DSM 5: Simple Procedure for Evaluating Addiction 

August 15, 2016

The DSM 5 allows clinicians to specify how severe the substance use disorder is, depending on how many symptoms are identified.
MILD: Two or three symptoms indicate a mild substance use disorder;
MODERATE: Four or five symptoms indicate a moderate substance use disorder, and
SEVERE: Six or more symptoms indicate a severe substance use disorder. 

DSM: Severe Addiction
SEVERE: six or more symptoms indicate a severe substance use disorder. Clinicians can also add “in early remission,” “in sustained remission,” “on maintenance therapy,” and “in a controlled environment.” 
Here are the eleven symptoms (DSM Criteria):

Substance use disorders span a wide variety of problems arising from substance use, and cover 11 different criteria:
1. Taking the substance in larger amounts or for longer than the you meant to

2. Wanting to cut down or stop using the substance but not managing to

3. Spending a lot of time getting, using, or recovering from use of the substance

4. Cravings and urges to use the substance

5. Not managing to do what you should at work, home or school, because of substance use

6. Continuing to use, even when it causes problems in relationships

7. Giving up important social, occupational or recreational activities because of substance use

8. Using substances again and again, even when it puts the you in danger

9. Continuing to use, even when the you know you have a physical or psychological problem that could have been caused or made worse by the substance

10. Needing more of the substance to get the effect you want (tolerance)

11. Development of withdrawal symptoms, which can be relieved by taking more of the substance.

Take an alcohol and drug use history. Then ask the patient if he/she has ever experienced this (the symptom/criteria). Keep going between the patient’s discussion of each criteria and what they reported in the alcohol and drug use history. 
Then you can add a recovery specifier. They offer four options: 

Clinicians can also add one of four specifiers 

1. In early remission,

2. In sustained remission,

3. On maintenance therapy (such as methadone or Suboxone);

4. In a controlled environment (such as detox, residential living, sober living home, jail/prison, etc.)

Try it with patient or in a group and let me know how it goes by posting on my Facebook Page: www.facebook.com/GorskiRecovery 


Spin – The Art of Political Lying

July 20, 2016


By Terence T. Gorski

Here is how Wilipedia defines and describes SPIN: 

Spin is propaganda or presenting lies to the public as the truth. The term, “plausible deniability” actual means to protect politicians from the consequences of getting caught in a lie. 

In public relations, Spin is a form of propaganda, achieved through providing a biased interpretation of an event or campaigning to persuade public opinion in favor or against some organization or public figure. 

While traditional public relations may also rely on creative presentation of the facts, “spin” often implies the use of disingenuous, deceptive, and highly manipulative tactics.[1]

Politicians are often accused by their opponents of claiming to be truthful and seek the truth while using spin tactics to manipulate public opinion. Large corporations with sophisticated public relations branches also engage in “spinning” information or events in their favor. 

Because of the frequent association between spin and press conferences (especially government press conferences), the room in which these take place is sometimes described as a spin room.

Public relations advisors, pollsters and media consultants who develop spin may be referred to as “spin doctors” or “spinmeisters” who manipulate the truth and create a biased interpretation of events for the person or group that hired them.
The term has its origin in the old American expression “to spin a yarn”. 

Sailors were known for using their spare time on board making thread or string (yarn) and also for telling incredible tales when they were on shore. 

When someone fooled you, it was said that “he spun me an amazing yarn”. Yarn also became a synonym for “tall tale” – “What a yarn!”, means “what a lie”. 

A coarser and more contemporary version of this expression is “bullshit”, and, for anyone who seeks to deceive, “bullshit artist”. 
History of Spin

Edward Bernays has been called the “Father of Public Relations”. As Larry Tye describes in his book The Father of Spin: Edward L. Bernays and The Birth of Public Relations, Bernays was able to help tobacco and alcohol companies use techniques to make certain behaviors more socially acceptable in the 20th-century United States. Tye claims that Bernays was proud of his work as a propagandist. 

