Category Archives: Social Work Ethics

What is 12-step Coercion?

Allow me to walk the reader through why this call was so upsetting to me. I think it is a good case study in games ‘Addiction Specialists’ play.

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“Cl called requesting appointment. I returned call to assess cl’s readiness to resume treatment with me. I asked how long he had been seeing Jim Garrett”

How is the length of my time talking to a 12-step interventionist in any way related to my ‘readiness’ to have a therapy session that I am asking for?

“He stated ‘since January’ (see contradictory note on 3/20).”

On 3/20 I had quit sessions with the ‘addiction specialist’, because I had just received a letter from Samaritan Counseling suggesting that I was required to see James Garrett for an indefinite period of time before I might possibly be able to resume ‘normal people therapy’. I had been in and out of rehabs, fighting for my ‘right’ to be in them, on his recommendation for almost a year. Records show that he told her I was not following ‘my side of the contract’ after being terminated from expensive and ineffective outpatient rehab for complaining about the cost of drug tests and Step One worksheets.

“I asked how frequently. He stated ‘once a month'”.

Yes, I was doing as few addiction counseling sessions as possible because they were $110/pop and I was only doing it so I could get back into therapy. I had already spent several thousands of dollars on this that insurance was not covering.

“I stated that Jim’s message indicated cl. felt ambivalent about seeing me again and asked him to comment on that. He stated he did not know what I meant.”

I was a bit ambivalent about asking for the appointment, because I suspected that she might tell me I didn’t do enough rehab correctly (again). I also suspected that James Garrett would be discouraging her from meeting with me (which turned out to be true). I was not, however, ambivalent about seeing her again; I wanted very much to tell her about my rehab experience, and hoped since she recommended it, she might care about how it went. More importantly, his use of the word ‘ambivalent’ implied that I was ‘addicted to therapy’ and probably needed therapy with him for that.

“I asked if he had consulted with Jim about boundary issues and his transference issues with me. He stated that he did not think he needed to and asked if I thought he needed to do that. I stated it would be a good idea if he did so.”

First of all, I don’t see how refusing to speak to someone unless they pay a lot of money indefinitely for treatment that isn’t helping, or joining a religious cult, is a healthy professional boundary. (A doctor just got evaluated and suspended for requiring everybody to say ‘I’m wonderfully hungry’ before he would speak to them. This goes above and beyond the ridiculousness of that) It’s certainly not my own ‘boundary issue’. If I as a client say “I don’t want anything to do with this AA addiction treatment anymore”, that’s a reasonable boundary that should be respected, and it is most certainly NOT a ‘boundary issue’ that I need to go back to 12-step treatment to resolve. WTF.

As far as the ‘transference issues’, transference is described as a normal phenomenon. A client feels a connection with a therapist after many hours of soul-baring, and feels a range of emotions as part of the therapy process. At this time, I was feeling abandoned and betrayed (because in fact in many ways my own interests WERE being abandoned and betrayed), as well as holding on to the hope that she would be my witness in this process (which was in some sense agreed upon in January). Remember, I had just waited two more months for the opportunity to ask for an appointment, and spent another $220 dollars for ‘addiction treatment’ because I was told I’d get that appointment (by both her and James Garrett). I did not need another $110 12-step lesson in ‘understanding that I can’t get my way all the time’ WITH the very people jerking me around for money and then smirking when I get a case of the ‘fuckits’.

“He said he was engaged in Rational Recovery and wanted to tell me about his experiences with it and began to read me literature related to Rational Recovery. I explained that I did not have time to listen to the literature and stated that, as I had explained to him many times, I was not an addiction counselor and I could not address any of his addiction issues.”

It’s ironic that she didn’t have time to listen to me here, since she had the time to push me into 12-step programs repeatedly for about a year. What I was trying to explain to her about Rational Recovery was that ‘choosing Rational Recovery’ was a decision to avoid all “addiction treatment” because it is almost invariably 12-step indoctrination. Even the addiction specialist did not seem to understand this point and told me I still needed meetings, to which I told him that RR cancelled all meetings 15 years ago because you DON’T need meetings or treatment to stop drinking. He said there were a lot of politics involved. Apparently he hadn’t been paying attention to those politics for at least 15 years, then. Only 8 years before this, he had written a book about using leverage and consequences to coerce people into inpatient 12-step ‘treatment’. I thought it was especially ironic that he was using ‘lack of support in my life’ as a reason for needing meetings, while at the same time basically discouraging my ‘non-addictions’ therapist from supporting me.

