Therapy & Treatment

Medical Treatment

Note: this module needs more research to be sure that it reflects the current standards for eating disorders, addiction, and other therapy and treatment professionals.

Obviously there are times when addiction has had physical consequences that warrant medical intervention, even hospitalization. Yet it is common for addicts to avoid going to the doctor for several reasons.

Many physicians have been judgmental, and may have preached at you, as if you didn’t already have enough guilt and shame already! They may have been operating from good intentions but were ignorant or frustrated because they couldn’t help you. If you have learned about your disease, and started a recovery process, try to share that with your doctor, so she or he might become more openminded, too.

If you need to be hospitalized for your addiction, be sure to choose a program with a competent medical, counseling, and nursing staff.

Counseling

The field of counseling is a broad area of health care that includes all kinds of knowledge and skills to help people solve their problems and improve their living skills.

You should feel free to ask about credentials, and remember that you are the employer. Many people blindly trust counselors that have far less training and experience than their automobile mechanics.

Addictions counseling is designed to help you specifically with the tools needed to recover from addiction and closely related issues. The best, most experienced counselors or therapists will have certification in your specific area of addiction (if it is available), and they will probably have advanced degrees or other educational experience.

Certification Alcohol and drug counselors should have or at least be working toward certification at stateor national level.

Eating disorders counselors should be certified or working toward certification as Certified Eating Disorders Counselors (CEDC) or as Certified Eating Disorders Therapists (CEDT) by the International Association of Eating Disorders Professionals (IAEDP).

Certification in one area of addiction counseling does not necessarily imply competence in another. For example, many certified alcoholism counselors have virtually no specific knowledge of eating disorders, and vice versa. Also, addictions counselors may be inadequately prepared to deal with issues outside the mainstream of addiction, like marriage problems, incest issues, or psychological problems.

Marriage/family therapy If you have issues with your marriage or your family, seek a specialist in this area. An excellent credential for this area is Marriage Family Child Counselor (MFCC). Knowledge of addiction would be helpful to sort out which issues are addiction related and which may be incidental to the addiction.

Pastoral counseling Some counselors are specially trained to deal with religious and spiritual issues, and these may be very helpful for those having problems in these areas. Often, ministers, priests, rabbis, and other pastoral counselors are also certified in marriage/family or other counseling specialties.

Psychological therapy Mental health problems, especially those having little to do with addiction, may require the services of a psychologist or other psychotherapist. Examples are phobias, depression, anxiety, and various personality, character, or thought disorders. If physical problems or medications are involved, a psychiatrist may be helpful, having both medical and psychiatric training.

Group vs. individual Individual therapy can be helpful to begin a concentrated look at one’s own self and specific issues. It is usually more expensive than group therapy, and it can be confusing or even dangerous if you are naive and happen upon a counselor who is lacking in the experience or the integrity to know when he or she can no longer help or doesn’t need to. A good counselor may refer you to someone else — nobody is universally competent.

Group therapy gives you the advantage of being able to see yourself in others, having others see your blind spots, and learning to share feelings and experiences. The power of a group has proven itself in the success of the Twelve-Step fellowships. Addicts seem to have trouble getting well in groups of two or less.

Professional Ethics

Some fields of addictions counseling have established certification standards. Part of the process of establishing a profession is to adopt a statement of professional ethics. For example, the International Association of Eating Disorders Professionals requires certified counselors and therapists to pledge adherence to a six-page code of ethics relating to professional and personal conduct. The ethical principles in that code include:

Responsibility We must be alert to pressures that might lead to misuse of our influence over the lives of others. We must provide accurate, objective, and complete information about eating disorders and related topics. We must be objective and honest in research efforts.

Competence We can only perform those services and techniques in which we are qualified by training and experience. We maintain knowledge of current scientific and professional information related to the services we render.

We accurately represent our competence, education, training, and experience. We recognize the need for continuing education and are open to changes and new procedures.

We recognize differences in people’s age, sex, economic, and cultural backgrounds. We avoid any situation in which our personal problems may harm a client, colleague, student, or others.

Moral & legal standards standards and provide a positive role model regarding our personal patterns of eating and use/misuse of food and drugs and alcohol. We support humane treatment, civil rights, and fair laws.

Public statements In public statements or advertising, we accurately and objectively represent our professional qualifications, affiliations, and functions, as well as those of the institutions or organizations we represent. We avoid misrepresentation through sensationalism, exaggeration, or superficiality.

Confidentiality We reveal information about a client only with the client’s permission, or when not to do so would result in a clear danger to the person or to others, or when disclosure is mandated by law.

Welfare of the consumer We protect the welfare of our clients. If there is a conflict of interest between the client and our employing institution, we let everyone know of our commitments, and take appropriate action. We do not exploit the depehdencies of clients, students, or subordinates. We avoid dual relationships, like counseling employees, students, close friends, or relatives. Sexual intimacies with clients are unethical.

We terminate a counseling relationship when it is reasonably clear that the consumer is not benefiting, offering to help locate alternative assistance.

Professional relationships We act with respect and regard for eating disorders colleagues, other professions, and the institutions and organizations with which we or our colleagues are associated. We make full use of available professional and other resources to help our clients. We support professional training and development. We do not condone or engage in sexual harassment.

We bring minor ethical violations to the attention of the offending eating disorders counselor or therapist. Major or unresolved ethical violations are reported to the appropriate ethics committee.

Research Any research done with human subjects must be done with respect and concern for the dignity and welfare of the participants. It must adhere to all regulations and professional standards for such research.


Therapy & treatment, see also: Abstinence, Addiction model (PEMS), Aftercare, Alcoholism, Anorexia nervosa, Certification, Codependency, Core functions, Counseling, Crisis, Disease concept, Dual diagnosis, Employee assistance programs, Family, Family of origin, Half-measures, Halfway house, Impaired professionals, Incest, Intervention, Professional organizations, Psychological problems, Sabotage of recovery, Sex, Sponsorship, Step Six, Withdrawal.

Updated 12 Sep 2015

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Addictionary 2 by Jan & Judy Wilson

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