A Clinician's Journal

Post Modern Therapy Blog

2008-08-15T08:10:00.000-07:00

Here is a blog I just found that has some very nice summaries and reflections on various post modern theories, including Solution-Focused Brief Therapy and Narrative Therapy. It is bilingual, keep scrolling down for your preferred language. I prefer Swahili but don't actually understand it.

Annette Spiezio and Affiliates

2007-07-17T12:15:00.000-07:00

I've added a new link to the side-bar, under Counseling Links. Spiezio and Affiliates not only offer quality counseling and consultation services here in the Chicago area. They also have a great line-up of workshop/training presenters.

On a personal note, I am two weeks away from completing my masters in counseling. Then a few more weeks before I begin the new journey of fatherhood. Perhaps I will find time in there to attend to this blog. Hmmm, not likely. In the meantime I hope you find the links in the side-bar to be helpful resources.

-Andy

Solution Focused Change

2007-04-30T11:48:00.000-07:00

Here's a link to an interesting blog with a solution-focused slant. It's not strictly about counseling/therapy, infact the author seems more involved in coaching corporate businesses in using solution-focused leadership techniques. Nevertheless, there are some great pdf articles and lots of useful ideas.

solution focused change

While I'm At It - Another New Link

2006-11-27T22:34:00.000-08:00

Just found what looks like another great link...

In The Room is a blog focusing on Cognitive Behavioral Therapy techniques. The title is suggestive of the blog's focus on clinical techniques rather than theories. Mark's recent post on therapists' favorite questions has me thinking of some things I've been learning recently about 'purposeful' questioning and 'circular' questioning, both of which suggest that there is more to asking a question than simply asking a question.

What I mean is that a question may be used as an indirect suggestion. For example, asking a client "How do you think you might manage to get out of that power struggle with your wife?" may be an effective way to introduce the notion that he is in a power struggle.

In the case of circular questioning, the therapist asks questions which call attention to the interactive processes going on in a family or relationship. An example might be asking a daughter "Who in the family seems to notice first when Mom and Dad are in a power struggle?" This type of question invites any family members present to consider the recursive nature of their relationships.

New Link - Bill O'Hanlon

2006-11-27T22:09:00.000-08:00

Hello Friends, Long time no write.

I've been busy, clocking away internship hours at a family therapy center. I've had a million things to write about, but not much time to do so. In the meantime I've added a link to the side bar. It's the website of Bill O'Hanlon, www.brieftherapy.com. If your not familiar with Bill, he is a therapist who founded what he calls Solution-Oriented Therapy. As the name suggests, it's akin to Solution-Focused Therapy. I'm adding his link for a few reasons. One, I'm really interested in learning more about Bill and his work. My internship supervisors have turned me on to some of his articles, which have been very eye-opening for me. Secondly, the site is a great example of what a therapist with some ingenuity and entrepeneurial spirit can do.

Hope you are all well.
-Andy

Education vs Therapy

2006-06-01T07:16:00.000-07:00

One question that was posed after the Partner Abuse intervention training in Springfield last week:

"You say that group interventions with men who batter should be educational groups rather than therapy groups. One distinction you make between the two is to say that education is directive, the facilitator takes the group in a pre-determined direction, whereas therapy 'meets the client where they are at'. Yet, then you talk about using Motivational Interviewing in Partner Abuse Intervention groups. Isn't 'meeting the client where they are at' a key principle of Motivational Interviewing and doesn't this contradict your distinction that these groups should be education rather than therapy?"

First, I appreciated that this question came up after the training because a similar question was asked during the training, essentially asking why we are advocating any therapy-based techniques if this is strictly education.

