“Two steps forward, one step back is an inescapable reality for substance-abuse social workers, in-demand counseling professionals who assist alcoholics and drug abusers on the road to recovery. These social workers recognize that chemical dependency is a chronic condition with a high rate of relapse, for which there is rarely a quick fix (monster.com, para1).” Social Workers and their jobs and requirements are vastly changing and the face of social work is changing as well. Social Workers were deemed primarily to assist with schools, jobs, and government agencies. The criteria for the mentally ill and the abusers have been thrown in as well and social workers are helping.
Social work is a profession that is forever changing. The role of social work as it relates to substance abuse/mental health has a role of helper, advocate, and educator and in the future these roles will encompass even more responsibilities and assignments. Substance abuse/mental health are two issues that affect our lives, economy, behaviors and families.
Substance abuse is when the use of a substance repeatedly and that use if the substance has social consequences that relate to taking the substance. This means that when the person is on the substance they cannot meet the requirements for work, school and family obligations. A substance is any medication that can be used or abused to either stimulate or depress the body and mind. Dependence is better known as addiction. Addiction is when changes physiologically and behaviorally the person is altered. If a person gets the effects and if the person ceases taking the substance, then withdrawal symptoms will persist and allows us to know that this person is addicted.” Substance abuse is more likely to be diagnosed among those who have just begun taking drugs and is often an early symptom of substance dependence (medicaldictionary.com).” Examples of substances of substance abuse include: alcohol, cannabis, cocaine, hallucinogens, inhalants, nicotine and sedatives. Some of the more common or drugs that may be readily available would include: caffeine, alcohol, glue, over-the –counter drugs and prescription medications.
There are factors that are thought to contribute a person becoming a substance abuser. The first is genetic factors. Studies have shown that there is a gene that is associated with alcoholism. Psychopathology is the second factor that may make a person more apt to becoming a substance abuser because the use of the substance can eliminate issues if you already have Bi polar disorder, depression or other disorders. The final factor is a learned behavior and it determines if the person that is exposed to the substance will continue to use it based on whether or not it is accepted. DSM-IV-TR has seven criteria have to be met to be diagnosed as having substance dependence.
All seven do not have to be met in order to be diagnosed, but three have to at least be met. (1) The person has developed a tolerance for the substance with extended use of the substance. (2) The person will show or feel all the mental, emotional and physiological changes that stop usage of the substance (3) The person uses the substance for extended periods of time in greater amounts than they originally started. (4) The person tried over and over again to decrease the usage of the substance or stop. (5)The person uses the majority of their time using and finding the substance and recovering from the effects. (6) The person is unable to work and have active social lives because of substance abuse. (7) The person continues to use after the negative effects on the body are evident.
“There are three goals for the treatment of people with substance use disorders: (1) get the patient to abstain from the substance; (2) get the patient to reduce the frequency and severity of relapses; and (3) get the patient to develop the psychological and emotional skills necessary to restore and maintain personal, occupational, and social functioning (medicaldictionary.com).” With treatment each substance abuser should be assessed, have a treatment plan created and create some type of mental health treatment plan. “Prevention is best aimed at teenagers and young adults aged 18-24 who are at very high risk for substance experimentation. Prevention programs should include an educating those at risk and inform of that substance use and advise on how to resist peer pressure to use drugs. Prevention programs should work to identify and target children who are at relatively higher risk for substance abuse (medicaldictionary.com).”
Effects of substance abuse on children may include the fact that children that are raised by alcoholics and/or drug users tend to be unpredictable and chaotic, which tends to lead to problems in their adult life. The parents may have mood swings, which can confuse children. The children then have to be prepared mentally and physically for a parent that may be high or drunk. Mental health is the state of an individual being able to cope with life and not be able to work and be contributor to the community. “The CDC estimates that only about 17% of U.S adults are considered to be in a state of optimal mental health. There is emerging evidence that positive mental health is associated with improved health outcomes. Mental illness is the altering of the way a person thinks defined. One of the most common forms of mental illness is depression. Depression is the most common type of mental illness, affecting more than 26% of the U.S. adult population. Some of the most common disorders include depression, anxiety, bipolar disorder and schizophrenia.
