Advocacy-Week 12

 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 am very comfortable in the role of advocating for my clients. Because I have worked with adolescents for so long, and particularly in a clinical research settling, it is crucial to speak up or push back on their behalf at times. There are many times when the focus becomes about the data and results, and people start to overlook the child or person that is behind that number. Even the families and parents can get to the point where they are invested in having someone “fix” their kids that they can’t hear the kids when they say they have had enough.

I have found myself in many situations when I have had to challenge bias, generally biases or stigmas about mental health, or the abilities of a mentally ill child. I probably challenge some biases more than others, either because they aren’t familiar to me, or as important to me. I definitely will need to continue to learn about other cultures so that I am more aware when biases are occurring and how they affect the client at whom the bias is directed.

I would probably have difficulty advocating for people who abuse children, sexually, physically, emotionally, or through neglect. I just think that children are so vulnerable and helpless, and I can’t find anything in an abuser to attach or connect with as a helper.

 

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Childhood Impressions- Week 11

 

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

I grew up in a big, Irish Catholic family, where drinking in moderation wasn’t part of the vocabulary. Our annual family reunion is a perfect example of my family’s attitudes about drinking. My Uncle was an executive at 7-up, and lived just outside Indianapolis. Every year, he would score VIP access to the Indy 500, and my extended family would converge on Indianapolis for the race. The race is run on Sunday, but they would start the pre-party Wednesday. Needless to say, the Indy 500 is a big deal up there, and everyone is partying. One of my uncle’s best friend’s would throw a massive party- imagine industrial size trash cans full of a concoction called Bora-Bora, and about two watermelons, 20 oranges, apples, etc., cut up and floating on top. That is quite possibly my first taste of alcohol, because the kids would steal the fruit out and eat it, completely oblivious to the saturation of grain alcohol we were consuming. After three straight days of round the clock partying and no shortage of lovely displays of complete buffoonery in front of no less than 15 children between the ages of 12 mos-12 years, race day arrived. Race day began at 6:30am at the country club for Bloody Marys and betting. Once everyone (our family plus the extended families of the other 7-up executives) was assembled and nicely buzzed, the line up began so that we were ready to go when the POLICE showed up for our police escort to the track. I can say that the four of us kids old enough to go, were always in the van driven by my Aunt who, while not completely dry, did drink responsibly. So imagine a police escort, and as our caravan is blowing through red lights, the adults in our cars are heckling the people at a standstill because of us, by toasting them with their beer cans singing “In heaven there is no beer, and that’s why we drink it here!” There was literally a mini-van designated as “The Chariot of the Coolers,” because they took so much beer to the race. Anyhow, I could do this all day, but I think you get the picture. I couldn’t make stuff up that was this dysfunctional if I tried!  Needless to say, I think my views and attitudes about drinking, and what was normal, were probably quite distorted. 

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 grew up in Olney, MD, and it was a small town, in the middle of nowhere back then. Most families were on the upper end of middle-class, so with the lack of things to do and places to go, plus a little disposable income, there were drugs and alcohol around enough that it was pretty normalized. But, my oldest friend was in AA, and I spent a lot of time with her attending young people’s sober activities, so I had the experience of seeing substance abuse from both sides. My views of substance use are much different now than they were then, in the way that most people see things differently through the lens of maturity and knowledge. I don’t look back at my choices and see them as all or nothing or right or wrong, nor do I think how I navigated my adolescence has any bearing on how I would advise a client. I think I would just strive to give them the best information and support I could, regardless of the choices they make.

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 don’t remember any preventative drug or alcohol programs being given at that time, and it was just before the danger of smoking cigarettes campaigns really took off. In addition, it wasn’t something that my parents or any of my friends’, were discussing with us. Remember, this was quite a long time ago, they were focused on butchering conversations about HIV and AID’s with us. Also, my parents were not part of the hippie movement, so they were fairly clueless. They came from the “teens having good wholesome fun” upbringing, so there was no proactive “Don’t do drugs” talks, because it didn’t occur to them that we would.

