Feeling Stressed

• 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?

Honestly, this semester has been very stressful for me.  I am currently working two different part-time jobs throughout the week, as well as another job answering phones at my church every other Sunday.  I took two weekend elective classes and am taking two semester-long classes, one of which is my practicum.  Unfortunately, while I really like my site for practicum, it is two hours away and one of my clients is extremely difficult.  My brother is also getting married in a few weeks. In addition to helping out with that, the other bridesmaids and I have been trying to plan a surprise bridal shower and a baccellorette party for my brother’s fiance through email, since we are all over the country and have never actually all met, which makes it a lot more difficult.

In the past month, I have been coping by staying up watching TV and eating out a lot more than normal to save time that I would spend preparing food for myself.  This has led to me sleeping less and spending a lot more on food.  This has led to me feeling exhausted during the day, making me rely even more on these coping mechanisms.

That being said, the bridal shower is this weekend and now completely planned, and I am getting a lot of help from my supervisor with my difficult client, so this past week I have begun to feel less stressed and am getting back into my regular pace of doing things.

 

12-Step Programs

 

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

12-step facilitation of treatment is very much in line with my personal theory of life because I feel like people mimic those that they surround themselves with.  By surrounding themselves with others working towards recovery and actively practicing sobriety, individuals will follow this behavior more easily.

In my own personal life, I like the idea of making amends.  I think that this is something that a lot of people don’t do out of embarrassment.  I try to apologize whenever I am at fault for something or recognize a way that I have negatively impacted someone else.

• How does 12-Step facilitation of treatment relate to your preferred counseling orientation? What parts do you see that you could utilize for treatment?

I think that using a 12-step program in conjunction with therapy is the best approach.  I do not think that it is best used entirely on its own, since there a lack of therapeutic support in 12-step programs.  However, used with cognitive behavioral therapy or another therapeutic approach to addiction treatment, the social support gained from being in a 12-step program could be extremely beneficial and something that I would recommend to clients.

The thing that makes me really wary of the 12-step approach is the reliance on God.  A lot of people, especially in this area, are not religious and do not want religion pushed onto them.  I think that everyone’s own personal beliefs should be respected, so I do not think that individuals working on addictions should be forced to surrender themselves to these religious ideas.

 

Pharmocotherapy

• Choose one of the following perspectives and explain your position: “Do you support the use of pharmacotherapy in the treatment of addictions? If so why? If not, why not?”

I do support the use of pharmocotherapy if it is what the client feels is going to be the most useful for him or her.  Suboxone, methadone, and other drug replacement approaches have been proven to be effective in treating addictions.  Therefore, I think that if a client wants to try pharmocotherapy, I should not stand in the way of an approach that works.  I do, however, think that this is something that needs to be heavily monitored.  By replacing one drug with another, there is a risk of adverse effects and a chance of replacing one addiction with another.  At my practicum, there is a group on suboxone and there have been instances of individuals in the group selling it to those addicted.  Ultimately, if a client is struggling with different approaches and want to try pharmocotherapy, I would definitely support this decision, but would monitor closely the impact that it is having.

 

Counteracting the “Us Vs. Them” Mentality

 

• A quote from your text states: “… we get so involved in the role of counselor that we sometimes forget the client inside us. It can become habit to separate ourselves from our clients with a sense of self-righteousness that we do not have the problems they do.” Do you see this tendency in yourself? How do you stay in contact with your inner client? What does that mean for you?

Depending on the way I look at this quote, I both have this tendency and I do not have this tendency.  I am aware of the fact that I need help with certain issues in my own life and have been in therapy for myself in the past.  I think that this is very important for counselors, since if we do not work through our own issues, these are likely to spill over into the counseling session in the form of countertransference.  I also, however, am able to separate my own issues from my others’.  I feel that it is important not to over-identify with a client because this can also lead to countertransference and pushing our own perspectives of an issue onto a client or not fully understanding what the client is saying.  As I move forward in this career, I think that it is important to do a lot of introspection to identify what my own issues or biases might be and to address these and work on them so that they do not come into the counseling session with me.  For me, this means continually reflecting on my own responses and being willing to go to my own counseling if I think it is necessary.

• What beliefs about yourself do you have that will allow you to find commonalities with your clients so that you do not see it as “us” versus “them”?

I try to be as accepting as possible of others.  When people get on my nerves or bother me I try to think through their reasoning for doing whatever it is that bothered me and rationalizing it from their point of view.  For example, I have a coworker who always leaves the fitting room a mess for everyone else to clean up.  I am able to realize that she views interacting with customers as the most important aspect of the job and if at all possible will seek out customers to help and talk to in order to make their shopping experience as enjoyable as possible.  This allows me to not be as bothered by this, since I understand why the fitting rooms were neglected.  Going into counseling, it is important to try to understand the reasoning behind a client’s poor choices.  When it comes to addictions counseling, gaining this insight can also then help put in place alternative actions that the client can take in the future in similar situations.  It is also important to remember that we are human also and often do not make the most rational decisions either.

 

Cognitive Behavioral Therapy

 

• Which of the foundational philosophies of counseling are you most comfortable with and why?

Of all of the foundational philosophies of counseling used for the treatment of addictions, I am most comfortable with the idea of using cognitive  behavioral therapy with this population.  This approach is very commonly used with addicts and has been proven to be extremely effective.  Cognitive behavioral therapy with addicts works with a combination of different interventions: social, environmental, emotional, cognitive, and physical.  In my opinion, all of these play a crucial role in whether or not an individual will continue to use and are most effective when used in conjunction with each other.  For example, by reducing environmental exposure to triggers, such as the neighborhood where he or she used to buy drugs or watching movies with lots of heavy drug use, there is less temptation to use.  However, by pairing this with cognitive interventions aimed at stopping automatic thinking and modifying beliefs about use, when exposure to these triggers does eventually occur, the client will be able to be able to reduce the weight that these triggers have.  When all of these interventions are combined together, the client is well equipped to face the world with tools to avoid using again.  I feel as though this is a very lasting approach that will have more permanent results than some of the other approaches used.

• Are you a hopeful person? Are you motivating and encouraging? Do you have a judgmental attitude?

I tend to be a hopeful person.  I feel as though anyone is capable of change and I feel that things that happen in life, even the worst things, can be used to strengthen a person if looked at in the right context.  When it comes to substance abuse, the ability to look back on one’s life to evaluate what went wrong to lead to addiction and then being able to change this to get through the addiction is one of the most hopeful and strong things that a person can do.  I also think that I can be motivating and encouraging because I feel so strongly that everyone is capable of change.  I feel as though I am able to convey this to others.  Unfortunately, I can have a judgmental attitude at times when I feel that someone is unwilling to try to address the things that are causing them problems and are willing to just throw in the towel.  I don’t judge someone based on the problems or way that they are, but I do judge when someone is aware that a change needs to be made but is unwilling to take the steps to make that change happen.