Depression is mood disorder that gives the feelings of hopelessness, despair, and sadness for no particular reason makes it abnormal. The person may experience lack of motivation and it may alter the way the mind and body acts or reacts. When the body is impaired severely mentally without cause then a person is thought to be psychotic (medicaldictionary.com).” “Depression can be genetic, pharmacologic, endocrinal, infectious, nutritional, neoplastic, or neurologic, the behavioral effects can appear as aggression or withdrawal, anorexia or overeating, anger or apathy, or any of myriad response (freedictionary.com).” “Anxiety is a feeling. Anxiety is a perceived threat or danger. It reflects a combination of biochemical changes in the body along with the patient’s personal history and memory, and the social situations can cause this feeling. It is important to distinguish between anxiety as a feeling or experience, and it can be anxiety disorder or a psychiatric diagnosis.
A person may feel anxious or afraid. Someone facing a clear and present danger or a fear is not usually considered to be in a state of anxiety (freedictionary.com).” Bipolar disorder is a disorder that switches from one extreme of manic to depressive. Manic is where the person feels energetic or euphoric. Then the person goes through periods of depression or hopelessness for extended or unknown periods of time. These episodes can turn into cycles. It depends on the severity of the case as to how long the cycles of manic and depression will last. Bipolar disorder is found genetically in children who have one parent with at least one parent with a disorder are more than likely to develop another disorder such as ADHD. Several studies have uncovered possible genetic connections to the predisposition for bipolar disorder. “According to the American Psychiatric Association, the DSM-IV-TR describes a manic episode as an abnormally elevated or irritable mood lasting a period of at least one week that is distinguished by at least three of the mania symptoms: inflated self- esteem, decreased need for sleep, talkativeness, racing thoughts, distractibility, increase in goal-directed activity, or excessive involvement in pleasurable activities that have a high potential for painful consequences.
If the mood of the patient is irritable and not elevated, four of the symptoms are required. Although some clinicians find the criteria too rigid, a hypomanic diagnosis requires duration of at least four days with at least three of the symptoms indicated for manic episodes (four if mood is irritable and not elevated). The DSM-IV-TR notes that unlike manic episodes, hypomanic episodes do not cause a marked impairment in social or occupational functioning, do not require hospitalization, and do not have psychotic features. In addition, because hypomanic episodes are characterized by high energy and goal-directed activities, often result in a positive outcome, and are perceived in a positive manner by the patient (medicaldictionary.com).” Treatment for the disorder has medicine as the most effective way for treatment. “A combination of mood stabilizing agents with antidepressants, antipsychotics, and anticonvulsants may be used to regulate manic and depressive episodes.
Mood stabilizing agents are the most commonly prescribed drugs to treat bipolar disorder. Their function is to regulate the manic highs and lows of bipolar disorder. Psychotherapy and counseling are treatment options for the disorder. Bipolar disorder is thought to be biological therapy is recommended as a companion to, but not a substitute for, pharmaceutical treatment of the disease. “Psychotherapy, such as cognitive-behavioral therapy, can be used in helping patients and their families adjust to the disorder along with medication treatment plans and counseling. Schizophrenia is a psychotic disorder (or a group of disorders) (medicaldictionary.com).” This disorder does not allow for clear thinking, rational behavior or emotions as well. Most people with schizophrenia do not interact with others and tend to neglect their own personal grooming needs. There are phases of the disorder: acute, stabilization and maintenance.
“In 1908, by a Swiss doctor Eugen Bleuler, to describe the splitting apart of mental functions that he regarded as the central characteristic of schizophrenia. Recently, some psychotherapists have begun to use a classification of schizophrenia based on two main types. “People with Type I, or positive schizophrenia, have a rapid (acute) onset of symptoms and tend to respond well to drugs. They also tend to suffer more from the “positive” symptoms, such as delusions and hallucinations. People with Type II, or negative schizophrenia, are usually described as poorly adjusted before their schizophrenia slowly overtakes them. They have predominantly “negative” symptoms, such as withdrawal from others and a slowing of mental and physical reactions (psychomotor retardation) (medicaldictionary.com).” “It is thought that these disorders are the end result of a combination of genetic, neurobiological, and environmental causes. A leading neurobiological hypothesis looks at the connection between the disease and excessive levels of dopamine, a chemical that transmits signals in the brain (neurotransmitter).
