DavidLCPCCSADC

Look for a recent movie titled "Canvas"......it seems to be one of the better hollywood treatments on what it's like for the patient and their family.

Why is it neccessary to make something up? Since they are not a direct threat to self/others, at this point, that's "good" news. Ultimately if they keep drinking and/or drugging there will likely come a day where they will need the inpatient psychia...

"This is unacceptable. People MUST be held accountable for abusing healthcare workers, and management MUST back up their employees in situations such as you have experienced. You have every right to file assault and battery charges against that patie...

You realize that you're likely looking at a huge pay reduction if you make the switch as a BA level counselor. Many substance abuce facilities use RNs and get a chance to do some counseling while still getting the nurse pay. Suggest that you start he...

Sounds like it's time to get a support network in place. This is a good issue for individual and group supervision. Many of us are blessed with a supportive fellowship that is available 24/7......it's also a good idea to have a personal network of p...

I went through this early last year with our patients. My review of the research suggested that the patients generally take to it easier than the staff does. Indeed, our staff anticipated issues but they were minimal. Giving patients access to the "p...

As a general rule, guded imagery relies on the patients internal state to influence the content and "feel" of their imagery experience. For a patient that is in acute distress, this is generally an unpleasant "place" to go. Using some abreviated imag...

Guided imagery is much more appropriate for the nonCMI population. For the patients in need of short-term stabilization it's generally noneffective and can actually elevate the symptoms and stress. A focus on symptom management, self-monitoring, CBT ...

BTW, just to clarify, when I refer to a "addictionologist" I am referring to an MD who is ASAM Certified. If you have such an MD who is also good at group, 1:1, and in coaching coping skills it sounds like a terrific resource :-)

"I just find it sad that so few of these pts ever become free of any of their addictions!" Often working in the field you mostly just see the revolving door patients and frequent relapsers. It's rare that a patient will return to visit with you, just...

Withdrawals are typically divided into two stages: AAS (acute abstienence syndrome) and PAWS (post acute withdrawal syndrome, AKA: protracted withdrawal). AAS can take a couple of weeks with benzos while PAWS takes months. Also, it's not uncommon to...

My fear is that we may be guilty of "trivializing" real CMI while at the same time discounting the genuine pain & sufferring of many of our patients. Granted there are some valid points here about the med-reps, over-use of Rx meds, etc.... Howeve...

Was the attending MD contacted.....what was his/her's position?

My prayers and best wishes go out to you and the staff. Although it's of little help now, the time to have the safety net (support network) in place is before people need it. Many of us are blessed with a supportive fellowship that is available 24/7...

My first suggestion is to speak with the nurses on the floor and to your clinical instructor. Second, your job is not to "orient her to reality" but assist in her general functioning on the unit. Rather than focusing on the delusions, you might want ...

I'm used to SOAP and DAP but the current hospital I'm with is using APIE: A: Asssessment P: Problem, I: Interventions, E: Evaluation.

The movie "Canvas" is excellent and looks at the effect on the family in addition to the thought disorders. "28 Days" is just plain over-the-top silly, "Clean & Sober" is better for CD. "Leaving Las Vegas" is romatic nonsense and doesn't come any...

With behavioal disorders in general we can entertain a deviance model for abnormal behavior and speak in terms of a continuim of behaviors. However, it's important not to forget that CMIs are actually the result of a chronic brain disorder. Reactive ...

This patient could have easily been abusing bezodiazepines by buying them on the street, taking them recreationally or to medicate withdrawal symptoms, otherwise just serving as his own "doctor" and attempting to justify his behavior..... and rationa...

I don't know if "over-dx" is any worse than what it used to be. Fortunately, over the years it appears that ETOHics and other Addicts are more frequently diagnosed with CD and not mistaken for Bipolar Disorder as often as they used to be. I've got ma...

I suspect that what you're dealing with is just a rumour. The Studer principles are good solid principles and there's nothing wrong with the principles. Now, how administration attempts to put them in place may be another matter. If you're not alread...

Commuinity meeting is a good opportunity to check on the patient's therapeutic goal for the day, self-assessment of persisitent symptoms and any symptom management challenges. Also a chance for peer to peer feedback and any "housekeeping" concerns.

While he may be inappropriate at this level of care, his behavior must have some payoff values and current treatment may be reinforcing behaviors rather than modifying them. Can he articulate any personal short and long term goals for himself? Does h...

Linda, If you're considering the nursing schools at the local community colleges, you'll find that the entrance requirements to be very competitive. They typiocally have many more applicants than they have available slots. Four year degree programs w...

Linda, In the Chicago area you can earn a certificate at most of the local community colleges that will qualify you to enter the MHT positions. Some of the Mental Health Worker positions may require a BA degree at a minimum but most "tech" positions ...