Pregnancy/Advocacy/Resources

Discuss the complexity of working with clients who are also pregnant. As was discussed in this week’s main post, Sandra’s case study presented some the challenges that women in particular face with respect to receiving treatment for addictions. Which include: societal expectation of women & addictions, shame/guilt, lack of support groups, etc. Include pregnancy on top of these challenges just make everything all the more complex and difficult. How would a pregnancy change your approach to treatment? Well, the biggest concern is the health and well being of not only the individual, but also the child in the mother’s womb. What issues might come up for you as a counselor? I read the story of Lyal in this week’s reading, a child with fetal alcohol syndrome (FAS), with this disorder come the possibility of other comorbid conditions, such as: OCD, ODD, ADHD, & others. Meaning the client addiction whether that is alcohol or drugs can cause significant harm to the child. The textbook makes mention that, “pregnant women who abuse alcohol put their babies at risk of developing FAS, the most preventable form of mental retardation… Children born with this syndrome suffer developmental delays, behavioral problems, and facial and neurological abnormalities” (Capuzzi & Stauffer, 2012). How might you talk about these risks with your client? I would make it abundantly clear to my client the risk they are taking by continuing to consume alcohol or use various substances. I would also provide brochures, books, and videos even about some of the complications associated with FAS their child would experience if they continue to drink/use alcohol or drugs. How would you respond if your client continued to heavily drink or use substances while pregnant? If my client continues to drink heavily or use substances while pregnant, which is indicating to me they’re fully aware of the risks and are choosing not to do anything about it, which is just plain ignorance, I would look into taking legal ramifications. I’m not aware of what power I have to inform, but I would look into what option are before me to ensure this child has a good chance of being born without these complications.
 

What does it mean to you to advocate for clients and challenge bias? It means that to speak up and raise awareness of general public regarding some of specific challenges that my client may be facing that the average person may not be aware of. And perhaps present in such a way that the average person can understand. Raising awareness can often lead to change, whether in policy or other forms of change that can take place as a result of advocacy work. How do you feel about taking on that role? I feel strongly that as counselor, we must speak up and advocate for the marginalized and the outcast. I feel comfortable doing that, as it is a important aspect of our work as counselors not only to help those who are experiencing difficulties and are hurting, but also to make sure that we represent and advocate for those who cannot often speak for themselves. Is that a role you expected to take on as a counselor? Yes, I think as I gain experience as a counselor, I will look for opportunities to partner with other group to advocate regarding particular issues that are near and dear to me or just things that I have been made aware of during the course of my counseling career. 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? Certainly, this goes back to my worldview or anyone’s for that matter. For every individual, there are particular areas where we are more passionate than others. My theology guides my life and there are certain issues that I’m very passionate about and other ones that I’m not so passionate about. I believe if we’re going to advocate on a particular issue, we must believe in the change we’re advocating for, otherwise it will not be genuine, and people will see right through that.

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.

 

Women for Sobriety

Link: http://womenforsobriety.org/beta2/

Women for sobriety (WFS) is an organization that assist all women in their recovery. This is done through: discovery of self, shared experiences, and hope/encouragement with other women in similar circumstances. WSF is an abstinence based self-help program for women struggling with alcohol or substance use addiction. WSF as the website indicates is an organization of women for women, and this is no different when it comes to their treatment approach, which is very different to that of men, by offering a variety of recovery tools to help with coping skills that focus on emotional growth, spiritual growth, self-esteem, & healthy lifestyle.

 

March of Dimes

Link: http://www.marchofdimes.com/

March of Dimes (MD) is an organization that seeks to help mothers have full-term pregnancies, and researches issues that threaten the health of babies. However, MD also helps mothers once their baby is born by helping to issue national guidelines for screening among all states in order that all babies are screened for life-threatening identifiable, but treatable disorders. This would be a great resource for women who are pregnant and have recently given birth to their baby.