The genetic factor in schizophrenia has been underscored by recent findings that first-degree biological relatives of schizophrenics are ten times as likely to develop the disorder as are members of the general population. Prior to recent findings of abnormalities in the brain structure of schizophrenic patients, several generations of psychotherapists advanced a number of psychoanalytic and sociological theories about the origins of schizophrenia. These theories ranged from hypotheses about the patient’s problems with anxiety or aggression to theories about stress reactions or interactions with disturbed parents. Psychosocial factors are now thought to influence the expression or severity of schizophrenia rather than cause it directly (freedictionary.com, para 16, 17, 21). The treatment of schizophrenia depends on the severity and phase that a person is in.
“Psychotic symptoms and behaviors are considered psychiatric emergencies, and persons showing signs of psychosis are frequently taken by family, friends, or the police to a hospital emergency room. A person diagnosed as psychotic can be legally hospitalized against his or her will, particularly if he or she is violent, threatening to commit suicide, or threatening to harm another person. A psychotic person may also be hospitalized if he or she has become malnourished or ill as a result of failure to feed, dress appropriately for the climate, or otherwise take care of him- or herself (freedictionary.com).” Family therapy is often recommended for the families of schizophrenic patients, to relieve the feelings of guilt that they often have as well as to help them understand the patient’s disorder. The way the family acts and behaves toward the family member determines the likelihood of the member being able to handle the stress of everyday life. Family therapy focuses on communication and the ability to solve problems.
Humanistic or humanism is the study of a person as a whole, and their individuality and how they react. ”Humanism is a psychological approach that emphasizes the study of the whole person. Humanistic psychologists look at human behavior not only through the eyes of the observer, but through the eyes of the person doing the behaving (simplypsychology.org para2).” “Carl Rogers (1902-1987) was a humanistic psychologist who agreed with most of what Maslow believed, he added that for a person to “grow”, they need an environment that provides them with genuineness (openness and self- disclosure), acceptance (being seen with unconditional positive regard), and empathy (being listened to and understood) (simplypsychology.org para1).” “Abraham Maslow’s hierarchy of needs model which can be divided into basic (or deficiency) needs (e.g. physiological, safety, love, and esteem) and growth needs (cognitive, aesthetics and self-actualization) (simplypsychoogy.org para3).”
The lower levels of basic needs have to be met in order for that person to go to the next level of growth. One must satisfy lower level of needs before progression can be made to meet one level has to be met in order to go to the next. Finally the greatest level is self-actualization. Every person is capable and has the desire to move up the hierarchy toward a level of self-actualization. “Unfortunately, progress is often disrupted by failure to meet lower level needs. Life experiences including divorce and loss of job may cause an individual to fluctuate between levels of he hierarchy. Maslow noted only one in a hundred people become fully self-actualized because our society rewards motivation primarily based on esteem, love and other social needs (simplypsychology.org para3).”
“Maslow’s (1954) theory has been elaborated upon by other researchers and the original five-stage model has been adapted by other researchers who have interpreted Maslow’s writings to develop both seven and eight-stage hierarchy of needs pyramids (simplypsychology.org para3).” “Abraham Maslow (1954) presents a hierarchy of needs model which can be divided into basic (or deficiency) needs (e.g. physiological, safety, love, and esteem) and growth needs (cognitive, aesthetics and self- actualization). One must satisfy lower level basic needs before progressing on to meet next level of growth needs. Once these needs have been reasonably satisfied, one may be able to reach the highest level called self-actualization.
Every person is capable and has the desire to move up the hierarchy toward a level of self-actualization. Progress is disrupted by failure to meet lower level needs and life challenges and experiences. Life experiences may cause a person to go back and forth from one level to another in the hierarchy. (www.simplypsychology.org/maslow, para3).” Maslow’s original five-stage model has been adapted by other researchers who have interpreted Maslow’s writings to develop both seven and eight-stage hierarchy of needs pyramids. “The original hierarchy of needs five-stage model includes: 1. Biological and Physiological needs – air, food, drink, shelter, warmth, sex, sleep, etc.
