Addictions: An Integrated Client Approach FCRC 2017

1. Addictions: An Integrated Client Approach FCRC 2017

2. Who Is An Addict? “Most of us do not have to think twice about this question. WE KNOW! Our whole life and thinking was centred in drugs in one form or another – the getting and using, and finding ways and means to get more. We lived to use, and used to live… We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions and death.” - Narcotics Anonymous Chapter 1 pg 3

3. VMIAC Victorian Mental Illness Advocacy Council The VMIAC will always work towards ensuring that people with a mental illness or emotional distress are at all times treated with respect, dignity, fairness and honesty, ensuring their right to empowerment, personhood and equal citizenship. To this end, the core purposes of the VMIAC will be to ensure that people with a mental illness or emotional problems receive natural justice (a fair go) in all areas of their life.

4. Case Study 1 - Peter • Peter is suicidal & a recovering drug addict • He has a mortgage in arrears • Peter has lost his job • He is easily overwhelmed & gets angry • Peter has not been helped when he has tried to talk to his bank • The bank was obstructive

5. Gambling • Low, medium and high risks gamblers. Problem Gamblers make up approx. 5% of gambling population. • Gambling becomes a problem when it stops being fun, or a big win, or using gambling to cope with stress, for example • Gambling related harm (of the person or significant other) • DSM 5 2013 Added Gambling Disorder – persistent and recurrent problematic gambling behaviour (over a 12 month period)

6. Gambling – cost to community Types of gambling……? Gambling Losses 2015/2016 (EGM data only) Ballarat 55 million Bendigo 49 million Horsham 9 million (3 venues) Geelong 112 million Mildura 26 million Warrnambool 18 million

7. Odyssey House Update

9. Examples of Mental Illness • Depression & anxiety • Bi Polar mood disorder • Schizophrenia • Personality disorders • ADHD • Psychosis • PTSD

10. Some Characteristics • Unopened mail and don’t answer phones or door • Easily overwhelmed & confused • Short fuse & erratic • Suicidality • Episodic and symptoms changeable • Memory loss • Make unrealistic arrangements • Multiple issues in crisis

11. Characteristics (con’t) • Secrecy and fraudulent behaviour • Best intentions to stop behaviour and do payment arrangements • Family violence and relationship difficulties • People affected by others gambling (every 1 gambler, 10 people are affected)

12. Considerations • Always discuss with your client and have their permission before disclosing their mental illness and/or their addiction. • Be clear about no shows and their responsibilities in the counselling process. We want to empower and change beliefs around being a victim or being powerless. • Having an addiction or mental illness is not a licence to continue old behaviours. Recovery comes with change. This is an opportunity to let go of the outlaw psyche.

13. Integrated Practice • Co-location and/or agency relationships • Professional expertise and experience • Self exclusion strategies • Defined boundaries • Referrals • Co-Counselling & case conferences • Focusing on the issues • Confidentiality

14. Case Study 2 – Ms KAvoidance • Multiple issues all in crisis; bankruptcy, fines, utilities and credit card • Ms K overwhelmed and paralysed with fear • Wouldn’t open mail or answer phone or door • Even with FC assistance struggled to take responsibility for affairs • Was at immediate risk of losing her home • Wouldn’t discuss credit card debt

15. Why is Financial Counselling a Part of Recovery? • Relapse education and prevention • Dealing with fear and intimidation • Regaining optimism – there are solutions • Getting some breathing space – seek counselling and support • Restoring confidence • Financial literacy and education

16. Some Presenting Issues • Infringements and fines – Fines Reform • Debt collectors and harassment • Loans, credit cards and payday lenders & sharks • Superannuation (early release) • Utilities, Telcos, Disconnections & Disputes • Centrelink • Crime, prostitution and drug debts

17. Presenting issues (con’t) • Multiple credit cards/loans • Comorbidities (gambling/drug use/mental illness) • Debts or dealings with pawnbrokers • Debts to family and friends • Caveats or changes on property • high incomes and assets (sometimes joint) to protect

18. Affected Others • Who’s the client? • Working together • Conflict of interest • Family violence • Secrecy • Asset protection

19. Superannuation • Access: - hardship – apply to fund - compassionate – apply through DHS - permanent incapacity – apply to fund • Insurance – apply to fund but assessed by insurer - Income Protection - TPD - Death/Terminal Illness • Duty of Care - risk of relapse - need to discuss keeping money safe

20. In Summary • Expect relapsing, no shows and complexity • Cases often take longer and more work • Use empathy and non judgement coupled with clear boundaries • Empowerment without condoning past behaviour and self victimisation • Vicarious trauma is real • Ensure you create space for debriefing, supervision, contemplation and down time

21. Agencies • See Referral Sheet • Directline – drug counselling • Family Drug Helpline • Gamblers Help • Money Help • Consumer Action Law Centre • Mental Health Legal Centre • CAT Team • Lifeline • Suicideline • Men’s Line Australia • CASA

22. Garry Rothman Senior Financial Counsellor Odyssey House Victoria grothman@odyssey.org.au