SUBSTANCE ABUSE COUNSELING

Boundaries in Substance Abuse Counseling

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Abstract

This report reviews studies of substance abuse counseling in order to identify boundaries and its significance in the relationship of counselor and client. The substance abuser is already a sufferer and counselor tries to overcome the client. In doing so, counselor has to maintain professional boundaries by not getting involve in personal relations, either friendship or intimate physical relations with clients. In addition, counselors are also ethically prohibited to receive monetary or non-monetary gifts, as well as to meet the client outside counseling setting for coffee and other reasons. Mainly, because such acts may lead the counselor to legal accountability; on the other hand, client might get wrong signs from counselor that disrupts the professional credibility.

Table of Contents

Abstract2

Table of Contents3

Introduction4

Background4

Purpose & Scope of Paper5

Significance5

Discussion6

Substance Abuse Counselor6

Counselor-Client Relationship7

Transference7

Counter-transference8

Secondary traumatization9

Establishing the Treatment Frame and Special Issues12

Building trust15

The client “fall in love” with the counselor16

Dealing with dangerous or disruptive behavior19

Avoiding the “rescuer” role21

Recognizing professional limitations23

Agency Responsibility to Provide Support to the Counselor24

Common Boundaries Issue26

Professional Boundaries for Substance Abuse Counselor33

Conclusion & Recommendations35

Establishing Boundaries & Advice to the Counselor36

Establishing Counselor Credibility & Advice to the Counselor37

References38

Appendix42

Key Terms Definition51

Boundaries in Substance Abuse Counseling

Introduction

Background

Substance abuse is a pattern of using harmful substance for the purpose of mood alteration. Medically, substance abuse is defined as an illicit drug use or over-the-counter drugs or the abuse of prescription for purposes except for that they are designated or in quantities or manner other than prescribed (Brown, 1998).

According to the National Survey on Drug Use and Health 2002, the people aged 12 and above, 10.3 percent of men and 6.4 percent of women accounted last month use of illicit substance. On the other hand, there is no change in the usage rates of non-medical psychotherapeutic substance because it remains 2.7 per cent for men and 2.6 per cent for women. Among the population aged between 12 to 17 years, 10.9 per cent of girls and 12.3 per cent of boys were accounted any illicit drug use (Kressel, Zompa & De Leon, 2002).

Drug and alcohol counselors, together with other mental health professionals have to face many special issues and challenges when comes in contact with people who have undergone use of substance abuse. Abuse survivors may encounter coherent challenges to the counselor. At the same time, such clients are usually suspicious and skeptical, thus require a “push and pull” dynamics and trustworthy relationship may result.

Counselors can find themselves excessively captivated by and endowed in an abuse history of client (at times to the other life's exclusion and issues of therapy), or they may desire to stay away from abuse discussion due to personal reasons. Counselors have to be careful of these likely reactions and design suitable strategies to make sure effective client's care. Since, substance abuse reflect the ultimate carelessness and negligence, it is vital that counselors uphold a professional relationship with suitable limitations and boundaries in counseling practice. The counselor should provide a safe relational context ...