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September 2010
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Army Group Counseling

The US Army has recently implemented group counseling to help those related to fallen soldiers move on in the event of a soldier’s death.

This program, known as Survivor Outreach Services, will call army survivors and ask if they wish to join a group of those who also lost relatives in the army.

Like many outreach programs, one call will not convince people to attend group so many calls are are done but in a non-aggressive way.

This program has helped hundreds of survivors make some kind of sense of their loss and move on.

Group counseling can be extremely intense and personal and can help anyone with any kind of problem.  Comfort in a group and acceptance is a powerful therapeutic alliance.

Welcome Back! Thanks for visiting!

Detox without Drugs

There is a growing trend among drug treatment centers to provide initial detoxification without the use of drugs to minimize cravings.

This ‘cold turkey’ approach combined with sauna baths to release toxins from fatty tissues and life skills therapy is proving to be very promising.

The rate of recovery for this new method of detox is cited at a whopping 70% permanent sobriety.  Mostly this treatment has been used with heroin/opiate users but is gaining popularity as a form of treatment for all types of substance abuse.

I’m sure we will here of this approach in the future.

Substance Abuse Statistics

I’m sure everyone has heard this before but….substance abuse in America is increasing at a scary rate.  Did you know that over the last 10 years the number of substance abusers has more than doubled from an estimated 6 million abusers to a current record of 15 million drug abusers.  And most of this increase is due to abuse of prescription drugs.

And even though the number of dug abusers has risen 150% the amount of drug treatment programs has not changed in 10 years.  There is virtually no treatment for a substance abuse problem!

The media used to refer to the rising drug problem as ‘the war on drugs’ which fostered an attitude that drug users do not live next door, so called ‘normal’ people do not have such a problem…  But this view is slowly changing; with the increasing number of professional people being cited as having substance abuse problems, the ‘war on drugs’ is now the ‘war on ourselves’.

More than ever before, people are openly admitting they have a substance abuse problem except there is little to no treatment available!

Successful marketing programs funded by the pharmaceuticals coupled with an increase in the number of wriiten prescriptions has resulted in an out-of-control abuse of legal drugs.  We are conditioned from birth to take a ‘pill’ to ‘make it all better’.  Anxiety is dealt with through benzodiazepines – pop a Xanax and feel better.

‘Mothers little helper’ in the 50s and 60s was nothing more than a pill to supress anger and frustration in other words, a mood stabilizer.  If we have a headache we reach for the aspirin, tylenol or ibuprophine.  There is a pill for every conceivable disease and condition and we all take them…

Do you personally know of anyone who does not take pills for something, whether aspirin or prescription medication?  I don’t.  It’s scary…

Bureaucracy Sucks…

Anyone with a few years in the working world will agree with this…bureaucracy sucks.  ‘Never underestimate the stupidity of people in large groups’.

I have been working for a living for close to 32 years now and I dislike (hate) bureaucracies.  In one way they actually perform a function in that a general and uniform code of behavior and ethics is established but the downfall is the sometimes complete depersonalization of the individual being served.  And in a corporation whose job is to serve those who need help in whatever way…this depersonalization is downright sad.

Case in point:

My job was to model so-called ‘normal’ behavior for an individual recovering from substance abuse who also had a co-occurring mental instability.  To perform my job I went to see this individual, who we will call Tom, every working day to bring him out in society and teach him how to interact in any conceivable situation.

And I started this job right after Tom, who was living in his own apartment, relapsed and threatened physical violence to his case manager which landed him in a ‘lock-down’ ward for the violently behaviorally disturbed.

Yes, I was starting at a disadvantage but I persevered for a year teaching Tom all the ways to survive in the real world.  But I could not overcome his fear of being independent.

Tom learned rather quickly that in a hospital situation such as his the person who ’screams’ the loudest will get the attention…negative attention, maybe, but attention nonetheless.

Tom learned that violent behavior was the way to get everyone at the hospital focused on him, especially the female nurses whose attention he so desperately craved.  Yes, it got him physically restrained but it also got him a woman holding his hand and speaking softly to him for an hour or so to calm him down.

Anyone with a basic concept of behaviorism will see how reinforcing this was…

Tom was now not allowed to own or see any violent or sexually explicit movies but this did not bother him; whenever he was in the mood for such movies he would merely borrow the DVD’s from fellow inmates and watch them.

Tom now listened closely to staff for guidelines as to his behavior.  For instance, if the local doctor said, ‘low fat diet’ then Tom would make it his business to ‘pig out’; in fact he ballooned up to 350 pounds when this happened.

Whatever staff did not want, Tom did…he was manipulating staff and the bureaucracy.  I was relegated to a side attraction, a vehicle for upsetting staff in that I took him into the world for him to perform his mischief but the real ‘golden ring’ was the female nurse attention.

Suffice it to say that Tom’s behavior became worse and worse to the point that he threatened suicide by smashing a CD and threatening to cut his wrists.  It was all a ploy in my mind, because I witnessed this, but the CD proved sharper than Tom realized so he actually did cut his wrists.  I remember the shocked look on his face as the blood gushed from his arm.

Later, my place of employment who really serviced those in a somewhat stable frame of mind, gave up and we dropped him…

All that potential wasted…

And when we dropped him I was not allowed to give him any advance notice of when I was leaving or to even tell him I was leaving for fear that this would cause his violent behavior to escalate.

I remember that last day being with Tom, eating out and planning what to do the next week, all the while unable to say ‘goodbye’ to this person I had grown to care about over the past year.

In this case the bureaucracy did Tom an inservice which I got to witness first hand; instead of helping him in a proactive way we merely reacted to his manipulatory behavior.  The real victim here is Tom….

Addiction Treatment News

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.

