Counselling is not the only option

Counselling is not the only option

Counselling is not the only option

 

Drug and alcohol use affects not only the person using the substance themselves, but the people around them too. It is estimated that for every problematic substance user, between five and twenty family members are affected by their use (ADFAM).

I wanted to write about why counselling isn’t the only option. Don’t get me wrong, I will never, ever discredit counselling because I’ve had it myself and had a positive experience. I also work with counsellors and fully respect what they do, so they would not be too impressed with me if I said otherwise!

That said, counselling isn’t the only option. Recently, I’ve had a few conversations about this very point.

 

About my service

 

For the type of help someone using substances can access, have a look at my blog, Drug and alcohol help- choices for a friend or family member.

Speaking for myself, I am a qualified and experienced drug and alcohol practitioner, also qualified in teaching, NLP, a safeguarding practitioner and soon-to-be professional coach and I have led and developed services and teams. I have a track record of supporting individuals and families to recover from their own substance use or the effects of it as a family member.

I offer solution focused therapeutic interventions.

What does that mean? It means when a person using substances, or a family member, comes to me and asks me to help them with drugs, alcohol and associated problems, they set the goals and I guide them towards achieving these goals within a specific time-frame, following a specific programme.

The therapy isn’t just the session we have together. The individual I’m working with has to put into practice what we’ve covered in the session. Therapy requires a commitment to change.

I used evidence-based programmes for my family work. Evidence-based means that I use programmes that have been developed by other people that have been tested out to be effective for the people I’m working with. If my client goes off track, that’s fine, I’ll help them get back on their path to reach their goal, or we’ll set new ones together. Things change, so do people.

My clients are in control, I advise and guide them to get to where they want to be, but in planned, semi-structured sessions. We cover different topics in each session, have a check in and review at the start of each session and plan an action for the week at the end of it. I want to move people on.

For me, the session doesn’t end there, there is additional work that takes place behind the scenes such as recording notes, admin tasks, contacting services I have consent to speak with or refer to and so on. If there is more than one family member getting support, then this will increase the time spent on each case. I have an option to travel to my clients, so this time is factored in.

What my clients get as standard is:

  • Weekly one-hour therapeutic session (Skype/face to face with options in family home or at my Manchester base)
  • Solution-focused work so they will see a change in the time they work with me which is evidence by a relaxed assessment at the start and end of our work.
  • Actions to follow up between sessions with support
  • Programmes are evidence based
  • Referrals and communication with existing or new services (with consent)
  • Email/text contact between sessions

 

I also offer options to support people in their own homes or at an appropriate venue or their choice.

My expertise in supporting recovery from drugs and alcohol ensures that the people I support get a specialist service for a special issue.

 

Other types of support

 

I asked some colleagues and friends of mine what they offer in their services, so I could attempt to explain counselling and alternative support…

 

Counselling

 

Louise Wilkinson is not only a qualified drug and alcohol practitioner but is also a counsellor. I asked her what the difference is in drug and alcohol work and counselling. She said,

“A counsellor process is led by the client. The counsellor doesn’t have an agenda. The session is directed and led primarily by the person coming for help. The sessions help them to achieve whatever brought them to counselling in the first place. It doesn’t mean the presenting need ends up being the problem they end up dealing with, but they are autonomous in their decision making and how the session goes.”

Following the session, some counsellors will write up brief therapeutic notes, so unless there are any safeguarding issues, when the session finishes, the therapists work is complete. The client will have a lot to think about. Louise says that in her role as a substance misuse worker, she does use counselling skills, but also offers information and advice, which wouldn’t be the case in her counselling sessions where she would encourage her clients to work through feelings, emotions and behaviours.

Some counsellors specialise in addiction (and many other areas) too, so be sure to ask this because it is really useful to work through the feelings that led to the substance use in the first place. There is usually no time limit to counselling so some people might access it for years and others a much shorter period of time.

 

Hypnotherapy

 

Thomas McGowan is a hypnotherapist and he describes hypnotherapy as,

“Relaxation, like daydreaming, that’s what the feeling is almost. Clients are fully aware of what’s going on, but are focusing on the subconscious mind, where everything is controlled, including feelings and functions. By working directly with the subconscious mind, we are able to get to the root cause of presenting problems. We cannot change memories, but we can sever the emotional ties, are so clients getting the best possible outcomes with the least discomfort.”

Thomas delivers addiction hypnotherapy in which he deals with changing perspective, letting go of the past and building the future. The initial offer is five x 1.5 hour sessions with the option of ongoing support if needed.

In Thomas’s opinion, hypnotherapy clients revisit their pain-points but they are moved on from these in a comfortable way, rather than staying in the moment. He believes counselling works through these painful times by revisiting them and the feelings associated with it.

 

Community Drug and Alcohol Services

 

Each local authority provides funded drug and alcohol services, guided by our drug strategy. They are free for people who want to use the service. Every locality offers a service for adults and also for young people. These services provide support for people experiencing problems with substances. Some also provide support for affected family members too. For example, One Recovery in Bury delivers CRAFT which is an evidence- based model supporting families living with a loved one’s substance use. It is a similar model to the one I use in my practice.

