Week 9 discussion response to classmates

Please no plagiarism and make sure you are able to access all resource on your own before you bid. Main references come from Van Wormer, K., & Davis, D. R. (2018) and/or American Psychiatric Association. (2013). You need to have scholarly support for any claim of fact or recommendation regarding treatment. I have also attached my discussion rubric so you can see how to make full points. Please respond to all 3 of my classmates separately with separate references for each response. You need to have scholarly support for any claim of fact or recommendation like peer-reviewed, professional scholarly journals. If you draw from the internet, I encourage you to use websites from the major mental health professional associations (American Counseling Association, American Psychological Association, etc.) or federal agencies (Substance Abuse and Mental Health Services Administration (SAMSHA), National Institute of Mental Health (NIMH), National Institutes of Health (NIH), etc.). I need this completed by 04/28/19 at 12pm.

Expectation:

Responses to peers. Note that this is measured by both the quantity and quality of your posts. Does your post contribute to continuing the discussion? Are your ideas supported with citations from the learning resources and other scholarly sources? Note that citations are expected for both your main post and your response posts. Note also, that, although it is often helpful and important to provide one or two sentence responses thanking somebody or supporting them or commiserating with them, those types of responses do not always further the discussion as much as they check in with the author. Such responses are appropriate and encouraged; however, they should be considered supplemental to more substantive responses, not sufficient by themselves.

Read a your colleagues’ postings. Respond to your colleagues’ postings.

Respond in one or more of the following ways:

· Ask a probing question.

· Share an insight gained from having read your colleague’s posting.

· Offer and support an opinion.

· Validate an idea with your own experience.

· Make a suggestion.

· Expand on your colleague’s posting.

1. Classmate (G. Sim)

    The family is seen as a preventative unit within the picture of recovery for the addicted person, a buffer between them and their drugs of (no) choice. Strong family support is so important for an addicted person (I hate the perjorative term “addict”) in order for a chance at recovery and success. The family’s abilities to resiliency and healing is a key component in the recovery picture as family members adopt survival roles to minimize stress and pain during this difficult time (Van Wormer & Davis, 2018). The TV show “Intervention” has provided a fascinating look at how families can bond together, confront the person who is addicted and offer unconditional love while adopting a firm stance that the status quo can no longer be tolerated.

A unique characteristic of families with addiction problems is how sometimes family members can become enablers without intending to, or even knowing they are doing so. Good intentions can sometimes leave family members open to manipulation from addicted family members, whether they are parents or children, as addicted people become very good at manipulating the people in their lives to sustain their addicted lifestyle (Van Wormer & Davis, 2018). Parents, in particular, often have problems with direct communication and confrontation (Lander, Howsare, & Byrne, M., 2013).

A possible ethical dilemma in helping addicted clients and their families can be, who is my client? HIPAA rules are explicit when it comes to sharing information even between family members; I have a client right now whose parents live in another state and have not heard from their daughter and are worried and want me to call them. I know I must at least get my client to sign a release of information in order for me to call her parents to discuss her case, in the meantime I can at least pass on to her that her parents are concerned.

Lander, L., Howsare, J., & Byrne, M. (2013). The impact of substance use disorders on families and children: from theory to practice. Social work in public health, 28(3-4), 194–205. doi:10.1080/19371918.2013.759005

Van Wormer, K., & Davis, D. R. (2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage.

2. Classmate (R. White)

Family Roles and Dynamics

When discussing the key roles that exist among families of clients with addiction problems, many interactions exist to normalize the family. Accordingly, the family roles occupied by members of a family with substance-use problems act as a buffer to mask the individual’s addictive behaviors (Vernig, 2011). Thus, the role of the enabler is often the spouse of the individual with addiction problems. In this role, efforts are made to protect the spouse from encountering adverse circumstances resulting from their maladaptive behaviors (Vernig, 2011). The enabler attempts to disguise the problematic actions from the immediate and extended family and the abuser’s professional interests. Consequently, since a great deal of energy is expended reacting to problematic behaviors, the enablers wants and needs are often left unattended (VanWormer & Davis, 2018). Additionally, the Stages of Change model asserts that individuals can be motivated to transition from the pre-contemplation stage to the contemplation stage in the presence of external pressures like legal problems, marital issues, or occupational setbacks (DiClemente & Velasquez, 2005). Therefore, by acting as a parachute or cushion to the chemically dependent person, negative consequences that can potentially facilitate behavioral changes are inhibited by the enabler, and thus reinforce the patterns of substance use.

Furthermore, another significant role is that of the hero. This person is viewed as the golden child of the family. VanWormer and Davis (2018) postulate that the hero represents the exemplar of the family. In other words, their success and achievements provide reassurance that the dysfunctional family climate is not representative of the entire family. Consequently, the hero receives most of the positive attention from family members and is regularly praised by those outside the family. However, Vernig (2011) indicated that the family’s values are often fulfilled through the hero, thereby producing a fear of failing and low self-esteem. Likewise, the hero can manifest in parentified and controlling behaviors throughout the individual’s life (VanWormer & Davis, 2018)

Unique Characteristic of Families of Members with Substance Abuse Problems

One unique characteristic of families with parents or children abusing alcohol or drugs is the communication within the family. Although family roles on the surface distract from the reality of what is taking place in the home, negativism is a predominant communicative pattern within the family. According to the Center for Substance Abuse Treatment (2004), family interactions are regularly filled with complaints and criticism, and any display of positive behavior is usually overlooked. Therefore, attempts to seek attention is often gained through a member-induced crisis. For example, a child may intentionally exhibit behavioral problems to divert attention away from the substance-directed chaos. Furthermore, the persistent negative attitudes of members reinforce the addictive patterns (Center for Substance Abuse Treatment, 2004).

Ethical Concern

An ethical or legal concern that arises when counseling families with addictions diagnoses is the potential for social problems. The Center for Substance Abuse Treatment (2004) noted the high prevalence of domestic violence, child abuse or neglect, and criminal behaviors in families with persons diagnosed with substance-use disorders. As such, the client’s limits of confidentiality should periodically be reiterated to ensure the client understands the legal duties of the counselor, such as situations requiring mandated reporting.

References

Center for Substance Abuse Treatment. (2004). Impact on substance abuse on families. Substance Abuse Treatment and Family Therapy. Retrieved from www.ncbi.nlm.nih.gov/books/NBK64258/

DiClemente, C. & Velasquez, M. (2005). Motivational interviewing and the stages of change. In S. Rollnick & R. Miller (Eds), Motivational Interviewing (pp. 1-20). Baltimore, MD: Guilford Press.

Van Wormer, K., & Davis, D. R. (2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage.

Vernig, P. M. (2011). Family roles in homes with alcohol-dependent parents: An evidence-based review. Substance Use & Misuse, 46(4), 535–542. Retrieved from the Walden Library databases.

3. Classmate (T. Rod)

The the family dynamic is affected tremendously by the person who has an addiction. According to Van Wormer & Davis (2018), for every person that has an addiction, “the lives of at least four other people are consistently altered” (p. 392).  In this post, I will describe two ways that family roles and dynamics interact with the action. Then I will identify at least one unique characteristic within families of clients with addiction problems.  Lastly, I will describe one ethical or legal concern related to counseling families with addiction diagnoses.

Description of Two Ways Family Roles & Dynamics Interact with Addiction

According to Sharon Wegscheider, six family roles can exist in a family who has a person who suffer from addiction. The six family roles are “the chemically dependent person, the chief enabler, the hero, the scapegoat, the lost child, and the mascot” (Van Wormer & Davis,2018, p.402). The two-family roles I chose are the chief enabler and the chemically dependent person. The chief enabler, also known as the family manager, is sometimes the partner of the person who has an addiction. This person takes control over and tries to create a balance in the family dynamic (Van Wormer& Davis). This person makes excuses or tries to deny that there is anything wrong with the person or there is an addiction issue.  A chemically dependent person is the person who is suffering from addiction. Some chemically dependent person is remorseful in what his or her addiction has caused their family member. Sometimes, they do not care and want to be self-fish and fulfill his or her addiction needs (Van Wormer & Davis, 2018).

Another way family roles and dynamics interact with addiction is the addicted has a codependency issue.  Codependency is often viewed as the disease that predated the relationship with a partner who was addicted to alcohol or other drugs (Van Wormer & Davis, 2018). A codependent person usually decides the person who is unable to make due to the person’s addiction.

One Unique Characteristic Within Families of Clients with Addiction Problems

One unique Characteristic within families of the client with an addiction problem is how the families handle the addiction culturally. Each culture has its way of handling the addiction problem, and their response to the person has an addiction. For example, in Hispanic Culture, there is a strong influence that a person is not allowed to discuss any substance use or abuse. In the LGBT community,” drug use and suicide attempts were three to eight times more common among youth in rejecting than accepting families” (Van Wormer and Davis, 2018, p. 424). Therapy is beneficial, and the person has to be culturally competent, and they had to ensure they request the culture of the client and his or her family.

Description of One Ethical or Legal Concern Related to Counseling Families with Addiction Diagnoses

One ethical concern related to counseling families with addiction diagnoses is confidentiality. Confidentiality can be an issue because the person who has addiction diagnoses sometimes has a trust issue which can affect how they interact with the Therapist. It is the counselor duty to respect the confidentiality of his or Her client (ACA, 2014, Standard B.1.C). A counselor has to explain to the client What is confidential and what is not considered to be confidential.  A person who has an addiction diagnosis can be getting care from a different place and due to the “nature of managed care requires more extensive justification for treatment, and the number of individuals that need information about a person’s treatment is increasing”( Center For Substance Abuse Treatment. Substance Abuse, 2000) and this can cause a a significant issue with confidentially/

Reference

American Counseling Association (ACA). (2014). ACA Code of Ethics. Retrieved   
from http://www.counseling.org/docs/ethics/2014-aca-code-of-ethics.pdf?sfvrsn=4

Center for Substance Abuse Treatment. Substance Abuse Treatment for Persons with HIV/AIDS. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2000. (Treatment Improvement Protocol (TIP) Series, No. 37.) Chapter 8—Ethical Issues. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64933/

Van Wormer, K., & Davis, D. R. (2018). Addiction treatment: A strengths perspective (4th ed.). Boston, MA: Cengage

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Required Resources

  • Van      Wormer, K., & Davis, D. R. (2018). Addiction treatment: A      strengths perspective (4th ed.). Boston, MA: Cengage.
    • Chapter       10, “Family Risks and Resiliencies” (pp. 391-430)
  • Epstein,      M., Hill, K. G., Bailey, J. A., & Hawkins, J. D. (2013). The effect of      general and drug-specific family environments on comorbid and      drug-specific problem behavior: A longitudinal examination. Developmental      Psychology, 49(6), 1151–1164.
         Retrieved from the Walden Library databases.
  • Jang,      M. H., & Ji, E. S. (2012). Gender differences in associations between      parental problem drinking and early adolescents’ internet addiction. Journal      for Specialists in Pediatric Nursing, 17(4), 288–300.
         Retrieved from the Walden Library databases. 
  • Klosterman,      K., Kelley, M. L., Mignone, T., Pusateri, L., & Wills, K. (2011). Behavioral      couples therapy for substance abusers: Where do we go from here? Substance      Abuse & Misuse, 46(12), 1502–1509.
         Retrieved from the Walden Library databases.
  • Vernig,      P. M. (2011). Family roles in homes with alcohol-dependent parents: An      evidence-based review. Substance Use & Misuse, 46(4),      535–542.
         Retrieved from the Walden Library databases.
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