Tuesday, October 4, 2016

Licensed Counseling Professionals and Our Responsibility

Do you think fudging on the time you spent with a client is an innocent mistake?  It is not.  I am always saddened when I hear of a licensed counselor being charged with fraud. We, as therapists, are entrusted with helping people when they are their most vulnerable.  It is our responsibility to know what we are doing, and that includes billing.  

If you think a billing system is too complicated, hire someone to do it and keep an eye on them.  Or go to work for a reputable agency and keep an eye on the billing.  Are you getting the point here?  If you have the license it is YOUR responsibility to understand what you are doing.  You can hire other people to do things, but it is still your responsibility to know what they are doing under your license.  

I have supervised people who are trying to get their license and they have been depending upon someone else to tell them what they can and cannot do.  They have never read the licensing laws.  Yes, ladies and gentlemen, what we do as licensed people is governed by law.  The board of directors, for our licenses, enforces, approves, but the law guides what they do. 
Those who know me well might say I am impatient, I am rigid, and that I don’t suffer fools gladly.  They are right about all of the above when it comes to my profession.  If you are going to share my profession then it is your responsibility to carry it well and not give the rest of us a bad name.  It is your responsibility to be competent, to practice within your “scope of practice”  (don’t know what that is, then look it up), to consult with others when in doubt, to get legal advice if you go into private practice, to always treat clients with dignity and respect.  It is also your responsibility to know what you are agreeing to when you accept a contract to provide services and to know very clearly how to bill for and how to get paid for said services.
I am sickened and saddened when I hear about fraud or mistreatment of clients.  I am further out-raged when I hear a therapist claim ignorance.  You at least have a master’s degree if you are a licensed therapist; I don’t know what the others learned, but I learned most of this in school. 

Monday, February 15, 2016

Addiction Treatment

Someone recently asked me about the Medical Model of Addictions versus the 12-Step Model.  I asked them to give me some time to ponder.  After going to school to get a Master's Degree in Counseling Psychology and over 30 years in the addiction field, it is hard to answer that question easily or quickly.  I will say that my views and practices have certainly evolved over the past 30 years.

I believe in the 12 steps for recovery from addictions. I think the belief you can be "cured" is dangerous. But the critics say believing you can't be cured is discouraging. That said, I do not believe one size fits all. A thorough evaluation and individualized plan is what is considered "Best Practices" today. Not everybody needs inpatient and not everybody benefits from 12-step meetings; although I usually recommend twelve step meetings and explore reasons why, if someone is resistant. My favorite expert, Dr. Mee-Lee is at UC-Davis.  The link is for his blog.  https://www.changecompanies.net/blogs/tipsntopics/
Why do I think that the idea you can be "cured" is dangerous?  Because it assumes the addict is just like everybody else.  There is evidence that the brain of addicts is different, thereby making this a brain disease, and yes, it is a disease.  Alcohol and other mind-altering chemicals react differently in an addict's brain.  Yes, with therapy, medication, program of recovery, things can get better.  My question is always, "Why would you want to take that risk (try to drink alcohol or take other drugs "socially") with something that has caused you so much pain, caused you to lose so much?" (insert whatever consequences the addict has suffered.)   

Discussion to Be Continued