By Keith Martin, RCSW, CASAC,
Social Workers Offer Holistic Approach to Mental Health and Addictive Disorders
By Keith Martin, RCSW, CASAC,
Director of Mental Health and Chemical
Dependency Services, Paul T. Cooper Center
Before she was born her grandparents introduced her to nicotine and alcohol.
At conception her parents introduced her to marijuana and cocaine. After birth
she knew what it was like to have a drug withdrawal syndrome. Her generational
predisposition put her in an 80% risk factor group for becoming addicted to
drugs.
By her first birthday her interpersonal, social, economic, educational, and
familial life events set the course for her many challenges to come. By age
9 she experienced her first hangover. By age 10 she smoked her first marijuana
joint. By age 15 she became a daily user of cocaine/crack. By age 20 her drug
addiction had resulted in multiple detoxifications in inpatient and outpatient
drug treatments. She has no high school education, a limited work history and
an arrest history. She is a physical and sexual abuse victim and has a history
of mental illness. She has 2 children in foster care, is currently homeless
and has no family support network.
This case history presents an all too familiar lifestyle that I encounter combating
chemical dependence disorders. Drug addiction is an equal opportunistic problem
that penetrates every fiber of American culture. It has no respect for age,
gender, color, race or economic status.
There are numerous drug treatment philosophies, models and theories. There are
an equal number of professional credentials which qualify an individual to treat
persons with addictive disorders. However, social work is the only field of
practice that equips the Health Care Professional to treat the complexity of
the addiction and the associated problems from a holistic vantage point. The
down side is that not many social workers choose addictions treatment as a field
of practice.
Mental Health & Addictive Disorders-Intricately Connected
I have dedicated my career as a social worker to the fields of mental health
and addictive disorders. Understanding the intricate connection of two social
issues is the key to effective social work interventions. People do not wake
up and decide they want to become an alcoholic or drug addict. The process of
introduction to mood/mind altering chemicals tells the person that there is
an escape from the conditions that they experience as unbearable, and painful.
The problem is that drug use is only a temporary escape from reality. When the
intoxication subsides the problems become reality again, and can increase. The
only answer for many is to consume more drugs, until the process of addiction
becomes their reality. They end up existing, not living. This becomes death,
not life.
The struggle to stop the addictive cycle is rooted in resolving the underlying problems. When the symptoms of addiction are arrested, the manifestation of intra- and inter-personal problems surface. These are the mental health issues that were masked by the drug use.
Social Work Theory – Conceptualizes “Whole Person in Context”
The theory of social work conceptualizes the whole person in context and comprehends
the interventions necessary to address both the symptoms and the problems. Throughout
my career I have employed a comprehensive approach to treating persons with
addictive disorders. The focus is not on the addiction, but the end result of
a new and improved quality of life.
In the above case, clearly identifying problems helps the person to understand
all the major life areas targeted for change and why. Helping the person to
self actualize goals re-instills hope. Establishing action-steps that are defined
by the person’s strengths and limitations produces motivation. Helping
the person to identify resources to assist them resolve the target problems
provides a new reality that says “I don’t have to do this by myself”.
My goal is to help the individual break-down the recovery process and establish
a life management plan based on rehabilitation and habilitation needs.
Barriers to Appropriate Care
Working with drug-addicted persons, families and communities poses a tremendous
challenge. There is no “cookie cutter” approach. Drug addiction
is a symptom of a primary societal problem. There is a claim to holistic care,
but people often can not access appropriate levels of care due to endless barriers.
For example, insurance is denied, women are imprisioned for giving birth to
addicted babies, and funding is provided for prisons to house addicts instead
of treating their affliction.
Social work as a profession represents an open field of practice that has unlimited
potential to influence social change within the drug prevention and treatment
system. Not until the systemic problems of chemical disorders are addressed
will there ever be any effective movement to stop the band-aid approach to symptom
management. r