Adolescent and Theraputic Issues

After reviewing the videos: Adolescent Brain, Dr. Randal Pinkett on Judge Hatchett Show Mentoring a Teen, Wyoming Camp for Troubled Teens, and One Move At A Time. I noticed that all the video dealt with troubled teens who only needed a change in their environment and someone to encourage them and show them that they could do better. I think that we as adults are easily willing to give up on children in today's society, we are quick to say that they are trouble makers, uncontrollable, or even evil. But as mentioned in the Adolescent Brain video, the adolescent years are when the brain is producing more and more of the gray matter in the frontal lobe of the brain, which is referred to as the thinking part of the brain; unfortunately this is the time when adolescents are experimenting with drugs and risky behavior, and because we are quick to outcast them I think we are giving them the go ahead to carry out the behaviors that they display. As mentioned in the video, Adolescent Brain, if a child does not use the cells developing in their brains then they loose them, be it not being active, or drugs. If we look back during the 50's and 60's I don't think that children behavior was a difficult as it is today. I think that our values and services to children have changed. I can remember witnessing a child threaten his parents with social service, if they did not allow him to go the neighborhood dance. I think we have given the adolescents more freedom and less rules. children want discipline, but if they see that they can get away with something then that a chance that their willing to take. I think that adolescents have too much free time and need more positive activities in their lives

Assignment 9 of 9

After watching the videos; Heroin Addicts Speak, choice or Disease, Cross- Addiction: The Back Door to Relapse, and Killing the Pain. I think that you did a great job at showing that drug abuse can happen to any one not just some poor or uneducated person. I think these videos show how easy it is for someone to loose everything by abusing substances, and not recognize or seem to care that they're destroying their lives. I noticed that many of the participates in the videos were educated, had a great life, thought they had everything under control, and wished they could live a normal life. I did not agree with the choice argument that says that, " Addiction can't be a disease because drug taking is a behavior and all behaviors are choices." When I first entered this course I also thought that substance abuse was a behavior and not a disease. I think that by learning more about substances and the behavior of the human brain I may have to change my thoughts. In The video Choice or disease, a comparison was made between diabetes and substance abuse; which says, that substance abuse is a choice, and diabetes is not, but if we look at it, is diabetes not a choice? I mean our diet is a choice, I know some people can't help what they eat and what their genes pass on to them, just as some people's drug problems are not exactly their fault. I noticed in the Killing the Pain video, some of the abusers started out trying to alleviate pain. I don't know. I guess we all have our addictions or things that make us comfortable; just knowing when and how to control them is sometimes difficult.

Assignment 8 of 9

After reading through TIP 31. I notice that it is covered by different laws and social services, asses people 11 to 21 years old, and has a time limit for assessing adolescents. There are legal issues of screening and assessing teenagers, including confidentially, duty to warn, and how to communicate with other agencies. As mentioned in the reading, "Adolescents differ from adults both physiologically and emotionally..." so special assessments and screenings are necessary and needed to improve the services to adolescents. I think that if the resources and time is concentrated on adolescents then we can prevent them from becoming adult substance abusers. Unlike adults; adolescent have not yet fully developed physically, psychological, or emotional; which leaves them susceptible to psychological issues, while already dealing with the issues of being a teen; such as sexuality, egocentrism, and peer pressure.

Assignment 7 of 9

I think that the LOC cheat sheet is an excellent tool for providing guidance to health and social service providers. Not only does it inform the providers on how to plan and/or care for potential clients, it can also help facilities build the teams needed to provide the correct level of care for potential clients. Listed below are three of the many treatment centers located in Southeast Alaska:

1. Gateway Center for Human Services
Substance Abuse Services Division
3050 5th Avenue
Ketchikan, AK.99091
Primary focus: Mix of mental health and substance abuse services
services provided: Rehab for drugs and/or alcohol, Detoxification
Types of car: outpatient, Non-hospital residential(24hour)
special groups/programs: Adolescents, persons with co-occurring mental and substance abuse disorders, women, men, DUI/DWI offenders, criminal justice clients.
Forms of payment accepted: self payment, medicaid, medicare, private insurance, military insurance (e.g., VA, TRICARE)
Payment Assistance: sliding fee scale (fee is based on income and other factors), payment assistance.

2. Juneau Recovery Hospital
Bartlett Regional Hospital
3250 Hospital Drive
Juneau, AK. 99801
Primary Focus: Drug and rehabilitation Services
Services Provided: Rehab for drug and/or alcohol, Detoxification
Type of care: outpatient, partial hospitalization/Day treatment, Hospital inpatient
Forms of Payment Accepted: self payment, medicaid, private health insurance, military insurance (e.g., VA, TRICARE)
Payment Assistance: sliding fee scale (fee is based on income and other factors)
Special Language Services: ASL or other assistance for hearing impaired

3. Southeast AK. Regional Hlth Consortium
Ravens Way
222 Tongass Drive
Sitka, AK. 99835
Primary Focus: Drug and alcohol rehabilitation services
Services Provided: Rehab for drug and/or alcohol
Types of care: Non-hospital residential (24hour)
Special Programs/groups: Adolescents, persons with co-occurring mental and substance abuse disorders
Forms of Payments Accepted: Medicaid, Medicare, Private health insurance
Payment Assistance: Payment assistance

Assignment 6 of 9

I think that the reading from the ASAM Assessment Dimensions; although overwhelming, provides the health and human services field with up-to-date information which can help providers make well informed decisions with their patients and/or clients. The reading provides evidence reports, protocols, preventive medicine, and consensus reports; which, are all necessary in diagnosing, providing medicine or therapy, and informing the patients and/or clients. I know that most of the clients I've worked with in the past, say that they feel better after knowing that their provider has done his or her home work on the issues facing their health and/or needs, and by providing them with evidence and other ways to approach their medical or substance abuse needs they are able to obtain knowledge that will help them to make the necessary changes in their lives. In the end. I think that this assignment really arms me with the tools needed to research or find information in which I can provide clients with in the future; while also enhancing my competency, because we should always strive to learn more.

Assignment 5 of 9

After reading the stages of change,and chapter 4 of TIP35 I could not help but shake my head in agreement with the methods and procedures used to help substance abusers get on the road to recovery. From contemplation to relapse, this is a cycle that may play it self over and over again before a user is completely ready and able to stop abusing or using substances. I agree with reading, that providing more information is not always the better route to go with a substance abuser who is in the stage of precontemplation. I think that a person should be guided into the stages slowly, given the correct information as mentioned in the reading, and given as much time as needed to make the first steps to becoming independent of drugs and/or alcohol. I think giving them too much information may overwhelm them, and sometimes even cause the substance abuser to think that remaining on the substance is easier than taking in too much information. The substance abusers must realize for themselves the problems and grief caused by their abuse of drugs and/or alcohol, and want to make the necessary steps to help themselves. As mentioned in the readings, our goals in assisting abusers are to establish reporrt and trust, explore events that precipitated treatment entry, and commend clients for coming. I think that if these guidelines are practiced better in some establishments, there would be more successful recoveries. I think that most of the time stereo types and prejudice gets in the way of progress, which only leads to more devastation. I know from my experiences dealing with substance abusers most of them are always trying to see if your there to help them, or there to receive a pay check.