I have previously worked at Early Break and I’m currently delivering a project there for their Holding Families Service. Early Break has a range of services that supports young people and families. I might be biased but they are brilliant!

 

In summary

 

The difference between these service and the others I mentioned is that these are free and the others are private, which means the client pays for them. Some counselling can be offered through GP’s along with other therapies like Cognitive Behavioural Therapy, which are equally as effective, depending on the needs of the client. They usually require a bit of a wait to access them because of the high need.

It is always advisable to check a practitioner’s experience of supporting drugs, alcohol and/or families before deciding to work with them. In addition, check their credentials and who they are registered or accredited with because this gives an extra layer of protection for the services you opt for. I am registered with the Federation of Drug and Alcohol Practitioners, which means I have to follow their code of practice and I’m listed on there in their practitioner directory.

Some people want a private service, others don’t, but everyone listed above works confidentially. Every one of the services above may be qualified in one or more type of support. The important thing is to ask.

Hopefully this has made a bit of sense about the options available to support families and that counselling is not the only option.

 

Other support

 

I obviously don’t have time to mention every type of support here. There are so many options for therapy. Here are some services relevant to my clients:

  • For children affected by parental alcohol use, take a look at NACOA.
  • For families, take a look at ADFAM’s website.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area or via Skype worldwide.

I also have an online therapeutic programme. Take a look at my services here

Follow me on Twitter and Facebook

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

Take care,

Victoria.

 

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How do I know if someone is an addict?- Part two- The diagnosis of substance use

How do I know if someone is an addict?- Part two- The diagnosis of substance use

Hopefully you read part one of my blog last week How do I know if someone is an addict?- Part one- The stages of substance use

This week, I’ll focus on the diagnosis of substance use. To put it simply, I think if someone has a problem with substance use, then they need help. In our culture, we seem to always want some sort of diagnosis.

 

How we diagnose

 

The ICD-10 International Statistical Classification of Diseases and Related Health Problems (mental and behavioural disorders) is what medical professional use to diagnose health problems. It is led by the World Health Association and is the main reference guide in the UK.

Interestingly, the ICD-10 does not even refer to ‘addiction’ as a disorder and hasn’t done since 1964.

Instead, it refers to:

Harmful use– A pattern of psychoactive substance use that is causing damage to health. The damage may be physical (as in cases of hepatitis from the self-administration of injected drugs) or mental (e.g. episodes of depressive disorder secondary to heavy consumption of alcohol).

 

The diagnosis requires that actual damage should have been caused to the mental or physical health of the user and not just the social impact on themselves or their family members.

 

OR

 

Dependence syndrome– A cluster of physiological, behavioural, and cognitive phenomena in which the use of a substance or a class of substances takes on a much higher priority for a given individual than other behaviours that once had greater value.

The explanation given is that people have an overwhelming desire to take their particular drug(s) of choice or alcohol and if they do give up temporarily, they are more likely to return to old behaviours quickly, as opposed to someone who does not have a problems with substances but uses them.

 

Criteria

 

ICD10 states, ‘A definite diagnosis of dependence should usually be made only if three or more of the following have been present together at some time during the previous year:

(a) a strong desire or sense of compulsion to take the substance;

(b) difficulties in controlling substance-taking behaviour in terms of its onset, termination, or levels of use;

(c) a physiological withdrawal state (see F1x.3 and F1x.4) when substance use has ceased or been reduced, as evidenced by: the characteristic withdrawal syndrome for the substance; or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms;

(d) evidence of tolerance, such that increased doses of the psychoactive substances are required in order to achieve effects originally produced by lower doses (clear examples of this are found in alcohol- and opiate-dependent individuals who may take daily doses sufficient to incapacitate or kill nontolerant users);

(e) progressive neglect of alternative pleasures or interests because of psychoactive substance use, increased amount of time necessary to obtain or take the substance or to recover from its effects;

(f) persisting with substance use despite clear evidence of overtly harmful consequences, such as harm to the liver through excessive drinking, depressive mood states consequent to periods of heavy substance use, or drug-related impairment of cognitive functioning; efforts should be made to determine that the user was actually, or could be expected to be, aware of the nature and extent of the harm

 

Screening tools

 

Here are some handy screening tools which can be self-scored. If you can get your loved one to complete it, great! If not, you may know enough about their substance using patterns to be able to give it a go yourself.

AUDIT

The Alcohol Use Disorders Identification Test (AUDIT) is considered the most accurate alcohol screening tool for identifying potential alcohol misuse, including dependence. Here is a self-screening that you could explore with your loved one or have a look yourself on their behalf.

 

DUDIT

The Drug Use Disorder Identification Test is here in PDF form to use if you suspect your loved one is using drugs.

 

A note about language

 

I always refer to ‘people who have problems with substance use’ or something similar. I don’t like labels, but what individuals choose to refer to themselves as is their choice. As long as we are not labelling each other, then I think that’s fair enough. There is lots of choice around the help people get for their drug and alcohol use which means that people tend to label themselves depending on the model they use to get help. This doesn’t mean we should be doing it on behalf of individuals or making assumptions.

