezer 16 bit, 24bit tidal mqa (which isn’t actually lossless), and 24/192 qobuz but you need a premium account and things break from time to time

    https://github.com/nathom/streamrip

    Apple music remains a very closely guarded secret although I recently saw this: https://github.com/zhaarey/apple-music-downloader . I have to create a burner and vm to play with this though bc it’s pretty sketch



  • Most of the publicly available ones that rip streaming services to lossless fail spectral checks. They can rip high quality MP3s which they then transcode to flac but if you were to upload this somewhere like RED you’d get shit for it. Literally every one I’ve found has failed the spectral check thread on RED

    This MAY not apply for Spotify as they don’t stream lossless to begin with

    The people that can actually rip fully lossless files from deezer, apple music, qobuz, tidal, etc guard that info like crazy. The second the method gets public you better believe all those companies are patching it out. Plus it probably doesn’t hurt that being the one with the keys to the method gets you like infinite ratio