Chapter 1

Question 1

The Role of the Mental Health Professional in Prevention and Treatment

Answer 1

• On the other hand, our experience training mental health professionals has taught us that you need a framework to understand how AOD issues affect not only the lives of the people you will be working with, but also your own lives and the society in which we live.
• AOD abuse leads to less work productivity, more school absences and work absences, and bad effects on partners, children, and fetuses
• The “helping professionals” (school psychologist, school counselor, marriage and family therapy intern, and social worker) did not treat substance abuse, but they needed to know about and be skilled in the field of AOD in order to do their jobs well.

Question 2

Philosophical Orientation

Answer 2

• What makes the AOD field unique is that many drug and alcohol counselors, other people who help alcoholics and other addicts, and many people who are recovering from AOD problems believe that Jerome has a disease that has affected him mentally, physically, socially, emotionally, and spiritually.
• This spiritual part is what makes AOD problems different from other mental health problems, and it has changed how we think about and treat AOD problems.
• Methods like Alcoholics Anonymous, which focus on the spiritual side of treatment, are a common part of treatment. Another implication is that many people who help people with AOD problems do not have formal training as counselors, but they are “in recovery” and strongly believe in a certain approach to treatment. This may not be based on science, but on their own experience and the experiences of other people who have recovered. This is like how a person’s religious beliefs can’t (and shouldn’t) be questioned by research because those beliefs are true for that person.
• When both scientific and spiritual ideas are used to try to solve the same problem, as has been the case in this field, disagreement and controversy are likely to happen.
• It is important to remember that people who change or stop using AODs in ways other than formal treatment do not see treatment providers.

Question 3

Professional Orientation

Answer 3

• Whatever the case may be, we want to caution you against dismissing new information with the thought, “I don’t need to know that because I won’t be dealing with that in my career” or “I don’t believe that.” It doesn’t fit with how I think people act.”
• Don’t believe everything you read here, but be sure to keep an open mind.

Question 4

Attitudes and Beliefs

Answer 4

• The work of a mental health professional is affected by how people think and feel about alcoholics and drug addicts.
• Imagine you are a mental health counselor and a well-dressed middle-aged woman with signs of depression comes to see you. If you think that all alcoholics are dirty and drunk all the time, for example, you might miss diagnosing clients who don’t fit your stereotype.
• Our reply is that you wouldn’t care if you were wrongly labeled as an alcoholic or drug addict unless you believe that addiction is a disease that affects some people but has nothing to do with morals or a lack of willpower. If you do care, you must think that people who drink too much or use drugs have some kind of flaw in their character. This helps a lot of people who want to be mental health workers change how they think and feel about alcoholism and drug addiction.
• Believing that alcoholism or drug addiction is caused by a moral weakness or a character flaw could make it harder to help people with AOD problems or find the right help for them.
• You think that going from heavy drinking to moderate drinking mostly comes down to willpower and desire, and you tell your drinking partner this. If this person is addicted to alcohol, your beliefs will not match up with what is true for this client. Your client may feel ashamed that he or she isn’t strong enough or angry that you don’t understand. Resistance and being kicked out are common results, and the client doesn’t get the right help. So, if you think that using AODs too much is mostly caused by moral weakness or character flaws, you should refer these cases to someone else.

Question 5

Denial, Minimization, Projection, and Rationalization

Answer 5

• The person who is addicted may be seen as having a close and exclusive relationship with alcohol or other drugs, and he or she may think that he or she needs the drug to function and stay alive. A person who is addicted to alcohol or drugs may deny that the substance is having a negative impact on their life despite clear and convincing evidence to the contrary, much like someone who is in a dysfunctional relationship.
• People use denial, minimization, projection, and rationalization as defense mechanisms so they don’t have to face a scary reality: a life without alcohol or other drugs.
• People who want to work in mental health should take a good look at themselves if they can’t give up a substance or activity for 15 weeks. This is especially true if they will be telling their clients to give up alcohol or other drugs for life
• Now would be the best time to get help if there is a problem. This would be much better than becoming one of the many professionals who are too drunk to do their jobs well and could hurt their clients or themselves.

Question 6

Helping Attitudes and Behaviors

Answer 6

• Even though we’ve met a lot of mental health professionals with AOD problems, we’ve found that a bigger issue may be the people who want to be mental health professionals but can’t find a job because they have unresolved problems in their lives. Even though these potential mental health professionals may want to help people, they may not be good for their clients.
• Ex. A counselor couldn’t look at her clients and herself as a counselor objectively because she was too worried about her anxiety and how well she did her job. She was afraid of conflict, so she didn’t want to talk to her clients, which made her less effective.
• If you want to become a helper because you want to be needed, that’s not a problem. It is a problem if you don’t look at your own problems and don’t take steps to fix them so that you don’t do bad (or sometimes even harmful) work with clients.
• In this field, there are people who work to help others but can’t do a good job because they use drugs themselves or have seen their families or partners use drugs.
• In the rest of this book, we will try to give you information that will help you deal with the direct and indirect problems caused by AOD use that social workers, school counselors, mental health counselors, marriage and family therapists, and other helping professionals will face. But you won’t be able to use any of this information if your own use patterns or problems aren’t fixed and they affect your work. Because denial is so common, we encourage you to get an unbiased opinion on whether or not you need to work on your own use of alcohol or other drugs or other problems, and if you need to, we can help you decide what to do. But please, for your own sake and the sake of your future clients, don’t choose to avoid these issues.