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DRINK & DRUGS NEWS :: Q&AYou ask the questions - you answer the questions. Please keep your answers coming, and feel free to email a new question. Thanks to this issue's respondents for their contributions. Question:I used to have a drug problem, but since getting clean have
enjoyed my job as a drugs worker. A few months ago I relapsed for
the first time. I took leave from work and booked myself into treatment,
determined to sort myself out. My problem is that my counsellor
at rehab is threatening to tell my employer about my relapse, saying
that she has a duty to protect my future clients. I am horrified,
as I thought my confidentiality was protected when I went into treatment.
Please can anyone advise me on my position? [Amy, by email] Your replies...Dear Amy The first thing to say is that you are not alone. Relapse is part of the journey to recovery, and many former users working in our field have faced personal challenges like this. I have remained alcohol free now for over 24 years, but only because I kept to a 12-step programme which required rigorous honesty, particularly being honest with myself. I have worked outside the drug treatment field, with employers who had wonderfully supportive employment practices, and others where drug and alcohol misuse was often hidden in the workforce partly because of a lack of enlightened policies. But in truth, I have also worked with a few in the drugs field who had not got much of a clue about addiction and dependency. However, what you have to recognise is that if your drug use had continued without any intervention by yourself or others, your actions may well have affected not only the reputation of your employer, but you may well have posed a risk to those users with whom you worked. There have been many times in my life when I felt emotionally off the wagon. Remaining drug and alcohol free is not easy when life gets difficult. But each time I felt wobbly I looked at the triggers that lay beneath and talked to people who understood. I can understand how you feel, of course. Sometimes it may seem that some colleagues who have never had a drug dependency themselves, can't understand the courage it has taken to stay drug free. But most are supportive and wise, even if they haven't fully experienced the same challenges. The counsellor who you say is 'threatening' to reveal your situation is in a difficult position. This counsellor has a duty of confidentiality but also a wider one to the client group. She is not the one who should talk to your employer but you should. You may find that they already suspected you had relapsed and were waiting for you to face up to it. You are hopefully back on track now, and I understand how frightened you must be feeling. But, ultimately this is not about job security, it is about you remaining drug free and growing in strength and experience to become the best person and best drug worker you can be. It is fantastic that you took yourself off for treatment. You will have tremendous and invaluable insight gained through this experience. Any sound employer in this field will understand relapse issues, will appreciate your honesty and offer you support. Your employer will want to be assured that you can fulfil your work and that you have support networks yourself. If this particular employer is unsupportive, and your story is as straightforward as it sounds, then they should not be involved in running drug treatment services. Talk to them, and do keep DDN informed of what happens and what you learn from it. I for one will be rooting for you. Rosie Brocklehurst, Rosie Brocklehurst Communications Ltd (rosie.brocklehurst@zen.co.uk)
Dear Amy I read your letter in absolute despair, disgust and disbelief that anyone could be treated in the way you describe. Unfortunately, of course, I also totally accept and trust that this has happened and I know I should be shocked, but I am not. Your confidentiality is paramount here and that is final. I am so fed up with listening to stories with this common thread of very poor keyworking and the flagrant disregard some workers have for their clients' basic human rights - let alone their right to an individual package of care which begins and ends with confidentiality and consent to share information. Your treatment, therapy and recovery is what this person should be concentrating on, and how to best support you on this journey - to enable you to get back to work and continue to help the vulnerable, not wreck your career and the future lives of the people you will work with because of their lack of understanding of the protocols or guidelines that govern their work and protect you. Best wishes to you, Ahmed, by email
Dear Amy Firstly, I would like to congratulate you in accepting that you needed more support from your relapse and went into treatment to seek support and more understanding as to why this happened. To me you write as a sound person and a giver, which is so common for us addicts. However, having yourself worked in a rehab, you know it can be very emotional, stressful and mentally painful sometimes when you're working with ill people just coming into treatment. Maybe something has been said, or you brought up issues from the past you had not dealt with, that were in your subconscious. Amy, I can understand why you are horrified that your councillor feels she has a duty to protect future clients coming into treatment. You're not on your own: I know I cannot work in groups, rehabs etc as I feed into others' pain. But it is wonderful that you are determined to sort yourself out once and for all: go for it, lock stock and barrel! You are the most important person in this world and if you cannot sort yourself out or recover, then it's a fact - you are no good to anybody else at all. Look after yourself. Yes, I can see you are horrified with your councillor, because it brings up trust and rejection and for you - maybe more; yet she sounds professionally wise. Please try not to beat yourself up over this. Ask yourself: would you want a user, addict member of staff supervising you? I feel you know the answer - yet addicts as we are, we sometimes need the final hurdle to jump from others understanding and supporting. Sort all your issues out and look after yourself. Use all the past as a learning process, and you will become stronger, wiser and more able to cope. I sincerely wish you the best, and that you can decide what is best for your wellbeing. Take care, Sean Rendell, by email.
Amy, Are you worried that you might loose your job if your counsellor and employer communicate? Before getting into questions about the rules of confidentiality maybe you should look at your own position as a recovering addict from your position as a drugs worker. If you have worked in rehabs, you will have experienced the situation in groups where some clients focus too much on other people's problems thus ignoring their own. Such behaviour is called externalising, denial or deferment and needs to be challenged as a renowned predictor of relapse. So challenge yourself: Maybe you shouldn't be working to help others at this time? There's an old saying: 'You need to be able to help yourself before you can help others.' As to your counsellor, empathise and think of what you would do in his/her position. It is a very tricky conundrum. I would hate to make such a decision. In my understanding of the rules of confidentiality, a counsellor/therapist is allowed (or is required) to break confidentiality if the client presents a threat to themselves or others. Your situation is a borderline case. From the comfort of home I might say: 'If nobody knows about your relapse, how much of a threat can you be?' and keep your secret while maintaining my faith in your ability to solve your personal problems. However, as a working counsellor I would have all sorts of worries and doubts about the ethics of your situation and would feel compelled to speak with your employer. But how do you feel? Will you feel comfortable helping others towards a goal that you have failed to achieve? My advice would be to tell your employer face to face. In the light of mutual trust, your employer should react better hearing the news from you rather than second hand via your counsellor. If you open up, it will be beneficial to your own recovery (paramount) and those you work with (12 step style). If you hide the facts and live a lie, it will be detrimental all round and your counsellor may be forced to do that which all counsellors hate to do. Mike Richardson, volunteer group worker
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