As information technology has increased dramatically since the end of the 20th century, commentators like Joe Trippi have advanced the theory that modern Internet activism spells the end for political spin. By providing immediate counterpoint to every point a “spin doctor” can come up with, this theory suggests, the omnipresence of the Internet in some societies will inevitably lead to a reduction in the effectiveness of spin.[4]
The techniques of spin include:
Selectively presenting facts and quotes that support one’s position (cherry picking). For example, a pharmaceutical company could pick and choose trials where their product shows a positive effect, ignoring the unsuccessful trials, or a politician’s staff could handpick speech quotations from past years which appear to show her support for a certain position)

  • Non-denial denial
  • Non-apology apology
  • Politically-correct deception
  • Making misinformation (deliberate lies) seem like the truth 

“Mistakes were made” is an expression that is commonly used as a rhetorical device, whereby a speaker acknowledges that a situation was managed by using low-quality or inappropriate handling but seeks to evade any direct admission or accusation of responsibility by not specifying the person who made the mistakes. The acknowledgement of “mistakes” is framed in an abstract sense, with no direct reference to who made the mistakes and what exactly the mistakes were. The ultimate mistake, of course, is to get caught in the lie. 

A less evasive construction might be along the lines of “I made mistakes” or “John Doe made mistakes.” The speaker neither accepts personal responsibility nor accuses anyone else. The word “mistakes” also does not imply intent.
Phrasing in a way that assumes unproven truths, or avoiding the question[5]

“Burying bad news”: announcing unpopular things at a time when it is believed that the media will focus on other news. In some cases, governments have released potentially controversial reports on summer long weekends, to avoid significant news coverage. Sometimes that other news is supplied by deliberately announcing popular items at the same time.

Spin includes the art of misdirection and diversion[6]

For years businesses have used fake or misleading customer testimonials by editing/spinning customers to reflect a much more satisfied experience than was actually the case. In 2009 the Federal Trade Commission updated their laws to include measures to prohibit this type of “spinning” and have been enforcing these laws as of late. 

Additionally, over the past 5 to 6 years several companies have arisen that verify the authenticity of the testimonials businesses present on the marketing materials in an effort to convince one to become a customer.

https://en.m.wikipedia.org/wiki/Spin_(propaganda) 

GORSKI BOOKS: www.relapse.org


Flakka: What You Need To Know

August 18, 2015

 
By Terence T. Gorski
August 19, 2015

Cautionary Note: Flakka is a relatively new drug that can cause extreme behavioral reactions during intoxication and immediately after using. There are also reports of long-lasting neurological effects. It is definitely a dangerous drug that is rapidly entering the drug-using culture. 

It is important to be cautious not to exaggerate the incident rate (number of people using it) or the type and severity of symptoms (stripping down naked and chasing people down like a fast-moving zombie). 

The information in this blog is summarized by usually reliable news reporting sources on the Internet and corresponds with real incidents reported to me by colleagues and clients. It is important, however, to be cautious about extreme reports of new designer drugs. 

According to Jacob Sullim in his blog on reason.com, there are three designer-drugs that are closely-related to Flakka that are recently entering the United States. These are — meow-meow, krokodil, and Jenkem. 

  1. Meow meow, is a nickname for mephedrone, another synthetic cathinone sold as “bath salts.” and
  2. Krokodil, is a homemade version of the narcotic painkiller desomorphine, which was first synthesized in 1932 and marketed under the brand name Permoid. Krokodil caught on in Russia as a cheap substitute for heroin because it could be made from codeine, which was available there without a prescription. 
  3. Jenkem is fermented human waste that supposedly generates intoxicating fumes when inhaled. 

When doing internet research on any new drug or controversial issue, I strongly recommend you do a Google Search on the topic and the another on the topic plus the word “hoax.” This will give your review more balance. 

To get a balanced mind-set about Flakka it may be helpful to read this blog from Reason.com: http://reason.com/blog/2015/06/17/flakka-turns-people-into-zombies-just-li

With these cautions in mind, I hope this blog will summarize some information about Flakka that will help you to better understand the epidemic of Flakka as it emerges in the USA. 

Summary:

Starting in the Spring of 2015 a new drug of abuse called Flakka or Gravel was smuggled into South Florida and rapidly made it’s way up to Northern Florida and beyond. Its use is rapidly spreading across other states leaving a trail of victims behind.

Flakka, a variation of synthetic substances known as bath salts, is an illicit drug concocted in labs overseas and shipped into North America.

Flakka delivers a cheap, powerful high while acting as an amphetamine, according to officials. The drug can be snorted, smoked or taken by mouth and can cause violent behavior.

