Many people use alcohol to relax and unwind. People with alcohol-related disorders can often and easily drink to excess causing major problems in their lives.
For most adults, moderate alcohol use — no more than two drinks a day for men and one for women and older people — is relatively harmless. (A “drink” means 1.5 ounces of spirits, 5 ounces of wine, or 12 ounces of beer, all of which contain 0.5 ounces of alcohol.
Moderate use, however, lies at one end of a range that moves through alcohol abuse to alcohol dependence:
Alcohol abuse is a drinking pattern that results in significant and recurrent adverse consequences. Alcohol abusers may fail to fulfill major school, work, or family obligations. They may have drinking-related legal problems, such as repeated arrests for driving while intoxicated. They may have relationship problems related to their drinking.
People with alcoholism — technically known as alcohol dependence — have lost reliable control of their alcohol use. It doesn’t matter what kind of alcohol someone drinks or even how much: Alcohol-dependent people are often unable to stop drinking once they start.
Alcohol dependence is characterized by tolerance (the need to drink more to achieve the same “high”) and withdrawal symptoms if drinking is suddenly stopped. Withdrawal symptoms may include nausea, sweating, restlessness, irritability, tremors, hallucinations and convulsions.
Although severe alcohol problems get the most public attention, even mild to moderate problems cause substantial damage to individuals, their families and the community.
According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), 1 in 12 American adults is an alcohol abuser or alcoholic.1 And, says NIAAA, young adults aged 18 to 29 are the most likely to have alcohol problems. For example, a government survey revealed that almost 8 percent of young people aged 12 to 17 and almost 41 percent of young adults aged 18 to 25 indulge in binge drinking — downing five or more drinks on the same occasion at least once during the past month.
Alcohol Awareness Month was established in 1987 to help reduce the stigma associated with alcoholism and provides a focused opportunity to increase awareness and understanding of alcoholism, its causes, effective treatment and recovery.
In this course, the author offers in-depth and in-person strategies for therapists to use in working with clients who present with the characteristic behavior patterns of codependency. Clients are usually unaware of the underlying codependency that is often responsible for the symptoms they’re suffering. Starting with emphasis on the delicate process of building a caring therapeutic relationship with these clients, the author guides readers through the early shame-inducing parenting styles that inhibit the development of healthy self-esteem. Through personal stories and case studies, the author goes on to describe healing interventions that can help clients identify dysfunctional patterns in relationships, start leading balanced lives and connecting with others on a new and meaningful level. Evaluative questionnaires, journaling assignments and other exercises are included to help you help your clients to overcome codependency. The rewards of successfully treating codependency are great for client and clinician alike. Even though the propensity for relapse always exists, it’s unlikely that a person who has made significant progress towards overcoming this disease will lose the gains they’ve made.
Culture is a primary force in the creation of a person’s identity. Counselors who are culturally competent are better able to understand and respect their clients’ identities and related cultural ways of life. This course proposes strategies to engage clients of diverse racial and ethnic groups (who can have very different life experiences, values, and traditions) in treatment. The major racial and ethnic groups in the United States covered in this course are African Americans, Asian Americans (including Native Hawaiians and other Pacific Islanders), Latinos, Native Americans (i.e., Alaska Natives and American Indians), and White Americans. In addition to providing epidemiological data on each group, the course discusses salient aspects of treatment for these racial/ethnic groups, drawing on clinical and research literature. While the primary focus of this course is on substance abuse treatment, the information and strategies given are equally relevant to all types of health and mental health treatment.
