Session 12 Reflection Post

o 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?

One of the complexities of working with clients who are also pregnant deals with the fact that I am now assessing what is best for both the client, as well as, the unborn child. One issue that might come up for me as a counselor working with a pregnant client is that I may have a client that is abusing alcohol and other drugs while pregnant. Capuzzi and Stauffer (2012) stated that, “Pregnant women who abuse alcohol put their babies at risk of developing fetal alcohol syndrome (FAS), the most preventable form of mental retardation” (p. 367). I would discuss these issues with my client by educating them about the risks and dangers of using while pregnant. Also, women that use drugs while pregnant increase the risk for suffering miscarriages, and delivering prematurely.

The following question, “How would you respond if your client continued to heavily drink or use substances while pregnant” was literally a question that my friend asked me the other day. It took me some time to formulate the most appropriate response, as I wouldn’t want to appear as though I am judging the client. In all reality, when I see woman that is smoking and drinking while pregnant, it truly bothers me. It upsets me to think that the baby is taking the brunt of the substances, alcohol, smoke, etc. I believe if you decide to bring a child into this world, you should do the best that you can to provide the child with unconditional love, time, and support. While the baby is in the mother’s womb, it makes me upset to think about how women will smoke a cigarette and act like it’s nothing. Instead of the baby taking in healthy nutrients and food, the baby is inhaling cigarette smoke. I guess if I had a client that continued to smoke and drink while pregnant I would explore deeper issues. I would wonder whether the mother wants the child, or whether she is dealing with some type of mental illness that causes her to feel the need to self-medicate with substances.

o 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?

As a future counselor, my goal is to always be an active advocate for my clients. I am a firm believer of equality and social justice, so I take my role as an advocate very seriously. When thinking about groups that I feel may be hard for me to be an advocate for are clients that have a history of abuse to animals, children, the elderly, or people with disabilities. If I were in a session and a client disclosed to me any of the following indications of abuse, obviously I would be mandated to immediately report it, but I may be given clients that are court-ordered to see me and have this history.

o 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.

http://www.algbtic.org

On the website, the Association for LGBT Issues in Counseling (ALGBTIC) is devoted to raising awareness about LGBT issues. The website provides various sections for information on the ALGBTIC State Branches, the mission of the ALGBTIC, resources for learning about LGBTQ issues, and affirmative resources to counseling professionals and educators, community organizations, LGBT individuals, and their families and friend friends. I think this website provides a great deal of information regarding the current events and issues that are occurring in the LGBT community, which is valuable to know when working with LGBT clients.

http://www.marchofdimes.com

This website is for people, especially mothers, who want to learn about the problems that threaten the health of babies. The website provides research updates on infants’ health issues, materials for professionals, and local programs that are devoted to improving the health of babies across the country. If I work with a client who is pregnant and is seeking resources that allow her to learn more about her pregnancy, this is excellent resource to show the client. Also, the website provides sections that deal with ways to cope with pregnancy loss, newborn loss, and dealing with grief.

http://www.hrc.org/

The Human Rights Campaign works for lesbian, gay, bisexual, and transgender equal rights. The website provides resources to aid and help youth with the coming out process, and provides information on hate crimes, marriage, and current issues in the LGBT community. This website is a great resource for both LGBT individuals’, as well as, other individuals who want to learn more about the LGBT community.

http://womenshealth.gov/

The U.S. Department of Health and Human Services (USDHHS) provides addiction and health information for both men and women. Along with information on addiction and health, the website provides information for women who want to learn more about Breast Cancer, breastfeeding, fitness and nutrition, menopause, mental health, pregnancy, and violence against women.

References
Capuzzi, D., & Stauffer, M. D. (2012). Foundations of addictions counseling (2nd Ed.). Upper Saddle River, NJ: Pearson Education Inc.

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Session 11- My Attitudes and Perceptions of Substance Use in Childhood and Adolescence

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

My attitudes toward use of substances as a child and an adolescent were that I felt it was just associated with people that had low socioeconomic status, and wasn’t aware of how prevalent it was in other populations. As a child, I thought cigarettes were so disgusting and thought differently of people who I saw smoking. I thought that people who smoked just did so to make themselves “look cool”, and wasn’t aware that people could have an addiction to nicotine. As an adolescent, I was much more aware of drug use, as I was seeing it more in movies and the internet.

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?

Growing up, my father and mother would smoke cigarettes outside. I remember sitting in the back of the car thinking, “Ugh, the smell is horrendous.” My dad quit smoking cigarettes January 16, 2007, and has remained nicotine-free since that date. My mom was a social smoker, so quitting smoking for her was relatively easy. I would say that was my first experience with seeing substances being used first-hand.