Flakka induces paranoia, psychosis and extreme aggression. Users high on this dangerous drug have attacked authorities, caused disruptions on the streets and in emergency rooms, engaged in self-injurious behavior, including in one case, and in one case, a man impaled himself on a spiked fence.

Detailed Information about Flakka.

What is flakka?

Flakka, which  is also called gravel because its crystals resemble small pebbles, is a stimulate drug with a chemical composition similar to bath salts. The active ingredient in Flakk is alpha-PVP, a synthetic version of cathinone, the active ingredient in the stimulant shrub qat, which is also the active ingredient in bath salts. 

What Is Flakka-induced Excited Delerium?

In high doses, Flakka induces “excited delirium” in which users’ body temperature can rise to up to 42 C, which might explain why so many users end up naked while hallucinating. People report stripping off their clothing because they feel like they are on fir or burning up. 

How is Flakka ingested?

Flakka can be taken in different ways:

  • injected,
  • swallowed,
  • smoked or
  • snorted.

Can people overdose on Flakka?

Yes! Especially when it is smoked. Vaporizing and the smoking Flakka allows the drug to very quickly enter the bloodstream and may make it particularly easy to overdose.

What is the chemical composition of Flakka?

Since Flakka in manufactured in illegal labs overseas and can be cut by other chemicals before sale in the USA, there are differences in each batch of Flakka analyzed.

According to the U.S. Drug Enforcement Agency, Flakka is essentially a stimulant hallucinogenic. The main ingredient in all batches of Flakka is alpha-PVP, which is linked to cathinone, the drug found in bath salts. 

Flakka is a stimulant drug and users often mix it methamphetamine to increase the intensity of the stimulant high.

In July 2012, the Synthetic Drug Abuse Prevention Act made it illegal to possess, use, or distribute many of the chemicals used to make bath salts, including Mephedrone and MDPV. Methylone, another such chemical, remains under a DEA regulatory ban. Alpha-PVP, the active ingredient in Flakka, has not yet been banned. 

What are the behavioral effects of Flakka?

Alpha-PVP is a stimulant, so its users encounter:

  • alertness,
  • wakefulness,
  • tremors,
  • agitation,
  • irrational rage,
  • violence

Flakka, when taken in high doses, induces “excited delirium” in which the users’ body temperature can rise to up to 42 C, which might explain why so many users end up naked while hallucinating and panicking because they feel like they are on fire or “burning up.”

What does Flakka look like?

According to the National Institute on Drug Abuse, Flakka “takes the form of a white or pink, foul-smelling crystal,”

Dr. James N. Hall, an epidemiologist and co-director of the U.S. Center for the Study and Prevention of Substance Abuse at Nova Southeastern University, told NBC News.

“Some [users] get high, some get very sick, and many become addicted. Some go crazy and even a few die. But they don’t know what they are taking or what’s going to happen to them,” he said.

Some people experience heart problems, muscle breakdown or even kidney failure. The NIH says Flakka has been linked to deaths by suicide and heart attack.

Hall says flakka’s name has Spanish origins. “Flaco” means thin, while “la flaca” in rough translation is a party term for pretty, thin girl.

“They give [synthetic drugs] names that are hip and cool and making it great for sales,” he told NBC.

What is the street value of Flakka?

Flakka is relatively cheap. A single dose is about a tenth of a gram which has a street value of about $5.

What are common complications of Flakka? 

1. Flakka can make the drug user acutely agitated, making them irrational and vetberbally aggressive   This puts the Flakka patient at high risk of injuring self or others.  

2. These patients are a threat to themselves, the people around them, and the first responders (police, EMS) who are there to help them. It is common to hear reports that it takes multiple people to restrain and sedate these patients. 

3. Rescue crews and emergency department staff need to give sedatives to these patients as soon as possible to calm them and make them safe.

4. If police interventional be required to control an acutely aitate Flalka. This can result in officers using a  Taser or other methods to restrain the patient that have the potential to harm the individual. Officers need to rember that in these severe states of agitation, panic and adrenalin increase the patient’s strength while diminishing their perception of pain. Their paranoi is often focused on the first responders. 

5. Medically, the severe consequences of the agitation caused by the drug appear later. Patients who are agitated can go into a state called “excited delirium,” which is a medical emergency. 

