Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
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From the Big Book – Step 9: “Made direct amends to such people wherever possible, except when to do so would injure them or others.” After facing yourself, your past and the wrongs, identifying what needs to be fixed….then time to fix them, if possible. Unless fixing them would directly injure others further. The ‘Closing the Addiction Treatment Gap’ or CATG, a national program composed of at least 9 separate organizations, was founded to increase awareness of addiction and help provide more resources for addiction treatment. It is estimated that 4 out of 5 Americans requiring addiction treatment do not receive it. The CATG organized and ran valid, well run studies to determine the effectiveness of addiction treatment, especially counseling. They have found that people who receive addiciton treatment will use less health care money for emergency room visits, hospitalizations, etc than those receiving no treatment. Thus addiction treatment can now be viewed as a valid way to help reduce health care expenses. I spent 8 months as a counselor intern in what I’ll call a ‘recovery center’ for lack of a better word. It was a place where people socialize, attend AA meditation meetings and attend groups oriented toward personal growth. This was a time when I practiced group facilitation and individual counseling but mostly it was to learn more about myself to see if I would make a good counselor. And to see if I even wanted to do it. I did enjoy it but it was a tough time: doing an internship in addition to normal work hours is hard enough but one designed to make you face your inner self….? Extremely hard and discouraging at times. Also very rewarding. The internship finished the beginning of May and I was invited back today to see everyone and to attend a special luncheon centered around 3 AA speakers. As usual the group setting, the speakers and the comradeship were inspirational; I realized what I had been missing the last 2 months – security in a group. Some notable thoughts from the meeting (paraphrased): “You’ll never have it all so once you learn to celebrate your life and be thankful for what you do have, you will be happy.” “You do not go through the 12 steps just once, you make them part of your life and use them every day.” “We, alone, are responsible for taking drugs and drinking. No one is forcing us to do it.” “Drinking is done to fill the ‘black hole’. The problem is it’s bottomless.” “Start drinking for self medication and watch everything of value in your life slowly vanish until you have nothing.” ‘Boston Legal’ was a weekly television series in the USA and very popular. After many seasons they stopped making new shows and are now in syndication it seems. It portrayed a law firm in Boston, MA whose lawyers seemed to take on some strange cases and always seemed to get themselves into trouble. The reason I mention this show is because they were on last night and had a show examining counselor ethics and patient privacy. It was very interesting and here it is: A ‘Boston Legal’ lawyer is receiving therapy from a counselor but the counselor is clearly distracted and asks to reschedule. As the lawyer leaves, the counselor asks to speak to the lawyer as a lawyer for some advice and proceeds to tell her about a patient of his who is worrying him. The patient seems to spend his sessions explaining to the counselor how he will kill his ex-wife and in graphic detail. The counselor is at the point where he thinks there may be some substance behind the patient’s ramblings. The counselor believes if he keeps silent and the patient kills his ex-wife the counselor will be at fault. Yet he cannot call the police because he is not ‘reasonably certain’ the patient means what he says. And if he tells the ex-wife he is violating confidentiality and will be liable. In addition the counselor has videotaped one of these sessions and plays the tape for the lawyer. As the lawyer watches the tape she becomes convinced that something must be done and eventually decides to sit in on the patient’s next session posing as a fellow counselor. During this session the counselor asks the patient about his ramblings of killing his ex-wife and the patient denies it all and storms off. The lawyer now decides to go and inform the patient’s ex-wife of the possible danger and shows the ex-wife the tape. She becomes frightened and asks the lawyer to represent her. When the lawyer returns to her office she runs into the patient who has been sufficiently rattled to seek legal counsel of his own and happened to come to this same law firm. As he sees the lawyer who posed as a doctor and learns why she did this he explains with tight control that explaining how he will kill the victim to his therapist is a way he vents his anger and has been doing so to therapists since he was a teenager. He explains that he has no intention of killing his ex-wife. After he leaves, the lawyer decides to visit the ex-wife to explain and apologize but as she approaches the building she finds it is surrounded by police and ambulance. When she arrives at the apartment of the ex-wife she learns that the ex-wife shot and killed the patient when he arrived asking to speak with her… Talk about a legal quandary… both the lawyer and counselor acted as if they were never trained to perform in their respective roles. Not only was the law broken by both, but several ethical boundaries were violated. In my opinion both counselor and lawyer should lose their respective licenses and face criminal charges… I found it interesting. What would we do without a good rationalization to protect us from the truth. I know I cannot get through the day without a rationalization. So what am I talking about? A rationalization is a Freudian defense mechanism and it merely means finding a positive reason for something we did wrong in