Do you want to be a drug counselor?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

The need for qualified drug counselors continues to grow.

Pill for that?

Drug Counseling?
Photo courtesy of Pixabay.com

The growing opioid epidemic has highlighted the need for more drug treatment. So has the use of other drugs, methamphetamine, the so-called bath salts, and a whole host of new substances which continue to grow. The need for treatment among the older generation is at an all-time high as many baby boomers have continued to use their drug of choice into their retirement years. While the increasing problem with hard drugs gets a lot of media attention, we can’t forget that the two legal drugs, nicotine and alcohol remain huge killers. In medical settings, most of the patients have illnesses caused by or made worse by the use and abuse of alcohol and drugs.

There are several reasons why you might want to become a drug and alcohol counselor. For over ten years now I’ve taught classes in counseling those with substance use disorders. This week another class is starting. Over the next few weeks, I’d like to talk to you about some of the things drug counselors learn. Let’s begin today with reasons you might want to become a drug counselor and why your reason might help or hinder you in becoming a good drug counselor.

The field of drug counseling continues to evolve. The laws and regulations vary from place to place, and so do the names given to drug counselors. Counselors in this field are sometimes called substance abuse counselors, substance use disorder counselors, drug and alcohol counselors, or AOD counselors which stands for alcohol and other drug counselors.

This field used to separate alcoholics from drug addicts and provide two different kinds of treatment. Today it’s rare to find treatment programs where the two issues are disconnected. People with alcohol only problems usually end up in a drunk driver program or self-help groups such as AA. People with drug problems go to drug programs even though they often also have alcohol problems.

If you are in recovery, you may want to become a drug counselor.

Today’s substance abuse counseling programs mainly grew out of the alumni from drug programs and people who had attended 12 step groups. If you’re in recovery yourself, you may want to give back. The good part about this is that you probably have a lot of knowledge about the process of addiction. Many of my students are former alcoholics or addicts now in recovery. I tell the class, only half-joking, that many of you have done “extensive field research” on drugs and alcohol.

If you’re a recovering person, you probably know a lot about the 12 steps. While a lot of research is being done about what works and doesn’t work in the substance use disorder field, working the 12 steps and attending self-help groups continues to be a significant component of most recovery programs.

The downside to being a recovering person is that you may struggle with the academic, professional part of the curriculum. People in recovery who rushed too rapidly into becoming drug counselors put themselves at risk for relapse. For recovering person to work in the treatment field, they need to not only know the disease of addiction, but they also need to understand the process of recovery. If you’re in early recovery give yourself plenty of time to get used to your new sobriety before beginning to work in the field, otherwise you can put yourself at risk of relapse.

You may have had a family member or friend with an addiction problem.

Many people come into the field because they lost a family member or close friend to the diseases of addiction. I’ve seen some very effective counselors who have not themselves been addicts but have grown up in a home with an addicted parent or partner. If you’ve lost a child to addiction, death, or incarceration, that can be an exceptionally strong motivation to work in the field.

The caution for family members is like the one for recovering people. Make sure you are fully recovered from your experiences of living with an addicted person. Don’t expect to work out your own problems by working with addicts. Living with an addicted person can cause severe emotional trauma. You need to be fully recovered from that trauma if you plan to do this kind of work. A number of my drug counseling students were family members of addicts. They pretty much all told me they benefited by taking the classes. Many however decided they needed to work on themselves rather than trying to fix themselves by fixing addicts.

You have discovered a lot of the people you work with have drug problems.

No matter where you work there’s a strong possibility that many of the people you see each day have a drug problem. One survey estimated that 80% of the people in prison were drunk or high in the 24 hours before the committed the crime that led to their incarceration. VA Hospital estimated half of their hospital beds on the results of patients whose condition was caused by or made worse by alcohol. People who work in the criminal justice system or the medical field need to know about addiction and recovery.

People who work in the welfare system need to be knowledgeable about drugs, alcohol, addiction, and recovery. Many people who are unemployed have substance use issues. Among the homeless population, one drug is almost universal. It’s probably not the drug you are thinking of, the drug of choice among the homeless – is tobacco.

If you’re working in education, you need to know about drugs, alcohol and the problems they’re creating for your students. Surveys tell us that at the college level F students consume twice as much alcohol as A students. Many elementary school students begin experimenting with drugs and drinking around the third or fourth grade. They start by smoking their parent’s cigarettes or drinking their alcohol. With the shift towards legalized marijuana more and more elementary and middle school students are using marijuana. If you work with kids in any capacity part of what you should be doing will be drug prevention and early interventions.