6. In the excited delirium state, restrained patients struggle to free themselves, scream, flail, and can even have seizures. 

7. This struggling causes a high core body temperature called hyperthermia

8. The combination of a high body temperature and the extreme muscle overactivity can cause other metabolic problems to happen in the body. 

9. Muscle tissue begins to break down, releasing proteins and other cellular products into the bloodstream, in a process called rhabdomyolysis

10. The extreme struggling can also cause dehydration. 

11. The end result of the cellular products and proteins released during rhabdomyolysis and dehydration can impair the filtering function of the kidneys, leading to renal failure and death. 
Gorski Books: www.cenaps.com 

The Drudge Report Archives contains articles which historically track the introduction and growth in the use of Flakka: http://www.drudgereportarchives.com/dsp/search.htm?searchFor=flakka

Here is an article from Fusion.net that described the impact of Flakka from an “on-the-street” point of view: http://fusion.net/story/117767/a-complete-guide-to-flakka-the-horrible-street-drug-terrorizing-south-florida/ 

Flakka: Special Obstscles in Treatment: http://www.sun-sentinel.com/local/broward/fl-flakka-treatment-issues-20150813-story.html 

This blog describes the major complications that can occur when treating Flakka patients: http://www.medicinenet.com/script/main/mobileart.asp?articlekey=188097 

References:

REFERENCES:

“‘Bath Salts’ Intoxication.” N Engl J Med 365 Sept. 8, 2011: 967-968. <http://www.nejm.org/doi/full/10.1056/NEJMc1107097&gt;

Kaizaki, A., S. Tanaka, and S. Numazawa. “New recreational drug 1-phenyl-2-(1-pyrrolidinyl)-1-pentanone (alpha-PVP) activates central nervous system via dopaminergic neuron.” J Toxicol Sci 39.1 Feb. 2014: 1-6. <http://www.ncbi.nlm.nih.gov/pubmed/24418703&gt;.

“The Science of Alpha-PVP (‘Gravel’), a Second-Generation Bath Salt.” The Poison Review. Mar. 14, 2014. <http://www.thepoisonreview.com/2014/03/14/the-science-of-alpha-pvp-gravel-a-second-generation-bath-salt/&gt;.

“Violent, Impaired and/or Excited Delirium (ExDS) Patient.” Greater Broward EMS Medical Director’s Association. <http://www.gbemda.org/adult-2/2-5-adult-neurologic-emergencies/2-5-2-violent-andor-impaired-patient&gt;.


Thank God for the Atom Bomb

August 7, 2015

 Nuclear Weapons: A Time-Lapse History 

By Terence T. Gorski 

All people with a conscience have mixed feelings about war and the weapons of mass destruction used in modern day warfare. 

The fear of nuclear war is once again raising its head. Many of us would prefer to ignore the issue and pretend “it can never happen again.” The current deal with Iran over nuclear weapon development and the possibility of widespread nuclear proliferatio in the Middle East is raising the issue and the fear of the real possibility of nuclear war. 

People without a conscience (i.e. psychopaths/sociopaths) are not hobbled in their decision making about nuclear weapons by issues of morality, empathy, and fighting for the good. When making decisions involving the use of weapons of mass destructions psychopathic/sociopathic leaders will do anything necessary to expand their power even if it means destroying humanity in the process. 

In my opinion, the reality is that people of conscience need to come to terms with the need for violence to protect personal freedom. This means facing the issue of using violence on all levels to protect individual freedom. This includes, of course, coming to terms with the production and use of nuclear weapons. If they don’t, people motivated by high moral standards will eventually be killed, imprisoned, or controlled by psychopaths/sociopaths who are well armed and organized. This is especially true if evil intent can be cloaked by a religious ideaology. 

People of good will must recognize and name the true nature of the enemy –those who don’t are usually condemned to be defeat by the enemies they refuse to name. 

The following article was forwarded to me by Buck Yancy, a friend and mentor who keeps challenging me to face and think about the hard issues of life. It is the reprint of an essay written in 1981by the late Paul Fussell, a cultural critic and war memoirist. 

Reading this essay was unsettling. It contrasted two perspectives of making decisions about using nuclear weapons: the anstract perspective of those who make and critique policy; and the personal perspective of the troops whose lives were spared because the land invasion of Japan became unnecessary because the use of nuclear weapons forced Japan to surrender. 

