Week 12: Pregnancy, LGBT Issues, and Challenging Bias

• Discuss the complexity of working with clients who are also pregnant. How would a pregnancy change your approach to treatment? What issues might come up for you as a counselor? How might you talk about these risks with your client? How would you respond if your client continued to heavily drink or use substances while pregnant?

Working with clients who are addicted to alcohol or drugs and are also pregnant presents many potential issues. It may be beneficial for all clients working through recovery to be treated by a multidisciplinary team. However, I think there is an added importance when the client is pregnant. Pregnant clients need to gain a deep understanding of the repercussions of their actions on their own bodies, as well as their unborn child’s body. As difficult as it is for the average person to recover from addiction, it is all the more important for the pregnant woman to do so. Not only is she putting her child at risk for many health issues, she is potentially putting herself at risk of having that child taken away from her. I would probably not treat a pregnant client without the help of a multidisciplinary team, which may include legal help.

I’d imagine that there might be a few complications in the counseling relationship from the counseling perspective. As we discussed early on in the course, clients experiencing difficulties in recovery who may relapse often have the added pressure of disappointing their counselor. Sometimes, counselors don’t understand why clients relapse, and they become impatient and judgmental. I think it would be very difficult to counsel a pregnant woman through recovery, because of the added health risks and potential legal battles. The challenge would be to continue to check myself, as the counselor, in what I do and say so that the sessions don’t become about me or how I feel.

If my client continued to drink or use substances while pregnant, I would consult the other members of my multidisciplinary team, and possibly seek inpatient help. I don’t know if there are programs out there that are specific to pregnant women, but treating just that population alone seems like a very good idea. Pregnant women could detox and learn about how to care for their bodies, as well as learn about parenting and what their babies need. They could stay until they give birth, maybe even a little while after that, so they could adjust to being a sober parent.

• What does it mean to you to advocate for clients and challenge bias? How do you feel about taking on that role? Is that a role you expected to take on as a counselor? Are there some groups for whom it would be harder or easier for you to advocate for? Does that reflect on your own beliefs and values? How so?

I decided that I wanted to be a counselor in order to be an advocate for clients. In my current work, this means advocating for children and their best interests. To me, challenging bias while advocating for clients means standing up to and challenging the status quo. It means helping others see that they have biases they didn’t think they had. For example, I work in a school where most of the population comes from El Salvador. Most parents don’t speak English, and most teachers don’t speak Spanish. There are many assumptions the staff makes about our parents, one of which is that they want to learn English and don’t want us (the staff) to learn Spanish. During these past couple weeks of the beginning of the new school year, I’ve been speaking in Spanish to parents, and their eyes light up when they are able to converse with me.

There are some challenges that I face as an advocate for minorities, and it’s something I’m constantly cognizant of. I am a white woman. There is one white child in our school of over 1,000 students. I know that there are families who feel I cannot fundamentally understand their situations. I try very hard to be nonjudgmental, non-biased, and understanding. I try to be honest, out loud, that I may have a different life perspective, but that I am open and eager to learn about theirs. But I know that there will be people who never come to see me because they see me as different. The funny thing is, I might be white, but I’m Jewish, too, which makes me a minority (especially in my school!). So I know more than they think I do what it’s like to be a minority.

• Using the Blog References, find and specifically report on at minimum of four websites that you could use for information regarding gender and/or LGBT issues in addictions counseling. Give a minimum of one paragraph of explanation for each site listed.

Association for Lesbian, Gay, Bisexual & Transgender Issues in Counseling: http://www.algbtic.org/

This site is very helpful for counselors working with LGBT people. It is well-organized and includes information on local chapters to join or visit. There are many resources that can help counselors who are already counseling people from the LGBT community, and it is also helpful for LGBT people to find LGBT-friendly counselors in their area. There are other resources that can be helpful for counselors who are unfamiliar with working with LGBT people who may want to familiarize themselves and welcome LGBT clients.