You work in mental health and clients want to talk to you about drug problems.

There’s a substantial overlap between mental health issues and substance use disorders. If you work in a program or facility that treats mental health problems you’re seeing people with substance use disorders whether you know it or not. Please don’t say “I don’t want to work with those people.” You are. If you give off the attitude you don’t want to talk to them about their drug problems, their sex problems, or their gambling problems; they just won’t tell you the truth about those issues.

Roughly half the people with a diagnosed mental illness, abuse substances and many go on to develop substance use disorders. About 60% of the people with substance use disorders also have a mental illness. The area of working with clients with both problems, now called “dual diagnosis” used to be called “co-occurring disorders.” The most effective treatment for people with both disorders is to get them both treated at the same time and either at the same place or with two different providers who work together to coordinate care.

You would like to help “those people.”

If your motivation to become a drug counselor is because you feel sorry for people with a history of substance use disorder, I’m going to suggest, please don’t become a drug counselor. You’re likely to come across as feeling superior and looking down on them. If you want to be helpful, work with them on their other needs, housing, meals, job training, or basic literacy. Leave the drug counseling to people who will put in the time to develop the needed skills.

Stay tuned for more posts on what drug counselors do on the job and how someone would go about becoming a drug counselor. If you have questions as I move through this series of posts, please leave a comment or use the “contact me” form. I will get back to you just as quickly as my schedule allows.

Staying connected with David Joel Miller

Three David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

SasquatchWandering through a hole in time, they encounter Sasquatch. Can they survive? The guests had come to Meditation Mountain to find themselves. Trapped in the Menhirs during a sudden desert storm, two guests move through a porthole in time and encounter long extinct monsters. They want to get back to their own time, but the Sasquatch intends to kill them.

For these and my upcoming books; please visit my Author Page – David Joel Miller

Books are now available on Amazon, Kobo, iBooks, and many other online stores.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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2018 First-Foot.

2018 First-Foot.

By David Joel Miller.

The first-foot through the door each year sets the tone for the rest of the year.

First foot in the door.

First Foot.
Photo courtesy of Pixabay.com

There’s an old tradition; they say it comes from Scotland, that the first person through the door each new year’s sets the tone for the rest of that year.  Because of that, I wanted this to be my first post for the new year.

If this is your first time reading counselorssoapbox.com, I hope this post will start off your year in a good direction.  Longtime readers will know that this blog’s premise is having a happy life.

Life can have it struggles.  At some point in their life, everyone is likely to experience a mental, emotional or behavioral issue.  Because of this, I write a lot about mental health, mental illness, substance use disorders and overcoming the bumps on the road of life.  Here is hoping that this new year will bring happiness to you and yours.

Throughout this year on counselorssoapbox.com I plan to bring you tips about having a happy life, coping with emotional and mental issues and the impact that using and abusing substances might have on your mental and emotional health.

We will also present posts to help you with being a success. However, you define that success.  With over 1100 posts on counselorssoapbox.com so far, you’ll find plenty of tips in the past posts with more to come this year.  You might even want to consider subscribing to counselorssoapbox.com.

Thanks for being my lucky first-foot this year.

P.S.  If it takes you a while to get around to reading this post I will understand.  Whenever you get to it, please drop me a line.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

6 Top Reasons to Go for Counseling.

By David Joel Miller.

Reasons you may want to consult a counselor.

Many people avoid going to see a professional counselor until their life falls apart.

Counseling

Counseling or Therapy
Photo courtesy of Pixabay.com

There’s been a growing acceptance of preventative medicine for physical health issues. Still, some people believe that going to see the doctor or the therapist is a sign of weakness.

An increasing number companies provide E.A.P.’s (employee assistance programs) for their employees. There are plenty of good reasons to see a counselor before your problems become severe.

Avoiding counseling appears to me like walking around town with a broken leg. See the doctor, and that leg might heal, keep walking on that broken leg you may do permanent damage to it.

1. There are things you can’t talk to your family and friends about.

Your family and friends may be sympathetic but if you keep talking to them repeatedly about the same problems you can burn them out. People close to you may judge you for what you think or how you feel. A professional counselor can listen to you nonjudgmentally.

