Current Issues in Addiction Counseling: A Conversation with Dr. Linda Salvucci

Mar 28, 2013 by Tom Dellner

Dr. Linda SalvucciCalSouthern faculty mentor Dr. Linda Salvucci has three decades of experience in the behavioral health field, with most of her career dedicated to the study and treatment of addiction. She’s worked in almost every imaginable setting, from hospitals to prisons, community and private mental health agencies and addiction treatment centers. She’s also performed a wide variety of functions, serving as clinical director, primary therapist, crisis therapist and detoxification technician, to name just a few.

An integral member of the School of Behavioral Sciences faculty, Dr. Salvucci brings this wealth of experience to bear for the benefit CalSouthern learners. She also played a critical role in developing the curriculum for CalSouthern’s new Pre-Baccalaureate Certificate in Addiction Studies, which has recently been found to meet the educational requirements for both the California Association of Alcoholism and Drug Abuse Counselors (CAADAC) and the National Association for Alcoholism and Drug Abuse Counselors (NAADAC).

Dr. Salvucci—who holds a BA in psychology, an MA in counseling and a PhD in clinical psychology—sat down with CalSouthern to discuss the new addiction studies certificate, as well as broader issues of importance to practicing and aspiring addiction treatment professionals.

 

CalSouthern: You were intimately involved in developing the curriculum for CalSouthern’s Pre-Baccalaureate Certificate in Addiction Studies. What were you trying to achieve with the program and how did you settle on the particular subject mix?

Dr. Linda Salvucci: My primary goal was to develop a curriculum that would meet the educational requirements for CAADAC and NAADAC, so that those who earn the certificate would be able to progress toward certification by one of these bodies as an alcohol and drug abuse counselor. Requirements vary by state, but in California, CAADAC certification is basically essential for those who wish to function as an independent counselor and build a career in this field.

Secondarily, I wanted to provide the broadest possible educational base so that students will gain exposure to as much of the field of addiction as possible—all while utilizing the best and most current texts and materials available.

 

CalSouthern: Could you expand upon why it’s so important to provide students with such a broad-based curriculum?

Dr. Salvucci: Addiction continues to be a controversial field in many respects. For example, some continue to question whether addiction is really an illness or more a matter of self-will. I think it’s extremely important for students to form their own belief systems and to come to terms with their perspective on this and many other issues—these core beliefs will ultimately inform how they will treat their patients. The curriculum is designed not only to teach students about addiction, but to help them form and embrace these fundamental beliefs, which I think is absolutely critical for those who want to practice in this field.

The feedback I have been receiving has me very optimistic that we have accomplished this goal. Just recently I heard from a student who shared with me that he enjoyed the courses because they exposed him to aspects of addiction and its treatment that he had never considered before.

 

CalSouthern: To back up slightly and ask a rather broad question, is the problem of addiction growing, decreasing or static? What are some of the forces at work?

Dr. Salvucci: In my opinion, the shifts that occur are related more to the types of drugs that are being abused, rather than the number of addicts. While alcohol is still the most abused drug, we are seeing an increase in heroin and opiate use in the past few years, where that had been in something of a lull before. So I think the overall population of addicts may remain relatively static, but there are significant changes that occur within that population.

 

CalSouthern: Any other trends that are emerging or hot-button issues that you’re seeing?

Dr. Salvucci: Medicinal marijuana raises interesting issues. Putting aside for the moment the question of whether or not it is a helpful treatment, we are seeing great potential for abuse of the system, where those without valid medical reasons are gaining access to extraordinarily potent marijuana.

Another important issue is how addiction treatment is evolving into a highly specialized, multi-million dollar industry. When I first entered the field, I was something of a one-stop shop. If an intervention was required, I did it. I also did groups and recovery coaching—whatever was needed. But with so many specialists and so many methods and styles of treatment available, I am concerned that we are not being consistent from one provider to the next—one specialist may have a holistic approach, another may be confrontational and a third might focus primarily on vitamin therapy. I sometimes wonder if one hand knows what the other is doing.

We’re also slowly seeing more of an emphasis on focusing on the impact addiction has on the family. This is something of a return to the past. Back in the late ’70s, if you didn’t have a family member with you, you couldn’t begin treatment. Later, and for a long time, we focused primarily on the individual and not the family, and a very important component was left out of the loop. That’s often still the case, but as I mentioned, I think an emphasis on family is slowly returning.