Human Rights Campaign: http://www.hrc.org/

This is a very organized and information-filled site. My husband and I are active members of HRC. This site is a wonderful place to learn about issues in the LGBT community and research historical context issues. For example, right now, there is information on the home page detailing how HRC is involved in the 50th anniversary of the March on Washington. This is a great site for counselors to learn about the LGBT community and what’s going on nationally and locally. There is also a section that may be beneficial to School Counselors on how to make schools safe for LGBT youth and children of LGBT parents. It has information specific to administrators, educators, parents, students and others. If you search “addiction” in the search tab on the HRC site, there are many articles and resources available to counselors, allies and LGBT people.

Community United Against Violence (CUAV): http://www.cuav.org/

This site is very helpful for those working with LGBT in recovery from addictions. As we have learned in this class, many people recovering from addictions are also dealing with abuse from their past or in the present. Whether they are the perpetrators or the victims, they need help dealing with the repercussions. There is advocacy-based peer counseling programs, which have an added benefit in the LGBT community as a place where people can seek out people who share their experience in many different ways. This site can also be a helpful resource to counselors as something they can pass on to clients for more information and support.

 

Pride Institute: http://pride-institute.com/

This site is the most specific of the 4 I’m discussing in this post as to helping LGBT clients recover from drug and alcohol addiction. This organization is specific to the needs of LGBT clients, and the home page even explains the added difficulty of being an LGBT client in recovery, vs. their heterosexual counterparts. On the home page, there is a drop down menu where you can choose a specific addiction to understand how each specific treatment is used in the LGBT client community. There is a general understanding that the prevalence of addiction is much higher in the LGBT community than the general public, and therefore there are added concerns and challenges when working with this community. This is a great resource for clients, as well as counselors who are looking to become more familiar with the specific addiction issues that LGBT clients might face.

Week 11: Childhood Attitudes of Substance Use

• What were your attitudes toward use of substances when you were a child and an adolescent?

I am the eldest of three children. I did everything I was told (…for the most part). I went to a Jewish day school through the 8th grade, and didn’t really have friends who were partying or trying drugs (that I knew of). There was an instance in 8th grade when a girl brought vodka and orange juice into school and got in trouble, but we otherwise stayed pretty young and naive about drugs.

When I got to high school (private Quaker school), I was curious about the parties I was hearing about on Friday nights. I wasn’t allowed out on Fridays, as it was Sabbath and my family celebrated together. I started to resent my parents for it, but alas, I never went to a Friday night high school party. I did have friends who got drunk at parties, but I never heard of anyone doing anything else.

Although I was always curious about drinking, I have always been completely disinterested in trying other drugs. I never even saw marijuana until I was 21 years old, and to this day I’ve never touched it. It doesn’t interest me. I didn’t mind other people doing it, but I had no desire to try it. I just wanted to know what it was like to be drunk…because all the cool kids were doing it.

• What was your personal and peer group experience of substance use? How are your views the same or different now? What might it feel like to work with clients making different choices, or to encourage choices that you did not make?

I didn’t get drunk until I was in college. In high school I surrounded myself with friends who didn’t really want to drink or go to big parties so I didn’t feel left out of a peer group. I think my views aren’t really different, I’ve never been a big drinker and I still have no desire to try drugs. However, I think if I’d been given the chance to go out on Friday nights, I would’ve taken the opportunity to go to parties and sleep at someone else’s house so I could get drunk without my parents finding out. Once I was in college, my younger sister would stay with me sometimes and I’d live vicariously through her!

I think it would be challenging to work with clients who differ from my perspectives on many topics and levels. I think it might be challenging for the clients to come to me for counseling in something I’ve never experienced. We do all have our struggles, but I’ve never struggled with substance use. In fact, it doesn’t interest me very much. I’m at the other end of the spectrum, I guess you could say. I would almost feel like a fraud in trying to encourage clients to abstain from or reduce their substance use. I don’t know how hard that can be. My challenges lie elsewhere, but maybe I can foster those feelings to help my clients be successful in their own challenges and journeys.

• Who advised you about drugs and alcohol, and when? What was your response? What encouraged or discouraged use in the approaches you encountered? What do you hope to emulate or discard from your models?