During my senior year of high school, I tried a cigarette for the first time. I remember thinking that the smell didn’t bother me as much as it used to. I continued to smoke in college until senior year. Surprisingly, quitting smoking was easy for me, and I quit cold turkey (which works for some, and doesn’t for others). I would say I smoked during times of stress, while drinking, and to take breaks from writing papers. Although the smell didn’t bother me as much as it used to, I still always used hand sanitizer or washed my hands after smoking. I didn’t like having my hair, hands, or clothes smelling like cigarettes. Today, although I have no desire to smoke, I am surrounded by friends that all smoke.

While working with clients that make different choices and decisions that I have will be very interesting. As a counselor that once smoked, I want to be careful about making suggestions about what they should or shouldn’t do. As counselors, our role is not to be an “advice-giver” with our clients. I need to make sure that I do not make those suggestions based on my success with quitting smoking. For example, just because I was able to quit smoking easily, doesn’t mean that it will be easy for my client nor may it be something on their agenda.

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?

The first time I learned about drugs and alcohol was during my D.A.R.E program in 5th grade. I vaguely remember what the program entailed, as I was so young. I think that the overall purpose of the program was a good idea, although I am not sure that teaching kids about drugs at such a young age is effective. The reason I feel that it may not be effective is that many 5th graders can’t capture the intensity of drugs and the effects that it has on someone’s body. Their mental capacity and maturity is not truly capable of digesting all of the information they learn about drugs. Although I say this, I am aware that there are kids that start using drugs as early as 5th grade, which is a serious issue.

Dealing with Stress

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?

When I think about a time where I was under a lot of stress, I think back to about a year ago. During this time, I was working two jobs, and going to graduate school. One of the jobs was working as an administrative assistant for a clinical psychotherapist, and the other job was working as a hostess at Romano’s Macaroni Grill. My responsibilties as an administrative assistant were to do the billing of the clients and to conduct the contact notes. On top of the responsibilities that I had to do in work and school, I also had responsibilities as a girlfriend, daughter, sister, and friend.

My responsibilities as a student, friend, daughter, girlfriend, employee, and sister all required a great deal of my time and energy. One specific time that I remember being extremely stressed out during this period of time was when I had to work all day as a hostess, then come home and do paperwork for the counselor, which then followed with working on assignments for the two classes that I was taking. I felt that the only way that I would be able to pull off all of these tasks during the day was to pull an all-nighter. I pulled many all-nighters during this time period due to being overwhelmed with the amount of school work that I had to do in a certain amount of time. By staying up all night, I was depriving myself from getting much needed sleep, which obviously is an essential factor in one’s physical and mental health. Each time that I had to pull these all-nighters I would feel exhausted and even more stressed. Also, I became more prone to getting colds and sinus infections. I felt as though I was devoting all of my time to other people, assignments, and activities, which was causing me to neglect time that I spent towards fulfulling my needs. Don’t get me wrong, I love spending my time and energy towards helping other people, but I realize that I also need to spend a good amount of time towards myself and other areas in my life that I enjoy.

When I worked as an administrative assistant, there was a time where the counselor’s clientele increased tremendously, which caused there to be an increase in the paperwork and tasks required of me. I realized that working two jobs and going to school became too stressful, so I made the decision to have a job that was close to home. I wanted to be able to save gas, as well as, earn some extra cash while in graduate school. I currently work at Pet Valu, a pet’s supplies store in Olney. I absolutely love this job, as I am a HUGE animal lover. While working at Pet Valu, I am able to interact with numerous customers’ dogs, cats, guinea pigs, etc. I refer to this job as being therapeutic, as it provides me with happiness and comfort. I am an advocate for both animal rights and human rights, so I feel that this job is perfect for me at the moment, as it allows me to educate people on both of those areas. When I become a counselor, I still want to either volunteer or devote time towards helping animals.

12- Step Programs

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

The 12-Step facilitation of treatment relates to my personal theory of life in many ways. The first way that it relates is that it views God as a primary source of strength and courage. Being raised as a Catholic, I have developed a spiritual relationship with God, and seek Him during times where I am in need of strength or guidance. Many of the 12-Steps in AA focus on God and His power to help us remove our shortcomings.

I think that the 12-Step facilitation of treatment can be integrated into a client’s treatment plan if they are struggling with any addiction. I think that parts from these twelve steps may be particularly helpful for clients’ that are in touch with their spiritual side, and are seeking power from a greater source.

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

The 12-Step facilitation of treatment relates to client-centered therapy, which is one of my preferred counseling orientations. Client-centered therapy focuses on unconditional positive regard, empathy, and genuineness, which are all major components in 12-step programs. These three components of client-centered therapy can be used with an addicted individual in treatment, as it helps the client to feel as though they are not being judged or looked down upon because of their addiction.

Pharmacotherapy in the Treatment of Addictions

I support the use of pharmacotherapy in the treatment of addictions. Pharmacotherapy can be beneficial in treating addictions, which was the case for Sahira (case study in session 2). Sahira suffered from an opiate addiction, and during her treatment within the rehab center, she was prescribed Suboxone. She stated that without Suboxone, she wouldn’t have been able to stop using drugs.