I also am seeing more and more of a holistic approach to treatment, focusing on mind, body and spirit. We’re not just treating the individual, giving them some information to aid their recovery and sending them on their way. Led by the Betty Ford Center and other organizations both large and small, there’s more of a focus on follow-up care. We help people with diet, exercise, and even aspects of spirituality to help them discover their purpose in life and develop a plan for their careers and personal lives in recovery. And, to tie it into a point I made earlier, more and more frequently, the family is brought in to help in this regard.

Take the example of the 24-year-old who has been using since the age of 12. Well, adolescence is when you are supposed to learn how to deal with life emotionally, but that probably never happened. Emotionally—and perhaps, to an extent, mentally—this person is still at the level of that 12-year-old. How does he get a job? How does he deal with anger? How does he have fun or enjoy life without using? These are issues we are dealing with now in recovery coaching, things that we can’t possibly teach in treatment.

 

CalSouthern: You’ve had decades of varied experience in the field. Do you enjoy it? What’s the most rewarding aspect of your work?

Dr. Salvucci: I do enjoy it. Very much. The most rewarding aspect is helping people become truly honest with themselves—perhaps for the first time in their lives—and discover who they really are and help them begin to live the lives they want to live.

 

CalSouthern: What are some of the biggest challenges or sources of frustration?

Dr. Salvucci: When working at a facility, the clinical staff can sometimes find themselves at odds with owners and higher management because what is clinically best might not be what is best for the center’s bottom line. That’s a frequent source of frustration.

But without a doubt, losing a patient is the hardest. Recently, a patient of mine died from a drug overdose. He was 22. I had worked with him and his family for almost four years. I gave his eulogy and still work with his family today. Cases like this are heartbreaking.

 

CalSouthern: How do you deal with these sorts of situations?

Dr. Salvucci: As a counselor, you have to realize and accept that relapse is a part of the process. You can’t have the expectation that, if you just do a good enough job, the person will never relapse. In reality, we can’t make anyone change. We can only be guides and educators, supporting our clients and giving them the best tools we can and helping them learn to make better decisions. But ultimately, it is up to them, and we have to understand that.

But we can educate our clients about relapse, letting them know, before they leave the office, that relapse can be a reality. And we can plan for it and develop a strategy about what they can they do if relapse occurs. This may not prevent relapse, but being proactive might limit it. It will help the client understand that relapse doesn’t mean that all is lost. You can keep them from thinking “I’m the scum of the earth” and never coming back to treatment.

 

CalSouthern: For those interested in the field, is now a good time to consider a career in addiction counseling?

Dr. Salvucci: I think the field has at least maintained status quo through the economic downturn. Obviously, there are still addicts; there are still treatment centers. As with other fields, those interested in careers are going to have to be diligent in their job search. And personally, I believe that at least a bachelor’s degree—along with the sort of addiction education the CalSouthern certificate provides—is going to be necessary.

 

CalSouthern: In your opinion, what are some qualities required for success when working with this population?

Dr. Salvucci: The one that immediately occurs to me is open-mindedness. You need to be willing to accept that you don’t have all the answers and that you will have to learn from your clients in some respects. This also might mean that—for those counselors who have been through recovery themselves—you can’t counsel all your clients the way you were counseled in recovery. You need to be objective and open to other modalities and techniques.

In addition, you must have the capacity to be caring and empathetic, but also to detach and maintain boundaries and not becoming too emotionally invested. It can be a hard balance to strike, but if we can do it—while being open and genuine—it’s in the client’s best interest and he or she will feel and understand it.

 

CalSouthern: Any words of advice to those interested in enrolling in the certificate program and perhaps entering the field?

Dr. Salvucci: I would ask people to be honest with themselves and assess why they are interested in addiction treatment. If it’s because, for example, they have a brother who has a drug problem and they want to “fix” him, they might not be open-minded enough to gain sufficient perspective on addiction and its treatment. It all comes back to what I said before about being objective. It you really take the time to understand your motives, you’ll be better suited to maintain the necessary objectivity to succeed in your studies and in your career.

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