Professionalization of Substance Abuse Counseling

Abstract: Individuals who have a dual diagnosis of substance abuse and chronic mental illness pose unique challenges in the delivery of vocational rehabilitation services. Barriers to service provision include an underestimation of prevalence; agency classifications that require a separation of disability conditions into primary and secondary disability; a lack of counselors’ awareness of the unique needs of this population; and the impact of negative attitudes and stigma on vocational success. Although individuals with dual diagnosis can benefit from rehabilitation services and stable employment, changes in the traditional service delivery system are recommended. To address the unique needs of this population, rehabilitation practitioners are encouraged to seek specialized training and continuing education through regional training programs and interagency consultation.

Abstract: Co-dependency has become an important concept in the treatment of substance abuse, yet there is still disagreement about what it means. The meaning of co-dependency is important because it shapes public perceptions of helping behavior and affects the treatment that persons with addictions receive. However, some observers have criticized co-dependency, arguing that the concept is gender-biased, denigrates women, and blames innocent victims of substance abuse. This investigation examined the social construction of co-dependency in the treatment of substance abuse by asking substance-abuse counselors three questions: (a) what do they mean by co-dependency, (b) to what extent does co-dependency mean women, and (c) to what extent do they agree. The findings suggest that co-dependency is a reliable social construction that substance-abuse counselors use to describe persons of both genders.

Abstract: This research was initiated to determine if differences exist in the attitudes of vocational rehabilitation counselors toward substance abusing clients. Using the Substance Abuse Attitude Survey (SMS), ninety-one vocational rehabilitation counselors were surveyed regarding their beliefs and attitudes toward substance abuse and substance abusers. Results comparing those counselors with and without training in substance abuse issues found those with trainning reported significantly more positive attitudes than their non-trained counterparts in only two areas. However, the attitudes of all counselors were found to be somewhat negative.

Abstract: This investigation examined the reliability and validity of a rating scale for codependency in substance abuse treatment. The investigators developed an example-anchored rating scale to operationalize codependency as substance abuse counselors construe it in practice, and recruited 27 counselors for a counterbalanced multiple-treatment experiment. Counselors were randomly assigned to one of four continuing education workshops for rating-scale training, and asked to evaluate codependency in five videotaped cases. Semistructured case interviews were videotaped with a male and a female from five adult populations to vary the gender and codependency of cases: (1) outpatients in treatment for addiction, (2) outpatient spouses, (3) members of Codependents Anonymous, (4) United States Bureau of Land Management smoke jumpers, and (5) college students majoring in business or economics. To control for gender effects, one workshop presented male cases, one workshop presented female cases, and two workshops presented cases of both genders. To control for order effects, the assignment of videotapes to workshops was randomized to counterbalance the order in which counselors viewed them. The findings suggest that the rating scale yields reliable and valid evaluations of codependency without appreciable gender bias.

Abstract: Alcoholism, America's third leading disabling condition, is discussed in regard to (a) its relation to other disabilities relevant to rehabilitation counseling, (b) its more critical symptoms, (c) intervention and confrontation, and (d) signs of recovery. Based on a theoretical “hourglass” model of alcoholism, aids for diagnosis and treatment, as well as recommendations for counselor training, are presented.

Abstract: Literature on the counseling needs of special populations typically has focused on the inadequate treatment those populations receive. Counselor education programs have responded by developing courses that target specific populations such as women, minorities, or disabled people. There are serious drawbacks, however, to this proliferation of specialized courses. In this article the authors discuss those drawbacks and argue that counselor education programs should include an integrated course that facilitates student self-awareness in conjunction with practical experience with a variety of clients.

Abstract: This review examines the incidence, problems and treatment issues involved when dealing with individuals who have a psychiatric disorder and concurrent substance abuse problem. There is an increasing number of these clients evidenced in psychiatric and substance abuse rehabilitation facilities and the reasons are not very clear. Suggestions are offered for a pilot treatment program and future directions recommended for addressing the special needs of this subpopulation.

Abstract: Alcoholism, America's third leading disabling condition, is discussed in regard to (a) its relation to other disabilities relevant to rehabilitation counseling, (b) its more critical symptoms, (c) intervention and confrontation, and (d) signs of recovery. Based on a theoretical “hourglass” model of alcoholism, aids for diagnosis and treatment, as well as recommendations for counselor training, are presented.

Abstract: The author describes cognitive deficits that are attributable to alcoholism and discusses the prospect for recovery of these impaired skills. Rather than viewing neuropsychological testing simply as a diagnostic exercise, the author considers the potential treatment role of this psychological subspecialty and its implication for alcoholism counselors.