an attempt to minimize how wrong that action was. For example: you have been drinking and as you walk down some steps you trip. When you get up you say ’someone should fix those steps’. Or you cheat on your taxes and justify it by the fact that the government wastes money anyway so why should I give them all of my money? As a drug and alcohol counselor you can hear some rather interesting rationalizations for relapse and continued drug use. Such rationalizations include: ‘Everyone said I wouldn’t last so went and I took the drug’ or ‘I relapsed because I got mad at my parents. That’s what made me do it’. Another: ‘So I got drunk and got arrested…it’s not like I shot someone…’. And my all time favorite is ‘I’m just seeing if I can resist temptation’. All these rationalizations have one thing in common; they all avoid reality by making excuses. And that is what continued, compulsive drug seeking behavior does, it forces us to make excuses to help justify the compulsion. One of the goals of counseling, both individual and group, is to help the patient take responsibility for their behavior. Coming to terms with addiction by making it personal is a good step in overcoming it. Consider the following 3 scenarios and tell me which one not only violates ethical boundaries but is against the law:
Actually #1 and #2 definitely violate ethical boundaries and are illegal. #3 is conditional upon whether a previous ‘release of information’ to the patient’s wife was specifically signed by the patient. In a helping profession such as counseling there are strict legal and ethical boundaries to adhere to in order to remain certified as a counselor. These legal and ethical boundaries protect the patient’s privacy and protect from exploitation. And if you do not adhere to these standards your certification will be yanked away and you will not be able to practice counseling. The process of becoming a drug and alcohol counselor is tough, at least in Connecticut. Requirements include passing approved classes and completing an on-site internship experience in an actual counseling setting that touches upon each of the 12 core functions of the drug and alcohol counselor. In addition you need recommendations, a completed case study on an individual in your internship and you need to pass the Connecticut Certification Board’s Drug and Alcohol Counselor Test which, apparently, many people have taken several times but failed. You also need 6000 hours of training signed off by an LADC (Licensed Alcohol and Drug Counselor). The LADC is distinguished from the CADC (Certified Alcohol and Drug Counselor) by virtue of having a master’s degree. And once you become certified you pretty much need a master’s degree to find a job… Well I don’t have a master’s degree but I’m still plugging along. What it comes down to is that to want to be a drug and alcohol counselor you need to really, really want to do it. I was a former computer programmer consultant working in state agencies and different insurance companies and pretty much spoiled by my salary. These days my salary is 33% of what it used to be and I’m broke but I finally have a satisfaction and contentment with what I do. I could go back to it but I never will – working in an insurance company is a pretty useless job; you do absolutely nothing for others besides maintaining the company profit. And I’ll apologize in advance for those who are now working in an insurance company that I have offended. In another year I will probably have 4000 experience hours under my belt. Since I’ve already completed the required classes, done the internship, gotten my recommendations and taken and passed the dreaded certification test I will apply for provisional certification. And in another year after that I’ll have a full 6000 hours of experience and I’ll finally become fully certified; recognized by several states in the USA as well as internationally. Wish me luck… Too often in the treatment of addiction the role of the family is never examined. Instead, addiction is seen as an individual problem. And when I speak of ‘family’ I refer to friends, the neighborhood and peer group friends as well as family members. It is estimated that 1/4 of the entire population of America is part of a family affected by addiction and that the overwhelming majority of addicts either live with a family or partner. The role of the family in helping to maintain an addictive lifestyle is very important so therapy of any kind for addiction should include family members at some point. What are the major parts or goals of family therapy for addiction? First, find a way to live without drugs and maintain that lifestyle. Treatment for the addict is important and so is treatment of all family members involved for past and present mental problems. Second, in maintaining a drug free lifestyle communication among family members is vital. Lines of communication should be explored in therapy and opened up. Next, and most important, is the acceptance by the addict as well as all family members that drug abuse and addiction is not a weakness and stopping it is not a moral choice; it is a disease and, as such, can be treated. Finally once a drug free lifestyle is explored and adopted, communication within the family is open then what now? Addiction and its surrounding behavior took up a lot of time in the family so adjustment is necessary. Mutually pleasing activities must be found so the family actively participates in life. “Made a searching and fearless moral inventory of ourselves.” This might look like a simple task but it is not… It is extremely difficult to come to terms with what you have done in the past which leads to what kind of person you actually are. And most importantly it is a life transition where you forgive yourself and start on the road to true recovery feeling better about yourself than you ever have before. |
 
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