Assignment 4 of 9

After reading chapters 2 and 3 from TIP 35 I've found a new appreciation for clinicians and substance abuse counselors. I agree with the elements of current motivational approaches and found all approaches to be of great value for a substance abuse provider. I did not know that there are so many elements of effective motivation intervention. I feel that the frame approach, decisional balance exercises, discrepancies between personal goals and current behavior, flexible pacing, and personal contact with clients not in treatment are all excellent approaches in providing help to clients. The brief interventions used in emergency medical situations are also critical. I thought that the methods used in interviewing clients, giving responses to clients' questions, and allowing clients to make decisions on their own, by providing them with the necessary tool and information needed. I've always thought that the decision to seek help should be left up to the person needing the help. The reading says that a client's ambivalence should not be mistaken for denial. I think that most of the times when people are abusing drugs and/or alcohol there are underlining problems that need to be addressed, before a successful recovery can take place, and we should not prejudge clients based on their culture and positions in society. I did not know that there are certain ways to express empathy with clients based on their cultural background. I think this makes sense, especially since African Americans are apprehensive about dealing with the counselors and medical providers, due to past experiences, such as the Tuskegee Experiment. I found the methods in which the reading suggests that counselors avoid arguments with clients clever. Methods such as; "rolling with the resistance", and "agreeing with a twist". I think this really gives the client a sense of control over their treatment, and shows that its not about the counselors or medical providers. I remember when I use to work for a youth rehabilitation center in Memphis, TN. Our turn-over rate was so high, because the counselors could not deal with having a child talking back or using profanity towards them. I guess that they did not realize that it was not about them, and had they only applied the methods that they were taught they may have been able to deal with the situations that were presented to them. I found chapters 2 and 3 of TIP 35 to be a great motivation in improving relationships and treatment plans for the clients and the providers. I would want the principles and approaches used on me or my family members.

Assignment 3 of 9

I want to start by expressing my thoughts on the use of screening instrument/tool from the "Clinician's Desk Reference TIP 24. I have heard the questions from "The Audit Questionnaire", from clinicians at the VA(Veterans Affairs) Medical Center when I've gone there to receive my annual check up in the past. I did not know that the clinicians were using my answers to determine whether or not I was at risk for developing drug or- alcohol abuse- or dependency. I found it interesting that no 1 instrument is used in the examination of every patient. The reading states that, "certain instruments may work better for different age, gender, racial, and ethnic groups." I also found it interesting that the screening could reveal if a person in the patients family has problems with alcohol or other drugs. I chose the "TWEAK" test to practice my questioning methods on my sister-in-law. "TWEAK" is an acronym which stands for: T(tolerance), W(worried), E(eye-opener), A(amnesia), and K(c)(cut down); it has a sliding scale of seven, with 2 points going to positive answers for tolerance and worried, and 1 point going to positive answers for the final three letters. A woman scoring 2 or more is more likely to be a risk drinker. I also chose the "TWEAK" Test, because my sister- in- law is pregnant, and the reading state that this test is preferred by a panel from the Institute of Medicine for the best results for pregnant women. I am happy to say that my sister-in-law scored a one out of a possible seven, which indicates that she is not a risk drinker. The reading also mentions that a positive screening does not mean that a clinician has to give a diagnosis. The clinician should discuss the results with the patient, and explain the implications of including the results in the medical records. I would think that this would be a wise decision, because maybe that patient has had a bad week or month, and trying to diagnose a patient would be unreasonable, if the person is not a long time patient.

The videos I thought were very interesting and informative. Dr. Carl Hart video (Alcohol: A Women's Health Issue) was informative, because I learned that women are more pron to alcoholism than men and face more issues, such as breast cancer, hepatitis,though I disagree with the notion that alcoholism is a disease I do agree with someone getting help and if calling it a disease helps someone admit they have a problem with alcoholic, then I don't think it could do any more harm than allowing them to continue abusing the substances. I also do not agree with genetics being a factor for some one becoming an alcoholic. I think that its the up bring and surroundings that influences a child to drink ,and then continuous drinking is transforms into drinking habits which leads to alcohol abuse. Like the woman in the video said she had a lot of curiosity from seeing her family drink as well as pressure from her peers, just like the woman in the video says genetics is not your destiny. I disagree with the statement from the video that said, "there is no shame in being an alcoholic." I think it should be, I see no shame in being a recovering alcoholic, and Americans should make being an alcoholic shameful in some positive way. I think we as Americans want to find the the quick fix, so we give explanations for our mistakes and failures in life, and instead of working on the problems we want to diagnose and prescribe drugs. I' not saying that diagnosis and drugs are bad, I'm saying that we need to take responsibility for some of our problems.
The video states that alcohol kills more teenagers that all the illicit drugs put together, and yet getting alcohol is easier than taking the drugs off the streets. I heard some one say that if a child says they are going to be like their parents, or family members, who abused drugs and alcohol, their setting themselves up for failure, if the don't find someone positive to look up to.

Which brings me to the video on Dr. Nora Volkow, the director of The National Institute on Drug Abuse. I think that this woman really made the students feel like they have a voice in this video. One male student near the beginning of the video says, "They say, 'just say no', but they don't really care what I have to say." I know from experience, coming in drug infested projects and schools, sometimes its hard to believe that some one cares about what you say or do. For someone like Nora to take time to come and speak to a group of inner city students is a blessing indeed; they must have felt special. I think the approach of coordinating the students ideas into solving the problems students face when dealing with drugs is excellent. I thought that her explanation on why students who do marijuana on a regular basis do so poorly in school was simple and to the point. She said, that marijuana targets Cannabinoid receptors(modulating the pleasure center of the brain) and cannabinoids receptors are also located in the memory sensors of the brain; which allows you to learn,and can be completely taken over by marijuana. I guess I can start giving up on the reasons to legalize marijuana, because after taking these classes and learning that there are so many side effects to using it, I would not want my children to be able to use it. If I knew half of what I know now. I would not have used marijuana.

assignment #2of9

First I want to start by answering the questions from the beginning of chapter 1 of TIP 35; which asks, Why do people change?, What is motivation?, Can individuals' motivation to change their substance using behavior be modified?, and Do clinicians have a role in enhancing substance using clients' motivation for recovery? I think that people change for many reasons, but perhaps the most profound reason is self fulfillment. For example, drug abusers can see that they can cause pain and harm not only to themselves but also to their family, but the pleasure received from the drugs and/or alcohol overthrows their desire to stop causing this pain. I think when the abuser find something that motivates them more than the pleasures of substance abuse they can be encouraged to change the way in which they live their life. To answer the question of what is motivation? We would have to asked the person in question. Motivation to me is any thing or person that uplifts or inspires me to accomplish a goal; whether the motivation is negative someone telling I'll never amount to any thing, or positive someone congratulating me for receiving my high school diploma. I think that individuals' motivation to change their substance using behavior can be modified. Take for instance, the medical model of abuse; which describes substance abuse as an illness; although I don't agree with this model I think that if this diagnosis helps substance abuser to address their problems then I see no harm in the use of the diagnosis, because now the abuser may not look at themselves as being a problem for their family or community but as a sick person trying to get help. I think that clinicians do have a role in enhancing motivation for recovery, because most of the time the family or community has failed or abandoned the substance. Clinicians can educate, be that partner the abuser needs, and be that motivational counseling needed to help lead them into steps toward recovery. We have to remember that we all have problems just like the girl in the (Crackberry Addiction) commercial, who was suppose to be relaying a message about drug addiction, but could not handle her own addiction with her blackberry phone. We can't shelter our children or family members from all that is wrong in the world; like in the (Cannonball Rez PSA) we have to teach them respect and be positive role models for them.

The best of the class

I would like to wrap up what I loved about this class in three words, tools, tools, and tools. After going through my notes for the final exam, what shined the most was personal experiences and hands on examples from how to treat a client to what to say. In this class the professor took the class to a grass roots level of experience. We got into the nitty gritty of what's going to happen during an assessment to what to say when they get angry, and addiction is a tough issue. It's not really a popular one.