2. You don’t know what you don’t know.

Professional counselors can provide you with the information you may need. They talk to many people with similar problems. They may be able to fill in gaps in what you know and refer you to resources where you can find answers to your questions.

3. They can mentor you on life skills.

If you didn’t have a knowledgeable adult or older sibling in your life, a counselor could fill that need. Even when you have great role models, you may not have learned every lesson. Counselors can help you with skills to reduce or manage your anger. They can help you cope with your anxiety. If there are feelings you find it difficult to manage, a good therapist can help you learn the needed skills.

4. When you get counseling, they can tell you the truth.

The smartest people sometimes get extraordinarily dumb ideas. Top executives need to beware of yes-men and yes-women. The people close to you may not want to hurt you or offend you by telling you the truth. A professional counselor can help you do something called reality testing. They can help you sort out your thoughts and separate the good ideas from the fanciful ones.

5. Prevention is cheaper and faster than cure.

Dealing with emotional problems in the early stage can prevent them becoming huge problems.

6. Counselors can give you another perspective.

Successful athletes have coaches. You can’t see your own swing.  A good counselor can give you a fresh perspective on the challenges you face.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

How long are assessments and treatment plans good for?

By David Joel Miller.

When do you have to do a new assessment or treatment plan?

assess

Assessments.
Photo courtesy of Pixabay.com

At 1st glance, it would seem like we ought to be able to come up with a specific number to answer this question. It’s a whole lot more complicated than that. Think of this like asking how long the food you buy at the grocery store is good for. The correct answer should be – it all depends.

For the counselor or therapist, this matters because redoing assessments and treatment plans can take a lot of time, time you would rather be spending with the client. For clients, this comes up when they must redo paperwork they have completed previously.

Three possible answers to these questions, the theoretical answer, the answer that pleases the funding source, and the program’s policies.

Theoretical reasons to reassess.

There’s a difference between an assessment, the form you fill out, and assessment, the process. Initially, the counselor does an assessment to gather information, define the client’s problem, and develop a plan for treatment. This process is documented by filling in an assessment form. The information should be used to develop a plan of care.

Assessment, the process, continues throughout treatment. Any time new information becomes available, the assessment, the diagnosis, and the plan of care, may need to be revised. If it’s a small piece of information, a note in the chart may be sufficient. If a whole new problem is discovered, it may require a new assessment.

Reassessing is primarily a matter of clinical judgment. As long as the client stays in treatment and nothing changes, the original assessment should still be valid. Presumably, a client in treatment should be getting better. At some point, it would be good practice to reassess to verify whether the original problem still exists and needs treatment.

Clients who leave treatment, and then return, should be interviewed, to see if anything has changed, and a new treatment plan is developed.

Funding sources have their assessment rules.

People who pay for other people’s treatment what to know they’re getting their money’s worth. Insurance companies, criminal justice, Medi-Cal, Drug Medi-Cal, Medicare, Medicaid, may all have varying requirements. A lot of the rules beginning counselors learn about how long assessments and treatment plans are good for come from the rules of the funding source their program works with.

Your program or agency’s rules about treatment plans and assessments.

Some agencies set their own policies and procedures for how long an assessment and treatment plan are good for. One agency locally creates treatment plans good for a full year, another creates treatment plans for 90 days, and does updates every 30 days. When an agency works with multiple funding streams, they frequently do their assessments and new treatment plans frequently enough to satisfy the funding stream with the shortest time requirement.

Thanks to the reader who sent in the original question on this topic. I hope it helps you understand why there’s so much variation in how frequently assessments and treatment plans are done and revised.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

What is “Conditions for Further Study?”

By David Joel Miller.

Are there more mental illnesses than we know about?

What is? Series

What is “Conditions for Further Study?”
Photo courtesy of Pixabay.com

“Conditions for Further Study” is a chapter in the DSM-5 which describes some possible mental illnesses that have not yet gotten full official recognition. These are not something a clinician can diagnose, or one which insurance companies will pay to treat, not by these descriptions anyway.

You would think that by now we would have identified every possible mental, emotional or behavioral disorder, and come up with sure-fire treatments for each of them. Unfortunately, it doesn’t work that way.

Periodically a new disease comes along. It wasn’t all that long ago that no one had ever heard of AIDS or even HIV. The same thing, sort of, is happening in mental health. Researchers would like to be sure that when they tell you about the characteristics of and the treatment for a mental illness that everyone who was a subject in the research had the same disease.

