Home » Posts tagged 'Alcohol and Drug Counseling' (Page 4)
Tag Archives: Alcohol and Drug Counseling
10 Signs of Alcoholism
Contributor: Yvette McBride Thomas
An addiction is defined as a maladaptive behavior that one engages in repeatedly, without the ability to quit, despite enduring serious and significant consequences as a result of that behavior.
Alcoholism is a biological disorder that impacts a person’s physiology as well as their psyche. Addiction is a highly genetic disorder such that over 90 percent of addicts have a relative or relatives who are addicts within 1 to 2 generations. Thus, those who come from families with a high incidence of addiction need to be careful, and monitor their own potential to abuse substances. Of course, if one who is genetically predisposed to be an alcoholic chooses to simply stay away from alcohol, this genetic disorder will never have an opportunity to be expressed. Unfortunately, many do not know that they are predisposed toward alcoholism until they are already embroiled in an unproductive cycle of self medicating their negative mood states with drugs or alcohol.
Denial goes hand in hand with addiction, so most addicts, especially in the early stages of using, will deny that drugs or alcohol are impacting their life in a negative manner. They may continue to deny this reality, even as they begin to lose friendships, have trouble with the law, or perform poorly at work or school. Such is the power of denial. Below are 10 symptoms indicating a drinking problem. They should be used as a guideline to help an alcoholic or problem drinker admit that they do not have control over their alcohol use:
DYI! Get ready with me.
Samantha DeLint – Youtube Channel
- Drinking alone
- Making excuses to drink
- Daily or frequent drinking needed to function
- Inability to reduce or stop alcohol intake
- Violent episodes associated with drinking
- Drinking secretly
- Becoming angry when confronted about drinking
- Poor eating habits
- Failure to care for physical appearance
- Trembling in the morning
These symptoms are all indicative of problem drinking. Not all problem drinkers are addicts however. Some people may not be addicted to alcohol, but may drink to excess primarily as a coping tool to deal with negative feelings. These types of drinkers, who DO NOT have ANY family history of addiction, who have NOT suffered extreme consequences as a result of their drinking, and who WANT to stop drinking, may be excellent candidates for individual therapy. Those who DO have a family history of addiction, who CANNOT stop drinking on their own and who have suffered severe consequences such as social difficulties, legal trouble and work or school problems may be excellent candidates for Alcoholics Anonymous and group therapy in order to promote sobriety. Alcoholism and problem drinking are serious physical and mental health issues and need to be treated as such. If YOU believe that you may be an alcoholic or a problem drinker please consult your physician in addition to contacting a mental health professional who specializes in substance abuse in order to coordinate your treatment.
Dr. Maloff specializes in the outpatient treatment of substance abuse and addiction disorders. jared on October 9th, 2007
ASAM Dimension 3 – Emotional/Behavioral Conditions
Contributor: Yvette McBride Thomas
Dimension 3: Emotional/Behavioral Conditions
Problem (need)
- Patient reports evidences of possible depressive symptoms
- Patient reports unresolved loss/grief issues due to deaths in immediate family
- Patient has a history of poor anger management
- Patient has a history of illicit behavior which has led to legal problems
- Patient reports difficulty coping with loss of child custody
- Patient exhibits very low frustration tolerance
- Patient’s current functioning affected by history of verbal/sexual/physical abuse
- Patient experiencing grief due to divorce/desperation
- Patient experiencing difficulty coping with loss of significant relationship
- Patient seems unable to keep schedule of structured recovery activities, showing erratic or irresponsible behavior.
Goal (I will)
- Patient to address unresolved loss issues
- Patient to increase frustration management skills
- Patient to increase anger management skills
- Patient to cease illegal behaviors
- Patient to develop alternative to illegal behavior
- Patient to increase communication skills
- Patent to address emotional needs of family
- Patient to increase responsible time/task management skills
Intervention (Objective)
- Patient to complete mental health symptoms questionnaire with counselor within ___ weeks
- Patient to examine situations precipitating frustration and anger and discuss nonaggressive responses to address and discuss in counseling sessions and monitor progress on anger/frustration.
- Patient to contact anger management group with in _______weeks and attend as scheduled, following up with primary counselor (pc)
- Patient to process the loss of loved one in counseling sessions and progress on grief management to be monitored with with grief support group within ______ of referral
- Patient to process feelings over possible loss of child custody
- Patient to explore ways to cope with emotional affects of serious illness
- Patient is to discuss progress on avoiding arrest and illicit activities
ANGER MANAGEMENT
Behavioral Definitions
- History of explosive aggressive outburst out of proportion to any precipitating stressors leading to assaultive acts or destruction of property
- Overreaction of hostility to insignificant irritants
- Body language of tense muscles (clenched fist/jaw, glaring looks, or refusal to make eye contact)
- Consistent pattern of challenging or disrespectful treatment of authority figures using verbally abusive language
Long term goals
- Decrease overall intensity and frequency of angry feelings and increase ability to recognize and appropriately express angry feelings as they occur.