As an example, I remember one role play where our professor pretended she was a client who had many years of experience but relapsed. I was stunned. There was no assessment that I knew of for this client and our teacher just gave us one off the cuff. Here it is. What is your purpose of meeting with us? What's not working this time? Is thee anything in your past that may be comming up? What about relationships, or lack of them? What about depression? And I love this line, "I don't have the time we need to get to know you. Could we meet again? Here the teacher projects as sense of almost intimate caring. When she talked I would think, "Could I come?" Now that is what I am here for.

I really want to learn how to be a supportive person who builds trust early on in the relationship and can maintain it, always giving the client something to take with them as they gain self-efficacy and the quality of life of their choosing.

Summing up the course

This was a comprehensive class with some great info about interviewing skills and motivating clients. In learning the dimensions of the ASAM PPC2, I became aware of what all goes into deciding on a treatment plan and what Level of care a person should be placed in. The time we spent on how to make the client comfortable, and role playing a screening for drug and alcohol abuse, was useful to me. I am not in the substance abuse field yet but I was interested to learn about the different screening and assessment tools that are used, and about the TIPS, and the Stages of Change. I also found the instructor’s comments about her personal experience in the field to be enlightening. It was not a boring class at all – I looked forward to each class and enjoyed writing in the blog and reading other’s comments in the blog. When I took the final exam I felt that I came away from the class with a good understanding of the material that was presented.

Making Difference

This course consists lots of useful information for effective implementation in professional arena. Stages of Change levels is important classification system for identifying client's placement and progress in treatment. Many available resources online and SA fundamental information from the Bookshelf stimulated my learning experience with additional interest and excitement. Most of the materials from the blackboard and ASAM's learning experience from this course will be very helpful to me in my professional practices.
I enjoyed to hear everyone insight, learn new strategies and techniques, play role situations and most of essential to learn from each other.

With great appreciation for being in this class, I wish everyone all the best on the road of professional adventures of helping other people. We can make a difference.

"Life can either be accepted or changed. If it is not accepted, it must be changed. If it cannot be changed, then it must be accepted". - Winston Churchill

My Learnings from HUMS 261

This Substance Abuse Assessment class was a fast, but great learning experience for me. I enjoyed all the classes that I participated in, writing in the BLOG, and everybody’s input throughout the class. I learned the different techniques about doing an actual assessment, and the different tools that can be used. I also learned that listening is the best tool you can use when working with any client. I learned how the diagnosis of substance abuse is decided in a treatment setting and how to be prepared for it.

I am not a counselor yet, but some day I will be, and this class has taught me how to make it easier. I am excited to have learned all these great techniques and tools to help me as I move towards my degree. I will practice with pretend clients using the different strategies of assessing clients. I understand that if I don’t do it consistently, I will lose the skills that I just learned. And, I do not want that to happen.

Lara is a great instructor, and I am so honored to have her help me to move on to achieve my educational goal. I wish all the instructors/professors were as courteous and supportive like Lara. Thank you Lara and I look forward to working with you again in the near future.

10/07/09

In this class I learned about ASAM dimensions and how they are used in addressing substance abuse as well as the different types of substance abuse screenings and approaches used when counseling substance abuse clients.
I have become more familiar with the terminology used in substance abuse treatment.
Before this class I didnt realize that the primary care provider is the best person to do an early intervention, it makes sense I just never thought of that. I always assumed the family would be the begining.
I will contiue to build on the skills I have learned in this class while at work and in my journey as a student.
The handouts are great and I will use them while working with individuals with substance abuse as their primary disability in vocational rehabilitation.
This was a wonderful class, I wish it was longer and we could learn more skills to early interventions and perhaps prevention.
I look forward to having others in future classes.

"TIP 35"

Tip 35 (Enhancing Motivation for Change in Substance Use Disorder Treatment), shows how clinicians can influence the change process in their clients by developing a therapeutic relationship, one that respects and builds on the client's autonomy and, at the same time, makes the treatment counselor a participant in the change process. This TIP also describes different motivational inteventions that can be used at all stages of change, from precontemplation and preparation to action and maintenance.

Another very useful TIP, which even requires us "counselors" to be a part of our clients changes.

now or never

After reading the information introduce to me by this class I have to say I was overwhelmed, but in an informed manner. In the beginning I thought that the only way to stop someone from using or abusing drugs and/or alcohol was to simply stick them in a treatment facility, but now I know that there are certain steps that need to occur even before addressing someone who has a drug and/or alcohol problem. In many cases intervention is necessary, but how to go about introducing that intervention is critical, and not all intervention is welcomed with open arms. We don't want to force intervention unless the situation is life threatening, because if a substance abuser is not ready then the treatment is not going to have the effect intended. As mentioned in the article, behaviorally oriented treatment is one option where the patient takes primary responsibility for their change in behaviors. I would image that this gives the substance abuser a since of empowerment, and many clinicians think that this a more favorable prognosis for recovery.

Many treatment programs provide information to families, communities, and substance abusers. I would guess their primary goal would be to help families, communities, and substance abusers understand their situations. In many cases family members who have relatives or friends who become substance abusers do not know or understand that they are not alone when dealing with a family member or friend who has become a substance abuser. I know that in my community drugs and alcohol are as a part of everyday life, as waking up in the morning. In every corner of the city there is a liquor store and drugs are easily available. As mentioned in the article,"... about 5 million users of illicit drugs and 18 million people with alcohol use problems need treatment, but only one fourth of them receive it." these are staggering numbers; inwhich, many of the programs to help combat these problems are under budget.

I don't understand why something that seems to work does not have the support or funding it needs to help save our youth. Are we willing to let something drastic occur before we make the right decisions? Are we really going to allow cost to be the deciding factor for us to take control of our future? Another portion of the article that really catches my attention is that 1 in 20 high school seniors use marijuana daily, maybe this is what happened to the kid in Chicago who was beaten to death by a group of his peers. We have to ask ourselves, when does it matter? Do we wait until it hits home? And trust me it will happen if we don' t do something now. How is it that we can contribute millions of dollars to campaigns and wars, but when it comes to our youth, citizens, and country we feel that we are wasting money. I think that we are enabling our nation to become substance abusers, by allowing ourselves to think that there is a drug for every little ache and pain. I think that many companies are just out to get money at the expense of any and everyone, and we can't trust the government or city officials to speak up for us, because they too are in the pockets of these big industries whose sole purpose is to direct advertisements toward our youth.

Motivation + Improvements = Positive Chages

Treatment Improvement Protocol (TIP 35) is a practical guidance for substance abuse treatment. It based on experience and knowledge of clinical research. Major goal of TIP is to make applicable relevant updated information and recommendations toward practical implementation. Availability and access of Internet allow to provide latest updates for practices and make that information easy available.The TIP 35 focuses on Enhancing Motivation for change in Substance Abuse Treatment and presents main concept of motivation in new perspective as dynamic and changeable. The TIP 35 is helpful guidance for clinicians to emphasize and influence change process by supporting and respecting client's autonomy and still as a professionals being a part of change process. The TIP provides different motivational interventions, which applicable through all stages of change. Promoting motivation for change interventions, the TIP supports its wide use in clinical practices and treatment programs in United States.