 

Association for Lesbian, Gay, Bisexual & Transgender Issues in Counseling

Link: http://www.algbtic.org/

The ALGBTIC helps to promote LGBT issues among counseling and helping professions. This is done by improving standards and delivery of counseling services being provided to LGBT individuals. Identify possible barriers for development of LGBT individuals and communities by using counseling skills, programs, and efforts to protect LGBT development. And to secure equal treatment, advancement, qualifications and status of LGBT members of counseling/helping professions. This is a good resource for counselors specializing in serving the LGBT community. This is a valuable resource for any counselors toolkit.

 

Religious Tolerance

http://www.religioustolerance.org/

I found this website very intriguing, and it’s main purpose is to provide an explanation of various            belief systems from atheist to theist. I do believe that although religion can be a source of division if handled poorly. However, understanding can often bring people with very opposing beliefs together. I believe this is the attempt of this website. Is to bridge a gap between faiths or non-faiths by allowing for understanding of other worldviews to take place. This too can be a valuable resource irrespective of gender, sexual orientation, or anything else for that matter.

 

References:
Capuzzi, D., & Stauffer, M. D. (2012). Foundations of addictions counseling (2 ed.). Boston: Pearson Education, Inc.

Don’t Do Drugs!

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

 

My father was an alcoholic, chain cigarette smoker, and smoke opium as well. I was aware of what my father was doing, and I even tried smoking cigarettes when I was about 6 or 7 years old. My father has modeled it, and so I wanted to give it a try, I took my first puff and started to cough uncontrollably. Ever since then, I didn’t want to smoke anything. The older I got, I understood some of the health implication for taking various drugs. And because I’m a very health conscious person, that was enough for me to say no to them.

 

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 never really felt pressured to use various substances. All around, my peers were predominately smoking marijuana and drinking heavily but I had not desire to use any of these substances. In addition my faith played a huge role, God created me and I wouldn’t want to do anything to harm my body in any way shape or form.

I certainly understand people who have very differing opinions on this topic, which is totally okay. I have learned to be understanding of every individual, knowing that they don’t have the same upbringing and worldview that I do. And I don’t expect anyone to think the same way as I regarding any issue, but I will do my best to understand their story and what has cause them to make these decision during the course of their life.

 

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?

 

My mother advised me, she never really went in-depth regarding drugs an alcohol. But what she said was sufficient for me. She just mentioned that smoking, drinking, etc. were not good for me mentally and physically and that was enough, I didn’t need to be sold on the idea because I had seen what drugs had done to my father. My mother encouraged me, because what she had told me was the truth, and that’s what she communicated to me, the truth. I will try to emulate my mother by communicating the truth, I’m not going to sugarcoat anything, but tell people about the facts of how drugs can impact a person both mentally and physically.

 

-Cyrus

My Summer = VERY BUSY

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?
 

Yes, most definitely, as a matter of fact, it’s happening to me right now as I typing up this reflection blog post. I think a little context might help:

 

1) Work: I work full time as a administrative assistant for the NIMH. Our specific office is making lots of big changes that are being added on to everyone’s workload including mines. It seems that when I check of 1 or 2 items off my to-do’s checklist, another 5 or 10 get added. It certainly is a busy time in our office, and I don’t imagine this is going to change anytime soon.

 

2) Family life: My wife and I have been married a little over a year 🙂 However, because of the many things I’m involved with, I don’t have as much time to spend with her as I would like. This has taken a toll on Esther (my wife), and it is evident to me as well. She has been a trooper though, very understanding of my situation. In addition, my father came here over a month ago to visit us from Iran. He’s currently staying at our home. This has proven to be challenging because he wants us to spend most of our free time with him, which is very hard, since we have so many different things going on right now. As a result, we have gotten into many arguments and our relationship that wasn’t all that great to begin with is now even worse.

