This author writes today coming with a plethora of experience and techniques in the intial identification and treatment of acohol abuse and dependency. By virtue of having worked at two universities where the young adult population either is forming their realtionship and choices around alcohol or is already showing early warning signs of alcoholism, there are a host of entities utilized in understanding, informing, and socially “norming” young adult's decisions with alcohol. This writer resides philosophically somewhere between pusher (i.e. bartender) and prohibitionist with this topic. It's a grey place to reside and unfortunately with student's cognition development, they often have a hard time understanding the grey area instead of being clearly black and white with orientation around alcohol. Perhaps the law serves as the clear and cut parameter around alcohol and how one chooses to either abide by the law or not is where the most cognitive growth can occur around good decision making in regards to consumption.
As I project out a number of years as a psychologist and consider adult patients, I am of the understanding that acoholism is a family disease of which all parties need treatment. As stated in earlier weeks, this writer impresses upon anyone entering within a counseling treatment with a professional like myself at the healm that if “you are not part of the solution in reagards to alcohol than you are part of the problem.” Al-Anon is recommended for family members so that they learn not to support the alcoholism behavior. Not doing this step, as related to the societal and cultural constructs in psychological dynamics and within a family, creates negative feedback loops at many levels. (Nicholson, 2010).
In introductory counseling sessions the client with alcohol problems will need to define family in the terms of people in his or her daily sphere of influence. This idea of family may extend to friends, peers, and co-workers. In matters of professional confidentiality, the client may be asked about comfort level in reporting to superiors or Human Resources about garnering additional resources and assistance towards reforming alcohol dependency issues. These conversations and inquiries about support can come either directly from the client or can be facilitated by the professional.
Beyond getting the client to talk about family and supportive types, we can also begin to explore what constituted their history with alcohol. This writer gets to utilize empathy as alcoholism has run rampant in my family and I am the first generation to break the habits of the disease though my genes are wired to addiction. My consciousness is half of the battle. I work not to put any triggers in range of myself. Peers know that I have alcoholism in my family and that I will not be having any adult beverages or spirits. While I might role model strength and proactivity around the disease of addiction, what works for me may not necessarily work for my clients. Indeed these clients may not be able to ward off the alcohol so successfully. Serenity might work better for them instead of warrioring through. Group processes like AA may be a better fit. Creating a supportive, spiritual group and structure may work better for some clients (Hersen, Turner, & Beidel, 2007) .
Beyond family members and support groups being identified, issues around genetics, environment, and emotion needs to be explored. Is the client feeling guilty or ashamed of their issue? These deep emotions can work sometimes in the client and professional's favor if it acts like a catalyst for change. To uncover a family history of alcholism is not unheard of, and perhaps the client had learned poor coping skills with emotions and soothed with alcohol to a precarious brink. CBT may make its debut at this time. Within the learned behavior is also consideration of the genetic inheritance of alcoholism from biological family members. Also, questions around the client's social environment are key. If they are a clubber, they place themselves in trigger, high risk environments not only for alchol but for drugs.
Assessment of alcohol dependency issues may come to a professional by virtue of the judicial system. To be clear, if a court has referred an individual to counseling because of alcohol, it's safe to say a behavior choice involving alcohol lead to this point. While the motivation to work within the parameters of counseling may not be of the intrinsic sort, none the less, a sphere of the client indicates that some behavior is enough to indicate that the client's relationship with alcohol is not on normal, functional parameters. The client may do the motions of therapy but only when they are ready on their terms will impact on their disease really be accomplished. It is not any fault of the therapist to take things personally when a client resists treatment. The professional must believe in their capabilties should their timing and skill meet up with the right client with a “readiness” factor. This may not happen as frequently as one would like, but when one can get the client to sobriety every hassle patient or every mismatched patient within a broken system tends to fade in comparison to those that wish to be helped.
Hersen, M., Turner, S.M., and Beidel, D.C. (2007). Adult Psychopathology and Diagnosis, Fifth Edition. Hoboken, NJ: John Wiley & Sons, Inc.
Nichols, M. P., (2010). Family therapy: Concepts and methods (9th ed.). Boston: Allyn & Bacon.