2. Safety needs – protection from elements, security, order, law, limits, stability, etc.
3. Belongingness and Love needs – work group, family, affection, relationships, etc.
4. Esteem needs – self-esteem, achievement, mastery, independence, status, dominance, prestige, managerial responsibility, etc.
5. Self-Actualization needs – realizing personal potential, self- fulfillment, seeking personal growth and peak experiences.
Maslow’s Hierarchy of Needs
“Carl Rogers believed that every person could achieve their goals wishes, and desires in life. When they did so self-actualization took place. For Rogers believed that people who are able be self-actualize, and that is not all of us, are called fully functioning persons. This means that the person is in touch with the here and now, his or her subjective experiences and feelings, continually growing and changing.” In many ways Rogers regarded the fully functioning person as an ideal and one that people do not ultimately achieve. It is wrong to think of this as an end or completion of life’s journey; rather it is a process of always becoming and changing (simplypsychology.org para4, 5).”
According to Best, typifying is how people construct social problems to be most helpful for social work and issues dealing with social justices. Typification is the method of understanding why certain social problems are the way they are and we make claims and place emphasis on certain areas, but not on all areas by professionals (Best, 1997 p. 1-12 ). Social workers are advocates, educators and counselors; they are support systems and employment finders as well. Social workers have so many roles and it is ever changing. So, the role I would say would be to be ready for change and available. The role for social work is working with families to promote and implement policy changes for the protection of children from maltreatment, the elderly for both health care and abuse, women and other human services issues(NASW, 2012).
“According to Diana DiNitto, PhD, ACSW, a social work professor at the University of Texas at Austin, she states that a substance-abuse social worker’s responsibilities vary by setting, but most perform client intakes and assessments, develop treatment plans, and counsel patients in individual or group sessions. They also help families cope with the effects of addiction and refer patients to other social service organizations. Often, substance-abuse social workers, who earn about $33,000 a year, serve on multidisciplinary teams that can include physicians, nurses, addiction specialists and other human-services workers. “It’s more than a 9-to-5 day, DiNitto says. There is a lot of routine stuff, but crises occur, too.” Professional opportunities in the field abound for creative, caring social workers interested in finding new ways to attract individuals to substance-abuse treatment and in designing treatments to which clients respond (monster.com para12).”
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed., revised. Washington, D.C.: American Psychiatric Association, 2000.
Anxiety disorder. Retrieved from, http://medical-dictionary.thefreedictionary.com/anxietydisorder
Best J(Ed). (1997).Images of issues: Typifying contemporary social problems (Social problems and social issues) (2nd ed.) New York: Aldine de Gruyter.
Bi polar. Retrieved from,
Depression. Retrieved from http://medical-dictionary.thefreedictionary.com/depression
McLeod, S. A. (2007). [pic]Carl Rogers. Retrieved from [pic]http://www.simplypsychology.org/carl-rogers.html McLeod, S. A. (2007). [pic]Maslow’s Hierarchy of Needs. Retrieved from [pic]http://www.simplypsychology.org/maslow.html MentalHealth. Retrieved from, http://www.cdc.gov/mentalhealth/basics.htm
Rogers, Carl. (1959). A Theory of Therapy, Personality and Interpersonal Relationships as Developed in the Client-centered Framework. In (ed.) S. Koch, Psychology: A Study of a Science. Vol. 3: Formulations of the Person and the Social Context. New York: McGraw Hill.
Schizophrenia. Retrieved from,http://medical-dictionary.thefreedictionary.com/Schizophernia
Definition of Substance Abuse. Retrieved on August 20, 20012 from http://medical-dictionary.thefreedictionary.com/Substance+Abuse+and+Dependence U.S. Department of Health and Human Services. Mental Health: A Report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services; Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of Health, National Institute of Mental Health, 1999.
World Health Organization. Strengthening Mental Health Promotion. Geneva, World Health Organization (Fact sheet no. 220), 2001.