Clinicians, Be Mindful: Just Because It's Not Your Path For Recovery Doesn't Mean It Is Wrong.

Working in the field of addiction can be more difficult than staying sober.

For me and I’m sure countless others building rapport, treating a patient with respect and dignity, or meeting a client where they are at in their readiness to change comes quite naturally. It's not easy at first, but with diligence and a bit of work you can do it.

I understand that not many people wake up one morning and think- I want to be a drug counselor.

I didn’t.

I needed to make a change, do something with my life, make a change, punch a clock, and give up my control over my day. I knew recovery (or so I thought) so I went to school, got the 350 hours, interned, passed the test, became a CASAC/NY and then quit. I enjoyed the work.  I was ready to leave the nest as my director would say, move on and take back my power and control.

During my transition from working as a clinician to full-time freelance digital marketing my anger and frustration with the many personalities working in the field tormented me. I’m not saying the last program I worked for sucked. I loved my J.O.B.

The problem I had working in the field was not my clients or the sadness I sometimes felt, my problem was the vast majority of people working in the field-colleagues.

At my last job, my director and several colleagues shaped me into a not only a decent clinician but a better man. The way I see it working in the field as a member of the recovery community is a win/win situation, especially when your director and a majority of your colleagues are amazing clinicians.

For me, I was able to help people with substance use disorders connect with the resources needed to stop using and achieve sobriety. And I was able to get some counseling whenever I was off, couldn't solve a problem, and started to get too comfortable. Hell, my old boss was like having a personal clinician at the ready. She knew when I was off and would come to me to get back on track and her door was never shut to any of her staff. She made time no matter how busy she was that day.

I didn’t always respect her. I dreaded seeing her when I first started working for her. She was direct, quick to call out on my BS, and never used a filter. I dreaded Case Conference, so much that I would get a headache when I got to the office, on Thursday mornings.

From across the table, she would look me dead in the eye and say-”John, it's too late- the patient is already dead.” Of course, the patient wasn’t literally dead (Thank God), but I’d get the point. My failure to act quicker and present his behavior added to his relapse. And we all know there is no guarantee of making it back to the program after a slip, especially when the client is shooting fentanyl-laced heroin.

My heart would sink, and excuses would roll off my tongue as to why I waited so long to ask for the teams help. My director would sit there quietly, shaking her head until I finished. Then she would ask what I was going to do?

Ideas would roll out of my head.

Speak with his PO?

“No, you won’t- What are you gonna say. Hey PO SoinSo, your parolee is still using. I suck at my job.”

“Higher level of care?”

“No. The patient has only been here 3 weeks.”

“Increase his treatment schedule?”

“That might work but how are you gonna get him here?”

“I don't know what the fuck I’m going to do that is why I’m presenting him,” I would yell. “Just tell me, please?”

She would sit there like a stoic waiting patiently for me to come up with a plan that would work.

Eventually, she would start questioning me like she was Socrates. It was painful because I didn’t want to figure out the solution. I wanted her just to tell me what to do.

In my panic I would eventually get to a solution to address the behavior, but only after her asking question after question after question to get me outside of the box and blinded by my thinking

Most of the time I personal barriers, my thinking, and prejudices were the cause of my failure to see the situation clearly.  I would think why can't the patient just see his behavior is killing him. Argh. The light bulb would slowly heat up without having to beg for help.

I would fail my patients when I refused to meet them where they were at in their readiness to change. I was not addressing the patient's readiness for change. I was not meeting him where he was at.

I apply this approach to everything I do now. It works.

Eventually, I learned to go to her office anytime I felt I needed her help-professionally or personally. Our working relationship turned into a friendship over time and I am grateful for her willingness to invest in me. Hell, she is partially responsible for where I am sitting today.

It's unfortunate that not everyone in the field has a great teacher standing behind them. When I moved up to a position as a Sr. Counselor/ Ass’t Director I tried to be like her, but my failure as I didn’t want to work in the field. I wanted to write for the field. I still did my job well and helped the interns I had given a chance to test out the field become first-class clinicians.

Where I failed was not taking the time to help other colleagues and referral agency employees to learn to treat our patients with respect dignity and care. Instead, I would sit in my office and cringe when I heard a fellow colleague use the words -dope fiend, junky behavior, or crack head. I would do nothing when higher levels of care were presented as punishment instead of a chance to restart.

When harm reduction or methadone was mentioned, I did get involved. But still, I feel I didn’t do that much good. I could have done so much more. Instead, I feared confrontation. I felt I would get angry and personal. When advocating for a patient wanting to attend methadone maintenance I was met with resistance. Instead of meeting colleagues where they were at in their stereotypical prejudicial views about methadone maintenance and helping them change I did nothing.

So to rectify my failure to act, I will publish several Pulse articles to help dissuade those who feel Methadone Maintenance is not treatment. Until I begin this quest think about this kind words from addictions greatest foe:

There are multiple pathways for recovery and ALL are a cause of celebration.

-William White