All Things Substance Podcast
Assessment Episodes
Substance Use Decision Tree-Explained
Episode #116 Sometimes we have to make decisions pretty quickly. I remember being floored when I was out of school and had to diagnose in the first session. I had held onto charts because I wasn’t ready to do the diagnosis. I got in “trouble” with the three support...
Would You Have Guessed They Had Alcohol Problems?
Episode #115 People often hide things they are ashamed of. They also hide things that feel like it's the only thing holding them up. That can make it really hard to find out organically if someone is overusing substances. In today’s episode we’ll hear about five real...
Why Readiness to Change May Be the Biggest Factor
Episode #109 People change because they want to or because they have to. When neither of those things are true, change isn’t going to happen. When clients come to us, we have to focus on what they bring to the table. If they come to change a particular behavior, then...
When is Outpatient Therapy the Right Fit?
Episode #108 When therapists think about working with substance use, they may envision a meth addict or a heroin addict. They worry that someone will overdose and die. They are concerned that the person’s use will be more than they can handle. The great news is that...
Charting the Course is Here!
Episode 105 This is the program you need in order to feel competent and confident in addressing your clients’ use of alcohol and drugs. You don’t need to go back to school or refer out. The majority of clients who are using substances problematically don’t meet the...
Substance Use and Mental Health Are Under the Same Umbrella
Episode 102 Substance use is our problem. By “our” I mean mental health therapists. The subfield of substance use isn't big enough to be its own thing. It's just a further specialty. Like other specialties such as eating disorders, sex therapy, OCD treatment, trauma...
Stop Referring Out: You Can Work With Substance Use Clients In-House
Episode 101 I remember hearing the advice “refer out” in my early career. It was usually around substance use or personality disorders. I remember feeling like there must be a piece I was missing. Why were these seasoned therapists saying to refer out? If they don’t...
Recreational or Problematic? Signs that Use May be Moving from One to the Other
Episode 99 We don’t want to be wrong about what’s impacting our clients. We try really hard to assess what is happening in a client’s life that is getting in the way of their success. We ask all sorts of questions, compare it against all the information in our heads...
The Reason That Gets a Client Sober, Won’t Be Enough to Keep Them Sober
Episode 97 Love of others, the law, nor the hope of a good future are enough to keep someone sober long term. Great way to start us off right? I know it sounds like a real downer, but I promise if you stick around it’ll get better. People start working on reducing...
How to Take a Substance Use History
Episode 83 Taking a drug use history can sometimes feel like guessing. What questions should you ask? What do the answers mean? Did you ask the right things? In today’s episode we will be going over the questions I feel are necessary in getting a good history on...
Good Therapy-Protecting the Therapy Hour
Episode 81 Good therapy depends on both us and our clients. We need to show up ready to work, but our clients need to show up ready also. Substance use can get in the way. There are two ways that substance use interferes with our work. One is when a client’s brain and...
Adding a Substance Use Lens
Episode 80 Adding a substance use lens for our work is at the heart of my message. We already use a mental health lens, a trauma-informed lens and a lens for whatever our main theoretical orientation is. Adding a substance use lens is looking at the presenting...
Setting Up for Sensitive Conversations
Episode 78 Deliberating setting up for a sensitive conversation will make the whole discussion easier on both you and your client. People know when they come in to see us that we will be asking them questions. They even know it's going to be personal. They might have...
Shame and Addiction
Episode 77 Shame and addiction cannot be separated. The deeper someone goes into their addiction, the more things happen that they want to keep hidden. So many things are “normal” when a person is stuck in active addiction. Things that “normal” people who shake their...
Fear and Addiction
Episode 74 Fear and addiction always show up together. Being in active addiction fills a person with fear of so many things. That’s going to show up in our therapy sessions. Our whole job is to hold a safe space for people. We know that, but they don’t always know...
Client Responses That Impact Assessment
Episode 73 We can ask all the perfect questions, but sometimes a client’s answers aren’t as clear as we’d hoped. There are lots of reasons for why a client might not want to share about their use of substances. Today we’ll discuss the most common responses and how to...
Diagnosis Can Be Healing
Episode 72 Why do we need to diagnose clients? Is it harmful to give someone a diagnosis? Can’t I just give everyone an adjustment disorder? Diagnosing is fundamental to the work of a therapist. If for no other reason than you need to be able to bill insurance to get...
Why Therapists Might Not Assess for Substance Use
Episode 70 What keeps therapists from asking about substance use? Fear of practicing out of scope? Not enough information about drugs? Not sure what to ask? There are a lot of reasons why a therapist might be hesitant to assess substance use. Knowing ourselves is...
10 Reasons We Need to Assess Substance Use
Episode 69 Why should mental health therapists assess substance use? Is that really in our scope? My answer is a resounding, Yes. In this episode I go through ten reasons why assessing for substance use is vital to our work and to our client’s well-being. I often...
Effects of Substance Abuse-Progression
Episode 11 What are effects of substance abuse? What does progression mean when talking about addiction? How does progression relate to the DSM criteria? What addiction criteria shows up most often? Progression is the key to addiction. It’s not about choice or...
Addiction: Stages of Addiction and Use
Episode 10 What stages of addiction and use are there? How do I know which level of use my client is in? Do people bounce around in use stages or move in a linear fashion? Stages of use are helpful in assessing your client’s use and determining when you should be...