My thought tornado went something like this: My clients are trying to stay sober, but inevitably they will experience some conflict with another, and this poses a threat to their sobriety. But what if they’re able to see which state they tend to interact from and are being interacted with – might this help decrease the frequency of conflict and facilitate its resolution? I can show them the life scripts/life positions, and maybe this can get them exploring if their substance use is contributed to by how they see themselves in the world and in relation to others! And if they can see this, then maybe they can change the script that isn’t working!
This is the one disclosure that wasn’t even close to being on my radar. I figure, if someone truly wants to kill another, they’re not likely to foil their own plan by talking to someone who would oppose it and be mandated to report – they’d probably either just do it, or they’d keep the thought to themselves until it passes. But, as mandated reporters, counselors can’t just sit back à-la-Rogerian, listen, and hope such thoughts dissipate from a client’s mind and into the ether.
Even when there is evidence to the contrary a good counselor might begin to question what’s actually true, because the client is so consistent in making the same statements that it becomes like a mantra for the both of you. The client might even have other people in other areas of their life legitimately fooled (e.g., family members, a doctor, a caseworker), and this may be the product of them neatly compartmentalizing information and feeding specific bits to different people based on their “need to know.” As a counselor, part of my job is to pay attention to the signs of the disorder that bubble to the surface and are difficult for the client to dispute – at the end of the day, track marks don’t lie, and most of the time neither do laboratory tests.
Three things I quickly learned about conducting a SUD screening with a client who is ordered (or voluntold) by an agency with legal authority:
If something seems off it probably is, and you might want to head for the hills. Of course, it’s best to try to come to an understanding with an employer as to why its processes are the way they are, but if it keeps stinkin’, that ship’s a’sinkin’.