 

3) Church life: Esther and I are very involved at our church. We’ve been very busy this summer organizing an all-day basketball tournament (which took place 2 days ago); there was so much coordination and organization that needed to be done (this was a 14-team, all day basketball tournament, where different churches from the DMV came together for fellowship and basketball). In addition, Esther and I are going to be going a mission trip to Jamaica (leaving this Saturday); this has taken a great deal of our time as well. The biggest challenge was fund raising, which we have now collected, this was a great blessing and we were encouraged by it 🙂

 

4) School life: I’m only taking this one course during the Summer sessions, but as many of you may know, online courses can be very challenging in their own way. I have always felt that as a student I do twice the work for an online course than an in-person course. Which probably makes sense, since there is no face-to-face interaction and there must be a way for the professor to assess how much we understand or are taking away from the course. Although, online courses are convenient, they are VERY challenging and time consuming.

 

5) Free-time life: if I manage to have any free time at all, I try to exercise (I love playing basketball). I had planned to get into a very serious training regiment, however, couldn’t do so due to lack of time. I have spent a great deal of money of training equipment but have not been able to put them to good use 😛 I hope to do so in the Fall semester as I will be taking one 3-credit (in-person) course and one 1-credit (two-day) course. That is what I’m hoping anyway…

 

As you can see, I have a lot going on, and much that I want to accomplish. But I feel that currently there is a lot of stuff that I’m dealing with which is making it very difficult for me to do any of the above things well. I’m probably mediocre at all of the above things, instead of being good or excellent at one or two of them. In terms of coping strategies, my faith has been a integral part of my life and has sustained me in the midst of probably the busiest season in my life. Another strategy I can start to utilize is saying “No” to different opportunities that are presented to me. This is one of the biggest problems, is that I like to help or even please when possible, but I think there is a time and place for it. I’ve gone to the extreme end by trying to say “yes” to everyone, which has only led to me being burnt out. Saying “no” is challenging for me, but it will allow me to have more free time.

 

-Cyrus

12-Step Facilitation of Treatment

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

The most common denominator of the 12-step treatment method and how I operate my life is the notion or belief in a higher power or God. I am a Christian, and firmly believe in the triune God. One of the major ideas of the 12-step treatment is the individual admitting they are powerless over alcohol (or other substance) and that it the belief in God that can restore than back to the ideal or normalcy. In terms of integration in my own life, I have integrated many of these steps knowing that God is in control of my life, so in the good and bad times, I still cling on to God for guidance and direction. In addition, I ask God to remove various problems in my life or things that are no benefit to me and in the same way I communicate to other close friends about these same problems (in the hopes that they can help to keep me accountable so that I may not continue to suffer from the same problem, but experience some level of success over the problem). And lastly, my prayer life with God is something that is very important, and I make it a point to talk to God in prayer, even if it to simply give thanks for his provision in my life.

 

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

My preferred counseling orientation is cognitive behavioral therapy (CBT), which indicates that changing maladaptive thinking leads to change in affect and behavior. Through CBT and individual can recognize faulty thinking that they’re implementing that is causing harm to themselves or other on many different levels whether that is physical, psychological, emotional, etc. In the same way, through the 12-step treatment, one comes and admits that they are powerless over their situation and are in need of the help of a higher being in order to experience victory over their addiction. However, it is important to note, that pointing out a higher being or mentioning “God” may make some clients uncomfortable and even offend them. It is important to know one’s clients well before being so outright about the possibility of a higher being or God.

 

-Cyrus

Pharmacotherapy… Yes or No?

Do you support the use of pharmacotherapy in the treatment of addictions? If so why? If not, why not?

Yes, as long as it can help my client to deal better with their addiction. Personally, I have never been a big proponent of treating a drug addiction with another drug. But through this course and other testimonies, I have realized that for some individuals, pharmacotherapy is a viable option to experience success in counseling. However, before I go ahead and refer my client to a psychiatrist or physician who will prescribe medication, I will have to do my homework and make a determination of whether my client will not be at their best through psychotherapy alone. But rather psychotherapy + pharmacotherapy will get my client to the place they need to be. I think the testimony of Sahira from session 2 really opened up my eyes to this idea. She explained that taking suboxone while trying to go through the detox was critical as it allowed her to feel “normal” and able to “function.” It was the suboxone that allowed her to get through the period of detox and with the remaining of her treatment.

