We Still Have a Ways to Go
Four years ago I was inspired to open a clinic to help people with substance use issues because of the many, many stories I was hearing about ineffective and often times, harmful treatment.
While we are making progress with embracing more person-centered, stage matched interventions; I continue to have experiences that affirm how far we still have to go. For example:
I was training a large group of clinicians and practitioners about person-centered care, and we were having a very spirited discussion about why drug and alcohol counselors seem compelled to report their clients use to probation officers. I have worked as a mental health professional for over 2 decades and mental health clinicians don’t share this compulsion. In fact, I can’t recall any MH worker ever thinking that this was their professional responsibility.
As this discussion progressed, a man raised his hand and offered a useful perspective. He commented, “I worked as a probation officer for over 8 years, and throughout that time, we always thought of addiction providers as extensions of us. There was a strong sense of “we – they” and the counselors job entailed trying to catch the clients using.”
Why do drug and alcohol clinicians think their job includes the role of a correctional officer?
No wonder clients “go underground” in treatment and say whatever they think others want to hear.
I was interviewing a young woman who smoked a large quantity of cannabis daily and her parents were very concerned about her well-being. She had been in treatment previously including some very prominent programs. I asked this young woman why she smoked pot but before she had a chance to answer her mother jumped and stating, “She smokes because she has a brain disease, and her disease is controlling of her life”.
I again asked the young woman why she smokes, and she proceeded to explain that she smokes to relax especially at night before bed. What unfolded was a discussion about other motives for use and exploration as to whether this young woman even thought she had a problem.
A few days later her mother called me and shared this comment:
“My daughter has been in some of the best programs in the state and I have never heard anyone ever ask her why she uses. She has always been told that she has a brain disease and they have the fix for it.”
“Kudos to you for asking.”