I remember the week in high school every year when we had drug and alcohol awareness. We would have speakers come in – some who had used drugs and alcohol and hit rock bottom, eventually recovering and being successful, some who had seen addicts (doctors, ER nurses) at their worst. The shock trauma nurse who spoke to our entire school (I think I was in 10th grade) made a big impact on me, and the rest of the student body. We all talk about how we still remember that day. She spoke about getting hit by a drunk driver when she was 17 and being rushed to the hospital. She spoke about some gory scenes she’d seen in the ER from drunk driving and substance abuse. Someone fainted during her lecture! It was graphic and she left out no detail. It scared us a LOT. I can’t say it made people choose to abstain, but it definitely made us all think more about the impact drugs and alcohol can have on our lives and on those affected by our lives.

I think the most important piece from all of my experience that I am going to carry with me is to be patient and understanding – non judgmental – towards my clients. Everyone has a story and everyone has been impacted by different life events. There are reasons why people try that first drug or alcohol of choice, and there are reasons why they continue to use them. We have to fundamentally understand them in order to take all the bias away and treat the raw person that stands before us. It’s a challenge but it’s the only way.

Week 9: Coping Strategies

If you have been under a lot of stress, resulting in overuse of self-control resources, this fatigue may have led to ineffective coping strategies. Has this ever happened to you? What were the circumstances?

I was diagnosed with learning disabilities in middle school. I remember being tested quite frequently, and I was never given an appropriate title to my struggles, but have been explained what they are. If I have a lot of responsibilities with deadlines and I have to be working on them all at once, I have a very difficult time figuring out how to prioritize. I always feel that whether or not I am focusing on something important, I am neglecting other equally important tasks, and I get very frustrated and stressed.

What ends up happening is that I shut down. I freak out. My heart races, I get upset, and I don’t know what to do. At that point, what usually happens nowadays is that I’ll hurriedly tell my husband – I might cry, I might yell, but the gist of my message is, “I don’t know what to do, there’s no way to make this better, and no, you can’t help me!”

I will often leave everything and do something else, like cook, run, do other exercise, and wait to return to my list of responsibilities. I wake up the next morning feeling better about how to prioritize. It seems that I often just need to leave it all alone for a bit and come back to it when I’m not so anxious. I have also found that I do need to let people help me if they can. I am slowly learning that I can’t always do it all, all by myself. And there’s no harm in getting help from others, when I’m always helping them too. I don’t think any of us can go through life without the help of others. But it doesn’t mean that I don’t sometimes have those freakout sessions once in a while!

Week 8: 12-Step Programs

• How does 12-Step facilitation of treatment relate to your personal theory of life? What parts could you integrate if desired?

Until last week, I had never read the 12 steps and 12 traditions of Alcoholics Anonymous (AA). I will use AA as the focus of this post, as I think many people are familiar with the steps and traditions, and many other 12-step groups relate to these. I had very little knowledge of the steps, but I had read a book many years ago about a man who rejected the “higher power” idea embedded in the 12 steps of AA. Upon reading the steps, I did realize how founded in Christianity these steps are. At least, as a practicing Jew, that’s how I felt.

It is difficult for me to identify with some of the 12 steps, because they mention a god-like figure so many times, and I am not sure I believe in god. I’m not sure if I believe there is a higher power governing over all of us that will “restore us to sanity”. I believe that we all have power over our actions, though we can become powerless and need help in regaining that control. It is hard to reconcile the 12 steps with therapies like CBT. If I am powerless and must give in to a god-like figure to “save” me, what’s the point in CBT? It seems that therapy and religion can be dissonant. I know they often work together in harmony, I just can’t really imagine it.

The positives that I see in this program is the fact that there are so many steps and traditions. Clearly, addiction is complex and far from simple. The steps seem to cover many issues of being an individual with an addiction, and it brings people together as a group to help each other with common struggles. The steps also ask the individual to constantly evaluate him or herself – it’s almost demanding that individual, and others within that group, to meet that person where he or she is, and take them for exactly what they are in that moment. Those are the parts that I could see myself integrating. They are universal concepts and they adhere to our counseling philosophies of being mindful and in the moment, and accepting people for who and what they are. 

• How does 12-Step facilitation of treatment relate to your preferred counseling orientation? What parts do you see that you could utilize for treatment?

