Fulfilling the clinician role is entirely different when that patient is not related to us. That said, when it comes to disappointment, frustration, or betrayal by a loved one, those emotions hit a different nerve altogether. While we can apply the same skillset to manage and contain our emotions (ie, regulate ourselves and convey self-control).
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There is no manual on how to help ourselves when we are faced with the challenges of the caretaking role for our loved ones. We are not trained in how to respond when the individual struggling with a substance use disorder or addictions is a loved one. But what happens if the patient is a loved one? 3 Additionally, throughout our training, the need to preserve the therapeutic alliance with our patients is emphasized, particularly because a healthy relationship is one of the major protective factors. When it comes to chronic disease prevention and health promotion, the Centers for Disease Control and Prevention’s (CDC’s) National Center for Chronic Disease Prevention and Health Promotion identifies social connectedness as one of the 5 pillars of their framework. Often, this is so we can preserve the therapeutic alliance, which in turn facilitates desired treatment outcomes and prevents contention or confrontation with the patient. As clinicians, we are conditioned to not cross these boundaries regardless of our frustrations or feelings.
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After all, there may or may not be professional consequences. Succinctly, prioritize the patient’s needs and well-being while “keeping a lid” on whatever frustrations that may arise. Traditionally, evidence-based modalities including motivational interviewing (MI), motivational enhancement therapy (MET), cognitive behavioral therapy (CBT), contingency management interventions, community reinforcement, and family therapy (CRAFT), to mention a few, all advocate for openness and giving patients the benefit of the doubt-even when the reported interventions seem counterintuitive and deviate from our personal beliefs and values.
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The knowledge, skills, and attitudes of professional practice are all structured around preserving the patient’s autonomy and promoting the clinician’s need for objectivity.
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In the Substance Abuse and Mental Health Service Administration (SAMHSA)Technical Assistance Publication Series (particularly TAP-21), the addiction counseling competencies stress the importance of this approach. Between my phone lines, I had at least 10 missed calls and a few text messages from 2 neighbors.Īs clinicians, we are trained and encouraged to have an objective approach to treatment, especially with addictions-substance use addictions in my case.
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Instead, I called my colleague to tell him and everyone else to go ahead-I had an urgent matter to tend to. I requested a minute to run up to my room and slip on some comfortable shoes for the 5-minute walk. I remember thinking, this is addiction treatment done right! A colleague recommended that a group of us walk over to the Arethusa Farm Dairy shop for their famous “designer” ice cream. It could not have been better than what it already was. The activities of the day included a presentation and discussions about evidence-based addictions treatment modalities. A delicious dinner at the Study Hotel, where we were staying for the night, wrapping up a packed day of activities was what we needed to round off the evening. August 16, 2019, was a beautiful summer evening in New Haven, Connecticut.