“He stated that Jim Garrett agreed with him and that Rational Recovery was working well. I stated that that was excellent and it was good that his treatment with Jim was working out. He then said no, he was not going to be doing any addiction counseling.”

I did not want her to think that ‘treatment with Jim’ was working out well. I wanted her to understand that my decision to LEAVE ‘addiction treatment’ was valid.

“He became upset and stated that he did not understand why he could not just talk to me. He stated that I had ‘promised’ him that if he did counseling with Jim Garrett and rehabilitation, I could see him.. I asked if he felt he had really followed up on the recommendations. He stated that he had done rehabilitation at SPARC (see contradictory note on 2/28). He stated that he thought I had lied about this alleged promise. I reminded him that it was not a promise by a possibility and that he should be working on his recovery for himself, not for me.”

Clearly here she was grabbing at the very reasons my ‘Rational Recovery’ argument was supposed to eliminate. Of course, she didn’t bother to listen to that argument, and Jim Garrett certainly didn’t explain it to her, so how could she have known that saying I didn’t do rehab correctly or enough was no longer an acceptable reason to call me incompetent for normal people therapy? She said ‘You may THINK I promised you something,’ as if I completely imagined the ‘contract’ she supposedly discussed with Jim about 2 months monitoring by Jim before I could meet with her, which is written twice in his notes. I almost had the feeling that this conversation was coached, perhaps by David Olsen who seems to be particularly interested in tough-love ‘boundaries’ that serve the purpose of ‘pastoral excellence’, especially since several times in those last five months she seemed to agree to a meeting and then be dissuaded by the addiction specialist or her supervisor. Records show that David Olsen, her supervisor, intended me to be in treatment for 6-8 months before discussing anything, but I had never heard this. The fact that she wrote ‘I could see HIM’, could indicate that she may have felt she was not being allowed to do her job. When she told me to work on recovery for myself, not for me, it could have suggested that she knew I was set up for failure if I kept trying to get back into therapy.

“He stated that I was a terrible person and he wanted to die.”

I started crying and then hung up. The whole conversation made me feel like a liar, a failure, and I was just in disbelief at how ridiculous it all was. It gets even more ridiculous after she consulted David Olsen:

“I consulted with my supervisor David Olsen, PhD who state that I should not be alone with cl. again”

I’m not sure how begging for someone to listen to me to the point of becoming suicidal suddenly gets flipped into me being some kind of homicidal maniac.

“and the only possible contact might be a group session with Jim Garrett to complete the transfer and so that Mr. Garrett would fully understand the transference issues”

Again ‘the only possible contact’ suggests she might not have agreed with the whole idea of these ‘clear boundaries’ that James Garrett and David Olsen seemed to be promoting to keep me isolated in treatment. By the way, this session never happened, because I then sent a letter of complaint and got banned from all communications with Samaritan by David Olsen and Jenness Clairmont the Clinical Director, and James Garrett told her to keep clear boundaries because of my ‘Axis 2 (harassing, fixated)’ behavior.

“He stated it was likely that seeing me would cause a relapse and Jim should understand this.”

OK, this is where it just becomes completely absurd and idiotic. How could ‘recovery’ be a state of not being able to speak to a therapist without relapsing? That doesn’t sound like recovery to me in any way. And really, if your therapists are that horrible that the mere sight of them causes relapses, you should either fire them or consider that you might be a paranoid control freak.

I like to stick to the records as much as possible, because that means I’m arguing with their ‘official’ position on it, but I should also mention I got upset because she said [verbatim] “I will never support your decision to use Rational Recovery”. I demanded an explanation as to why she would ‘never support my decision’ to stop drinking and stop going to meetings and treatment that were expensive and confusing. She also said “It wouldn’t be therapeutic” to meet with me, which were the exact words the girl at the rehab used when I wanted to discuss the Step One worksheet, then asked her to put me in contact with my therapist so I could talk to someone else about it then.

On top of that, after five months of jumping through hoops, not being considered ‘better’ or insightful in any way made me want to die, and I actually checked into a psychiatric hospital, which would not have happened if I felt anyone at Samaritan was really listening to me. If you want to call that a mental health relapse, that would be one right there, and “modicum of perceived support or concern from another human being may have prevented it”.