As daily life continuously relies on changes in human services, technological, economical, social, political and other areas, it is important follow and implement improvements and new approaches especially in fields of substance abuse and mental health, where TIP 35 is playing significant role. Overall progress in therapeutical relationships comes with improvements and is inevitable when changes take place.

motivation

Tip 35 - Motivation

It took a lot of reading to get any inspiration to write a blog on tip 35 even though the topic peaked my interest. Finally I came to a part that inspired me and was a match for my own philosophy. It stated that today’s treatment included a broad range of action. In other words it is holistic. A new age term but so appropriate. We are now considering a person’s health, employment, reduction in criminal activity, and more than anything we are considering if it is improving a person’s life. Is there more joy, hope, intimacy, and self-worth through productive action. I like to ask myself if I am doing anything that I would like to write home about.
Here the attention is not so much on the drug but on life. I was recently talking to a friend who has liver failure and is living in a convalescent home. I said it sucks getting old doesn’t it. And she said, “I’m not concerned about getting old. I’m concerned about living. When I feel depression coming on I know that it will disappear if I get into action. Even doing the dishes works. Indeed there are AA meetings that I have gone to that made me want to head to the bar. Even in AA meetings they say to talk about how it was, what we did to change, and how it is now. And then they suggest that most of the conversation is on how it is now. That would be the living part.
I was also interested in the statement, “motivation was viewed as a static trait or disposition…Furthermore, motivation was often viewed as the client’s responsibility, not the clinician’s. This caught me off guard because I had no idea why it would be the clinician’s responsibility. And here they went into the counselor’s style as being the most often ignored but the most important. This gave me hope that I may succeed in this field as the style entails the ability to develop a trust with a helping alliance. They also named nonpossessive warmth, friendliness, genuineness, respect, affirmation, and empathy. This certainly sounds like the kind of person I would aspire to be.

I Love TIP 35

All of the TIPS I have reviewed have contained good information, but TIP 35: Enhancing Motivation for Change in Substance Abuse Treatment is my favorite so far. I have not read much of it, but I noticed that it is a very thorough, step-by-step guide to engaging clients and encouraging change at all the different stages. I read the part about dealing with precontemplators and I was impressed with how it not only explains what needs to be done but gives lots of examples of actual things you could say to someone who doesn’t think they have a problem. It even explains how the client often thinks that other people do not see the situation correctly, and how the counselor can seek to find the client’s viewpoint in a non-judgemental way.

In my presentation that I was going to give in class today, I was going to talk about an involuntary client, and I was going to quote from TIP 35 about how client motivation is influenced by the counselor’s style. The way the counselor relates to the client has a powerful effect on how they react to treatment and whether they achieve the intended results. I noted that “establishing a helping alliance and good interpersonal skills” were found to be “more important than professional training or experience.” It is interesting because I know someone who just did an alcohol assessment (involuntarily) and I casually interviewed him about it on the phone (because I’m taking the class) and while it can certainly be said that he is in denial about his problem, he was not persuaded in the least to become more contemplative by the way his assessor spoke to him. Apparently she did not make any effort to establish a rapport and came across in a very demanding and demeaning manner. TIP 35 says:

“A direct comparison of counselor styles suggested that a confrontational and directive approach may precipitate more immediate client resistance and, ultimately, poorer outcomes than a client-centered, supportive, and empathic style that uses reflective listening and gentle persuasion (Miller et al., 1993).”

I also read about this Johnston Intervention. It is a scenario in which friends and family rehearse what they are going to say to the client about how the substance abuse is affecting them and then, with some element of surprise all of these people confront the client in the counselor’s presence. Apparently is has been revised into a fairly successful way to get uninterested clients to come around to the idea that they need some help.

Some of the writing was repetitive and like I said, I haven't even read much of this yet, but I am happy to be introduced to this material. Thank you

10/05/09

TIP 35 is about the concept of motivation which is very interesting to me.

The motivation is directed toward the best interest of the client.
The idea that the clients best interest is at heart hopefully with spark motivation in the client who will be compliant with the reccommendations of the treatment plan.
Tip 35 explains how the counselor and staff can have a part of the plan and influence the client to change by building a rapport with the client. This will help the client trust the counselor and let them be a partner in their recovery process.
This TIP also describes different motivational techniques that can be used in all stages of change.

This TIP would be great for motivating involuntary clients who may not want to change and it states that motivation for change is the key to addressing substance abuse.

I believe this is an excellent TIP. The client needs to be "motivated" and want to change thier behavior in order for any treatment to work.

The different views on treatment are great because if something doesnt work, look at it from a different prespective and maybe the new techniques will work.

Counseling is an Art

When I was running a travel business, I hand-collected information about different suppliers and put together notebooks and lists of names and numbers. That material was always within easy reach, so when someone called to book a trip to Alaska, I had all of the information right there. It made my job a whole lot more manageable, made me look like I really knew what I was doing, and saved them time because they didn’t have to make a bunch of different calls looking for the same info. Of course, I had to update my material every year as prices and dates would change, companies would change ownership or go out of business, and new companies would be added. But what I’m getting at is I know how rewarding it can be to have scrapbooked your own collection of specialized information that is highly relevant to your industry. In this class we are getting a start on our Substance Abuse Counselor’s scrapbook of information.

Tonight we went over the six dimensions of assessment again and then we learned about levels of care. I am printing the information now. Encouraging us to collect and save this info, our teacher made the observation that although this is a short class, it is giving us more time to dive in and learn than we would on the job. She also said “counseling is an art” meaning the more we have a chance to use the assessment tools on the job, the easier it will be for us to work with clients and see what needs to be done to best help them.

Our teacher and other classmates have been able to enhance the class material with information gleaned from on-the-job experience. This has been pretty helpful to me, since I am new to this field.

Grist for my mill

As I was listening to the class I realised that the most valuable things in this class were the hands on experience of the professor. These included not only real life stories to paint a picture of where we were going but actual statements with clients as grist for our mill. My next thought was that I only wish that I had kept a separate notebook of these things to review once I moved into that dreamed of job in the field of addiction. Still, on an up note I may create this book while studying for the final.
I know this blog is to share my thoughts and opinions about the class but, as the "script" that is used while counseling is so helpful and vital to building a relationship I am going to just list a few of the jems that were shared tonight along with their importance.
- "In the past how long did you go without using?" (building confidence)
- "Do you feel emotional warmth when you enter your home" (change what you can)
- "It's OK to be here for awhile. We can take all the time you need! Everyone is different" (Stages of change)
- Decompression - When teens come home from treatment and realize that they are no longer in a safe environment. Now they have to deal with real people. So we try to get them in a program that matches as closely as possible their home environment.
- "Let me show you something, to see what you think." (Show them the stages of change and let them see if they can identify their stage)
- Great tip. List the services on the level of care cheat sheet where they fit in.
As always doing this blog is a great review that sets information in my brain. Let's just hope it sticks. I only wish I would have listened to the class with the perspective of documenting tools from a seasoned professional.

Everyday is a new learning experience

Considering myself being relatively new in Substance Abuse field, I do appreciate to learn more. And everyone's experience, including clients' experiences are beneficial to build professional competency level as well as meet a needs of someone who struggle with addictions. Holistically seeing picture, counselor's effort and time investments in client paid off when he or she notices positive changes client is starting to make. I believe that most of the clients are capable to make a difference in their lives. Probably the best satisfaction counselor experiences as a professional when the balance between performance of quality work and personal satisfaction of seeing the positive difference in clients in evidenced.

Levels of care (Cheat Sheet) provides very good explanation and criteria for placement. With interest I learned today, that the Levels of Care can be incorporated with recommended services for different programs. That piece definitely advanced my knowledge. I feel I have more screening tools now and equipped better. Seems to me ASAM-PPC2R , Levels of Care, Levels of Change are our "multiplication table" for Substance Abuse professionals.

I appreciate everyone's time and feedback on my presentation and look forward to hear rest of the class team on Monday.

“Learn from yesterday, live for today, hope for tomorrow. The important thing is not to stop questioning.” Albert Einstein quotes

Dimensions & Treatment

Learning about the six assessment dimensions is a very important tool to use. It will help me a great deal for when I do an actual assessment. Assessments is to offer a recommendation for our clients level of treatment needs. All we have to remember is that when we do assessments, we are painting a picture which is a live document.