Although I support the use of pharmacotherapy in the treatment in addictions, I do not think that it should be used with every client. Each client is different, and may be struggling with different addictions. Some clients may have experimented with more potent drugs that may have impaired their health. These clients may be opposed to the thought of having more drugs enter their body, as it would in pharmacotherapy.

It is important to consider the client’s attitudes and beliefs pertaining to prescription medications. Weiden and Rao (as cited in Capuzzi and Stauffer, 2012) provided ways in which clinicians can promote medication compliance with their clients which included: “(1) ask for-and listen-to the client’s beliefs and attitudes about the prescribed medication, (2) work to understand the client’s perspective rather than trying to contradict or correct this perspective, (3) understand that it is the client’s subjective beliefs, rather than objective medical, reality that influences client compliance, (4) withhold responding until the client has discussed all major arguments for and against a medication, and (5) ground any discussion of compliance concerns within the client’s point of view” (Capuzzi & Stauffer, 2012, p. 220).

References
Capuzzi, D., & Stauffer, M. D. (2012). Foundations of addictions counseling (2nd ed.). Upper Saddle River, NJ: Pearson Education, Inc.

Week 6- “The client within us”

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?

This quote was very eye-opening for me, as it allowed me to look at myself in a different light. Instead of thinking about my role as a future counselor, I was able to think about “the client within myself.” I think that this is so important to remember when counseling individuals’ in the future because it is crucial that counselors do not emphasize the power difference in counseling. Although clients’ will likely consider us as the “authority figure” as a counselor, it is essential that we do not take advantage of this role.

I think that to be able to stay in contact with my inner client, it is important that I constantly self-reflect and examine areas of my life where I may be experiencing feelings of vulnerability, anxiety, or fear, which are feelings that many clients may be experiencing when entering into the therapy session. I think it is important to remember and consider that just because we are counselors, doesn’t mean that we are invincible from developing or struggling with mental disorders like our clients. Many people have misperceptions about counselors being free from any mental health issue, which is not always the case. Some of the best counselors are the ones who deal with a mental health issue or have dealt with one in the past, which allows them to gain personal experience and an overall understanding of what the client may be dealing with. Another area that I will be conscious of, is my proximity with the client. For instance, I do not want to be sitting behind a desk or a chair that has me looking down to the client, as it shows/puts me in a superior role.

◦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”?

First and foremost, we are both humans. As humans, we desire to be loved and accepted. This love can be sought out within relationships or other areas that provide us with security and acceptance. There may be times where my clients and I are dealing with the same issues, whether it may be a break-up in a relationship, death of a loved one, or other losses that were of great importance. I look at a client and counselor relationship as a collaborative therapeutic alliance, one that is based on professionalism and participation on both the counselor’s and client’s part. On a situation that is presented to me that I can’t relate to or have experience with, I need to make sure that I become knowledgeable by talking with other clinicians or reading literature on the particular issue. I don’t want a client to leave a counseling session thinking that I was not in touch with what they were experiencing, therefore, I was not actively engaging in a meaningful dialogue.

Week 5- Philosophical Foundations of Addictions Counseling

              Capuzzi and Stauffer (2012) stated that there are seven foundational philosophies of counseling. The foundational philosophy of counseling that I am the most comfortable with is the strength-based approach. In counseling, a strength-based approach is used as a way to discover and encourage change by building on a client’s personal strengths and accomplishments. One major component of the strength-based approach that relates closely to my own belief is the assumption that people have the ability and capability for success. The counselor using a strength-based approach would conduct an assessment that includes the client’s strengths and achievements to create a comprehensive treatment plan. Another major component of this approach is that it emphasizes empowerment and change in a way that is both positive and insightful. Although a counselor that utilizes a strength-based approach assists clients to use their strengths and positive assets, they also make sure that they aren’t avoiding the client’s problematic behaviors, challenges, and other areas of conflict (Capuzzi & Stauffer, 2012).

             In addictions counseling, counselors use standardized assessments to obtain data on the addicted individuals’ drug use pattern. The client’s scores from the assessment are compared to those of a normative population. As a counselor, I would use the Substance Abuse Subtle Screening Inventory-3 (SASSI-3) with clients. The SASSI-3 identifies high or low probability of having a substance dependence disorder. Capuzzi and Stauffer (2012) stated that, “Recent survey data indicates that addictions counselors view the SASSI-3 to be the most important and most frequently used screen” (p. 107). Also, Lazowski et al. (as cited in Capuzzi and Stauffer, 2012), “…reported that the SASSI has a 95% rate of agreement with clinician’s diagnoses” (p. 107). Given the high internal consistency and reliability of the SASSI-3, it is very likely that I would use this assessment with clients.

References

Capuzzi, D., & Stauffer, M. D. (2012). Foundations of addictions counseling (2nd ed.). Upper Saddle River,  NJ: Pearson Education, Inc.