Treatment: What To Look For (Part I)

Almost every time I discuss this topic with colleagues in the field of psych/addiction, we end up in heated arguments.

I am a believer that a person does not have to be in recovery to be a good therapist or counselor (please read a previous blog entitled, “Are You in Recovery?”). This is not where most of the arguments begin however.

An area that can start arguments is when I state I believe a person should basically, ‘interview’ a therapist that they are going to see for the first time.

Their usual response back to that statement is, ‘well, if the therapist is properly trained they should be able to see any type of client.’

I disagree.

It would be difficult to convince me (or practically impossible) that a person with addiction issues and a history of trauma would be a good fit with a therapist that has worked in the substance abuse field, but has never had a client that also had trauma issues. Or, vice versa for that matter.

What if they had courses on trauma? That is a start. The client would benefit more I believe if the therapist has actual clinical experience working with those that have trauma in addition to their addiction issues. In all likelihood a therapist working in this area would know the resources available and how their client can access them.

Book smart alone doesn’t cut-it for me. Academia is great and necessary, and definitely enhances ‘clinical’ experience. In and of itself though, ah no.

Personally, the first time I meet with a perspective new client I will tell them beforehand that I would like to meet with them for twenty minutes or so (no charge) to have a discussion on specifically what they looking for from therapy and/or counseling, what is their understandng of therapeutic relationships, and then the two of us can decide if it is a good fit or not.

I know the areas where my expertise lies within the field of addiction and co-occurring disorders. If during that initial conversation they mention trauma issues, I would offer to refer them to several therapists that specialize in that arena as well as the addictions. I feel that I do not have enough academic nor clinical experience to assist them in a truly beneficial therapeutic relationship. Therefore referral.

For those with Bipolar and Depressive Disorders I always sugest that that they find a local chapter of DBSA (Depression Bipolar Support Alliance) and attend one of the meetings. Usually the largest sub-group within the meeting is 'Double Trouble' for those with the aforementioned disorders and addiction issues as well.

Additionally, and also of great import is one can learn from discussion with the members whom they would recommend as a therapist and psychopharmocologist.

Part II will be looking at treatment programs.