Learning about the different treatment programs for our clients and families is also very helpful. There are times when I have to do referrals for clients or families, so knowing that there's different treatment centers available is a must. It would be nice to have a listing of all the treatment centers in Alaska.

Learning from each other in class and from Lara has helped me a great deal and I am so thankful for that. Another great learning experience in class, as usual. Thank you...

9/30/09

Tonight was a great class. I enjoyed listening to the presenter. She did a wonderful job and was very thorough. You can definatley tell that she has done this before.
Reviewing the stages of change was nice. I had read them but listening to everyone else state examples and scenarios puts everything into prespective. This is a great tool that I will keep with me at work.
The levels of care is a very helpfull reference as well. I have often wondered how the levels of care are determined and this handout as well as the discussion helped me to better understand.
The review of the ASAM dimentions was something I really needed. I read through it, but as with the stages of change, it is always better for me to get others feedback and opinions. I feel confident that I will do well on my final with all of the handouts and worksheets provided.

Class Highlight

My highlight in class today was learning about the stages of change: precontemplation, contemplation, preparation, action, maintenance, and relapse. Precontemplation is a stage of denial. Many individuals in this stage are unaware or underaware of their problems. Contemplation is the stage in which people are aware that a problem exists and are seriously thinking about overcoming it but have not yet made a commitment to take action. Preparation is a stage that combines intention and behavioral criteria. Individuals in this stage are intending to take action in the next month and have unsuccessfully taken action in the past year. Action is the stage in which individuals modify their behavior, experiences, or environment in order to overcome their problems. Action involves the most overt behavioral changes and requires considerable commitment of time and energy. Maintenance is the stage in which people work to prevent relapse and consolidate the gains attained during action. For addictive behaviors this stage extends from six months to an indeterminate period past the initial action. Relapse is when people experience a recurrence of symptoms and must now cope with consequences and decide what to do next.

Tonight's Class

Tonight’s class was great. It went by really fast for me and I felt we were getting into some extremely helpful information for substance abuse counselors. The Stages of Change were new to me and I appreciate the handout with motivational ideas for those in each stage of change. Our teacher said that this is her favorite tool; I can see where this one really gets the counselor focused on where the client’s thinking is at this moment. The analogy about jumping up a flight of steps was a useful way to look at it. If you don’t make it, you’ll be worse off at the bottom of all the stairs.

The six ASAM Assessment dimensions are key to understanding a client’s condition and finding the best approach to helping a person with substance abuse issues. We learned that people with substance abuse problems often don’t seek help for other health problems, both emotional and physical. Sometimes they may not even realize they have other health issues. Part of the assessment is to note what other problems the person may have. We are going to treat the whole person.

I love the way our teacher has provided all of this information for us on the “bookshelf” of our virtual classroom. In this short class she has introduced us to some valuable stuff! I hope that we can talk some more about the assessment dimensions and stages of change in the next class.

Dimensions and Changes

Today was very informative structure of the class' study. Stages of Change is a great tool for counselors and clinicians. It includes great motivational strategies. When working on creating client's treatment plan, use of Stages of Change can be very helpful in designing treatment plan, evaluating client's progress and planning outcome. I like to see big picture first and then subdivide to subcategories and work one step at a time. Stages of Change helps to determine client's motivation for change throughout treatment process and helps counselor to make decision about most effective approach to practice.

ASAM dimensions underline comprehensive assesment and treatment plan and promote integration of knowledge about client's perspective.

1. Acute Intoxication and/or Withdrawal Potential
- Past history of serious, life-threatening withdrawal
- Currently having similar withdrawal symptoms

2. Biomedical conditions and complications
- Any current severe health problems

3. Emotional/Behavioral/Cognitive conditions and
complications
- Imminent danger of harm to self/others
- Unable to function

4. Readiness to Change
- Ambivalent or feels treatment unnecessary
- Coerced, mandated, required assessment

5. Relapse/Continued Use/Continued Problem potential
- Currently under the influence
- Continued use/problems imminently dangerous

6. Recovery Environment
- Immediate threats to safety, well-being, sobriety

Supporting questions for each dimension of ASAM help to determine and clarify the placement criteria. I found that dimension questions can be quite practical. It was new material for me.
The American Society of Addiction Medicine's (ASAM) Patient Placement Criteria (ASAM PPC-2R) is guidelines for placement, continued care, recommendations and discharge of patients with alcohol and other drug problems.
Thinking about Substance Abuse professional field, it is life time dimension.


“There is nothing wrong with change, if it is in the right direction” Winston Churchill

Stages of Change and Assessment Dimensions

This class was filled with information that put me if the frame of mind of a person actually working in the field of recovery. As the professor said that the "Stages of Change" hand out might actually be put on your desk while working with a client I felt relief. With a road map like this how much easier it would be to stay with the client and ask the questions that might encourage them to move into the next phase. I especially liked that in the later stages we would enforce that even "relapse should not disrupt the patient-clinician relationship." Again I am thinking, "Oh ya, I am not responsible for their recovery. I am responsible for my part in a relationship based on trust." I think this could be a theses paper for a doctorate. A counselor friend of mine told me that she went to "Not God" 12 step meetings. When they started the group they would say, "My name is, so and so, and I'm not God." She was a counselor that was there for you in every way that she could be, but she definitely did not enable.
Now having said that I want to reinforce how much the information that has been shared in this class has meant to me in terms of having gained some measure of confidence and a direction for more information in all the handouts that were posted. We certainly are not going to go into the workforce empty handed.

3 Movies

The first movie was very informative from a professionals point of view however it did not say much that made me feel like I did not want to try drugs. In other words knowing that glorification of drug in the pop culture or how drugs define membership boundaries without some amunition to deal with those issues only made me feel helpless.

The second movie seemed to be bits of a presentation from a very dynamic woman who not only shared facts that made me not want to use but brought up information that was new to me. I think the most dynamic part was that Marijuana can lead to cardiac arivula and that recepters covering the memory centers are all totally affected by Marijuana. I am so often faced with the "it's just pot" routine and just realized how unarmed I am to address it. She was very factual and short with her answers. They were like a gun going off. The other new piece of information was that the front brain is connected to the emotional brain but not until full maturity. Teens are not even equipted to put the information together with the caring emotional piece of themselves which has validated my gut feeling that I needed to protect my kids from association with drugs any way I can. And that is why they are homeschooling.

The third movie was not new information for me and I was dissapointed that there was not more on the reasons why women get addicted to alcohol easier. It was a movie perhaps more aimed at breaking down the denial of women as they might hear stories that they could relate to. I am not sure that it hit it's mark because I could even hear myself saying, "Oh that's not me", and I have 22 years clean and sober. Still there was one thing that was that women who started drinking younger had a greater chance of becomming addicted later in life. Again grist for our mill to protect our youth.

9/24/09

I was unable to access the internet on Wednsday due to a storm we are having.

The video on the Complexity of Drug Abuse was a good question and answer session. It was stated that Drugs are an everyday occurance and that people are being as responsible as possible, but due to the human behavior substance abuse happens. I strongly belive in these statements. Nobody wants to become an addict, it just happens. Learning the facts about drugs and the skills needed to either overcome or say no from the begining is very important!!
Prevention!!
This brings me to the Teen discussion on drug abuse. I really enjoyed this video. I believe that prevention is the key when it comes to youth. I liked how the kids got involved and asked questions. I wish there was someone to teach prevention when I was in school, or at least give information about what the effects of drugs are, not just say "drugs are bad". I think that drug abuse awareness needs to be incorporated into every high school curriculum.
The women and alcohol video was very emotional. The thing that stood out the most for me was the fact "alcohol kills more teenagers than all other illegal drugs combined" I was shocked by this statistic.
It was nice to see a happy ending and all the women telling how long they have been sober for. This video gives hope for many!

