Vol. 13, No. 8
To all in the USA, I hope you had a thankful and happy Thanksgiving and welcome everyone to the November edition of Tips and Topics. I’m glad you could join us this month.
David Mee-Lee M.D.
I have known Dr. Norman Hoffmann for over 30 years as a friend and colleague. Over the years of many presentations I have enjoyed and appreciated, Norm has shared quotes and quips that provide bits of wisdom as well as humor. Recently, as I listened again, I thought it was time to get some of those into print. So here a few of Norm’s favorites and what they mean.
Ponder these quotes and the wisdom they hold as told by Dr. Hoffmann.
1. “For every complex problem, there is a simple answer; and it’s wrong.” Attributed to H. L. Mencken.
2. “The truth is rarely pure and never simple.” A line from the play, “The Importance of Being Ernest” by Oscar Wilde.
3. “If your theory conflicts with folklore, recheck your theory.” This is a comment made by Paul Meehl during a graduate school seminar at the University of Minnesota.
4. “For the great enemy of truth is very often not the lie – deliberate, contrived, and dishonest; but the myth – persistent, persuasive, and unrealistic.” By John F. Kennedy in a commencement address at Yale.
“Then there are a few for whom I do not know the originator or ones that I have adapted from some recollection.” Here they are:
5. “Left unchallenged our beliefs become our truths.”
6. “If you torture a statistic long enough, you can get it to confess to anything.”
7. “Beware of a theory that explains everything, but predicts nothing.”
8. Finally, there is my own favorite contribution: “A computer program can make a diagnosis when it is licensed for independent practice in your state.”
Enjoy some vague terms often used in addiction and some fanciful definitions of Dr. Hoffmann.
1. “Heavy drinker”
2. “Problem drinkers”
3. “alcohol abuse”
4. “Data is not the plural of anecdotes”
Norman Hoffmann, Ph.D.
President, Evince Clinical Assessments
Dr. Hoffmann is a clinical psychologist who has evaluated behavioral health programs, provided consultations, and conducted trainings for over 35 years. He has worked with private organizations and governmental agencies in a variety of countries. Dr. Hoffmann has developed a number of assessments instruments used throughout the United States, as well as in Canada, Sweden, Norway, and the United Kingdom and authored or co-authored more than 190 publications. Take a look at some of Dr. Hoffmann’s work:
His faculty appointments include the University of Minnesota and Brown University. Currently he is President of Evince Clinical Assessments and adjunct professor of psychology at Western Carolina University.
SKILLS & STUMP THE SHRINK
Earlier this month, Ian Evans sent me the following message:
I was curious about slips when a client is in residential. Recently some programs we deal with have discharged clients who have drunk or used while on their pass. To me, it seems that residential treatment is the perfect place to deal with this issue. The client is in a structured environment, counselors they are familiar with, and in a treatment facility that can help them figure out what happened, why it happened, coping skills for the future, etc.
I have heard various reasons why: it being unsafe for other clients, there being state guidelines that someone must be discharged if they use while in treatment, etc. I was curious not only your thoughts on this in general, but also if you are aware of any guidelines for residential facilities in these instances.
I have reached out to the Department of Health Care Services as well, but to me it seems to make the most sense to allow someone to get treated in treatment rather than discharging and creating policies such as the client needs to check in and go to meetings every day for 2 weeks before they can come back to treatment.
Ian Evans MFTI #78016
Clinician I, Adult Forensic Care Team
Yolo County Department of Health Services, California
Work Cell: (530) 681-8165
Voicemail: (530) 666-8099 ext 1803
Note how our attitudes and actions about substance use while in treatment does not fit with treating addiction as a disease.
Your concerns are what I have written and spoken about a lot. Here are some links to what I have written before. You should also look at Appendix B in the latest edition of The ASAM Criteria (2013) pp. 401-410 where we suggest an approach and policy and procedure on use while in treatment. If you don’t have the latest book, I suggest you get it. See www.ASAMCriteria.org for more information.
Here are some links. If the links don’t work, go to www.tipsntopics.com and click on the edition on the right hand side Archives:
A. Tips and Topics, July 2014:
B. Tips and Topics, October 2012:
C. Tips and Topics, November 2012:
D. Tips and Topics, June 2009:
E. Tips and Topics, October 2004:
F. Tips and Topics, September 2006 SKILLS section:
Hope this helps, but let me know if not.
In a follow up message, Ian raised a common State policy preventing clinicians from treating relapse and flare-ups as assessment and treatment issues.
BARCLAYS OFFICIAL CALIFORNIA CODE OF REGULATIONS
Title 9 Section 10572 (e) that states:
“(e) No person, who, within the previous 24 hours, has consumed, used, or is still otherwise under the influence of alcohol or drugs as specified in section 10501(a), shall be permitted on the premises except for individuals admitted for detoxification or withdrawal. The licensee shall have specific written rules and policies and procedures to enforce this provision.”
It may be a huge question I am asking here, but do you see any way of working with the State to amend this so that if a client has a slip while on a weekend pass that they are not told they are discharged and must come back in 72 hours or 2 weeks like some programs do? There’s just something about discharging someone from residential treatment for slipping on a weekend pass and having them go back to the very environment they were using in before treatment that doesn’t sit well with me.
Thanks for your time,
Perhaps you have similar regulations in your State or county. I have pledged to Ian that I will do what I can to raise this sticky regulation with the powers that be to start a conversation for change:
Let’s start the conversation.
I’m not really an avid sports fan (except maybe for the New England Patriots National Football League, NFL, team). I am much more interested in the psychology of sports than the actual mechanics of why a person or a team wins. So when I heard that the Golden State Warriors (the San Francisco Bay area National Basketball Association, NBA, team) were about to make history, it sparked my interest. Golden State was about to have the best regular season start (16 wins in a row) in the NBA’s 70-year history.
As I listened to the sports pundits and commentators opining on why Golden State was so successful, I was intrigued by their explanation and analysis, heard on San Francisco public radio station KQED’s Forum with Michael Krasny. If you are into sports and want to listen, here’s the link: http://www.kqed.org/a/forum/R201511230930
Humility, fun, hard work, confidence but not complacence, unselfishness and team work – sounds to me like a winning formula for life, not just basketball history.
You might be interested to know that the Patriots are one of only two teams out of 32 in the NFL to have a winning start to the season, unbeaten in 10 games so far. I wonder if that is because of humility, fun, hard work, confidence but not complacence, unselfishness and team work too? Some other teams accuse the Patriots of being arrogant and cheaters, but they’re just jealous.
Until next time
Thank-you for joining us this month. See you in late December.