wsmith: (Default)
[personal profile] wsmith
It looks like I've got an interview for an internship tomorrow. It's at a substance abuse facility near Symphony Hall. Any tips on counseling for substance abusers?

Date: 2010-09-15 11:50 pm (UTC)
From: [identity profile] panzerkunst.livejournal.com
I believe GIllian does this, do you know her?

Date: 2010-09-16 02:37 am (UTC)
From: [identity profile] wsmith.livejournal.com
I don't think I do.

Date: 2010-09-16 12:11 am (UTC)
From: [identity profile] iterum.livejournal.com
Good luck!

I'm afraid the only tip I have on counseling substance abusers is "don't offer them a drink."

Date: 2010-09-16 12:14 am (UTC)
siderea: (Default)
From: [personal profile] siderea
1) Go read all the AA stuff, because most addicts -- and the other clinicians -- will expect you to speak that lingo. Shortly after I started my present job, I was on the phone to the sober house where my first patient was living, and the staffer casually explained, "We focus on Steps one through three".

2) One of the most useful things you can do is keep your intellect peeled for other mental health problems which are the real driving motive force for the addiction. Not at all universally the case, but when it is the case, if the underlying problem (e.g. PTSD, personality disorder, depression) isn't treated, it's hard-to-impossible to get any traction on the substance abuse. Which isn't to say you'll necessarily be treating the MH problem. It would be a wise interview question to ask them whether directly treating "mental health comorbidities" such as bipolar or PTSD would be part of your purview, or whether such a person should be referred out for psychotherapy. Not that it necessarily matters to you what the answer is; the question shows alertness to professional boundaries.

3) Be clear on the difference between abuse and dependence. The word "addiction" doesn't appear in the DSM.

4) Watched "House"? Everybody lies. Try not to take it personally. Working with addicts can harden a counselor, not so much because of the patient lies (all patients lie) as because of how utterly stupid and poorly executed the lies are, it actually starts feeling disrespectful, in a "how stupid do you think I am" sort of way. Remember, drug addiction makes you bad at stuff. Including lying to your shrink. They can't help it. If they weren't sick, they'd be better at lying. It's not that they think you're dumb, it's that they're crazy with their sickness.

5) Also, many substances of abuse, esp. opiates such as oxies and percs, can with long-term use cause durable debilitating anxiety. Get good at treating anxiety and handling anxious people.

Date: 2010-09-16 02:39 am (UTC)
From: [identity profile] wsmith.livejournal.com
Thanks for the advice. Great insights. I'll do some reading tonight.

Date: 2010-09-16 03:02 am (UTC)
From: [identity profile] shnells.livejournal.com
if this falls through, let me know. i can ask the psych docs i work with if there are any options either at our site or anyone else they know.

Date: 2010-09-16 12:26 pm (UTC)
From: [identity profile] couplingchaos.livejournal.com
Good luck, sir!

Date: 2011-04-13 08:10 am (UTC)
From: [identity profile] buheduel.livejournal.com
Great post! I wish you could follow up on this topic!

Date: 2011-04-13 10:59 pm (UTC)
From: [identity profile] wsmith.livejournal.com
Thanks, but I've not got a lot to follow up with. I've been working at the place now for about 7 months.

Date: 2011-04-13 10:44 pm (UTC)
From: [identity profile] laqopula.livejournal.com
hello, I sent an email to you about this post, its not coming thru for me. Can you connect with me when you get a chance.

Date: 2011-04-13 10:58 pm (UTC)
From: [identity profile] wsmith.livejournal.com
I'm here. I didn't get your email. What's up?

Date: 2011-11-02 04:03 pm (UTC)
From: [identity profile] warrenigyv.livejournal.com
Thanks for the information. I think that you should wash your face at least 3 to 4 times a day. You’ll be surprised how much better your face will look.

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