So often, we think of nutrition and its relationship to our bodies from the neck down. How it affects our heart, how it affects our colon, for example. Why do we not acknowledge its impact on our brain health as well? If a patient were to undergo an elective surgical procedure, he or she may be advised to lose weight, gain weight, or avoid certain medications or herbs beforehand. These recommendations are made to help ensure maximum recovery with minimal complications. Why would we not take this approach when dealing with mental illness as well? Shouldn’t we try to achieve optimal nutritional health of the brain if we are trying to heal it?This course discusses how good nutrition impacts a person’s mental health and well being. Includes discussions on “mental wellness” versus “mental illness,” hypothyroidism and it’s impact on mental health, neurotransmitters and amino acids, glycemic index, vitamins, fatty acids, caffeine, chocolate and aspartame, and herbal supplements and medications. Case studies are provided. This course will give the reader some insight into this concept, by providing the student with clinical research, anecdotal information and a good background for understanding the role nutrition plays in mental health.
Medication for chronic pain is addictive; therefore, the treatment of individuals with both substance abuse disorders and pain presents particular challenges. This course is based on a document from the Substance Abuse and Mental Health Services Administration (SAMHSA) of the U.S. Department of Health and Human Services, Managing Chronic Pain in Adults With or in Recovery from Substances Use Disorders: A Treatment Improvement Protocol (SAMHSA Tip 54). Intended for all healthcare providers, this document explains the close connections between the neurobiology of pain and addiction, assessments for both pain and addiction, procedures for treatment of chronic pain management (both pharmaceutical and non-pharmaceutical), side effects and symptoms of tolerance and withdrawal from pain medication, managing risk of addiction to pain medication and nonadherence to treatment protocols, maintaining patient relationships, documentation, and safety issues. Written by panel consensus, SAMHSA TIP 54 provides a good introduction to pain management issues and also a good review for experienced clinicians.
This course will demystify the diagnosis and treatment of chronic pain, the role and limitations of pain medications, and how to identify when pain relieving drugs may be harmful to clients. Participants will understand how to conduct a complete evaluation of clients with a pain disorder, chronic pain syndrome and co-morbid psychiatric diagnoses. Although the majority of chronic pain patients do not abuse pain medications, mental health practitioners need skills to assess when active substance abuse is present and develop appropriate treatment objectives. This course will also give special attention to specific clinical challenges for mental health professionals who treat clients with chronic pain, including suicide assessment and treatment non-adherence.
Data on alcohol use, abuse, and dependence show clear age-related patterns. Moreover, many of the effects that alcohol use has on the drinker, in both the short and long term, depend on the developmental timing of alcohol use or exposure. Many developmental connections have been observed in the risk and protective factors that predict the likelihood of problem alcohol use in young people. This course is based on four public-access journal articles published by the National Institute on Alcohol Abuse and Alcoholism in the online journal Alcohol Research & Health. The issue of the journal in which these articles appeared was devoted to the topic: “A Developmental Perspective on Underage Alcohol Use.” This course is based on the first four articles, which focus on the impact of alcohol on the development of children and youth from birth through 20.
PTSD & Substance Abuse: Dual Diagnosis Overview & Treatment is a 1-hour online continuing education course that examines substance abuse problems commonly experienced by those who have experienced trauma. This course discusses the complex relationship between trauma/PTSD and substance use disorders and provides a background for understanding comorbid PTSD and substance abuse. Topics covered include assessment, practice guidelines, common issues and their implications for treatment, and empirically-based treatment considerations in traumatized/PTSD individuals.
Offers valid April 1, 2016 through April 31, 2016.
Professional Development Resources, Inc. is a Florida nonprofit educational corporation 501(c)(3) that offers 150+ online, video and book-based continuing education courses for healthcare professionals. We are approved by the American Psychological Association (APA); the National Board of Certified Counselors (NBCC); the Association of Social Work Boards (ASWB); the American Occupational Therapy Association (AOTA); the American Speech-Language-Hearing Association (ASHA); the Commission on Dietetic Registration (b); the Alabama State Board of Occupational Therapy; the Florida Boards of Social Work, Mental Health Counseling and Marriage and Family Therapy, Psychology & School Psychology, Dietetics & Nutrition, Speech-Language Pathology and Audiology, and Occupational Therapy Practice; the Ohio Counselor, Social Worker & MFT Board and Board of Speech-Language Pathology and Audiology; the South Carolina Board of Professional Counselors & MFTs; and by the Texas Board of Examiners of Marriage & Family Therapists and State Board of Social Worker Examiners.