12-step facilitation of treatment relates to my preferred counseling orientation in many ways. I find myself increasingly interested in and counseling from an Adlerian perspective. Adlerian theory explains life through a social lens. Every problem we have stems from a relationship we are having. In that way, providing a 12-step group counseling experience to my clients works very well. If all the issues we encounter in our lives are in relation to other people, why not deal with those issues in a social setting – in a group – in relation to other people? If we didn’t have relationships, we wouldn’t have problems. But if we didn’t have relationships, there’d be nothing positive in our lives either. We live our lives in relation to others, and in that way, group counseling could be a positive experience for anyone. In terms of addictions, or any other shared issue, it helps group members identify with one another, regardless of diversity. The reason all of these individuals are in one room is because of shared experience, even if they look like they may have nothing in common. 

I think one part that I really like, that I’d think about utilizing, is the role of the sponsor. I’d probably change it to create a system where people seek each other out to be supporters of one another. In the general group setting, everyone supports each other, but I think the added layer of finding someone to meet more frequently with and with whom one identifies would also be helpful. It may not be the same kind of relationship as sponsor-sponsee, but it would help individual group members feel more useful, needed, helpful and helped. It would help group members foster positive relationships with people who share their life struggles. It would empower individuals to utilize the group experience to their fullest potential.

Week 7: Pharmacotherapy for Drug Addictions

English: McDonalds’ sign in Harlem. (Photo credit: Wikipedia)

This week’s post is in response to the question, “Do you support the use of pharmacotherapy in the treatment of addictions? If so why? If not, why not?” . It honestly did not take me very long to think of a response to this question, though I do believe the topic is controversial and will continue to be for quite some time.

 

American society is very blameful. Whatever happens to us, there’s an explanation, outside of our own bodies, outside of our own faults, that allows us to be innocent of the “crime”. For example, there have been court cases in which someone sues McDonald’s for their obesity. That’s just one example, but it goes to show how much we place blame outside of ourselves.

 

I think this is where part of the controversy over pharmacotherapy for drug addiction treatment comes in. We believe that if people REALLY want to change themselves, they can muster up enough willpower and get over their hurdles. Sure, it might be hard, but if you want it, you’ll succeed. We leave no room for error, mistakes, or failure. If you want it, you’ll get it. The American Dream.

 

However, there has been much research and scientific data to prove that there are processes happening in our brains that may control some or much of our behavior, and without the help of talk therapy and pharmacotherapy (a combination of both or one or the other), that is one mighty uphill battle we might be facing. 

 

I believe that there are positives and negatives to using pharmacotherapy. I believe that sometimes it’s right, and sometimes it’s not. I believe there are doctors who over-medicate, and those who don’t use it enough. I believe that our system of providing medication is too much dependent upon drug companies for profit than to provide the right care to our patients and clients. That might be my biggest issue with pharmacotherapy. But I have no issue with it if each client is treated as an individual and their plan of therapy is very specialized to their needs. If a client needs it, why not? If s/he doesn’t, why not? A therapy plan should be so fluid that it can always be altered and developed over time for the changing needs of the client. Nothing should ever be discounted right away, and the client should always be considered a very important part of the treatment team. If counseling goes that way, the client’s needs will always be taken to heart and small margins of error should occur, but nothing major. 

 

As long as the client is the most important part of the treatment, using pharmacotherapy as part of the treatment should be okay. The client should always be monitored, and pharmacotherapy should not be the ONLY treatment – I believe that if you’re on medication to change your brain chemistry, you should also be in talk therapy/counseling. Someone should always be monitoring your intake of medication, especially because there are side effects to take into consideration.

 

We need to change the way our society thinks about medication in general and pharmacotherapy more specifically. We need to be more accepting of our strengths AND our limitations as human beings. We’re not perfect, and as long as we can accept that, we should be able to accept our own paths and our own mistakes, knowing that we may need outside help to improve and change whatever we choose to.

 

Week 6: My Inner Client

I have only been a School Counselor for one year. I find myself in constant reflection on my

The Thinking Man sculpture at Musée Rodin in Paris (Photo credit: Wikipedia)

practice. I am always thinking about how I would feel if I were in any given situation presented to me by a student, parent or teacher. However, I have also been struggling with the fact that I almost feel like a fraud. I haven’t been in therapy since I was a kid, when I was forced into many painful rounds of family therapy, sometimes crying and stomping out of the room. I have this ongoing thought that I cannot continue to practice as a counselor without going to counseling myself.