Clinicians know that not everyone who has the same “diagnostic label” has the same symptoms. So you get a group of people who supposedly all have the same thing, say PTSD, and then you give them tests and assessments. For some things, personality characteristics like say introversion and extraversion, people will be on a continuum.

For other things like Posttraumatic Stress Disorder there will be clusters of people who all have similar symptoms and then clusters of other people who have different symptoms.

Lumpers and splitters.

Some people want only a few categories, like dogs and cats. The trouble with this is that Poodles are very different from Rottweilers. The house cat sitting on my desk is nowhere near like a Lion. So while we want to be specific about a mental, emotional or behavioral disorder someone might have, we also want to avoid creating several billion mental illness descriptions, one for each person.

Researchers and clinicians who notice these different clusters may become convinced that there are differences in symptoms that should be categorized as separate illnesses. For example, not all PTSD is alike. The PTSD that results from combat may show different features than the PTSD we see in battered women or abused children. Currently, they may all get a diagnosis of PTSD but there are different treatment approaches. Some clinicians have taken to referring to the form of PTSD that is the result of repeated abuse as “complex trauma” even though this is not officially a DSM diagnosis.

Are behavioral disorders a mental illness?

We see some similarities between drug and alcohol use disorders and some behaviors. Children and adolescents get some behavioral disorder diagnoses, things I sometimes refer to as “bad kid” diagnosis. But in adults not much in the way of behavior currently, meets criteria for a mental illness.

So far the only behavior that has gotten included in the Substance-Related and Addictive Disorders chapter is Gambling. Other behaviors, internet usage, compulsive gaming and pornography all have features that look like the loss of impulse control seen in Gambling.

Some of the major things that counselors treat are not diagnoses.

Anger is a huge reason for referrals to therapy, yet anger currently is not a specific diagnosis. While anger may be the reason for referral, currently it is seen as a symptom of some other problem, not a specific diagnosis. Despite the common practice of court-ordered Anger Management classes, Anger is not a diagnosis.

Suicidal behavior is not an official mental illness either.

Same problem with non-suicidal self-injury sometimes called cutting. Currently, the only place this fits is under Borderline Personality Disorder where it may be a symptom. This seems problematic. Does adding Non-Suicidal self-injury inflate the number of people with a diagnosis of Borderline Personality Disorder? Can you have one without the other? Shouldn’t someone who is thinking about killing themselves qualify for a diagnosis for that reason alone?

Disorders of special populations.

Several group-specific problems may be the focus of treatment but so far are not recognized as mental illnesses. This is a particularly acute problem for treatment of military personnel. Moral Injury is a situation in which you are required to do something that violates your sense of right and wrong. In civilian life, you may find ways to avoid this dilemma but in the military, there are few choices. Sometimes to do one good thing, following orders, you have to do something else that troubles your conscience.

Military sexual trauma is another non-DSM issue. In combat, you count on your comrades to keep you safe. Being raped by someone in your unit is a very traumatic incident. Having to continue to have good relationships with your abuser in order to stay alive is a tough situation.

Certainly, there are other problems, cultural or situational, that have not yet reached official disorder status but that require more research.

Do Conditions for further study make it to become a full diagnosis?

In each edition of the DSM, there are a number of proposed new diagnosis. Most do not make it as separate mental illness. After much research, they may get lumped in with existing disorders. Many of these proposed new disorders have long specific names. My observation is that the fewer words in the name the more likely it will get its own place in the DSM. Binge Eating Disorder made it. I have my doubts that Neurobiological Disorder Associated with Prenatal Alcohol Exposure will make it unless it gets a short name.  (More on Fetal Alcohol Exposure Problems is coming up in future posts.)

Currently, there are 8 “Conditions for Further Study” listed in the DSM-5. The DSM-IV-TR had 16, most of which disappeared in this revision.

What are those Conditions for Further Study in the DSM-5?

  1. Attenuated Psychosis Syndrome.
  2. Depressive Episodes with Short-Duration Hypomania
  3. Persistent Complex Bereavement.
  4. Caffeine Use Disorder.
  5. Internet Gaming Disorder.
  6. Neurobiological Disorder Associated with Prenatal Alcohol Exposure.
  7. Suicidal Behavior Disorder.
  8. Non-Suicidal Self-Injury.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

Therapy room secrets.