 

In summary then, although most of us are not medical professionals and therefore technically shouldn’t diagnose others, we can get a fair idea from the above to figure out whether we are on the right track with our loved one’s substance use.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area or via Skype worldwide.

I also have an online therapeutic programme. Take a look at my services here

Follow me on Twitter and Facebook

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

Take care,

Victoria.

 

How do I know if someone is an addict?- Part one- The stages of substance use

How do I know if someone is an addict?- Part one- The stages of substance use

Did I get your attention? Just so you know, I never ever label anyone an ‘addict’. I’ll explain why in part two of this blog. For now, forget the labels and read on…

 

Let’s face it, most of us have overindulged with alcohol and/or drugs in our time. Many people do this either regularly or occasionally and this causes minimal or no problems. It is difficult to recognise in ourselves that we might be going too far because ‘everyone is doing it’. ‘Such-and-such-a-body drinks more than me’. ‘I’ve been round and had nothing before (*reality check* – it was once) many a time and watched everyone get wasted’.

 

What I’m getting at here is that it’s easy for people to deny they have a problem. Sometimes we don’t recognise it in ourselves. Sometimes we don’t recognise it in others. Sometimes, others recognise it in us. We might recognise it in someone else that doesn’t have a clue!

 

Some people use drugs or alcohol and, other than tiredness and feeling a bit rubbish, get on with life as usual (ba****ds!). For others, it causes problems in daily functioning.

 

It is these people who often deny they have a problem and make excuses to deflect from the fact that they need to part ways with their substance(s) of choice. This is often too difficult to face for many and requires a whole lifestyle change and a lot of energy.

 

The starting point

 

The first port of call is to get clued up on the different types and stages of substance use. (Just so you know, I refer to substance use to include both drugs and alcohol)

 

To simplify…

 

I believe that if drugs or alcohol are causing problems in somebody’s life, then they need help. Depending on the stage of substance use they are at, their current lifestyle, their mental and physical health, motivation to change, Adverse Childhood Experiences and other life experiences, the help they need will vary.

Everyone’s recovery journey is unique and not everyone will want to stop.

 

The language of substance use

 

Firstly, there are differences between the language of substance use. Some terms commonly used are ‘problematic substance use’, ‘addiction’ or ‘dependency’, and, as they are used interchangeably, it starts being confusing!

Problematic substance use refers to drug or alcohol use which is affecting one or more areas of a person’s life. This could be work, relationships, health or anything else. People often don’t realise that the reason they are having problems, is due to their drug or alcohol use. They often don’t understand the impact of their particular drug on the way they think, feel and behave.

Dependency– is where an individual requires a drug, in order to function. In my view, this can be either physical or psychological. For example, some people use drugs to mask their feelings and some people use drugs to either mask their physical pain, or have what we refer to, as physical withdrawals when the drug starts to leave their system. Dependency is mostly attributed to drugs that cause physical symptoms in the body when someone tried to stop using them.

Addiction is where a particular behaviour is compulsive or habitual, despite the fact that it is having a negative impact on an individual’s life. The way I describe it is that the drug is in control of the person, rather than the person being in control of the drug.

Someone can be dependent and addicted to certain drugs (such as alcohol and heroin)

Someone can be addicted but not dependent on other drugs (such as cocaine and caffeine)

Someone can be dependent but not addicted (such as someone who is taking medication for pain)

 

Stages of substance use

 

Here’s a handy diagram to help you to start thinking about the above. Notice that ‘addiction’ is not referred to here as ‘addiction’ is not actually a diagnosis used for someone having problems with their substance use…

spectrum of pschoactive substances

Diagram source: http://www.cfdp.ca/bchoc.pdf

 

Beneficial use would generally be medicinal but, as stated, includes other benefits. Many substance users may say their drug use is beneficial for them. This could be true, but it could also be an excuse for continuing use. The minute the substance starts causing problems for them is the minute the negatives outweigh the positives.

 

Non-problematic use would be those people who manage their substance use with limited or no impact- This is sometimes where family members find out and start panicking. Talk to your loved one and get the facts. They might be taking them but managing their use well.

 

Problematic use (harmful use) can range from someone having a few problems or lots of problems- you may know more than your loved one that their substance use is causing them problems.

 

Dependence is where someone can no longer easily choose to stop taking their drug of choice. The individual’s priority is to source and use their drug and activities are centred around it.

 

Where is your loved one on the spectrum?

 

As I bring part one of this blog to a close, where do you think your loved one is on the spectrum of psychoactive substance use?

 

Head over here next week for part two where I will be focusing on the diagnosis of substance use.

 

I can help

 

My service, The Vesta Approach, supports families affected by a loved one’s substance use. You can access confidential support from me wherever you are in the world. I will help you to get your loved one into treatment and lead a better life. I offer face to face sessions in the Manchester (UK) area or via Skype worldwide.

I also have an online therapeutic programme. Take a look at my services here

Follow me on Twitter and Facebook

Sign up to my mailing list here to keep up to date with Vesta news and get my free Ten Steps to Family Recovery download.

 

Take care,

Victoria.