There are two points I think we need to keep in mind:

One is to make sure that we understand why we are making the distinction between therapy and education in working with men who batter. If we clearly identify why we focus on education rather than therapy it will help guide us in understanding when and why we bring in elements from the therapeutic realm. I believe that a main reason for this distinction is that philosophically, to say we are doing therapy with domestic batterers runs counter to the principles which founded this work. If you look at the history, batterer's intervention was born out of a hope to further provide safety to victims. Any healing (a word that may be associated with therapy) on the part of the perpetrator is secondary, if considered a goal at all. Perhaps a goal that many people are more comfortable with is change (cognitive and behavioral) rather than healing.

Some other reasons to lean away from calling this work therapy:

It might suggest mutual responsibility for the violence between perpetrator and victim.

Some therapy models might recommend rage-expression or anger management, approaches which may increase risk of violence or fundamentally misunderstand the beliefs that support domestic violence.

Other therapy models might see the violence as poor impulse control, rather than as an exertion of control over one's partner.

If a man becomes violent again, a therapy-based approach might see this as "relapse" behavior, which suggests his "affliction" got the best of him rather than seeing the behavior as a calculated choice on his part.

Understanding these basic principles, I think it is possible, if not necessary to bring in techniques from the realm of therapy without softening on these principles. In other words, we may borrow Irvin Yalom's idea of peer-modeling in group without using his concept of client-driven group goals. Perhaps where we borrow most from the therapy world is in cognitive-behavioral techniques, which focus on confronting thoughts and expecting behavior change. But again, I think we are borrowing techniques more than embracing theories.

____________________________________________________

My second point may be an extension of the first, and it relates directly to the phrase "meeting the client where he is at".

If therapy involves meeting the client where they are, and we are not doing therapy, why talk about Motivational Interviewing (MI) which largely seeks to meet the client where they are?

I think (my beliefs, here!) that there is a key difference in what we traditionally mean by this in therapy and what the MI model suggests. The Rogerian concept of self-actualization, or self-efficacy, which guides many therapists, really takes this idea of "meeting the client where they are at" seriously. It's a belief that the client will take you where they need to go. It's also a belief that the client has what they need to achieve self-actualization and the key role of the helping professional is to affirm and accurately empathize.

Motivational Interviewing is not exactly the same. If any thing, it's like Carl Rogers with a hidden motive. Here's a quote from the original MI book by Rollnick and Miller:

"...Motivational interviewing differs from the method described by Rogers as it is consciously directive. The terms "client-centered" and "non-directive" are sometimes used interchangeably, but they refer to different aspects of counseling style. Motivational interviewing is intentionally addressed to the resolution of ambivalence, often in a particular direction of change. The interviewer elicits and selectively reinforces change talk and then responds to resistance in a way that is intended to diminish it."

Motivation Interviewing, Miller, W., & Rollinck S. 2002, Guilford Press, NY p.25

I think that if motivational interviewing can help a facilitator effect behavioral change in a batterer's group participant, then it's worth looking at. I am constantly using MI skills in batterer's groups to elicit change-talk from the men with the goal of helping them move in a direction that I am very intentionally hoping they move toward.

I hope some of this helps to clarify. I also hope to hear your thoughts as you read this. Click on the word "comments" below this post if you'd like to leave a comment. As always, I am very open to other opinions, corrections, challenges, etc.

A Month of Trainings

2006-05-30T16:23:00.001-07:00

Well, I've just finished a month of trainings. I presented a workshop on Motivational Interviewing at St. Leonard's House in Chicago. Then, a workshop on working with men who batter at Safe Passage in DeKalb, IL. Followed by our semi-annual 3 day batterer's intervention training for IL Dept of Human Services in Springfield. Then, this morning I met with the staff at Emmaus Ministries to talk about working with resistance (ambivalence) and exploring the grey areas of doing para-professional urban ministry work. (whew!!)

To those of you who participated in one of these trainings, I truly appreciate the opportunity to interact with you and discuss the various clinical issues that arose. Feel free to contact me by email or phone, or to leave comments or questions here by clicking on the word "comments" after each post. I will try to post some follow-up posts to tie together loose ends that come to mind as I reflect on the trainings.

Thanks for stopping by.