However, I do want to mention that this is certainly not the case for everyone, and that not every client that walks to my office will need to be prescribed medication to aid them in their recovery. Before trying the medication route, I would attempt to exhaust all other therapy alternatives before moving on to medication. Although there are cases where medication can help a client, there are also cases where medication has done significant level of harm to the client. In the end  for me, pharmacotherapy will be implemented on a case-by-case basis and will be something I cautiously pursue in counseling.

-Cyrus

The Inner Client

A quote from your text states: “… we get so involved in the role of counselor that we sometimes forget the client inside us. It can become habit to separate ourselves from our clients with a sense of self-righteousness that we do not have the problems they do.” Do you see this tendency in yourself? How do you stay in contact with your inner client? What does that mean for you? What beliefs about yourself do you have that will allow you to find commonalities with your clients so that you do not see it as “us” versus “them”?

I believe this is an issue that ALL counselors can fall into. When I think about it, I have had extended academic training regarding how one provides counseling to an individual. It is easy to think that since these people are coming to me to find some solution to their problem, and that I have all the answers. That somehow or another I’m better than them because I don’t have “those kind of problems.” My problems are much smaller and I cannot be compared to them. And to answer the question, yes, I can see myself falling into this tendency or dare I say “trap.” It can be easy to think that I’m an expert, knowledgeable, experienced, etc. and that my clients are ridiculous, idiotic, crazy, etc. It can be quite easy to have a puffed up attitude about myself because I’m a counselor (or will be anyway).

I think I need to remember that a problem is a problem, and not to dismiss my problem because mine are not as bad, and not to blow up their problems and make it seem like their problems are so much worse than mine. I think having a humble attitude can be very helpful. In that, these problems that my clients may be experiencing can very easily happen to me if I’m not careful.

Also, I think if I were to work with a specific population of people. I need to get inside their world and truly understand what they’re going through and sympathize and empathize with their problem. If it’s working with addictions clients, then I need to search within myself to see if there are any addictions that I’m having difficulties with and it may be something that I need to look into. Perhaps attend meeting, seek counseling, etc. to get an insider’s perspective of what they daily issues that these individuals are facing. This can help me not to look down on them but see that what they’re experiencing is very challenging (both their current experience and desire to stop the addiction).

 

-Cyrus

Hope

Which of the foundational philosophies of counseling are you most comfortable with and why?

There are many foundational philosophies that I find intriguing, but the one that appeals to me the most is hope. As the text describes, “Effective counselors encourage a sense of hope in clients, because hope is seen as a condition of successful psychotherapy.” One of the main reasons I’m studying and training to become a mental health counselor is because I believe I can in some way, shape, or form, help my future clients with their presenting problem. I would not be a very good nor effective counselor if I felt that my client has no chance in changing their circumstances. I believe that under the right circumstances and a gentle nudge, every individual can change and be in a better position as when they first walked in to my office. Getting back to hope though, this is what will keep me going in the helping profession, in that I want to encourage myself in the message of hope and what it can do for people (and myself). In addition, I believe I generally have a hopeful disposition, and I believe that our clients can see that (how we speak, listen, respond to them, etc.), and this in itself will allow them to feel hopeful about their situation, knowing that they have a hopeful person who believes in them, in what they can become, and will cheer them on to where they need to go. I like how the text put it, “With some clients, especially those with a treatment refractory condition, i.e., ‘non-responders’ we may have little hope for change or even maintenance of current status. Yet, an effective counselor must believe and cultivate what is possible.” It is my hope that I may remain optimistic and hopeful about my clients as I am right now, when speaking about this very thing.

Are you a hopeful person? Are you motivating and encouraging? Do you have a judgmental attitude?

I believe that generally speaking I am a hopeful person, I enjoy looking at the positives more so than the negative. My philosophy is that people generally respond better to words of encouragement than words of criticism. Having said that there are a few individuals that respond well to words of criticism (the picture of San Antonio Spurs coach Popovich comes to mind as he is getting on his players about a mistake they made on the court). However, criticism often does not work well, and can further discourage an individual or make them want to quit. Instead I much rather try to come along some an individual and attempt to understand where they are coming from and in a positive/encouraging manner, take them to where they desire to go.