Electroshock for Addiction

Electroshock therapy for Internet Addiction….I could not let this one pass.  It seems that China has implemented a rather controversial therapy to induce conformity and cure Internet addiction – electroshock.

China currently has 300 million internet users and that figure is growing (isn’t that almost the population of the USA?).  With so many using the Internet day in and day out there will inevitably be problems and the main recognized problem is IAD or Internet Addiction Disorder.

And how is this being defined?  It’s the pursuit of the Internet instead of working or studying and having adverse reactions if not on the Internet.  And one must be on the Internet for at least 6 hours straight each day to qualify.

And you must be involved in one of these major Internet activities: porn, gambling, social networking, shopping or general surfing.  This seems to cover all Internet usage for anyone, anywhere in my opinion.

It seems that 3000 young people were tricked or coerced into signing up for a 3 month long course designed to cure one of Internet tendencies via electroshock.  The course cost the equivalent of over $800 per month and ended once the patient admitted to their addiction.

Electroshock was delivered for a violation of any of the Institute’s 86 rules among which included eating chocolate, taking pills before a meal or locking the bathroom door.  Patients were forced to talk about nothing but their Internet addiction and forced to kneel before their parents and confess their Internet ‘wrongdoings’.

Details of this ‘treatment’ became public when former patients got online and talked about their experiences.

Do you feel an electroshock coming on?  I certainly do…time to log off.

Group Formation

Group therapy is a powerful tool.  When sitting in a group and listening to others it is almost magic how closely someone’s thoughts and actions are like your own.

After a group has formed, individual change is magnified and almost guaranteed to happen.  But to reach this stage the group must go through its own specific stages of growth, and no matter what the group is about or who is in it the stages of group growth are always the same.

There are 4 basic stages of group growth and everyone seems to have labeled them something different.  The names I give the stages come from my teacher and most likely from some written source.  They are not my names but I like them…

Consider when 15 strangers get together as a group for the first time.  No one knows anyone else and some may be afraid to speak, others may be nervous and possibly over-aggressive or belligerent while others may just sit back and watch.  This is the stage where people test boundaries and form their specific identity in the group.  This first stage can be termed, Forming.

After a few weeks group members will be a little more comfortable with each other and will be vying for position in the group by actively testing boundaries.  The group is actually coalescing into a workable structure.  This stage is called Storming.

Once people have developed a place for themselves in the group and some tenuous bonds of trust have been established, the healing process can begin.  This is the process where group members see more things in common with each other than not and can actively gain insight as to their own behavior from group participation.  This stage is called Norming.

The last stage is called So Longing .  Since most groups are of a fixed duration, the end comes sooner than expected and it can be a sad experience.  There will probably be a sense of loss to deal with so as the group winds down people need to ’say their goodbyes’.

Internship Complete

My internship as a drug and alcohol counselor is complete in a couple days and I’ll have my life back for the first time in 8 months.

Now that I can breathe and look around I find that I am a changed person.  I seem to perceive the world with more compassion and tenderness but I’m also a harder personality.

I’ve made friends and I’ve opened my eyes to the wonders and the horrors of those in recovery.  I’ve watched people strive for that golden ring to just fall short of obtaining it and I’ve watched them slowly learn that the golden ring was in their pocket all along.

I’ve seen the wonder and hope in those that society has deemed worthless enough to ignore and imprison and I’ve finally learned what it is to be human.  I’ve learned to understand myself and my motivations and what I have found is a good thing.

I wish everyone could experience what I have experienced.

Counseling Boundaries

Counseling boundaries are extremely important for a counselor and, for that matter, for the client.

A counseling session brings out deep feelings such as anger, guilt, resentment, satisfaction, happiness and even romantic feelings.  And sometimes via transference these feelings are directed at the counselor.

Besides being private, these feelings are not to be taken personally by the counselor; it is merely part of the theraputic process.  When a client becomes livid with anger and it’s directed at me I do not take it personally because I have established boundaries.no entry,boundaries

Imagine if a counselor did take this anger, for example, personally…

The theraputic process would come to a screeching halt and the counselor would cease being a counselor.  This also ties in with counseling friends…it just cannot be done because boundaries with friends are very different from boundaries with clients.  If your friend directs some strong, negative emotions at you, you will take it personally.

Along with boundaries comes ethics.  Counselors cannot accept gifts or have any kind of personal relationship with the client.  The vulnerability of the client cannot be exploited.

The counselor cannot employ clients for odd jobs as this crosses ethical boundaries.  In fact, in the USA, if a counselor runs into a client out in public the counselor cannot by law acknowledge knowing the client until the client speaks first; yes, sometimes laws carried to the extreme can be somewhat ridiculous but a law is a law…

The point is: to be an effective counselor requires training as well as rules and such rules concern patient privacy, good boundaries and ethical behavior without which there would be no theraputic process.

Isolation

Being group creatures, isolation does not suit us very well.  When we do not have others to share our thoughts and actions with we can become downright strange…being alone

In fact, when a counselor is speaking to a client, seeing just how isolated the person is in their life is an important consideration in therapy.

When we have strong feelings such as anger, for example, being isolated and alone will tend to magnify the anger instead of defusing it.

Here is a case in point:

Being a counseling intern I facilitate groups as well as perform individual counseling.  As I was talking to a client we hit upon some heavy issues which brought out some strong emotions in the client.

When group started, the client opted to go sit alone rather than join the group and I thought “s/he needs to be alone for a while to think…” and I ran off to the group.

Luckily my supervisor stepped in and convinced the client to join the group rather than stay isolated and try to deal with such strong emotions alone.  The rationale was that the group would be invaluable in helping the client through the hard time.  And he was right, of course.

Being the intern I learned a valuable lesson about the possible negative effects of isolation and will not make that mistake again.

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