Motivational Interviewing

2006-05-09T16:20:00.000-07:00

Motivational Interviewing (MI) is a model of reframing and working with what is often referred to as client resistance. I'll be giving a workshop on Motivational Interviewing this Friday, so I thought I would summarize some of my thoughts here in preparation. And also provide some links to resources on MI.

I was first introduced to MI while working in the substance abuse field. It was, infact, developed in this field. This makes quite a bit of sense, given the ambivalence that individuals in early recovery or "pre-recovery" often experience.

The whole model revolves around this idea of ambivalence, a concept that could be summed up in a statement like, "I feel strongly both ways." Ambivalence is not a lack of motivation, but rather two competing motivations in different directions. For example, the substance abuser who is sick and tired of the consequences brought on by drug use, yet at the same time cannot fathom life without the drug. This sort of "fence-sitting" ambivalence typically makes behavioral change difficult.

In the counseling setting, such ambivalence is, unfortunately, seen by many clinicians as resistance or a lack of motivation. According to the MI model, what often occurs in the counseling relationship is that the ambivalence of the client gets played out in the therapeutic relationship.

An example might clarify:

Joe comes to counseling to quit smoking. He feels "strongly both ways", wanting to quit but not wanting to quit. The counselor, wanting to help enhance Joe's motivation, might ask Joe if he's thought about the health consequences of smoking. Joe says he has, but then proceeds to point out the relaxation and enjoyment he gets from it. Because the ambivalence inside Joe is complex, whenever one side of the argument (for or against smoking) is brought up, he may feel inclined to rebutt the other side of the argument just to balance things out.

This may often lead to a pattern in which the counselor is arguing for change, while the client is arguing for the status quo, or a lack of change. MI offers techniques to help the client become the one arguing for change. In some ways, MI does not look a whole lot different from classic Rogerian therapy. However, it may be seen as Rogers with more of a goal in mind. It is, perhaps more directional and behavioral in nature.

I'll leave it at that for now, so this post doesn't get too long. Next post, I'll describe some of the basic techniques. In the meantime, check out the Motivational Interviewing Website for tons of useful info, articles, etc.

Strength-Based Clinical Supervision

2006-04-13T16:02:00.000-07:00

Just a quick note to let you know I'm still alive. My theory is that once the semester is over I will have time to leave more posts. Key word - Theory. I make no promises!!

In the meantime, I'm currently working on my thesis proposal which is focused on the use of strength-based supervision in clinical settings. Having had some very valuable experiences as well as some, well... less than valuable experiences in supervision, I was drawn to the idea of fleshing out my own thoughts about what makes the process succeed or fail.

While I'm working away on that, here are a couple links to articles on said topic, in case you have interest. If you check them out, let me know what you think.

Edwards & Chen, Strength-Based Wu-Wei Supervision

Dunn, Navigating Ethical responsibility in Psychotherapy Supervision Using a Strength-Based Roadmap

Welcome St. Leonards Ministries

2006-02-15T14:26:00.000-08:00

For those of you who attended my workshop on Friday 2/10 at St. Leonard's Ministries, welcome and thanks for visiting this blog. Also, thanks for making it a lively and valuable discussion on Friday.

Here is a link to the Safety and Sobriety manual I mentioned in the workshop. It's a big document (185 pages) so you might want to save it to your computer rather than printing it out. To do this "right-click" on the link and select "Save Target As" or "Save Link As".

This document, produced by Illinois Dept. of Human Services has excellent information on best practices in domestic violence and substance abuse treatment. You will find the "Power and Control" wheel that I talked about near the end in a section called "Tool Kit".

If you have any thoughts or questions from Friday's workshop, please feel free to leave a comment by clicking on "comments" below. In the meantime, I'll try to put some of my own thoughts together and post something related to the workshop in the next few days.