-Cyrus

My Struggle

This week’s blog question has proven to be very challenging, I’ve been doing some self-reflecting about possible behavior patterns or substances that have cost me relationships and that are problematic. When I reflect on how I operate and what makes me tick, I had to ask the question, what part of who I am as a person am I uncomfortable with? What part of me is there that makes me go: “I don’t like that about me, I hate that about me, I despise that about me.” There is one thing that comes to mind (one that I have overcome, I think, and one that I’m presently struggling with).

I probably first encountered porn late in my middle school years, and I have recently been clean from it (as of 4 years ago). In middle school it was something that was joked about, stories of which of websites one visited and masturbating (or as I like to say, self-gratify) to a particular picture, video, etc. It became more of a secret as I began to get older. And later it became extremely shameful to bring up or share in front of others. I wanted to stop watching porn so badly, and would have weeks even months but I couldn’t stop. I had some level of success when I shared this struggle with a group of trusted friends, and I found out that they too were struggling with the same issue. There was a time that we kept each other accountable, and that seemed to help for a time, but I would later go back and watch porn again and self-gratify. I think the only thing that seed to help was dating my now wife, Esther. Especially when I began to date her, my thinking was, I cannot do this anymore, and to me it was like cheating on her if I ever were to watch porn (while we were dating). Esther and I just celebrated our one-year anniversary wedding anniversary, and I have remained clean ever since we started dating. However, this is an area that I always have to be careful about. In the words of Craig Ferguson, I have to live a life of vigilance with respect to the porn and self-gratification.

How do I consider this substance/behavior pattern a beloved “friend”? This pattern of behavior was a “friend” because it started as a source of pleasure. And when I was feeling upset, anxious, annoyed, stressed, anxious, etc. this is what I came back to, as a safe place to release tension. In a lot of ways, it was always there for me. For me, it was a guaranteed source of pleasure, it was readily available, didn’t cost me anything (monetarily), and made me feel good.

How is it sensual (appeals to my senses)? I don’t think it will take much to know that porn obviously appealed to me senses. Among other things, it mostly appealed to my sense of sight and sound. And with self-gratification there was something that was physically released that also made me feel good. I’m sure endorphins were released which me feel happy.

How does this substance/behavior pattern provide “healing” or is a “balm” to my emotional wounds? The basic concept of porn is two individuals are making love, and maybe on an unconscious level, I wanted to experience that on a deeper level than I ever had. I cannot say though, that there was an emotional wound behind this, at least I can’t think of any. It did provide some level of healing; it provided momentary pleasure from the pain that I was presently experiencing.

How my addictive substance/behavior pattern is hated – what has it “cost” me? The greatest thing that it cost me was that I would get very upset, even angry after the fact, after I had completed the act of self-gratifying. The feeling that would run through my mind was that of: shame, guilt, weak, fear, and many more. I felt unworthy; I asked myself the question, if people truly knew that this is what I did in the dark, what would they think of me? I now have the courage to share this with others, but that is because I’m experiencing an extended time of victory over this struggle. In my heart of hearts, I know I wouldn’t be able to share this if I was presently struggling with porn/self-gratification.

What might be a good resource or treatment method for a behavior change? With any change, one needs to come the knowledge that what they’re doing is wrong and detrimental. Some people may read this and say, and may not necessarily see anything wrong with watching porn and masturbating? I recognized based on my theology, values, up-bringing that it was something about myself that I desired to stop doing. Secondly, I firmly believe in sharing one’s secret with a community of people who are experiencing the same issues (whether it some kinf of organized group or trusted friends). Thirdly, not just sharing with individuals, but having a trusted friend or two who can keep you accountable and help and guide you to where you need to go. And lastly, if the problem is severe enough and occurring at an alarming rate, seeing a counselor to receive professional help for the issue at hand. There are many more, but those are just a few that might be helpful to consider.

