The
Fix, an online alcoholism and addiction website with daily news and
articles, presented an interesting story in its June 21, 2013 edition,
entitled Five Ways Therapists Are Clueless About Addiction, written by Marilyn Freimuth, PhD. Dr. Freimuth states at the outset of her article:
"One of the sad truths about addiction treatment is that many of the most talented clinicians—the licensed psychologists and social workers that most people seek out when they have mental health concerns—don’t treat addictions. And, worse, this state of affairs exists because many of these clinicians fail to identify addictive disorders in their clients, even when fairly obvious signs and symptoms confront them."
Dr. Freimuth goes on to list five reasons that therapists often fail to identify, and, therefore treat or refer for appropriate treatment, patients with drug and alcohol use disorders, including gambling disorders:
"One of the sad truths about addiction treatment is that many of the most talented clinicians—the licensed psychologists and social workers that most people seek out when they have mental health concerns—don’t treat addictions. And, worse, this state of affairs exists because many of these clinicians fail to identify addictive disorders in their clients, even when fairly obvious signs and symptoms confront them."
Dr. Freimuth goes on to list five reasons that therapists often fail to identify, and, therefore treat or refer for appropriate treatment, patients with drug and alcohol use disorders, including gambling disorders:
"1. "Behaviors are not addictions."
Many clinicians only inquire about, and consider, substance use when
they think about addiction. They do a quick check about alcohol and
other drugs but don’t delve deeply enough into a client’s behavioral
history to uncover non-substance-related addictive patterns, such as
gambling, shopping, Internet use, etc.
"2. "Real addiction stares you in the face." In addiction treatment settings, addictions are indeed obvious because they are the presenting problem. But in other setting—perhaps due to the way that addiction is portrayed in media and entertainment—many mental health professionals believe that the signs and symptoms of addiction are blatant, like the disheveled appearance and outrageous behavior of Lindsey Lohan. But in fact addictions often are not obvious—even to the client. SAMHSA research has shown that only 1 in 10 people whose alcohol use qualifies as problematic self-identify it as such. One reason is that addiction can often masquerade as a mental health problem ***
"3. "Alcoholics are men, shoppers are women…" Even clinicians with a more nuanced view of addiction can overlook the problem because of mistaken preconceptions. For example, more men than women have alcohol use disorders, so therapists may be more attuned to alcohol addiction in men. A woman’s drinking problem may be further enhanced because it may not create the kinds of apparent adverse effects (e.g., DUIs, arrests) typical for men. Gender is only one impediment to identifying alcohol use problems. Within healthcare settings, alcohol use disorders tend to go underdiagnosed in people who are insured, employed and Caucasian. Stereotypes also block identification of behavioral addictions.
"4. “I don’t treat addictions.” Many mental health clinicians think of their patient population as generally not including addictions, and they don’t actively seek out evidence to the contrary. In fact, addictive disorders are so common that it’s nearly impossible not to work with people who have them. A recent review of the prevalence of substance and A recent review of the prevalence of substance and behavioral addictions found that the annual rate of emerging or diagnosable addictions among adults is 47%. Some of these people will take their distress to therapy. In other cases, an addiction develops over the course of treatment as a person who has poor emotional regulation or limited means of coping turns to a substance or behavior as a way to manage the discomfort of issues addressed in treatment.
"2. "Real addiction stares you in the face." In addiction treatment settings, addictions are indeed obvious because they are the presenting problem. But in other setting—perhaps due to the way that addiction is portrayed in media and entertainment—many mental health professionals believe that the signs and symptoms of addiction are blatant, like the disheveled appearance and outrageous behavior of Lindsey Lohan. But in fact addictions often are not obvious—even to the client. SAMHSA research has shown that only 1 in 10 people whose alcohol use qualifies as problematic self-identify it as such. One reason is that addiction can often masquerade as a mental health problem ***
"3. "Alcoholics are men, shoppers are women…" Even clinicians with a more nuanced view of addiction can overlook the problem because of mistaken preconceptions. For example, more men than women have alcohol use disorders, so therapists may be more attuned to alcohol addiction in men. A woman’s drinking problem may be further enhanced because it may not create the kinds of apparent adverse effects (e.g., DUIs, arrests) typical for men. Gender is only one impediment to identifying alcohol use problems. Within healthcare settings, alcohol use disorders tend to go underdiagnosed in people who are insured, employed and Caucasian. Stereotypes also block identification of behavioral addictions.
"4. “I don’t treat addictions.” Many mental health clinicians think of their patient population as generally not including addictions, and they don’t actively seek out evidence to the contrary. In fact, addictive disorders are so common that it’s nearly impossible not to work with people who have them. A recent review of the prevalence of substance and A recent review of the prevalence of substance and behavioral addictions found that the annual rate of emerging or diagnosable addictions among adults is 47%. Some of these people will take their distress to therapy. In other cases, an addiction develops over the course of treatment as a person who has poor emotional regulation or limited means of coping turns to a substance or behavior as a way to manage the discomfort of issues addressed in treatment.
5. " 'My patients aren't 'addicts.' Despite
the fact that addiction is widely viewed as a treatable disorder, the
perception of “addicts” as unsavory, immoral, antisocial and
unmotivated for treatment may still hold sway. Given that we often come
to like the patients we treat, it may never cross our minds that our
patient could have an addiction. Also, many therapists may believe that
they are unqualified to help a patient with addictive behaviors; that
addiction treatment cannot be seamlessly integrated into psychotherapy;
that such patients need to be referred to a specialist; or that “you
have to be an addict to treat an addict.” Clinicians who are subtly
influenced by these mistaken beliefs may overlook signs of addiction in
order to continue working with a patient.
As always, comments are invited. Jan Edward Williams, 06/21/2013.
No comments:
Post a Comment