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I’ve selected the substance abuse rehabilitation center environment because it’s my field of interest and which I plan to pursue after graduation. I choose this environment basically because it is a very promising field. The fact is that, in today’s society, substance abuse ranks as one of the major public health issues. Moreover, whether directly or indirectly, abuse is responsible for increased risk of violence in the home, suicide, mental illness, work-related accidents, and approximately half of all fatal automobile crashes. Further, the use and abuse of substances span gender, socioeconomic levels, ethnicity, age, religion, profession, geography, and most dimensions of human existence and background. The simple fact is that all people during their lifetimes will be touched by substance abuse or addiction; therefore, counselors should be adequately trained to recognize the enormity of this problem, how to assess it, and ultimately how to treat inpiduals and families who come for assistance.
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In addition, I find the work of a substance abuse counselor a very challenging one. This is because substance misuse, abuse, and addiction is a multifaceted problem that varies across cultures and families as well as with inpiduals. It is a problem that affects everyone, and the costs are staggering. The complexity of the problem has resulted in no single treatment method evolving as most effective for health-distressed inpiduals experiencing the consequences of substance abuse. In fact, empirical research does not support the efficacy of many approaches. However, current research does find that some approaches are more effective than others and that family treatment approaches for substance abusers and their families may be one of those approaches.
The substance abuse rehabilitation center is the place or environment where substance abuse treatment services are provided. It is usually free-standing, non-hospital-based facilities that are often oriented to the well-recognized Minnesota Model of addiction treatment (Straussner, 1993). This substance abuse rehabilitation center is called Heaven, an inpatient and outpatient treatment facility dedicated to treating substance abusers.
Heaven has the following features: (a) the grace of a beautiful environment that promoted respect, understanding, and acceptance of the dignity of each client; (b) a treatment based essentially on the program and process of AA; (c) the belief that time away and association with other abusers was central to recovery; and (d) a very simple program whose expectations were for all clients to make their beds, comport themselves politely, attend the daily lectures on the 12 steps, and talk with one another while sitting around.
Further, “The Heaven,” offers a heavenly treatment as it denotes an effective and frequently used philosophy and methodology of delivering treatment. It has elements of medical (disease), social (psychological), and self-help approaches. The medical elements emphasize a professional staff who direct and control the planning process and its implementation (e.g., enforce and maintain facility rules, provide treatment recommendations and evaluations, educate clients about substance abuse). The social/self-help elements encourage clients to be responsible for developing their own recovery within a context of help from peers and recovering staff.
The ethical dilemma that I will be discussing in the second part of the paper is about Britney, age 17, and has been referred because of problems at school and becoming pregnant. She admits to “smoking some dope” every now and then and having a drink or two with her friends. She is dressed in black with pierced ears, nose, and lip. Her appearance is disheveled and her hygiene poor. She appears to be overly thin. Britney uses cocaine when with friends. She has learned that using helps her fit in—be “one of the gang.”
The complexity of this ethical dilemma arises in the care of a pregnant teenager. This case taps into the substance abuse counselor many layers of personal and professional beliefs. However, careful reading of the case reveals a firm commitment to consider - not ignore - fetal interests within the framework of respect for the autonomy of the competent pregnant teenager. The cases presented clearly relate to situations in which the pregnant teenager is deemed incompetent. Hence, the counselor needs a clear insight into the right approach to take when a medical intervention can benefit both fetus and mother, as in the case of Britney who is a teenager and is addicted to or abuses drugs.
Considering the economic costs and the price in human suffering of substance use and abuse, it seems imperative that counselors be trained in all aspects of substance abuse intervention and prevention. It is essential that all mental health professionals understand the process of abuse and addiction, the etiology of addiction, and the treatment modalities that are considered to be effective. The professional must also be aware of the psychological and physiological effects of drugs on the human brain and thereby on human behavior. Hence, I hope that this research paper will guide me in the recognition, assessment, and treatment of substance abuse or dependency in my future clients.
Specifically, I hope that that this case would assist me in understanding the process of assessment and diagnosis, treatment, and relapse prevention planning. In addition, this hypothetical case will allow me to integrate the many concepts presented in the course.
Straussner, S. L. A. (Ed.). (1993). Clinical work with substance abusing clients. New York: Guilford.
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