- Develop an awareness of current anger behaviors, clarifying origins of and alternatives to aggressive anger
- Come to an awareness and acceptance of angry feelings while developing better control and more serenity.
- Become capable of handling angry feelings in constructive ways that enhance daily functioning.
Therapeutic Interventions
- Identify targets of and causes of anger
- Verbalize increased awareness of anger expression patterns
- Verbalize how influential people in growing up have modeled anger expressions
- Identify pain and hurt of past or current life that fuels anger
- Utilize relaxation techniques to cope with angry feelings
- Verbalize increased awareness of how past ways of handling angry feelings have had a negative impact
- Verbalize increased awareness of and ability to react to hot buttons or anger triggers in a nonaggressive manner
- Write an angry letter to target and process this letter with counselor/therapist
- Write a letter of forgiveness to perpetrator of past or present pain and process letter with therapist/counselor
- Assist patient in identifying ways key life figures have expressed angry feelings and how positively or negatively these experiences have influenced the way patient handles anger
- Assign patient to list the experiences of life that have hurt and led to anger
- Ask patient to list ways anger has negatively impacted his/her daily life. Process list in counseling session
- Ask patient to write an angry letter to parents, spouse, or whomever, focusing on the reason for his/her anger toward that person. Process letter in counseling session
- Ask patient to write a forgiveness letter to target anger as a step toward letting go of anger. Process letter in session.
DYI! Get ready with me.
Samantha DeLint – Youtube Channel
Reference used: Jongsma, A.E. Jr and Peterson, L. Mark The Complete Adult Psychotherapy Treatment Planner 2nd edition
Suggested readings
Roselline, G., and Worden, M (1986) Of Course You’re Angry. San Francisco: Harper Hazelden
Runin, T. I. (1969) The Angry Book. New York: Macmillan
Weisinger, H. (1985) Dr. Weisinger’s Anger Workout Book. New York: Quill.
Smedes, L. (1991). Forgive and Forget: Healing the Hurts We Don’t Deserve. San Franciso: Harper
Lerner, H. (1985) The Dance of Anger: a Woman’s guide to Changing the Patterns of Intimate Relationships. New York: harper Perennial
Other Resources
http://www.kap.samhsa.gov/products/manuals/pdfs/angermanagement_manual_0508.pdf – 2012-09-10
Signs and Symptoms of Substance Abuse
Physical, behavioral, and psychological signs and symptoms of substance abuse. Short and clear. Very useful information.
Treating Substance Abuse/Addiction (Part II)
Contributor: Yvette McBride Thomas
Treating Illegal Drug Addiction
- Around half a million Americans are heroin addicts, and four million are regular users of marijuana.
- Treatment is often based on the AA model.
- Because of incarceration of illegal drug abusers, jail is the usual context for treatment.
- “Stay’n Out” is a prototype of a jail treatment program that works well and has a recidivism rate of only 25%.
Treating Families where there is Substance Abuse/Addiction
- Families either promote or enable substance abuse behaviors. The whole family has to be included in the treatment.
- Children with chemically dependent parents are at risk.
- Alcoholic families tend to be isolated and lack positive role models.
- Young people from dysfunctional families use substance abuse to
- Relieve stress and anxiety and structure time.
- Keep their minds off family dynamics and on predictable problematic behaviors.
- Substitute for sex and promote pseudo-individuation (a false sense of self).
Treatment Services
- Counselor can provide information.
- Counselor may have to be confrontational with the family over the effects of substance abuse on the family and individual. An intensive systems approach must be used that also involves agencies.
- Counselor can work to help family deal with feelings, such as anger and defense mechanisms.
- Counselors can also help the family take responsibility for their behaviors.
- Developmental issues are also worked on by the family.
Treating Women and Minority Cultural Groups in Substance Abuse
- Approximately five to seven million women abuse alcohol in the US alone.
- Women face societal rebuke and chastisement for alcohol abuse.
- Barriers to treatment include need for childcare, cost, family opposition, and inadequate diagnosis.
- Little evidence exists on the benefits of AA and NA on the one-third of the AA membership that women represent due to gender differences and cultural differences.
- “Women for Sobriety” is an alternative help group program that is based on a cognitive-behavior modification approach. Thinking is changed to overcome feelings of helplessness, powerlessness, guilt, and dependence.