Thanks for stopping by.
-Andy

Link of the Week

2006-02-09T15:35:00.000-08:00

I've added a new link to the sidebar. Wellbriety is an online magazine focusing on addiction recovery issues in the Native American communities. It's put out by White Bison, Inc., an organization out of Colorado Springs with the goal of "bringing 100 Indian communities into healing by the year 2010."

The magazine has articles you can read online or download as pdf. files. There's even a few articles by Illinois' own native son, Bill White. The organization also puts on conferences and has resources for linking recovery with arts and music.

I know here in Chicago we have a significant American Indian population and, unfortunately, this is one population that seems to get overlooked in too many discussions of multicultural counseling.

The sidebar link takes you right to the magazine. If you'd like to go to the organizations general website go to www.whitebison.org

Formula to Avoid an Escalation

2006-02-06T21:18:00.000-08:00

Here's a quick little formula that may help some of our clients avoid an escalation or, worse, a violent incident:

Turn SHOULD into COULD.

When we make a statement or have a thought like, "My wife should have approached me in a better tone of voice," we are practicing what some call counterfactual thinking. In other words, we are comparing reality to some ideal we have in our heads that runs counter to the facts. Frustration increases relative to the difference between what the other person did and what we feel they SHOULD have done.

If we replace the SHOULD with a COULD, we get something more like, "My wife COULD have spoken in a different tone, but she didn't. And that's OK." The word COULD acknowledges that there were other options but it doesn't place the same expectation or demand on the other person to live up to your ideal. This is about gaining flexibility and being able to accept when things don't go your way.

Obviously this sort of play on words is not fool proof, some abusers will take a tool like this, only to apply it to their partner rather than themselves. Nevertheless, I have seen 'lightbulb' moments for some of the men I've worked with as they've begun to see how black/white their thinking was through this little tool.

Counselor Audio Source

2006-01-30T07:46:00.000-08:00

I've added a new link to the side-bar on the right. It's the Counselor Audio Source. They offer weekly podcasts related to the counseling profession. It looks like a great resource for counselors and counseling educators. Supervisors might even be able to use it as a supervision tool, having supervisees give it a listen. If you check it out, let me know what you think of it.

-Andy

Loyalty, part 1

2006-01-19T19:55:00.000-08:00

Hi Everyone,
I'm back from a long hiatus which began as the fall semester came to a close with its usual chaos. Unfortunately the hiatus inadvertently continued through the holidays and I am just now getting back into the blog-swing.

And actually, to do so I'm going to refer back to last semester and a class I was taking on multicultural issues in counseling. At some point in the class we talked about how loyalty is a very important virtue in Latino families. I've had several lingering thoughts about loyalty since that discussion. Perhaps this would be a good place to flesh some of them out.

My first question: How does loyalty conflict with accountability?

In the field of partner abuse intervention, accountability is a concept that we come back to quite often as we challenge men who abuse to be accountable for their actions. I don't think it's a really new discussion to ask how such interventions may upset cultural norms like the "machismo" we see in Latino communities. I also doubt that many counselors think it's a bad thing to challenge something like "machismo" because it is widely seen as a gender role that is, in many ways, toxic for both genders.

But what about this broader concept of loyalty? Loyalty is a good thing, isn't it? Back to my first question: How does loyalty conflict with accountability? I'll try to answer my own question with a tangent looking at male friendships in general.

There's an article floating around out there called, "Men don't have real friends, they only have buddies." I don't know off hand who wrote it but it's used in some partner abuse programs. I like many things the article has to say, but it suggests that because men don't tend to be very emotionally open to one another that their friendships aren't real or meaningful. I agree that men often need to work on emotional expression, but it misses a part of male friendships that I think holds alot of meaning for men, which is loyalty.

I think it's important that we not minimize the importance of loyalty, as I think it holds alot of power for men in their friendships. That said, if our definition of loyalty boils down to a mutual code of not 'ratting' on one another, then perhaps it does nothing more than to perpetuate the male privilege that seems to underscore so many cases of domestic violence.

So...When loyalty becomes an unspoken expectation that you won't tell on me and I won't tell on you, it conflicts with accountability.