For 25 years, April has been recognized as Alcohol Awareness Month. So how does this campaign continue to be of value after all of these years?
Alcohol misuse and abuse still have a tremendous impact on our country today. As prom and graduation season are beginning to unfold, April is also a key month in which to highlight the dangers of underage drinking, as well as increase public awareness and understanding about alcohol.
Consider these facts:
In 2010, more than 10,000 people died in alcohol-impaired driving crashes – one every 51 minutes (National Highway Traffic Safety Administration, 2012).
Alcohol is the number one drug of choice for America’s young people, more than tobacco or illicit drugs, and underage alcohol use alone costs the nation an estimated $62 billion annually (National Council on Alcoholism and Drug Dependence, Inc., 2012).
More than 14 million people in this country are currently living with what can be defined as an addiction to alcohol.
Each year, more than 100,000 people die as a result of alcohol-related issues.
Every year, more than 13,000 people die as a result of liver disease related to alcoholism (rehabinfo, 2012).
As indicated by these statistics, alcohol is still creating a widespread problem of serious personal, physical, social and economic consequences. Yet, at the same time, there are many misconceptions about alcohol use, abuse and alcoholism today. One common misconception is that alcoholics lack willpower, and they could quit if they really wanted to stop drinking. This statement couldn’t be further from the truth. Unfortunately, misinformation, as well as stigma, is often perpetuated through peers, media, family and individual experimentation.
What is important to know and be aware of is that changes occur within the mind and body when alcohol is consumed, regardless of the amount. Therefore, even when drinking in moderation, there can be subsequent consequences (National Institutes of Health). Even small amounts of alcohol consumed during pregnancy or combined with certain medications may result in significant adverse consequences and therefore is considered risky drinking (National Institute on Alcohol Abuse and Alcoholism, 2003).
The craving a person with alcoholism feels for alcohol can be as strong as the need for food or water. A person addicted to alcohol will continue to drink despite serious family, health or legal problems. Like many other diseases, alcoholism is chronic, meaning it lasts a person’s lifetime, usually follows a predictable course and has symptoms. The risk for developing alcoholism is influenced both by a person’s genes and by his or her lifestyle (National Institute on Alcohol Abuse and Alcoholism, 2012).
Alcoholism can be treated. Alcoholism treatment programs use both counseling and medications to help a person stop drinking. Treatment has helped many people stop drinking and rebuild their lives (National Institute on Alcohol Abuse and Alcoholism, 2012).
Sadly, there are some who perpetuate the belief that alcoholism is not a disease and pure speculation. (Baldwin Research Institute, 2010).
The disease of alcoholism and the consequences of alcohol abuse can be deadly. Alcohol Awareness Month provides a focused opportunity to increase awareness and understanding of alcoholism, its causes, effective treatment and recovery. It is an opportunity to decrease stigma and misunderstandings in order to dismantle the barriers to treatment and recovery, and thus, make seeking help more readily available to those who suffer from this disease. This is the value of Alcohol Awareness Month.
In a survey of 196 men and women being treated for alcohol dependence, almost one-quarter of men and one-third of women reported a history of childhood physical abuse.
Abuse in childhood appears to be a particularly strong risk factor for developing alcohol addiction later in life, researchers reported Thursday.
Alcohol dependence is linked to many risk factors — including genetics, drinking in adolescence and having other mental health disorders. A history of physical, sexual or emotional abuse in childhood is known to be another risk factor. The new study, however, shows how strong this link could be.
Researchers at the National Institute on Drug Abuse surveyed 196 men and women who were inpatients being treated for alcohol dependence. Almost one-quarter of men and 33% of women reported a history of childhood physical abuse while rates of sexual abuse were 12% for men and 49% for women.