Here is an article by the same name in The New Republic

Below is the original essay I received:

Thank God for the Atom Bomb  

 

Wed Aug 5, 2015 7:36 pm (PDT) . Posted by: “Jim Baker” baycur on Aug 5, 2015, at 11:42 AM, by Jeff Murray tamu73@sbcglobal.net [CHAT_281AHC] <CHAT_281AHC@yahoo groups.com> who wrote:

The headline of this column is lifted from a 1981 essay by the late Paul Fussell, the cultural critic and war memoirist. In 1945 Fussell was a 21-year-old second lieutenant in the U.S. Army who had fought his way through Europe only to learn that he would soon be shipped to the Pacific to take part in Operation Downfall, the invasion of the Japanese home islands scheduled to begin in November 1945. 

Then the atom bomb intervened. Japan would not surrender after Hiroshima, but it did after Nagasaki.

I brought Fussell’s essay with me on my flight to Hiroshima and was stopped by this: “When we learned to our astonishment that we would not be obliged in a few months to rush up the beaches near Tokyo assault-firing while being machine-gunned, mortared, and shelled, for all the practiced phlegm of our tough facades we broke down and cried with relief and joy. We were going to live.”

In all the cant that will pour forth this week to mark the 70th anniversary of the dropping of the bombs—that the U.S. owes the victims of the bombings an apology; that nuclear weapons ought to be abolished; that Hiroshima is a monument to man’s inhumanity to man; that Japan could have been defeated in a slightly nicer way—I doubt much will be made of Fussell’s fundamental point: Hiroshima and Nagasaki weren’t just terrible war-ending events. They were also lifesaving. The bomb turned the empire of the sun into a nation of peace activists.

I spent the better part of Monday afternoon with one such activist, Keiko Ogura, who runs a group called Hiroshima Interpreters for Peace. Mrs. Ogura had just turned eight when the bomb fell on Hiroshima, the epicenter less than 2 miles from her family home. She remembers wind “like a tornado”; thousands of pieces of shattered glass blasted by wind into the walls and beams of her house, looking oddly “shining and beautiful”; an oily black rain. 

And then came the refugees from the city center, appallingly burned and mutilated, “like a line of ghosts,” begging for water and then dying the moment they drank it. Everyone in Mrs. Ogura’s immediate family survived the bombing, but it would be years before any of them could talk about it. 

Because Hiroshima and Nagasaki were real events, because they happened, there can be no gainsaying their horror. Operation Downfall did not happen, so there’s a lot of gainsaying. Would the Japanese have been awed into capitulation by an offshore A-bomb test? Did the Soviet Union’s invasion of Manchuria, starting the day of the Nagasaki bombing, have the more decisive effect in pushing Japan to give up? Would casualties from an invasion really have exceeded the overall toll—by some estimates approaching 250,000—of the two bombs?

We’ll never know. 

— We only know that the U.S. lost 14,000 men merely to take Okinawa in 82 days of fighting. 
— We only know that, because Japan surrendered, the order to execute thousands of POWs in the event of an invasion of the home islands was never implemented. 

— We only know that, in the last weeks of a war Japan had supposedly already lost, the Allies were sustaining casualties at a rate of 7,000 a week. 

— We also know that the Japanese army fought nearly to the last man to defend Okinawa, and hundreds of civilians chose suicide over capture. 

Do we know for a certainty that the Japanese would have fought less ferociously to defend the main islands? We can never know for a certainty. 

“Understanding the past,” Fussell wrote, “requires pretending that you don’t know the present. It requires feeling its own pressure on your pulses without any ex post facto illumination.” Historical judgments must be made in light not only of outcomes but also of options. Would we judge Harry Truman better today if he had eschewed his nuclear option in favor of 7,000 casualties a week; that is, if he had been more considerate of the lives of the enemy than of the lives of his men?

And so the bombs were dropped, and Japan was defeated. Totally defeated. 

Modern Japan is a testament to the benefits of total defeat, to stripping a culture prone to violence of its martial pretenses. 

Modern Hiroshima is a testament to human resilience in the face of catastrophe. It is a testament, too, to an America that understood moral certainty and even a thirst for revenge were not obstacles to magnanimity. In some ways they are the precondition for it.