ALCOHOL & ITS EFFECTS

Carl Hart discussed the complexity of drug abuse, such as, cocaine, marijuana, alcohol, and antidepressants. Alcohol is more widely available and antidepressants are not exempt. There is a generational change, with whom find their own way. Glue sniffing prevention articles caused an increase of abusers at a rapid level, because no one new about glue sniffing until it was printed. Stimulants go in cycles: one day it could be cocaine, the next it could be amphetimines.

Dr. Nora Volkow did a teen discussion on drug abuse, and these teens listened because Dr. Volkow was well known. She stated that when you are an adolescent, that is when you learn the most, because of your brain. She talked about internet addiction and cannaboid's, too. The teens gave good feed back on her discussion.

Alcohol, a women's health issue. Was a discussion based on seven women on their road to healing. After all, genetics plays a big role in rist factors. After you get older, you need more alcohol to get the same effect as when you first started. Alcohol abuse has caused them to miss functions, and to have their children taken away. Women feel vulunerable. This causes brain, liver, and heart damage, and also breast cancer. The younger a women drinks, the greater the chance of problems with alcohol later in life.

When a family member becomes addicted to drugs or alcohol, it affects the whole family unit. No one is sure what to do or how to react. This is a often a time to practice tough love. Family members must be firm with the addict in order not to be guilty of becoming enablers for his or her addiction. When the addict reaches rock bottom, he or she may realize that it is his or her responsibility to rebuild his or her life. Now it is up to him or her to claw his of her way out of the hole he or she has dug. His or her friends and family can either help or hinder his or her efforts.

Women and Teens at Risk in Today's Culture

"Alcohol: A Women’s Health Issue" brings up some incredibly frightening scenerios: The woman who said she needed to drink half a glass of hard liquor driving drunk; the girl with anorexia/bulemia drinking herself sick; a woman too drunk to care for her kids; another girl passed out in a field. Sexual assault comes to mind as another likely "side-effect" of out of control drinking. The toll excessive drinking takes on health, families, emotions, and relationships is HUGE. In most places, it is legal and easy to come by. The younger a woman starts using, the more likely she’ll have problems with it in her life.

Alcohol and drug use has become a sort of tradition in American culture. It’s a coming-of-age rite for teenagers and a social bonding ritual for men, women, and adolescents. Environment influences a person’s susceptibility to alcohol use and abuse. If everyone else is doing it, shouldn’t you do it too?

"Why are you drinking?"

Carl Hart in his video presentation addressed very important questions on influential factors of alcohol and drug abuse. He explored how culture can promote different drugs or increase likelihood of particular drug use in certain settings. For instant, drug can play a role to promote group membership. Another factor is availability of particular drug and its connection to become a drug of choice. Crisis times may be correlated to risk factor for people being involved with drugs more than normally. Overprescribing medication is linked to increasing drug abuse. While life brings inevitable changes, so abuse of drugs continues like a fashion go in and out. Parameters such as generational change, people change, styles, popularization of new drug and human nature to make changes are only few pieces of drug abuse complexity.
Nora Volkow in one of the Harlem's High School , NY discussed controversial topic on How Brain, Body and Behavior affected by drug use. Brain continues to be developed till age 25, so when adolescents start using drugs it affect memory, emotional state, abstract thinking, body organs. Most likely teens will exhibit risky behaviors (experimental, compulsive).
Alcohol abuse is a serious woman's health issue. Statistical data showing that 4 million women in United States abusively use alcohol or they are alcoholics. More than a half of population have family member involved in alcohol. Alcohol kills more teenagers than all illegal drugs combined. Alcoholism can happened regardless of age, culture, race, or environment. Genetics play contribution toward being risk factor. Women react to alcohol differently than man. More younger age women involved with alcohol more chance it will be a problem later in her life. Alcohol destroys families, relationship, self-esteem, body organs, taking away lives. Alcohol abuse and gender differences should be taken into account when treatment or prevention needed. Concentration on substance abuse education with prevention programs support are important focus for healthy generations.

The following excerpt is taking from the book Little Prince by A. Saint Exupery

The next planet was inhabited by a tippler.

This was a very short visit, but it plunged the little prince into deep dejection. "What are you doing there?" he said to the tippler, whom he found settled down in silence before a collection of empty bottles and also a collection of full bottles.

"I am drinking," replied the tippler, with a lugubrious air.

"Why are you drinking?" demanded the little prince.

"So that I may forget," replied the tippler. "Forget what?" inquired the little prince, who already was sorry for him.

"Forget that I am ashamed," the tippler confessed, hanging his head.

"Ashamed of what?" insisted the little prince, who wanted to help him.

"Ashamed of drinking!" The tippler brought his speech to an end, and shut himself up in an impregnable silence.

And the little prince went away, puzzled. "The grown-ups are certainly very, very odd," he said to himself, as he continued on his journey.

The Screening and "Assessment Dimensions"

Well I’m surprised to realize we have only two weeks of class and then our presentations and final exam. We are covering some good information; I got a lot out of the class today and the reading. Listening to the role play, which was very good, I had an image in my mind of these two women talking, and I got a good feeling of what it would be like to be in that situation. I wish I heard last week’s class also. I only heard the last scenario. I felt unprepared to try the screening myself, but after the class I went over my notes and chapter 2 in the Clinician’s Desk Reference, and I am ready to try it now.

Explaining a bit about myself and the services I can offer to the client, and finding little ways to complement them, are two things I can do when meeting a client to create a more relaxed atmosphere. “What can I help you with?” sounds like a useful question to ask the client. Also they might be more willing to participate in an assessment honestly if I mention I would like to spend more time listening to them at the next appointment, for the assessment, when I am ready to make that appointment. I liked one student’s comment that she would want to tell this assessor everything – she said it was because of the accent or something, and I don’t have that but anyhow, I would like to have that quality of “I could tell you everything” in my work! The notion that counselors and substance abuse assessors pay attention to their gut feeling about a client is good also, because more often we are going to encounter lying and minimizing the truth.

At the end of the class we learned the “assessment dimensions” which are the main topics covered by all substance abuse assessments. I want to print out the information the instructor said she was putting on blackboard for us. I am thankful to be receiving so much information in this class.

I am slowly beginning to develop an outline for my oral presentation. I was glad to get some clarity on this assignment.

The uniqueness of others

Today practicing counseling and analyzing particular life's situations was very interesting and beneficial. During our class we being able play and replay situations and develop concept on how to screen clients. In real life by the word we say people judging us(no replay). This make us be more responsible and accountable for communications with others.When things not exactly going well, there is a need to acknowledge for improvement. There are two sides of interviewing process in counseling: a counselor's and a client's. Building counselor-client connection require understanding and envision of best intervention approach (sometimes take time). The counseling exercises we practice today show variety of possible dimensions to go, array of questions to ask and outcomes it can lead to. First impression is most strongest and first interview session is most essential for building foundation for collaborative relationship between counselor and client.
Today I have learn something new, that I can relate to my approach. I know I have an accent (sometimes it devalue my confidentiality), but never thought it will be not bad idea to ask my clients, if I have been understood well. So I appreciate for pointing this out. Counselors need to learn as much about themselves as about their clients and need be respectful of client's level of knowledge, experience and competency.

