Counseling people for alcohol and other drug problems is one of my favorite things to do. One might be surprised how often these issues pop up, even when people are coming to see a therapist (or business consultant or Life Coach) for other reasons.
When Jim Stone was the Commissioner of Mental Health here in New York State, he reported to the Board of Visitors of the School of Social Work, at Syracuse University, that 70% of the people who were in the Mental Health system in New York State had some type of alcohol or other drug involvement in their case.
Researchers also report that approximately 70% of all the people in our jails and prisons were either under the influence of alcohol or other drugs when they committed their crimes or were trying to support their use when they entered the legal justice system.
As these statistics indicate, alcohol and other drug abuse are pernicious and hugely costly both to individuals and our society at large.
Another important aspect of alcohol and drug abuse, both for the client and the clinician is that abuse can easily be masked or covered up by other problems and issues. It is not at all uncommon for a client to come in for work related issues, or depression, or marital problems and without a thorough evaluation, a therapist might simply treat these symptoms, when, in fact, these symptoms may have been created or exacerbated by alcohol/drug abuse or addiction.
Happily the Mental Health field and the Alcohol and Drug Counseling field are finally beginning to move towards each other and they are being more open to seeing CO-OCCURING DISORDERS where they exist and, importantly, treating the whole person rather than simply their old area of expertise.
What does this mean? A simple, and common, example is the person who, in the past, might have shown up at a Mental Health counselor’s office (say a psychologist or psychiatric social worker) complaining of depression and exhibiting symptoms of it. Understandably that person could easily have spent an extended period of time (and money) simply being treated for depression with poor results.
That same person, with the same symptoms might show up in an Alcohol/Drug Counselors office after a DUI and been treated, again understandably, for alcohol or other drug abuse/addiction, without his/her depression being recognized or treated, therefore, once again leading to a poor outcome. One should treat the whole person.
Depending on the etiology of the problems and the circumstances that exist in the person’s life at the time of treatment, I take different approaches and advocate different interventions. Sometimes we focus more on the Mental Health issue first, sometimes the alcoholism. I base my interventions and recommendations on many variables, including; risk factors, client openness to change, internal and external circumstances and relationship and employment factors.
I view alcoholism and drug addiction as diseases, in the broadest sense of the word. My work is heavily influenced by the concepts espoused in Twelve Step programs. It is also influenced by some of the popular literature that describes Adult Children of Alcoholics, Co-Dependency issues and the characteristics associated with both.
I generally find that it is more important to help people with their drinking/drugging issues, rather than to make them buy into any particular intellectual framework at a given time, therefore I do not insist that clients be willing to adopt my beliefs or approaches to addressing their alcohol or other drug problems. But, with that being said, I do try to pay attention to what progress we are making or failing to make and I don’t like inadvertently becoming an “enabler”. So if we end up working together to try to address your alcohol or other drug issues and what we are doing isn’t leading to progress for you, I may recommend a referral to another therapist, or program, that suits where you are at the time. Naturally if circumstances change and it appears that I can be of service later on, I’ll be happy to oblige.
In Alcoholics Anonymous, they say that alcoholism is a “three fold” disease; physical, mental and spiritual. Psychologists often call it an “obsessive-compulsive” disorder. I think both are true. I never met anyone in their teens, or twenties, or thirties, etc, who woke up and said, “gee, I think I’d like to become an alcoholic/drug addict today”. It just doesn’t happen that way. Alcoholism is a chronic, progressive and fatal disease, if left untreated. It not only ruins the life of the alcoholic but also it damages and/or destroys the lives of the addicts’ loved ones on a regular basis.
If you think you may have a problem with alcohol or other drugs, I’m happy to try to help and I’m also happy to point you to other sources of help.