More Questions:

How do we redefine loyalty in such a way that it doesn't conflict with accountability?

Is loyalty a virtue to be respected, particularly in some cultures?

If so, how do we challenge male-privilege in those cultures without disrupting such widely held norms?

If, in the Latino community for example, loyalty means that family problems should not be taken outside of the home, what does this mean for the Latino man who is mandated to a counseling program?

Is he seen by others as committing a family betrayal simply by complying with the program?

I'll leave my thoughts there for now. Please feel free to respond with your own thoughts.

Anger Mgmt. vs Partner Abuse Intervention

2005-11-22T06:09:00.001-08:00

One interesting workshop discussion that sticks out for me was the distinction between the person whose anger results in harm to the family vs. the domestic abuser who may not display much anger at all. This grew out of an example given by one workshop participant, in which a man would smash dishes when he was angry. Once he realized that this caused his wife to fear him, he quickly stopped smashing things. I believe the person who shared this story said this man was not really an abuser, because he was able to feel empathy and stop his violent behavior after seeing how it affected his wife.

While that is a debatable question, the story highlights an important point in understanding many domestic abusers. As Lundy Bancroft (in ‘Why Does He Do That’, 2002) puts it, the domestic abuser "isn’t abusive because he’s angry, he’s angry because he’s abusive.” By contrast, the man in the story above IS abusive because he is angry. Let me explain how I understand this statement. At the core of the domestically abusive man is a sense of entitlement and self-centeredness, not an inability to control his anger. Often times, abusive men can demonstrate immense control over their anger. For instance, when confronted by the boss at work they may not react violently at all. For the abuser, anger often only comes into play when his sense of entitlement has been threatened and his more covert tactics to regain power/control are not working. His anger is simply another tool he uses with precision to exert control.

To paraphrase Bancroft from the same book, an abuser doesn’t have a problem with his own anger, he has a problem with his partner’s anger. This explains why so many abusers present for services complaining about how angry/crazy their partners are. This also explains how an anger management focus can inadvertently place blame on a victim, identifying her as the one who can’t control her anger. An abuser will often talk at length, exaggerating how angry his partner is. What he really means is that her anger (any anger on her part) gets in the way of his perfect world and must not be tolerated.

For the man in the above story, however, anger seems to be central. In fact, he may not have any issues with entitlement or male privilege at all. If that is so, perhaps he has no intention of controlling his partner or others. While his behavior, by its very nature is threatening and abusive, this is fairly different than the control-based abuser. Domestic abusers don’t just use violence, they use violence for a purpose. That said, this anger-based man is probably well represented in batterer’s programs. And my gut feeling is that this is a good thing. I would rather see an angry man who, by the nature of his rage, threatens his wife go through a batterer’s program than see an abuser go through an anger management program that might not address the gender/ entitlement issues.

This discussion may help distinguish anger management issues from domestic violence. Then again I might just be muddying the waters by splitting hairs. What do you think?

"Becoming Agents of Change" - follow up

2005-11-15T18:57:00.000-08:00

For those of you who attended the Partner Abuse facilitators training on Nov. 7, 8, & 9, I thought I would throw out some follow up questions as a way to touch base with you.

For many people who work in batterer intervention, attending a conference like this is a rare chance to talk with others who do the same work. Many folks seem to appreciate the feeling of connection, particularly because those of us who do this work are few and far between. Perhaps the most difficult thing is that during the conference you feel very supported, you're integrating new ideas into your thinking. Then you get back to your agency and you feel the excitement starting to wear off.

Here are some questions that may help you reinforce the bridge between the training atmoshpere and things 'back at the ranch'...

Now that you’re back at your agency and you’ve had time to digest the three days, what sticks out in your mind as most helpful or interesting about the training?

If you've done any groups since the training, what impact have you noticed on your facilitation approach?

What new ideas did you take from the training that you want to continue thinking about?

How do you want to put these ideas into practice?