-Cyrus  

Process Addictions (Biases, Beliefs, & Morality)

What biases do you find in yourself about process addictions?

Before I can fully answer this question, I need to first try to commit to a definition of what process addiction is. The introduction section of chapter 3 in “FOUNDATIONS of Addictions Counseling” points out the difficulty in coming up with an operational definition that is accepted across the helping professions with respect to process addictions. Despite this, the text does mention that, “an addiction, when one accepts the inherent nature of this disorder, results in marked impairment or functioning accompanied by a continuance of the behavior despite serious adverse consequences, thereby eliminating it from being merely a social habit or taboo.” With this as my definition for process addiction, I can see that certainly there are activities or volunteer opportunities that I’m involved with that some might say (and have said) is excessive. However, I don’t think these things have lead to marked impairment.

 

Are there some behaviors your more readily accept or reject as being problematic or addicting?

Looking over the course of my life, there are certain things that I’ve been involved with that are addicting, yes, but problematic, no. For example, my top two hobbies are serving at my church and basketball. I spend a great deal of time in both. The volunteering at my church allows me to serve others and do something that is outside of myself to benefit others. At the same time I’m able to align the truth of what I know and the reality of how I’m living. Also, there is basketball, which I spend about anywhere from 3-10 hours a week playing. I love playing the game, and it gives me a sense of satisfaction (some days are better than others :P), but generally the game has been good to me. However, it is important to note that I continue to play basketball despite suffering two right knee ACL tears. I have had two ACL reconstruction surgeries as a result; I still continue to play despite this. I have changed my style of play as a result of the injury just because I can’t do some of the things that I used to do.

 

What shapes your views of these processes?

 An operational definition would shape my view. The one I quoted above is a good one and can be applied to all addictions whether process, chemical, or otherwise. Whatever the addiction in question is, I would attempt to see through the lens of that definition and see if it is an addiction.

 

Are you more likely to call something an addiction if you are uncomfortable with the behavior or view it as undesirable or unhealthy? How might your own beliefs, morality, or spiritual beliefs shape your views of your client’s problems?

 I chose to group the last two questions together as I saw many similarities between the two. The first part of the questions is challenging to address, as it would all depend of what the activity in question is. Although my values may say that a certain activity or lifestyle is undesirable or unhealthy, that is not to say that everyone will agree with me. This is purely dependent of one’s worldview with regards to certain activities or lifestyle choices. It is important to note that I’m answering this question from a personal and not professional perspective. Just because I may certain biases against a certain activity, does not meant I would treat an individual differently based on the activity they’re engaging in. And if I recognize that I’m too uncomfortable with counseling a certain individual, I will make necessary referral so that the individual can receive the appropriate help they need with their presenting problem.

 

-Cyrus

 

Reflection on Sahira’s Story (among other things…)

I like Alcoholics Anonymous’ approach in that they bring in a spiritual component into the mix on the road to recovery. I will say that this may not be “the” approach for everyone, but certainly can help a multitude of people to recover from alcohol. I especially like the 12 steps of AA. In particular, step 8, where by the person suffering from alcoholism makes a list of every person he or she has harmed and is willing to amends with them all. This process alone can be very humbling yet very gratifying as well. I have gotten a chance to do this with a few people whom I’ve hurt and have found the experience to be quite freeing and therapeutic. 

In regards to my strengths to assist someone like Sahira, I would the two biggest is listening and providing practical steps she can take to recovery (if and only when she is ready). Others have told me that I’m a good listener (whatever that’s worth to you), it has some truth to it. I enjoy actively listening to others when they share about their problems or struggles, in the hope that I can aid them with a word of encouragement or even practical steps to assist them in their situation.

I don’t believe I’m quite there yet in regards to professional training in order to help someone like Sahira. I believe it’s that I’m not (as of right now) adequately trained to help someone like Sahira who was at one point suffering from sever opiate addictions. I would need to be more educated on addiction counseling in order to help in her addiction recovery.

 

-Cyrus