I don’t think that, at this early point in my career, I have struggled with losing my inner client…yet. However, I do often get wrapped up in thinking about my students and their issues, and I am so exhausted, physically, mentally and emotionally, at the end of the day that I neglect to care for myself in any of those arenas. I think the best way to stay in contact with my inner client is to become a client. I think it’s really, really important for me to have someone I can talk to, just like my students have me, so that I can begin to take care of myself and be there for the long haul for my students. Otherwise, this business is not sustainable.

As for the beliefs I have about myself that will allow me to find commonalities with my clients?

It’s hard to be self-reflectional (is that a word?) without sounding full of myself. But…

I’ve always thought of myself as someone who can be trustworthy, understanding, and above all, a listener to the core. In the past, I’ve made friends out of people who have gravitated toward me because of my ability to really listen and not talk back or give advice. I ask questions along the way, but I’ve watched what advice can do to people (it seems a very selfish act to me sometimes – this person is telling you what to do because that’s what THEY would do, but it may not be best for YOU) and hesitate to give it. I just want to lend an ear when people need it. I still find myself challenging the person, whether it’s a friend or client, but I try very hard to leave the judgment out of things. We all come from very different perspectives, but we all have common experiences and memories that shape us. It’s not hard to step into someone else’s shoes and view life from that perspective, but sometimes it’s hard to remember to do so.

Week 5: Foundational Philosophies of Counseling

As someone who mainly works with kids as a Professional School Counselor, I did not have to give much thought to the question, “Which of the foundational philosophies of counseling are you most comfortable with and why?”. I have always thought of myself as a very accepting person. I was always the friend people turned to just to get stuff off their chests. I always found it hard to give advice, at least unasked. I naturally felt that people seeking advice already had some idea in their mind of what they wanted to do about any given situation, and were really looking for validation for their thoughts or actions more than anything else.

My foundational philosophy of counseling stems from unconditional positive regard. Everyday, I work with students who, for many different reasons, feel neglected at home. Some act out in school because of it, and some don’t. But this idea of accepting someone just as they are, where they are, in that moment – this has really helped me keep an open door and open mind with my students. The only way to begin a successful counseling relationship is to accept someone for what they bring to your office and meet them where they are. The client may have her own expectations of herself and of the counseling endeavor, but as the counselor, I can only expect to be open-minded and helpful.

I don’t think that having unconditional positive regard for clients means always being nice, though I can imagine that people see it that way. I believe it means taking stock of your biases and understanding that clients choose to say what they do in your office because it has impacted their lives in some way. It is not up to the counselor to change the conversation, but it is ok to challenge a client.

For this blog post, I also considered the question, “Do you have a low tolerance for addicted individuals? How would your attitude affect a client in a substance abuse clinical setting?”. I struggle with the answer because I don’t think it’s black-and-white. There is a saying that says, “what you dislike in others is what you dislike in yourself”. It is a statement, I think, on countertransference. The biases you have against others may be a reflection of what you don’t like about yourself. I think we all have vices and weaknesses, and it may be difficult to counsel someone who is struggling the same way or with the same issues as you are. I don’t believe that I have a low tolerance for addicted individuals; however, I have this inclination to think that I would be frustrated with those individuals who continue to relapse. This frustration stems from my own inability to move forward and through certain issues in my own experience. If I decided to work with individuals in a substance abuse clinical setting, I would need to evaluate my own biases constantly. I would need to be in therapy for my own issues and experiences. I would need to immediately seek supervision for certain clients I felt were harder to work with than others (due to my own system of beliefs).

As counselors, we need to be in constant pursuit of professional development, which I consider to be a loose term. This would include assessing our own beliefs, biases and issues. Seeking out our own professional and personal help. Talking freely about our problems and being honest in our own therapy. Making an effort to work on our issues. Putting ourselves in the shoes of our clients. Etc. etc. ETC.!

Week 4: Our Own Addictions

This week, we are turning the camera on ourselves. I have been hesitant to answer the questions to create this week’s blog post, particularly because I know there are many issues I should be dealing with in therapy. For a long time I’ve been considering going to my own counselor, but of course I have the fear of facing my issues/neuroses/imperfections/etc. 