By David Joel Miller.

What do people get out of therapy?

Therapy room secrets.

Therapy room secrets.
Photo courtesy of Pixabay.com

People who have been to see a counselor or therapist, those who have gone long enough to see the results, know some secrets about the process that most other people never find out.

Counseling should help you create the life you want, not confirm someone’s opinion that there is something wrong with you.

Going for therapy does not mean you are crazy or a mental case. Plenty of people see a counselor to work on their life skills.

Being in therapy does not mean you are and will always be mentally ill. The point of counseling is to move you from being overwhelmed by life’s problems to a place where you can handle them.

Therapy should be about wellness, not sickness.

The really sick people don’t go for treatment even what they need it because they are afraid that getting treatment means they are ill. This is the equivalent of trying to not “give into cancer.”

You can learn that what you are dealing with is normal.

We hear in the counseling room from a lot of people that they thought they were the only one who felt that way or had that problem. Turns out that most of the life’s problems are common, so is suffering in silence. It can help a whole lot to know that what you are going through happens to lots of people at a particular point in life. It can also help to hear how others have solved this problem. This is one reason that group therapy is extra helpful.

Sometimes you just need to talk it out.

Family and friends find it difficult to just listen. They want to fix you or tell you what to do. It pains them that you are having problems and they just want to stop hearing your pain. Talking too much about life’s problems with family and friends can burn them out.

Sometimes all you need to do is just talk this problem through with an objective person who will not judge you or tell you not to feel what you feel. You partner can’t always be objective and hear you talk.

It helps to have someone listen to you.

They probably didn’t teach you about emotions in school.

Feelings are a taboo subject in many homes. You may have been taught that you should not have feelings or that it was not OK to express them.

Learning how to feel, recognize that feeling and then give it a name, can help you learn to regulate your emotions. If you have unrecognized feelings, therapy can help you learn to manage those feeling inside you.

Therapy can de-stress you.

Sometimes therapy makes you really face your problems. People come in depressed and after explaining their life to the therapist they decide that their life is a mess. Then they have a choice, do the hard work of changing things or leave things as they are, depression and all.

There may be gaps in your life skills inventory.

Mostly what you know about life came from living the one life you have had so far, yours. There are all kinds of life skills you need and it is hard to pick them up while rushing through your daily activates.

Your counselor can help you with the life skills you may have missed out on. Making friends, regulating emotions and getting things in perspective all require skills and practice.

It helps to have supporters.

You need supportive people in your life. Your therapist should be on your side. This does not mean that they will always agree with you or tell you that you are right. You need them to be honest if they are really supporting you.

They also should not try to make you dependent on them. You will need supporters after you are done with therapy. Helping you design a plan to create a support system is another thing your counselor may be able to do to help you get your life on track.

You can get a more objective opinion.

Friends tell you what they think you want to hear. Family members may want to influence you, get you to do things that are in their best interests or right for them but may not be good for you. A counselor can be really honest. They may slip up on that honesty, looking for a way to tell you things in a kind or gentle way, but know that at heart they want you to know exactly how things are.

You need to work on the things you are afraid of.

In the counseling room is one time you can really talk about the things you were afraid to tell anyone. This is the place to let your secrets out and know that this person will do all they can to maintain your confidentiality. Yes, there are a few things, like your being suicidal or abuse of a child they have to report, but most everything else they will keep to themselves.

If you have questions about this look at some of the other post on counselorssoapbox.com about what is and is not confidential. It also helps to ask your counselor and see how they answer this question.

Change is a process.

In the therapy room, you learn about the course of change. You can experience change a little or a lot at a time. We all move through our change process at our own rate. Sometimes you need to change a little and then change some more.

Prevention is important.

Sometimes it pays to go in and talk with an expert when you are faced with issues. This can help you to cope with a problem before it swamps you. Sorting things out can prevent your struggle becoming overwhelming.

This is one place you can really be you.

You do not need to worry about pleasing the counselor or if they will like you. This is a consulting relationship, not a long-term friend one. You should not need to worry about being judged. This is the one time you get to really “tell it like it is.”

Unpacking your baggage is painful and needs help.

Working through old issues, getting that baggage unpacked and sorted through, is something that happens often in the therapy room. This should be a safe place to work on those old hurts and pains that you can’t talk about anywhere else. This is one place you ought not get judged.