Do you have any follow up questions that I or others can help you work through?

To post a response, click on "comments" below, then choose either "anonymous" or "other". Choosing "other" gives you the option to leave your name, but feel free to remain anonymous. Once you've typed your comment, click "publish".

New Link - JTC

2005-11-15T12:12:00.000-08:00

I've added a new link in the side-bar to the right. It is The Journal of Technology in Counseling. It came my way today via an NEIU Listserv email from Dr. Jeff Edwards at NEIU. The focus of this journal is the use of technologies (digital media, internet, etc.) in counseling, including direct practice, research, and education. As you can tell, I'm becoming more intrigued by creative ways to use digital media to enhance the counseling field. This journal looks like a great resource toward that endeavor. Check it out when you get a chance.

-Andy

Incarceration/ Pain/ Motivation...continued

2005-11-10T08:29:00.000-08:00

Another bullet-point of my workshop at IAODAPCA talked about "amenability to treatment".

According to Marlowe, et al (Federal Probation, 00149128, Sep2003, Vol. 67, Issue 2), diverting someone to treatment in lieu of incarceration is often based on several criteria which may be more influenced by public tolerance and fears than by clinical outcomes. Some common reasons to consider someone un-amenable to treatment include having two or more convictions, having previous failures in treatment, committing rule violations in treatment, as well as certain 'exclusionary offenses' which automatically make the individual ineligible for treatment. So if any of these are present, state law may dictate that this individual is not appropriate for treatment in lieu of prison (depending on the state in question). The problem is, this is all normal behavior for someone who has developed the skills needed to commit street crimes.

Now, let's add another piece to this puzzle. According to a report by SAMHSA in 2001, 75-80% of substance abuse treatment is 12 step, abstinence-based, outpatient, group treatment. All this information taken together, I start to wonder, not if the criminal offender is amenable to treatment, but if treatment is amenable to recovery for the criminal offender. Another way to come to the same conclusion is to say that the only criminal offenders eligable for treatment are those who aren't really criminal offenders. I think we're selling them, and ourselves, short.

This is where I think a sociological understanding of the meaning of the drug-life can merge with cognitive-based intervention models to help us transform traditional drug treatment into something more effective for the criminal substance abuser. At their core, these three views (social, cognitive, and traditional drug treatment) remain philosphically opposed in their understanding of the relationship between crime and substance abuse. However, I think they can greatly enlighten and enhance one another.

Someone in the workshop asked exactly what the sociological model of treatment was. I don't know that there is one. I think the value of the sociological perspective is one of understanding the nature of the individual's behavior. It's the perspective that suggests that turning up the pain, whether in treatment or in prison, is not nearly as effective toward behavioral change as turning up the hope.
The value of the cognitive approach, on the other hand, is that it suggests that traditional drug treatment is not enough, we must challenge the "skills" of criminality and offer alternative pro-social skills.

So more questions:

How do you think we should change treatment based on this discussion?

As you think about these things, and as you look at how you've provided treatment over the years, are there things you would like to change about your counseling style or your treatment content?

What are some creative ways to instill hope for this individual, deemed by many as un-amenable to treatment?

Welcome, Agents of Change

2005-11-10T08:08:00.000-08:00

Hello and welcome to those of you who participated in the "Becoming Agents of Change" training this week. Thanks again for making it such a valuable experience. If you feel comfortable doing so, please feel free to post a comment to say hi and let me know you stopped by here.

In the coming days I will post some of my own left-over thoughts from the conference to generate discussion around working with men who batter. This website will only be as useful as we make it, so please join in the discussion, post your thoughts and questions.

To post a comment click on "comments" below, then choose either "anonymous" or "other". Choosing "other" gives you the option to leave your name, but feel free to remain anonymous. Once you've typed your comment, click "publish".

There are two ways to read comments: 1) Click on "comments" below or, 2) Find the title of the post on the right side of the screen under "previous posts". If you click on that it will take you to a page with my post and all comments to that post on one page.