I’ve decided to focus this blog post on my behavior pattern of wanting and trying to please everyone around me. I don’t necessarily have the need to make other people like me, I just want everyone to have what they want. Which is impossible. Anyway…here goes.

How do I consider this behavior pattern a beloved “friend”? Well, when I succeed in making others happy and/or satisfied, it gives me an immeasurable amount of satisfaction and happiness. I don’t know how to be any other way. I partly don’t want to change this or fix this by going to counseling because I like making people happy. I like that they know they can turn to me to achieve that level of satisfaction and happiness. It’s active. It’s something I can do without anyone asking me to. I can actively choose to do something I know will make others happy, and whether they thank me or not, I feel good about doing it (though getting the thanks is always better). This is a friend who can’t really let me down. Sometimes it even saves me from watching others argue or fight. I’ll explain this part later.

How does it appeal to my senses? In the most literal sense, I often bake and cook for my loved ones (and their loved ones…or even people I don’t really know that well, like my husband’s students!). When I cook or bake for others, even though I am giving that food away, it makes my house smell good and feel warm and homey. It creates a cozy environment that feels calming to me. 

How does this behavior pattern provide healing to my emotional wounds? I feel that I often seek out ways to make others happy or satisfied as a way of preventing a negative feeling within myself. For example, my husband and I just spent a week and a half at my parents’ vacation home where they live all summer. My mom is very particular about where to put things away, how to clean up, etc. I would often clean up after my parents – clean their dirty dishes that are in the sink – so they wouldn’t have to argue or fight about it. Naturally, I don’t like to watch my parents fight, but have noticed that in my adult life, they often do (to put it lightly). I try to prevent it by making them happy before anything can happen – I joke around, try to make them laugh, and do things for them that aren’t really for me to do.

What has this behavior pattern cost me? In engaging in these behaviors to perpetuate this behavior pattern, I may be costing myself my own happiness. I don’t deal with the real issues that are hiding behind this need and desire to make others happy. I am happy if I can make others happy. But what if I can’t succeed in making others happy? Am I then unhappy all the time?

As I’ve mentioned above, I think that the only way to face and change this behavior pattern is to talk to someone. I may need to go through some long-term counseling and CBT might be helpful. I may also want to look into group counseling with others who deal with family issues (as I believe this is one big root of the problem) so I can get others’ perspectives and understand my own through their eyes. I also need help finding my voice and being able to talk about the real problems with my loved ones without worrying that it’ll hurt their feelings and make them unhappy.

Week 3: Process Addictions

This week, we are challenged to think about our own biases we find in ourselves about process addictions. I have always found it difficult to identify my biases, especially outside of a context – I’m not sitting across from a client, finding it hard to work with him because I have biases against him. I also consider myself to be open and accepting, though I know that I sometimes have difficulty in my work because of my personal biases.

One of the preoccupations I have (I’m not sure whether or not I’d call it a bias) in terms of addictions is thinking about the society we live in. In American society, it is easy to place blame on others for our predicaments. People have sued McDonald’s for their obesity and health problems. I think living in our society makes it easy to say “oh, I have this or that addiction” and use it as an excuse for behavior. Maybe that is my biggest bias; I am not always convinced of someone’s addiction, and sometimes feel that people use it as a defense mechanism. People think it’s okay to say they struggle with a certain addiction, and that excuse helps protect their ego in that if they don’t succeed in overcoming the addiction, it’s not their fault.

I think I more readily accept some behaviors over others as being problematic or addicting. I think food addiction is becoming a very big problem in our country (and possibly elsewhere around the world). I wonder a lot about what we eat and how it contributes to the problem (for example, there are some studies that show that sugar is as addicting as chemical substances like cocaine, and as we eat more of it, we become more dependent upon it, and we also gain weight). I also think drug addictions are very problematic, particularly because people often voluntarily choose drugs to escape other problems, and the problems just pile on top of one another. I think drug addiction must be one of the harder addictions to overcome because of that. I find it hard to accept the ideas of gambling, sex, and internet addiction. Those fall under the category of “I’m making excuses” in my mind. However, I do see a growing problem in all three of those categories, and they are becoming more well-known and researched. I would think that clients self-identifying with those behaviors or addictions are probably also experiencing problems in other addictive behaviors.