- Cultural differences may play a part in the recovery process. Spiritual elements may be different for women and different ethnic backgrounds.
Affiliation, Certification, and Education of Substance Abuse Counselors
IC&RC
- The International Certification & Reciprocity Consortium.
- IC&RC’s credentials include
- Alcohol and Drug Counselor (ADC)
- Advanced Alcohol and Drug Counselor (AADC)
- Clinical Supervisor (CS)
- Prevention Specialist (PS)
- Certified Criminal Justice Addictions Professional (CCJP)
- Certified Co-Occurring Disorders Professional (CCDP)
- Certified Co-Occurring Disorders Professional Diplomate (CCDPD)
- The IC&RC is currently developing a Peer Mentor (PM) credential.
TCBAP
- Texas Certification Board of Addictions Professionals
• IAAOC
- International Association of Addictions and Offender Counseling
- Focuses on the prevention, treatment, and description of abusive and addictive behaviors.
- Publishes the Journal of Addictions & Offender Counseling
• NAADAC
- National Association of Alcoholism and Drug Abuse Counselors
- A national organization that certifies addiction counselors
• NBCC
- In 1994 the National Board of Certified Counselors added a certification process for becoming a substance abuse counselor.
Two types of counselors
- Recovering counselors
- Nonrecovering counselors
Reference:
Gladding, S.T. (2011). Counseling: A comprehensive profession (7th ed.). Upper Saddle, NJ: Pearson-Merrill.
Treating Substance Abuse/Addiction
Contributor: Yvette McBride Thomas
Characteristics
- About 25% of counseling cases relate to substance abuse and addiction.
- Substance abusers have dysfunctional dynamics making them difficult to work with.
- Three most common ways counselors work with addicted persons include outpatient, residential, and inpatient.
- Addicts must be “dry” or “dried out” for 30 days or more to give them a “clean” body and mind to use in doing something different and positive.
- Alcoholic family systems have an overresponsible/underresponsible phenomenon.
- Over-responsible people are codependent and seek to control others and feel inadequate when faced with disappointments but are easier with whom to work in counseling situations.
- Underfunctioning people are less motivated to change.
Factors Affecting Treatment include:
- Motivation – Most substance abusers/addicts do not desire to change and are self-centered and are comfortable where they are.
- Denial – is minimizing the effects of substance abuse/addiction on either oneself or others.
- Dual Diagnosis – An abuser/addict has more than one aspect of personality that needs treatment (i.e., addiction and depression).
- Matching – Finding the right treatment for a disorder.
- Control – the regulation of a behavior
- Relapse – the reoccurrence or recidivism of dysfunctional behaviors one they have been treated.
Treatment Strategies for Individuals
- Motivational Interviewing (MI) is used to lower resistance in substance abuse/addiction cases.
- This approach draws from person-centered counseling and includes such skills as active listening, reflection, and reframing.
- Bibliotherapy
- Bibliotherapeutic approach may work with some individuals.
- Abusers and addicts read books or view/listen to media and discuss ideas related to what they have experienced.
- Cautions to remember for counselors working with adolescents regarding alcohol and substance use:
- Working with adolescents is a treatment specialty.
- Family and significant people in their lives should be included for counseling to be effective.
- Adolescents need to be educated about what counseling is.
- Therapeutic techniques need to be specifically tailored to adolescents.
- Counselors cannot function as the adolescent’s friend.
- Counseling focus should be centered on problem solving, skill building, and just being heard.
- “Therapeutic moments” are more uneven with adolescents.
Specific Treatments
- Treating Alcohol Abuse/Addiction – Alcoholics Anonymous (AA)
- Background of AA
- AA is the oldest successful treatment program in the world and was founded in the 1930s.
- AA is a fellowship and a rehabilitation program.
- Alcoholics have “character defects” that “are feelings, beliefs, and behaviors that dispose them to seek a sense of well-being by abusing alcohol.
- Meetings are conducted with small groups and literature.
- Key component in AA
- A 12-step program that has its basis on a spiritual foundation
- Group discussions center on the need and availability of support of others and a dependence on a higher power.
- Members are never “cured;” rather they are “in recovery.”
- Emphasis is also given to responsibility, forgiveness, restitution (when possible), affirmation, ritual, and fellowship.
Treating Nicotine Addictions
- Over 25% of Americans smoke cigarettes, three million of whom are adolescents.
- About 80% of those who abuse or are addicted to alcohol smoke.
- Most nicotine dependent people are not successful as a group in their goal of smoking cessation.
Successful techniques for counselors
Telephone counseling
- Counseling consists of a 15- to 30- minute phone call where counselors give positive, nonjudgmental feedback to those who are trying to quite smoking.