In addition, the study found that sexual abuse raised the risk of also developing anxiety disorder and emotional abuse increased the risk of developing depression. People who were physically abused in childhood and became alcohol dependent were more likely to have a history of suicide attempts. Alcoholics who experience more than one type of childhood abuse were more likely to develop another psychiatric disorder or to attempt suicide.
The study suggests how important trauma assessment is in alcohol-treatment services, the authors said.
The study appears in the journal Alcoholism: Clinical & Experimental Research.
I often am asked questions regarding the ethical issues for counselors regarding social networking, specifically Facebook. At that point I usually hear about a situation that has caused professional and personal problems for an addictions professional. In each scenario that follows names have been changed and situations modified to protect the identity of those involved.
Danny is a substance abuse counselor who decided to join Facebook for a specific reason: he wanted to look up clients to see if they were posting information on Facebook that would indicate they were using.
What are the Ethical Concerns?
Client autonomy: Clients in treatment have a right to choose whether to use alcohol or other drugs. As a counselor would you drive by a client’s house to see if that client is sitting on the front porch smoking a joint? Clients have a right to their personal lives outside of treatment, whether or not it is what we would choose for them.
Counseling relationship: Trust is a major component of the counseling relationship. A client could consider it a violation of that trust to “spy” on him on Facebook. Before the advent of Facebook, a counselor asked clients if they were using and conducted drug screens. Should our methods be any different today?
Do no harm: Is there the possibility that such actions could harm a client? We must always consider the possible outcomes of our actions when it involves client care. A client could possibly feel betrayed by her counselor if such “investigation” is pursued by the counselor.
Professional boundaries: One of our responsibilities as counselors is to have healthy professional boundaries. These boundaries can easily become blurred if or when we begin to intrude on the personal lives of clients outside the professional relationship. Just as we need to set appropriate boundaries with clients regarding our personal Facebook pages, we too should respect their boundaries.
Situation 2 – The Personal/Private Divide
Mary Beth was a counselor at a large addictions treatment facility. She is not in recovery from drug or alcohol addiction. She had recently returned from a vacation at the beach. A client of one of Mary Beth’s colleagues at the same facility mentioned during an individual session that he had been searching people on Facebook and found Mary Beth’s page. He stated, “I really liked those pictures of her vacation.” After the client left, his counselor looked up Mary Beth on Facebook to see what the client was referring to. To her dismay she found that Mary Beth had no security on her page and all of her information was open to anyone who came across it. Additionally, she had posted pictures of herself in a bikini, holding a beer in her hand, with a male companion who appeared to be fondling her. Mary Beth was fired from her job. The agency maintained that she was not projecting a professional image and was negatively affecting the reputation of the agency.
What are the Ethical Concerns?
Counseling relationship: What did the pictures portray to clients and colleagues who saw them on her Facebook page? We have a responsibility to safeguard the integrity of our relationship with clients. (NAADAC Code of Ethics, Principle I) Part of this safeguard is to always being aware of perceptions and how those perceptions may change the professional relationship with a client.
Professional responsibility: If Mary Beth had put the security blocks on her page which would allow only invited friends to see her page, she would have been acting more responsibly. The addiction professional recognizes that those who assume the role of assisting others to live a more responsible life take on the ethical accountability of living responsibly. The addiction professional recognizes that even in a life well-lived, harm might be done to others by works and actions. (NAADAC Code of Ethics, Principle IV)
Discretion: Mary Beth’s actions in regards to Facebook appear to be poor professional judgment. She certainly has a right to her personal life and to enjoy herself. On the other hand, professional judgment includes how we conduct ourselves in public, even in our leisure time which includes what we post on a Facebook page for all to view.
Do no harm: Although Mary Beth is not in recovery herself, the posting of the picture of her drinking may cause undue influence on clients to assume that if it is OK for a counselor to participate in these activities that it must be acceptable for them also. Or clients may believe that Mary Beth is not “practicing what she preaches”. Again, often we are talking about perceptions which may not always be reality.