For too long Hiroshima has been associated with a certain brand of leftist politics, a kind of insipid pacifism salted with an implied anti-Americanism. That’s a shame. There are lessons in this city’s history that could serve us today, when the U.S. military forbids the word victory, the U.S. president doesn’t believe in the exercise of American power, and the U.S. public is consumed with guilt for sins they did not commit.

Watch the lights come on at night in Hiroshima. Note the gentleness of its culture. And thank God for the atom bomb.


THE DEFINITION OF RELAPSE 

May 10, 2015

By Terence T. Gorski

Here are the key points of the definition of relapse from a wide variety of internet dictionaries :

To experience a relapse means:

1. The return of a disease or illness after partial or full recovery from i

2. To suffer a deterioration in a disease after a period of improvement.

3. To fall back into illness after convalescence or apparent recovery

4. To have a deterioration in health after a temporary improvement.

5. To fall or slide back into a former state of illness or dysfunction.

6. To regress after partial recovery from illness.

7. To slip back into bad habits or self-defeating ways of living; to backslide after a period of progress.

8. To fall back into a former state, especially after apparent improvement.

Origin of the word RELAPSE: the word relapse comes from the Middle English word “relapsen,” and from Latin meaning to to “forswear” (to promise or swear in advance that a change will be made.   A combination of the words: relb or relps-, came to mean to fall back gradually; or to slide back without being able to stop ones self (as could happen when trying to move up a slippery or muddy hill.

The word relapse results from a linguistic process called “nominalization” which means to describe a process (like loving someone or relating to someone) into a thing (like love or relationship).

It is important to do a “cross-walk” between 12-Step language (i.e. dry drunk leading to a wet drunk) and the language of cognitive behavioral therapy (the process of falling back into an illness, condition, or habitual problem behaviors that ends in the act of drinking, drugging, or acting out an addiction or habitual self-defeating behavior.

Using an “addictive release” provided by an addictive drug or behavior is often seen as the start of a “relapse episode,” a single discreet episode of addictive use.

A relapse episode is usually preceded by stressful events (triggers), that raise stress and activate old self-defeating and addictive ways of thinking, feeling, acting, and relating to other people.

Marlatt distinguished between a lapse (a short term and low consequence episode of addictive use) and a relapse (a return to a previous state of out-of-control addictive acting out usually accompanied by a return of secondary problems related to the addiction.

I believe in a Twelve-Step Plus Approach that matches the needs of individual recovering people with a strong recommendation to attend 12-Strep Programs and to participate in other treatment activities (professionally supervised) and recovery activities (peer supported and community based) that meet individual needs, promotes long-term recovery, and uses appropriate relapse prevention methods. There is no wrong door into recovery. There is no wrong treatment or recovery activity if it helps people to live a sober and responsible life filled with meaning and purpose.

Language Programs The Brain,
Focuses The Mind, and
Motivates Behavior.

Think clearly to get results in recovery!

~ Terry Gorski Blog: www.terrygorski.com

~ Terry Gorski, via www.facebook.com/GorskiRecovery

www.relapse.org

— PERMISSION IS GRANTED TO REPRODUCE OR REPOST —

 


Anger Management

February 14, 2015

IMG_0969-0

“Anger management is a critical skill for all addiction professionals. These online courses from SAMHSA are important resources.” ~ Terence T. Gorski (The Publications of Terence T. Gorski)

SAMHSA Newsletter on Anger Management Courses

Everyone experiences anger from time to time. It’s a normal emotion. But intense or prolonged anger can jeopardize employment, relationships, education, and even freedom. Those who struggle to control their anger are increasingly finding their way to behavioral health professionals for assistance. It is precisely for this reason that SAMHSA has created resources and a new a online course to help.

We see it in our schools, workplaces, families, and out in public – the person who yells, hits, or throws things – and sometimes sparked by something as small as a missed parking space. In a culture where time is short, anger can surface quickly and with intensity. And anger can erupt into physical violence.

– The Centers for Disease Control’s 2010 National Intimate Partner and Sexual Violence Survey, found that one in ten 9th to 12th graders had been physically hurt on purpose by a boyfriend or girlfriend.

– SAMHSA’s 2012 National Survey on Drug Use and Health: Mental Health Findings revealed that nearly 19 percent of youth receiving mental health services have trouble controlling anger.

– In 2009, the Bureau of Justice Statistics’ National Crime Victimization Survey reported more than a half million nonfatal violent crimes took place at work.