I think my view of these process addictions has been shaped by my experiences. I have never been much of a drinker, and I have never touched drugs (no, not even marijuana, believe it or not!). I have absolutely no desire to even try smoking pot, and have often encountered times when that was challenged by others who were trying to get me to try it. I have never been tempted, but when I think more deeply about it, I wonder if it has to do with my concern that it would lead me to other more dangerous behaviors. I don’t know.

I have been in increasing contact with food addiction. Talking about ancestry, family members and friends, it seems this is a common thread. We all know someone who struggled or currently struggles with food. I think this topic is going to become more accepted in society and it is becoming of more concern in general.

I don’t think that I would be more likely to call something an addiction if I am uncomfortable with the behavior or view it as undesirable or unhealthy. I think it might take some time and a lot of observation to really understand where someone is coming from and how they are dealing with that particular preoccupation. As I mentioned above, I feel that, especially in American society, it is easy to place blame on others for our problems. Getting to know someone and really understand their individual life perspective is the only way to understand if they are truly struggling with an addiction or not.

My belief about blame, as mentioned above, is something I need to watch out for in my work with clients. That is a bias, and it can lead to a harmful relationship if I don’t remember my ability to deliver a client-based, whole-person, unconditional positive regard approach. Whoever walks into my office is seeking help for something, and I do have to accept that and the person as they are. I do have a sense of morality around drugs – I believe that engaging in those behaviors is wrong – but I do understand why people do it, and I would accept anyone who walks in my door, no matter what they are coming with. I can imagine being in a situation where I am working with a client who sees addictive behaviors that I don’t see, which would place us in a difficult position. In that case, I would probably terminate the relationship so that I don’t do more harm to the client.

Week 2: Approaches and Sahira

After I spent some time browsing the Chapter 2 websites, I realized: people with addictions to drugs and/or alcohol have so many resources at their disposal that not only treat the addiction, but other issues that person might be having. For example, there is a resource that explains the connection between drug use and the spread of HIV/AIDS. We have all learned that HIV/AIDS spreads through blood, and clearly if you are using needles as part of your drug habit, you are engaging in a risky behavior that could potentially pass these infections. However, there seems to be another underlying theme: risky behavior. Why would someone engage in risky behavior? There are so many reasons, and I think it varies from person to person.

Seeing all of these different resources made me realize: the best approach to treating someone with a drug addiction – the approach I am most comfortable with – is treating the whole person. This might mean that as the counselor, I am in contact with physicians, nutritionists, and other professionals that can help the client get back on track. It also means treating the underlying issues. Though drug addiction begins with the voluntary use of drugs, most people do not just decide they want to try drugs one day; they usually experience something that pushes them in that direction. I think it is crucial to have this understanding, and it is even more important to let the client open up about those issues or memories when he or she is ready to. The best approach to counseling someone with a drug addiction is to accept them for who they are and to give them the time to open up and heal the wounds they might have been carrying with them for many years.

I think my biggest strength that I would have in assisting someone like Sahira is my nonjudgemental nature. I know that as human beings, we have all been through things that we carry with us. They might be embarrassing or hurtful, but there is a reason we carry them, and they help mold and shape us to be who we are. I know that people are reluctant to change, or to face their demons, and someone with a drug addiction needs someone in their life who is going to accept them for who they are, but challenge them to think about their life through a different lens – challenge them to think about how to change things if they want to change.

I think there are many areas that I feel I would need to work on. I do not have much experience, at all, with people who have addictions to drugs and/or alcohol. In fact, just these last two weeks of class have made me think about a very close friend that I had in college who I suspected to have an addiction to alcohol. We had many mutual friends, only one of whom decided one day that we should go to an Al-Anon meeting or tell our friend we were worried about him. I was in denial myself for so long that he even had a problem. We, to this day, have never told him how worried we have been, and we still believe he has a problem. I need to find my voice in talking to people with addictions so they know that I care but don’t feel that I am judging them. I need to find my courage. I think I also need to learn more about the nature of each drug category, as described in Chapter 2 of our book, so that I can understand the physical and physiological repercussions on the body from taking these drugs over a long period of time. It will be interesting to continue learning this information, but to also try to remember and categorize it, and to always know to treat each person as an individual, no matter what.