Situation 3 – Information Sharing
Carla is in private practice working as a substance abuse professional. She recently joined Facebook and being a very social person, enjoys the interactions each evening with her Facebook friends. One of those friends is a counselor at a local substance abuse in-patient facility. For the past few evenings Carla has noticed that her friend has begun to post information about clients she has seen that day, funny things they have done or unusual crises they have experienced. Although her friend is not stating client names she has told others where she works.
What are the Ethical Concerns?
Confidentiality: We are to make every effort to protect the confidentiality of client information. (NAADAC Code of Ethics, Principle III) Carla’s friend has stated where she works and now she is talking about clients of that facility. She is not honoring confidentiality, even though she is not stating client identifying information. She may inadvertently be giving enough information that someone could deduce to whom she is referring. This is also a violation of client rights and their expectation that their information will be protected.
Due diligence: We are to be conscientious and careful in all of our actions when it concerns clients and our professional life. We, as professional counselors, should make every effort to avoid “gossiping” about clients. It is possible that, unbeknownst to this counselor, a client may be a “friend of a friend” on Facebook and actually can see what this counselor is posting and recognizes that the counselor is telling her story.
Legal concern: Carla is bound under 42 CFR Part 2 and HIPAA to make every reasonable effort to protect client information. This type of behavior could result in litigation.
Resolving Ethical Issues: Carla has a responsibility to go to her friend and discuss the ethical and legal concerns she has regarding her friend’s behavior. If her friend is unwilling to change that behavior, Carla next needs to seek supervision and consider her licensure reporting responsibility. (NAADAC Code of Ethics, principle VIII)
Situation 4 – Venting Frustrations
Martin has been having a difficult time at work lately. It is increasingly more stressful with an increased number of clients who are exhibiting more severe symptoms, fewer staff and fewer resources. He has recently been having disagreements with his supervisor. He has also begun to post his “venting” on his Facebook page.
What are the Ethical Concerns?
Discretion: As professionals we have an obligation to use utmost discretion in all of our professional life. Ethically, Martin would be well served to seek other supervision or peer support in his stressful situation rather than venting on his Facebook page.
Professional relationships: Martin is not building, supporting or treating his professional relationships respectfully. As professionals we are to respect other professionals by going to them when we have problems that are affecting us. I have heard many accounts of people losing their jobs as a result of airing their complaints about their jobs and employers on Facebook.
Situation 5 – Compromised Testimonials?
A 12 step focused residential treatment facility developed a Facebook page as a means of advertising. It is also a means for keeping a connection with former clients. These former clients may also write comments on their experience with the treatment program. Recently the administrator contacted former clients requesting that they post testimonials on Facebook. A counselor conducting patient aftercare was made aware of the request and was concerned about confidentiality.
What are the Ethical Concerns?
Informed consent and Confidentiality: In this situation clients need to be fully informed about the risks of posting testimonials on Facebook. If they do post voluntarily, they should be informed of the risk of confidentiality being compromised.
Due Diligence: This treatment facility, as well as the counselor who was made aware of the request, have an obligation to be diligent in the care of clients and sensitive client information.
Exploitation: Is the facility using client testimonials to help others who are suffering with addictions or are they using this to further their business and bring in revenue? The concern here is whether or not it is exploiting clients to ask them to help in marketing a program by posting personal testimonials about their treatment experience. Clients may not understand the far-reaching outcomes of this course of action. Treatment programs need to consider all aspects of their decisions to use media such as Facebook to market their programs.
Often I hear professionals say that they hesitate to report unethical behavioral because they are friends with the person or they don’t want to hurt the other person’s career. As licensed or certified professionals, we have an ethical and legal obligation to report unethical behavior that cannot be resolved or that is such an egregious violation that it is beyond being resolved.
As technology grows and becomes more and more available, we as professionals must always consider the ramifications of our actions when using any technology, including social network sites such as Facebook. When ethics are violated, we have an obligation to address the issue and report to licensure boards when necessary.
Be true to yourself, your profession and your colleagues.