Skittles- Week 9

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 believe the appropriate question for me is, “Has this happened to you in the last week?” I am confident that I would be the victor if there was a “Top 10 Mental Health Professionals with Deplorable Self-Care Habits!” So, allow me to go through my mental rolodex of ineffective coping strategies to see which one I will discuss for this blog. This will probably come as no surprise to some of you reading my blog, but I have a problem with sugar. Any kind will do when I am stressed out, in fact, my brother and I have many times referred to ice cream as, “Therapy in a Carton.” But I am particularly fond of skittles, purple skittles to be exact. The problem is when my healthy daily ration becomes my only source of breakfast, lunch, and dinner. When I get stressed out and overwhelmed, my good eating skills fall apart and I start to eat sugar for energy. Consume skittles-> blood sugar rush->blood sugar drops-> consume skittles->repeat. In the interest of full disclosure, there is a bag on my desk in front of me, as we speak. It is really interesting to stop and think about how easy it is to reach for a “quick fix” when we get busy and overextended, even when we know the healthy things we should be doing. It does make me stop and think about the importance of self-care, because if we are taking care of ourselves well in general, then maybe we wouldn’t get so stressed and fall back on vices and bad coping skills.

12 Steps

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

I have come to a place in my life where I truly believe that in order to live positively and productively, I have to accept the concept that we will have experiences in our life which are truly out of our control. Furthermore, I believe that the more we struggle to have and keep the control, the further we fall when life reminds us that control is just an allusion. I realize that I just posted a few weeks ago about my OCDish tendencies, and the calming effect that list making and organizing has on me, but there is a difference in my mind between having control, and having order. I put things in order when things that are out of my control begin to affect me in negative ways. The more I have embraced the concept of self-actualization, and strived to live better and be better, the less I struggle with needing control. Like the 12-Step treatment modality, I try to take personal inventories of my morals, as well as my values, behaviors and feelings, and when I recognize an incongruence, I try to face it directly.

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 counseling orientation is based on my belief that all human beings are flawed, and we make bad choices or have bad experiences often. In the way that the 12 step treatment modal allows people to admit their wrongs and start over, I believe in facing forward not back. True growth occurs when you are able to use your experiences to move forward.

Have You Learned Your Lesson?- Week Seven

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

I support the use of any evidenced based or best practice therapeutic intervention used for the treatment of addictions, including pharmacotherapy, if it is used safely, effectively, and is in the best interest of the client. If advances in research have shown that addiction is a brain disease, then in my opinion, pharmacotherapy is not “using a drug to treat a drug,” it’s using a drug to treat a brain disease which causes a person to compulsively abuse a chemical substance. I don’t believe that using a medication to treat the symptoms of a disease, while offering a person the best chances for a successful outcome and recovery, is wrong simply because of the nature of the disease. I wonder if some of the opposition to using pharmacotherapy to treat substance abuse disorders still comes from the judgmental beliefs that being an addict is a choice that someone makes. Does the opposition think that recovering from an addiction has to be agonizing and painful so the addict “learns their lesson?” There are risks involved with using medications to treat addiction, but that is true when medications are used to treat any disease. Pharmacotherapy should be part of a comprehensive treatment plan, and used based on the needs of each client individually, not just as a rule. Client’s need to be monitored for signs of medication abuse, miss-use, or dependency and medications should be discontinued if they are not being used properly. But, if the use of pharmacotherapy is in the best interest of the client, and they are invested in their recovery, then I absolutely agree with them being used in the treatment of addictions.

My Inner Client- Week 6

“To share your weakness is to make yourself vulnerable; to make yourself vulnerable is to show your strength.”

–Criss Jami

“He who knows others is wise; he who knows himself is enlightened.”

–Lao Tzu

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I believe that self-awareness is my greatest weapon against developing tendencies toward self-righteousness.  For me, to say that I don’t have the problems that my clients do, means that I am conscious of the fact that I have my own unique problems, as do most people.  I have always had the opinion that in order to be a good counselor I should know myself.  So, an important part of my self-care is to strive to always be healthier, both physically AND mentally.  Simply put, I stay in contact with my inner client by being a client.

I am past the time in my life where I had to do my own hard work in therapy.  I have put many demons to rest, made many changes in my life, and became the best version of myself.  I know how vulnerable and raw it feels to trust another person with your secrets, and allow them to see the very best of you and the very worst, as well.  To hope that you won’t be judged for the bad choices you’ve made or the poor character you once exhibited.  Just because I am a mental health professional, it was not somehow easier for me identify and change negative thoughts and behaviors or resolve conflicts in my life. There are not levels of clients, or personal issues that are any more or less distasteful or undesirable depending on who is sitting in the client chair.  When I look at my client sitting across from me I don’t see them as any different from me when I was sitting in that chair, and I strive to give them the respect and attention they deserve.

These days, I pop in and out of therapy when I am in need of a short-term “tune up”, or just want to do a quick mental health check-in.  I’m a huge advocate for therapy, and believe that there is not a single person who would not experience some form of growth or learn something new about themselves after a few sessions. I think that counselors are more likely to be aware of their inner client and avoid labels like “us” and “them”, if they have had the experience of being a part of the process from the other chair in the room.