“As we grow as unique persons, we learn to respect the uniqueness of others.” Robert H. Schulle

September 21, 2009
This was a very intense class for me as it covered so many areas from how to relax a client or break down barriers to the six dimensions of an assessment. I am very happy to have the hands on experience as well as being able to listen in to others as they experience doing the screening. I also like that we are going through all the stages that a client may experience which lead up to the assessment. I had no idea that this process was so involved. I remember someone telling me that they had answered the 7 questions and from that knew that they were an alcoholic. Unfortunately there is much more involved and I would like to share some great suggestions that I hope to remember when a real life screening comes my way.
First of all, I liked that some housekeeping was done to relax the client. This may involve going over confidentiality, explaining what a screening is and that their right not to answer would be respected to please feel free to ask me to repeat myself if you do not understand. I also liked that while getting to know the person it is important to find out what the purpose of meeting with them is. When the scenario was presented that a person with 25 years recovery may come in, all the rules seemed to change. Now we have to dig a little deeper to see what their need may be as they already knew recovery. Something else may have been put on their plate that needed addressing which wasn’t there before. Some key words or questions I would like to remember were, “What’s not working this time? Does this person need to go to treatment? Is there anything in their past that may be coming up? Are the relationship issues, depression or dual diagnoses? Having thought through these questions I love that the professor pointed out that our questions lead us to the answer. The above questions signify that an assessment needs to be done and beyond that perhaps referrals for outside help.
Another great tidbit of the evening was what the teacher tells court referred clients. That is, “I want you to know that I’m only going to report your participation because you know I have to. You always have a choice whether to answer or not. Then after a brief on assessments I can see that we will just see the tip of the iceberg on these topics by the end of the class. So I am grateful for all the extra readings that are offered to stretch my knowledge.

Assessments

Today in class a couple of my classmates interviewed our instructor for an assessment. It seems that it is much easier to listen to an actual interview, rather than do it. Why? Because when I did my assessment, my mind just went scrambling, and I got all buggered up. It is much easier to listen & learn from others and take notes for your own benefit. I learned that we all need to state our purpose when a client comes to us (court ordered or not) for help. We need to make them feel as comfortable as possible, let them know that they can call us whenever needed, and invite them back for another visit anytime during work hours.

I will watch the three videos on BLOG and write about it, before Wednesday's class.

I will also start working on my oral presentation. Maybe I will get an article from the newsminer or ADN.

I am finally able to log back into blackboard (thanks to UAF helpline), so now I can have access to everything that will be taught in class.

Today was a good day in class...thanks for reading my blog.

9/21/09

Tonight was a fun class. I was looking forward to doing my screening and felt good about it when it was through.
I felt a bit uncomfortable at first, just because it was something new and I could tell that my client was going to be a difficult one right from the get go.
I enjoyed the feedback from both the instructor and the students.
I tried to stay positive and get as much information as possible from the reluctant client.
I liked the suggestion about mentioning confidentiality in the very begining as an ice breaker. Some people may be reluctant to disclose personal information if they are not told it is confidential.
It is difficult to find things in common while doing the screening over the phone, but I think that after practice and carefull considerations of all the feedback, I may be able to do better next time around.
The second screener did a great job. She has a very soft voice and seems easy to talk to. I would feel comfortable talking with her. I like her comment " I admire your 25 years of sobriety" that is quite the ackomplishment and everyone deserves to be recognized for that.
Overall the class went great and I look forward to final presentations.

Breaking Denial and Being Soft

I doubt that we will meet many people who have not been affected by the disease of alcoholism. So when I hear of people or agencies who are holding out a welcoming hand of help a feeling of deep gratitude goes out to them. Tonight our professor told of an agency who invites every client to take an assessment for alcohol abuse. The most powerful part of addiction is denial and I cannot even imagine a more powerful setting to address it. Doctors have always been respected and listened to. Family and friends of alcoholics have become nags but a professional addressing it would leave an impression. It must have been an incredible person or team who wrote the grants and implemented such an innovative idea. So my heart feels good about that but I am still a bit shaky about the interview.
Having the opportunity to experience doing an assessment that felt so real was awesome. I missed the eye contact and offering of a cup of tea which relaxes me, but was very much reminded of the anger that is holding back the truth with this disease. Even while listening to the other classmate do her skit I knew that the personality portrayed was very real. I think It has prepared me for being ready to, “soften”. That is the word used by the professor which will be waiting in my mind like a mantra. While working with kids who have behavior (anger) issues I find that just waiting (softly) is often what they need and they join the circle on their own. I also like the comment that invited us to let their anger flow through us. That is kind of like being a ninja and using non resistance. Or maybe it is just showing them that we have safe space and they can too. I have my own fears and anger about this disease and without this awareness I may react which would not be helpful. There is a little rambling here but I am learning as I talk and I thank you all for listening.

Seeds of Faith

In counseling in general clients usually bring their problems. To my understanding the main role of counselor is not solving clients problems but help them to find opportunities to build solutions for their problems. Clients are responding by describing a problem, where counselor is gathering information and evaluating what approach will be most appropriate and successful. The foundation of client-counselor relationship should be based on mutual trust and respect, which cannot be gained over one-time session along. Without trust clients will be unlikely to contact for services or follow recommendations. Some clients can be very defensive (court-ordered) and maintain denial of any existing problem in their lives. Each counselor has unique style and skills to work with clients. Even a counselor's gender can can play in affect with approach. Seems to me, ladies-counselors have more tendency to nurturing style comparing with men'. In our family program client has a right to chose another counselor, if he/she believes it will meet better client's needs. Basic interviewing skills such as:
- Active Listening
- Formulating questions (Miracle questions/ Open-Closed questions)
- Getting details
- Echoing client's words
- Non-verbal responses
- Complimenting, etc
- Summarizing
are all can be effectively used during assessment.
The mission of counselors (consultants) is to empower clients with more knowledge and encourage to live life more productively. If counselors only focus on clients problems or disorders, clients may feel that they are victims of dysfunctional life. Helping clients to discover their own potential for recovery, find their own strength, motivating them to manage new life style skills and most important believing in and supporting in their progress will contribute to success of intervention outcome.

“Seeds of faith are always within us; sometimes it takes a crisis to nourish and encourage their growth.”

Susan Taylor

9/16/09

Tonight was a good class. I enjoyed the discussion about physician and prescription medications. The topic has been on my mind for quit some time and it is really great to get others feedback. As you could probably tell it is a very personal issue and I appologize if I offended anyone. I didnt mean to accuse or point fingers, I just wanted to get others point of view.
The example later presented about the patient asking for anti-depressants and the follow up from the physician on researching the patient history was great! I know everyone in the medical field are very busy and want to provide the best care possible for the patients but I would really love to see more traditional, natural healing techniques being used. I understand that South Central has tribal doctors which is something I would like to learn more about.
The substance abuse screening scenarios were fun to listen to. The first one was excellent and really made me feel comfortable listening to it. The tone of both the client and the helpers voices really set the mood.
The second screening was tense and uncomfortable, a perfect example of the diversity you may encounter when working with substance abuse.
The feedback was great and the instructors tips helped. The main idea is to connect with the client and make them feel comfortable disclosing such sensitive information.
I esspessially like the idea of making sure and ask the client if you can see them again. I think this really makes the client feel that you care.

Screening Practice

Today we did a role play on screening a client over the phone. To me, this was very hard to do, because I like to do screenings in person. It makes it so much easier because you can actually see how the client answers your questions. Body language is also a must if you want an accurate or truthful screening.

I was so nervous today in class because I haven't done a screening before. At first, my mind went scrambling for answers, which made me uncomfortable. And, the questions that I asked got my client irritated because my client didn't think she had a problem. And, this is not what I want to do in a real screening. I will continue to practice my techniques with coworkers or family members, to make me feel more comfortable. I will learn to listen more, I will learn to relax and not get so nervous, I will be as sweet as possible, and I will add a little humor to my screenings. I will do what it takes to make my client feel comfortable talking with me, and also to let them know that I'm there if they ever need me at any time.