I suggest checking back about once a week to read new content. I hope you find this blog useful. Please feel free to suggest topics you'd like to see here, as well as any other suggestions.

Thanks,
-Andy

Cheesy Counselor Cliche' #3873658......

2005-11-02T10:53:00.000-08:00

Intimacy = In to me see

.....heard on a radio call in show with a marriage counselor of some sort.

Why are we so drawn to these somewhat useful, often vile assaults on human intelligence? Or am I becoming jaded?

-Andy

Incarceration, Pain, and Motivation for Change

2005-10-31T07:18:00.000-08:00

In my workshop last week at IAODAPCA, a few important comments were made about the nature of pain (specifically incarceration) as a therapeutic factor in the process of change. I'll briefly summarize information I provided with key points made by workshop participants.

Elliott Currie suggests that incarceration fails to deter criminal behavior because of social factors that reinforce what may be called the “street-prison nexus”, also known as the revolving prison door. This street-prison connection may actually help to forge antisocial relations, turning the joint into another type of ‘hood’ that need not be feared.

According to Currie, incarceration fails to deter criminal behavior not in spite of its risks but because of them. In other words, doing hard time, or performing acts that could result in hard time, warrants respect and prestige on the street. Currie also suggests that the risks associated with incarceration provide a sense of challenge and meaning to committing street crime. This sense of meaning and challenge is necessary for human fulfillment and is often hard to find by legitimate means for many at the lower end of the socioeconomic scale. Therefore, the meaning and challenge of street crime may be more valuable than any other gains associated with it (money, drugs, etc), and may be more persuasive than the pain of incarceration.

On the other hand, some people suggest that the pain of being locked up is often a necessary ingredient in someone changing their behavior. Several relevant points were made during the workshop. One participant seemed pretty certain that the pain of incarceration is a very important factor in change. In other words, once the pain of committing crime or using drugs outweighs the pleasure, motivation for change is likely to occur. Others suggested that incarceration effects behavioral change for some, but not all, individuals. Another person pointed out that even if incarceration doesn’t work, that does not invalidate the “pain outweighs pleasure” theory, it just means that incarceration fails to cause meaningful pain for the individual. In other words, the sociological factors presented by Currie provide more meaning to the drug life than incarceration provides in deterrence.

So here are my questions to you:

Which side of this debate do you fall on? How is incarceration effective or ineffective for recovery?

If incarceration works for some substance abusing offenders but not others, which ones and why?

If you work in a correctional facility, do you see the trend toward more sanctions (limited movement, strict rules, etc) as enhancing treatment and recovery?

If pain motivates, how do we explain the cycle of substance abuse, relapse, and criminal recidivism in so many people’s lives despite what would seem to be immense amounts of pain?

How do you think this discussion should guide how we conduct substance abuse treatment with the court mandated/ incarcerated/ ex-offender?

(to respond, click on comments below, then type your comments in the new window, then click anonymous, then click publish.)

Welcome to my online journal

2005-10-28T19:36:00.000-07:00

Hello Friends and Colleagues,

Welcome to my online clinical journal. There are two main reasons I've created this weblog. On the one hand, I hope to use this as a follow-up forum for my trainings and presentations. In other words, if you attend one of my workshops you may come here afterward to continue the conversation with myself and others regarding issues discussed in the workshop. In this way, my goal is to transform the training atmoshpere from a uni-directional, one-time event to a multi-directional, ongoing process. The other reason for this blog is simply to have a place where I can work out my own thoughts regarding various clinical issues.

I believe that in order to maintain vitality and well-being in the counseling profession it is important to have a plethora of supportive voices providing ideas and feedback. I think that it is often times helpful that some of these voices are found outside of one's own direct work setting. My hope is that this blog can be such a resource for you (and me!!). To that goal, I encourage you to help me make this interactive and valuable by checking back often, leaving your thoughts and comments, and spreading the word to others you think may benefit from visiting.

-Andy