- The goal is to promote self-efficacy.
- Rapid smoking
- After counseling, smokers go through a series of six 1-hour sessions where they inhale a cigarette every 6 seconds until they feel too sick to continue.
- The goal is to produce a conditioned negative response to the taste of cigarettes.
- Skills training
- Coping skills are taught after clients have learned to recognize the triggers that produce the urge to smoke.
- Most successful skills taught:
- Self-statements about the financial and health benefits of discontinuing smoking
- Oral substitutes
- Increased physical activity
- Buddy system
Treating Substance Abuse/Addiction Part II
DYI! Get ready with me.
Samantha DeLint – Youtube Channel
Preventing Substance Abuse/Addiction
Contributor: Yvette McBride Thomas
Prevention Programs
“Just Say No”
- Sponsored by local governments and found in schools and public agencies.
- The program’s message is incorporated into public service announcements on television to influence preteens and teens by their peers to say “no” when offered a cigarette or other addictive or dangerous substance.
D.A.R.E.
- Drug Abuse Resistance Education
- Found in late elementary and early middle school grades
- Uses police as instructors and provides case scenarios that challenge fifth and sixth graders to think about and answer them.
S.A.D.D. and M.A.D.D.
- Students against Drunk Driving
- Mothers against Drunk Driving
- These associations help educate and orient young people about the hazards of drug abuse and the dangers of addiction
Tobacco and Cocaine Programs
- These programs focus on the external and internal factors important to teens. External factors
- External factors include: breath, teeth, clothes, and costs.
- Internal factors include: lifestyle choices, time management, and nutrition.
- Group pressure and dynamics are common elements in prevention.
- Adolescents who get involved in the use of drugs do so because of friends who use drugs.
- When a group perceives drugs as hazardous, its members are less likely to engage in the behavior.
- Educational and support groups are a valuable tool to help ward off abuse and addictive behaviors
Reference:
Gladding, S.T. (2011). Counseling: A comprehensive profession (7th ed.). Upper Saddle, NJ: Pearson-Merrill.
Understanding Substance Abuse and Addiction
Contributor: Yvette McBride Thomas
Intrapersonal Abuse and Addiction
- Intrapersonal abuse involves the misuse of objects or substances that were produced for one purpose, such as healing (prescriptive medication) or entertainment (video games), but are exploited excessively to the detriment of the person involved.
- The result is that often an addiction (a state of physiological or psychological dependence) occurs with excessive amounts of time and effort being devoted to the object or substance.
- Three C’s of addiction conceptualize its core characteristics: loss of control over addictive behaviors; compulsive use; and continued use regardless of negative consequences.
Substance Abuse and Addiction
- The habitual misuse of intoxicating and addicting substances, such as alcohol, drugs, and tobacco.
- Drugs – any substance other than food that can affect the way a person’s mind and body works, including stimulants, depressants, and hallucinogens.
- Abuse and addiction cause mental, physical, emotional, social, and spiritual damage.
- A major public health issue found across all demographic areas.
The Nature of Substance Abuse and Addiction
- Occurs frequently as a mental health problem in the US.
- One of 10 adults in the US has a significant problem related to alcohol use.
- Alcohol abuse/addiction is believed to be greater among Native Americans.
- A significant percent of patients who are hospitalized abuse alcohol.
- Health care costs are doubled among alcoholic families.
- Drug abuse/addiction among adolescents affects development and well-being more than crime, social pressure, grades, or sex.
- Approximately 3 million teenagers are addicted to or abuse alcohol,
- Half a million are marijuana users, and
- One out of 10 teenagers has tried cocaine.
- Substance abuse/addiction affects more than just the individual.
- Other than the abuser, up to four others are being adversely affected including family members, friends, or associates.
Polysubstance abuse/addiction
- Abuse of two or more substances at the same time is a growing problem.
- Social conditions may evoke other substance abuse/addiction, such as smoking.
- Conditions related to smoking
- Unsatisfactory life rooted in poverty and hopelessness
- Peer pressure
- Poor school performance
- Parental smoking
- Minority ethnic status
- External locus of control
- A behavior pattern with biological, psychological, sociological, and behavioral components .
- A persistent and intense involvement with and stress upon a single behavior pattern, with a minimization or even exclusion of other behaviors, both personal and interpersonal.
- Addiction is characterized as a preoccupation with one object that controls behaviors and limits other actions over time.
Reference:
Gladding, S.T. (2011). Counseling: A comprehensive profession (7th ed.). Upper Saddle, NJ: Pearson-Merrill.
LCDC Exam Review 