– Prisons and jails are even worse, where 38-50 percent of inmates experience persistent anger and irritability. When the problem results in an arrest or other disciplinary action, there often is a referral or requirement to engage in some therapy or treatment to help manage the intense emotion and prevent additional similar experiences.

The Anger Control Plan
(excerpt taken from SAMHSA’s new Anger Management for Substance Abuse and Mental Health Clients course)

1. Take a time out (formal or informal).
2. Talk to a friend (someone you trust).
3. Use the Conflict Resolution Model to express anger.
4. Exercise (take a walk, go to the gym, etc.).
5. Attend 12-step meetings.
6. Explore primary feelings beneath the anger.

Typically, when someone gets angry, there are responses that are physiological (becoming flushed, burst of energy and arousal, etc.), cognitive (thoughts that occur in response to an event), emotional (feeling afraid, discounted, disrespected, impatient, etc.), and behavioral (sarcasm, swearing, crying, yelling, throwing, etc.).

Problem anger occurs when someone experiences anger as a chronic irritability or a full-on rage – as an emotion experienced too intensely or too often. The consequences of long-term anger issues can lead to arrest, injury (self or others), adverse effects on important relationships, job loss, or treatment program ejection. Some groups have a higher risk of experiencing problems with anger, including individuals with substance use disorders, traumatic brain injury, post-traumatic stress disorder, and personality disorders.

Working with Angry Clients

“Anger management” is currently the most searched term on the SAMHSA website. This reality speaks both to the need for support around this issue and the practical benefit of SAMHSA resources like the Anger Management for Substance Abuse and Mental Health Clients: Participant Workbook and the newly launched Anger Management for Substance Abuse and Mental Health Clients course. The course is especially designed for anyone working with a person who struggles to control anger, but particularly substance abuse and mental health clinicians.

The Five Steps of the Conflict Resolution Model
(excerpt taken from SAMHSA’s new Anger Management for Substance Abuse and Mental Health Clients course)

Step 1: Identify the problem that is causing the conflict.

Step 2: Identify the feelings that are associated with the conflict.

Step 3: Identify the impact of the problem that is causing the conflict.

Step 4: Decide whether to resolve the conflict.

Step 5: Work for resolution of the conflict: How would you like the problem to be resolved? Is a compromise needed?

The online course takes approximately two to three hours to complete and uses a cognitive behavioral approach to working with angry clients. It covers a range of topics including how people respond to getting angry (passively, assertively, aggressively, or passive-aggressively), how to manage anger with people with traumatic brain injury or post-traumatic stress disorder, and how to assess anger and readiness for anger treatment. The course also includes a description of the cognitive behavioral therapy approach, treatment model overview, and other important information about anger management. The course is based on the Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual (also available in Korean and Spanish) and the Anger Management for Substance Abuse and Mental Health Clients: Participant Workbook (also available in Korean and Spanish).
In addition to behavioral health service providers, the course may also prove useful for human resource and other managers, school teachers and administrators, those working in the criminal justice system, or anyone experiencing anger issues. Upon completion of the course, certification is provided for continuing education credit.

Resources:
Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual (also available in Korean and Spanish)

Anger Management for Substance Abuse and Mental Health Clients Participant Workbook (also available in Korean and Spanish)

Resources on the Internet


Terrorism

January 18, 2015

2015/01/img_0908.gif
By Terence T. Gorski
Author, The Books of Terence T. Gorski

Life is full of danger and terror. Wherever we look we find the prospect of gloom. That said, let’s get on with living. 
REFLECTIONS ON 9-11:
I remember the terror attacks of 9-11. I was a part of that history, as were many of you. I honor the memory of all the people lost on that tragic day and in all the battles that followed.

We are now into year eleven of the war on terror.
– Justified? Of course!
– Necessary? Yes, in the judgment of many people more knowledgable than I!
– Courageously fought by our nation’s warriors? Most definitely! — Righteous violence? As righteous as violence can ever be!

Is the war on terror a part of a never ending historical cycle of war and violence? Most definitely!

It might just be me — but I pray that we, all humanity, find a way to peace.

“If there must be trouble, let it be in my day, that my child may have peace.” ~ Thomas Paine

The Books of Terence T. Gorski


%d bloggers like this: