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.