Today was quite the experience for me, but I'm glad that I am here to help or assist people in need. Thank you for reading my blog.

First Day of Class

My first day of class today was very interesting, considering that I don't have a syllabus or book yet. I'm looking forward to learning about assessments and how to handle difficult situations. This blog is also new to me, so I'm excited to learn about it. I forgot my blackboard info, so I will call to get it fixed tomorrow. Hopefully I will get my computer, so I can keep up in class, as I have a busy class schedule. Thank you for reading my blog.

Tools of the Trade

Tonight I felt a range of emotion from free floating anxiety over the learning curve I struggle with on computers to an excitement in discovering that the class which I thought would be about forms and questions is actually going to fill my carpet bag full of practical tools. I realized that the computer anxiety will pass and the confidence and calm that I will have with tools that are practiced make it all worth it.
One of the Jems of wisdom was, “Be kind to them. They will soften.” I can imagine myself in their shoes with a soft voiced woman like our professor offering me a cup of tea like she was inviting me into her living room. There is nothing better than feeling like someone likes me and would love for me to come back. Better yet if that like could be projected as unconditional acceptance. Now that is a skill that I would like to know more about. In a co-counseling course one of their tenants was that everyone is doing the best they can with what they have. I have processed this many times and find it to be true for me and we are all starting where we are. Another nugget was, “People will reflect back your feelings about them.” Boy isn’t that the truth.
I have three daughters in the hormonal puberty stage and if I am looking at them as cranky snarly teens they give it right back to me. If I am telling them about their strengths and gifts they are just that awesome. Today I made a commitment to do my best to put on my rose colored glasses which only reflect their value. And as I think about them I remembered another one liner that I heard tonight. That is, “Hurt feelings come out in anger”. And when anger is coming at me it probably has very little to do with me. So tomorrow I am going to try on the, “Be kind to them. They will soften.” All day. Thanks for a great class Professor H.

Make the Client Comfortable

Making the client feel comfortable prior to the assessment is really important -- you are not going to get a true assessment without this. Also, first impressions tend to be lasting, so a person’s ongoing treatment will be more effective if you can get started with a good first impression. I was just thinking about how being friendly, understanding, and non-judgmental when the topic of substance use comes up would make discussing problem use so much easier for a client. I think this is why some counselors tell their clients stories about their own drinking or drug use.

Another thing we were starting to talk about was being able to encourage people to change, letting them know you believe in their ability to get better. As helpers, we need to maintain a super positive attitude and be able to find the goodness in all kinds of people and situations.

One more thing to recognize prior to assessment is that bringing up this topic is bound to make people nervous. It may even cause some powerful feelings like anger, guilt, or embarrassment. Some people are going to try to hide their problem or play down how serious a problem is.

9/14/09

Tonight in class we reviewed the syllabus again. I am excited about the oral presentation. I have the perfect case in mind which I have been following in the police blotter and on the AK Courts Website.
I am also interested in the final exam. I have never taken an exam over the phone or on Blackboard so I am looking forward to experiencing that.

Also, tonight in class we began talking about assessments and the "pre-assessment".
In order to get truthfull information which will benefit the assessment and the client in the long run, to individual needs to feel comfortable. This sometimes is not such an easy task.
I know how hard it is to walk through the doors of an agency for a substance abuse assessment, let alone divulge all of your personal information to either a complete stranger or to someone who isnt too fond of you because of the bad choices you have made in the past.
I have used the technique of finding something to comment them on to break the ice, and let them know that you arent here to critisize or judge.
In some cases you must remind the client that what happens inside these walls are completely confidential and you are a professional doing your job to try and assist the individual.
It is sometimes hard to get the respect you need as a professional when the whole town knows your history as well.

Let's cook

Greetings Everyone!

I am excited to be in this class. I was enjoying to read others posted responses. As of today learning I found quite interesting the concept of "cooking" in its implementation to counseling theory. In fact if we all would cook the same meal with the same receipt, still outcome will vary. Our counseling style, our life outlook, our beliefs, moral and values are all play the major contributing factors to what extend we can be supportive to clients. " I cited this from the previous post "People will reflect back your feelings about them" and also would like to add that clients will reflect back our own feelings about ourselves. I believe that it is essential not only see positive sides in client but to maintain professional competency and show own self respect and dignity.

9/9/9

I chose IslandGirl as my screen name because I was born and raised on an Island in Alaska.
I chose to title my blogs with the date of the class I am blogging on. This will help me keep track of each blog.
It is always exciting to start a new class, meet new people and learn the teaching styles of a new instructor.
I am eager to begin learning the ins and outs of substance abuse assessment writing, as well as hearing all of the input from other students. One of the students and I have been in the same class in the past and I enjoy her spiritual take on all aspects of life.

I read the Guide to Substance Abuse Services for Primary Care Clinicians. After doing so, I spoke with my doctor who has been providing medical care for me since i was born. I asked her if she has ever been trained in any sort of substance abuse prevention and what sort of knowledge does she have on the subject.
Apparently, Medical school does not have a curriculum on substance abuse. This worries me...espessially with the Narcotic Abuse Epidemic which is currently underway.

I look forward to discussing this subject in class because it is a huge issue at the agency in which I work as well as my personal life.

I enjoyed the first class and I like the blog idea because I think we will have a much better discussion here than on the Discussion Board for the class. I used the discussion board in a previous class and it just takes forever, and you cannot read everything at once like you can here. Thanks!

I thought her discussion on "the politics of substance abuse counseling" was enlightening, and another thing that stood out for me in the class was when she briefly mentioned working with court appointed clients that don’t really want help. I know we are all going to encounter this type of person. It will be difficult for me to work with a person who can think only of themselves and denies the spiritual values. When a person thinks they are right and everyone else is wrong, they do not seem to be mature enough to achieve the growth required for personal change.

The first thing that comes to mind

The first thing that comes to mind about the class of Sept. 10th is the request that there be a creative component to our writing. This always frees me to speak freely and speaks to me of one who honors my uniqueness and personhood. This of course is what I am in school to learn and my interest has been stirred. In this blog it is my intention to share what jumped out at me rather than an overview of the whole class. The first was an answer to the question, “What is an addiction?” tied into where addiction starts and the sad truth about who gets treatment.
Twice in this class the word spiritual was used. Once when asked what an addiction was, one student answered, “A spiritual disease that someone can’t change”. The next was in a very neat picture of the four areas that addiction affects, one being spiritual and the others physical, emotional and mental. Here the attention was centered on the physical where the medical model suggests that addiction happens in the physical and affects all the others. And the sad part is the place of money in treatment focus and who gets help. Since treatment centers get funded because addiction is viewed as a disease and insurance companies are required to pay them, I suspect that they will be supporting the medical model more than the AA spiritual one. We also heard that acceptance into a treatment center is driven by funding from the government, which requires that over 80% of those entering treatment complete the program. I have been disillusioned but not discouraged. I have no doubt that there is a spiritual power within each of us that vitalizes, heals, and supports growth.
A friend of mine on his 50 plus birthday (he didn’t give up his age) said, “Aging is great. We just keep getting smarter. We can’t help it.” That is the spiritual element spontaneously happening in our lives. Still, as dual diagnosis was mentioned in the class I must say that our medical profession has made recovery possible for those who would not have a chance without a prescription. In the end I felt great relief to hear that our professor believed in a holistic model including, spiritual, mental, physical, and emotional healing. We could argue in which order these come in importance, but I prefer to agree with this holistic approach with the client steering what comes first for them.
-Luvmykidz

HUMS 261

Welcome to Substance Abuse Assessment.

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