Case Management or Coaching? Start with Caring and Concern

By David H. Kerr                           

What may be missing in our system of help for people with addiction?

Here’s today’s equation:

degrees + certification = qualified to help a person with addiction. 

What's wrong with this equation?  Do we also measure caring or concern or understanding in our pursuit of quality and excellence?  Is addiction now a brain disease to be fixed by assessment, labeling (character disorder, socially maladjusted, co-occurring etc.), and prolonged medication, counseling and “case management?”  Should people be referred to as “cases?”  We used to call someone “a mental case” and I’m hoping that we’ve grown out of this phrase.  I suggest that we replace the cold phrase “case management” with a phrase like “soul coaching” or just plain “coaching.”  We’re working with people and their very lives are often at stake.  Let’s call them people or “souls” rather than cases as in a case of beer.   

Real caring though often needs a balance of confrontation when the truth of a person’s statement is suspect.  My standard approach to a person seeking my help:  “I can do nothing for you if you are not willing to help yourself i.e. you must be your own counselor.”  My next question is “so what have you done so far?”  “You have to learn to play the game of life, clean and sober.  If you understand this then I will be your “coach” and mentor, not your “counselor.”  Understand this as stated in the words of the great philosopher O. Hobart Mowrer, “you alone must do it but you can’t do it alone.”  You should understand that recovery is a lifestyle and its process will take time and dedication every day for the rest of your life to ‘become you – your best self’.  Do you understand this?” 

Addicts are not helpless and if you think they are, look at the ingenuity they need to have to maintain a $300/day habit.  While used on the “streets” for bad purposes, this trait can be put to good use as part of their new clean and sober lifestyle.

I want to talk today about the way to work with a person suffering from addiction. It's really not all that complicated.  Before getting to that let's look at the system of health care in place right now.  First a person wanting to help a person with addiction must have a master's degree in a related field.  Usually this means a degree in social work or a master's-level in counseling or PhD in Psychology.  You get the idea. Then after the degree is attained you must become certified.  In New Jersey this means obtaining CADC (Certified Alcohol and Drug Counselor) followed by LCADC or Licensed CADC. With this and possibly no experience, you are ready to hang out the proverbial shingle and help someone suffering from drug addiction.

There is nothing wrong with degrees & certification and it’s laudable if not sometimes a challenge with the cost of higher education, to obtain this level of credential.  Most addicts in recovery have accumulated much debt and the tens of thousands of dollars for further education would make certification prohibitive.  It took me five years to obtain my MA since I was then, 1968, living with active addicts in Lincoln Park, Newark several months after the Newark rebellion and race riots in the summer of 1967.  During this time, I learned the hard way that my kindness was seen as weakness and I was mugged at knifepoint and gunpoint six times and lost all of my money.  My co-founder and cousin, Rich Grossklaus was mugged as well over 12 times and nearly lost his life on one occasion.  But in my experience in the field since 1965, I have clearly seen something else that is most effective in helping a person with addiction.  It’s so obvious that it’s sometimes neglected.

Far more important than a degree are the following traits: understanding, caring and concern.  Addexperience and common sense to these traits and the person with addiction will feel your help and will likely listen to you.  If you put these three traits + experience and common sense on one side of the scale and degrees and certification on the other side, the understanding, caring, concern and experience will tip the scales dramatically, far out weighing the degrees and certification.  Yet, what measures do we have for these essential traits?  One of the reasons that many if not most recovering addicts are successful in helping people is that they have much experience in the field and offer much compassion and understanding as well. They see themselves in the face of the person sitting in front of them looking for help and guidance. That person looking for help feels their concern, understanding and knowledge, expressed with sincerity and true caring.  Many of these people, often with no degrees, are highly capable and competent and have at least equal skills to help recovering people when compared to the graduate with an MA or MSW.  Why not allow them to present their knowledge to the certification board and qualify them with LCADC status based on their experience, knowledge and a recommendation from a qualified experienced professional?

Here is my formal suggestion to the Certification Board: 

Offer an equivalent recognition to the LCADC for a person in recovery and urine tested clean and sober for 10 years.  A person who’s coaching and advice to addicts has been monitored and guided by a counselor with an LCADC, for ten or more years.

In this way, we would bring back into the field competent and caring outstanding experienced role models in recovery.  These are the very people who have stood tall in the face of great personal loss and have come back to dedicate their lives and effectively help others like themselves.     

This spirit of caring is the same motivation that recently caused a perfect stranger, with no mental health credentials, to help another person avoid taking his own life by way of jumping off a bridge.  These two men are now friends as seen in the article below published in the Washington Post, May 8, 2017.  Please read the powerful true story below!  This same story has worked with addicts and alcoholics who are helped to stay on the road to recovery by the caring of another human being, often a perfect stranger.  In AA they call this person a “sponsor;” a sponsor to the one trying to change his/her lifestyle of steady personal destruction that often leads to overdose, liver disease, loss of family and friends and early death. 

Today we have begun to use the word “coach” which I believe is a better and more accurate term to describe the self-help process of regaining self-respect, self-esteem, family and friends and finally, long term recovery.

*******

Here’s the article from the Washington Post:

MENTAL HEALTH

The simple words from this stranger convinced a suicidal man to keep living

May 8, 2017, the Washington Post

https://www.washingtonpost.com/news/inspired-life/wp/2017/05/08/the-unlikely-friendship-between-two-strangers-after-one-saved-the-other-from-taking-his-own-life/?utm_term=.3da29379c380

Colby Itkowitz Washington Post

Meanwhile, the beat goes on….

NEWARK

Police make 27 drug arrests, seize guns over the weekend

Steve Strunsky For The Star-Ledger May 16, 2017

Police made 27 drug arrests in Newark over the weekend as part of crackdown in response to residents’ complaints, the city’s public safety director announced Monday.

The director, Anthony F. Ambrose, said that in addition to the arrests, police also recovered three firearms, 787 bags of heroin, 109 vials or bags of cocaine, 40 bags of marijuana and $4,694 in cash. The street value of the drugs totaled $11,120, Ambrose said.

“We are pleased to announce that this operation, which came about as a result of reports from concerned citizens, is producing tangible results that reduce crime,” Ambrose said in a statement.

On Saturday, Ambrose said, officers arrested Stephone Cook, 45, of Newark, on weapons and drug possession charges after stopping a vehicle at Nye Avenue and Clinton Place, based on an outstanding warrant, and then smelled marijuana and spotted a .45 caliber handgun inside the vehicle.

Siddiq Hooper, 38, and Paris J. Armwood, 21, both of Newark, were arrested on similar charges Sunday, Ambrose said, after they fled from police responding to a report of suspicious activity near Chelsea and Tremont avenues.

The two dozen people arrested on drug charges were from Newark, Belleville, East Orange, Nutley and Hamburg, Ambrose said. The tally was for arrests and seizures between Friday and Sunday, Ambrose said.

Steve Strunsky, NJ Advance Media,