Counseling should be taken as needed.

You may need to attend every week or every few weeks. Some people go for a while, take a break and return as their life changes. This does not mean you are weak or can’t handle life. What it does means is you know how to make use of professional help as needed.

Counseling helps you find and accept you.

Working on me and trying to find myself are common themes in counseling. This is the time and place to explore your inner self and really get to know those parts of yourself that may be hard to stop and take a look at.

Your therapist is on your side.

Your therapist is an ally in your self-change and self-exploration. They really want the best for you and will do what they can to help you get there. If you don’t feel this then this is one of the first things you should talk about.

For more on this topic see:     Counseling and Therapy

 

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – Newsletter. I promise not to share your email or to send you spam, and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

What is the ACA?

By David Joel Miller.

How many ACA’s are there?

What is? Series

What is the ACA?
Photo courtesy of Pixabay.com

These initial things don’t always mean what we think. Different groups of people mean different things by the same set of initials and the same group or condition may get more than one shortened reference. Currently, we are struggling with a sudden shift in the meaning of ACA. I will give you some possible meanings for ACA in a moment.

Context matters.

There is a lot of research out there and more being published every day. Sometimes I think that I read way too much of that research. Is there a treatment for excessive research preoccupation?

The convention in research is that the first time a writer uses a term in their article they give the full name of the condition, theory or test instrument they used followed by the abbreviation they will be using in parentheses. Thereafter they use only the abbreviation.

For example, older articles on Pervasive Developmental Delay used to read Pervasive Developmental Delay (PDD.) Thereafter the article would only talk about PDD. With the DSM-5, Pervasive Developmental Delay became a part of the Autism Spectrum Disorder (ASD.) There is now a new disorder Persistent Depressive Disorder (PDD.) Persistent Depressive Disorder is pretty much like the thing we used to call Dysthymia.

So if you see PDD in an article look back to the beginning of the article and see what the original term was that is being shortened to PDD.

So what is ACA?

In the mental health field, ACA has several meanings. Most likely these days ACA refers to the Affordable Care Act (ACA.) This is big here in America, right now, in that it expanded medical coverage to a lot more people. Unfortunate this does not mean that everyone here in the U. S. has medical insurance. There are still a lot of poor people who do not have medical insurance. We still have a long way to go to get everyone health insurance.

This does not mean those uninsured people do not receive medical care. They still show up in hospital emergency rooms and get free care there. The difference is that without insurance there is no provision for who will pay for that care and so the public gets the bill. Sure if you have no insurance they mail you a bill, but if you are homeless you are not likely to pay that bill.

The result of this system is that the uninsured are discouraged from seeking care if they have anything at all until they are dying and then the rest of us get that bill. This presumably saves money by avoiding preventative care and only having publicly funded care after there is a serious medical emergency. I will step off my large soapbox now and resume my place on the smaller soapbox.

ACA means something special to Professional Counselors.

The American Counseling Association (ACA) is a major organization in the counseling field. Most professional counselors, clinical counselors, mental health counselors and so on are members of the ACA (American Counseling Association.)

If you are a counselor you should be a member of the ACA and/ or its local affiliate. Here in California that would be CALPCC. Some people are members of both.

If you are a counselor that sees people with Behavioral Health coverage under the ACA (Affordable Care Act) you should especially be a member of the ACA (American Counseling Association.) I am still not sure why we call emotional and mental illnesses “Behavioral Health.”

ACA is also for people in recovery.

Adult Children of Alcoholics (ACA.)

American Council on Alcoholism (ACA.)    

Adult Children Anonymous (ACA.)

And that’s not all the ACA’s.

One internet source (http://www.acronymfinder.com/ACA.html) lists 241 different ACA’s. This includes groups in Australia, Austria, Alaska, and Arizona. They also list groups of Accountants, Actuaries and other “A” occupations. Just reading that list has started to make my head hurt.

We will leave our discussion of ACA there.

FYI These “What is” sometimes “What are” posts are my efforts to explain terms commonly used in Mental Health, Clinical Counseling, Substance Use Disorder Counseling, Psychology, Life Coaching and related disciplines in a plain language way. Many are based on the new DSM-5; some of the older posts were based on the DSM-IV-TR, both published by the APA. For the more technical versions please consult the DSM or other appropriate references.

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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.