Doe v. Samaritan Counseling

“Clergy sexual misconduct gets the most attention when boundary violations are discussed. Olsen and Devor believe that focus gets in the way of addressing the need for other kinds of boundaries that help ministry to flourish.” – The Christian Century Review of Saying No To Say Yes by David Olsen, Executive Director of Samaritan Counseling and Nancy Devor

I just found this case today and the arguments set forth seem highly relevant, not only because it has to do with Samaritan Counseling, but because it has to do with mishandled transference and employer v. employee liability based on whether the misconduct is within the scope of job requirements.

Here is the Supreme Court of Alaska’s decision. I don’t totally understand all the legal terms.

Doe v. Samaritan Counseling

“Jane Doe argues that Samaritan should be held liable for the acts of one of its pastoral counselors, Reverend/Dr. John Garvin. Doe went to Samaritan for emotional and spiritual counseling. During two of her sessions with Garvin, kissing and fondling allegedly took place. After Doe cancelled her counseling sessions with Garvin, the two allegedly met and had sexual intercourse. Doe claims that she suffered emotional harm as a result of Garvin’s abuse of their therapist-patient relationship. On summary judgment the superior court held that Samaritan could not be held liable for Garvin’s actions on grounds of respondeat superior…

…this relationship was found to have caused the patient emotional problems so devastating that years later she attempted to commit suicide.”

Bad Samaritans Make Dangerous Precedent: The Perils of Holding an Employer Liable for an Employee’s Sexual Misconduct

“This illustration suggests that a clinic should not be vicariously liable for a therapist’s sexual misconduct simply because the transference phenomenon the therapist manipulates is a common factor in both a responsible and irresponsible relationship with a patient. The real issue is whether his sole motive in manipulating this phenomenon is for his personal gratification. The very nature of a therapist’s deliberate sexual misconduct indicates that his motive is purely personal because such behavior completely undermines his authorized role as a counselor.”

I would argue that this argument of personal gratification (and the one about noncommercial businesses being incapable of assuming responsibility/liability for things like this because their overall public benefit is more important) is simply Samaritan avoiding responsibility for the dynamics of degradation and control inherent in the 12-step ‘rehabilitation’ process which is not coincidental but ‘part of the job’ at Samaritan Counseling. This article does mention the possibility that *unintentional* mishandling of transference (such as in a supervised scheme of emotional extortion to coerce 12-step treatment) in carrying out the demands of the employer would not absolve the employer of responsibility in the same way.

I would also add that these cases could be handled better (mishandling a mishandled transference complaint, especially in the manner 12-step programs do, is often more damaging than the sexual incident itself) and this piece does seem to say that negligence regarding these imposed dynamics would be a better argument.

“In congregational life, too often clergy become the scapegoat for their congregations.” – David Olsen and Nancy Devor, Saying No To Say Yes, 2015

OASAS 12-step Rehabs

Did you know that New York State not only funds 12-step promotional efforts, but actually RUNS 12-step rehabs? They run 12 of them, to be exact, which is kind of cute. One of them is called Dick Van Dyke.

It’s pretty much the state religion. Now that the entire 12-step rehab industry is being exposed as fraudulent and the lack of accountability in 12-step culture is coming under heavy criticism, one starts to wonder what really is OASAS’s purpose and mission, and are they ever going to be capable of seeing outside the confines of their ‘recovery community’? Would it even be possible for this government agency to question the appropriateness of the Big Book of Alcoholics Anonymous as ‘treatment’?

McPike (see picture with Bill W here) is the one I was supposed to go to, on the agreement that I could see my ‘non-addictions’ therapist, by the 12-step interventionist that charged me $110/session and I was required to see him and do what he said in order to potentially see my therapist again. I didn’t, because I did not want to be immersed in 12-step nonsense for 30 more days. I went instead to a one and a half hour session at SPARC (Saint Peters Addiction Recovery Center) once per week for about $165/group session (which consisted of videos or lectures), $100 dollars for a mandatory drug test (which they graciously stopped doing each week when I complained it was pointless, but then again they terminated me shortly thereafter and told my therapist that I was not compliant), and a private session (not sure how much but it was usually snuck in in about 15 minutes during the movie or session I was paying $165 for). They gave me I think 65% off in the end because they did not accept the insurance I was paying $700/mo for. Here is a tour of McPike. This is not the kind of ‘treatment’ I was looking for when I said AA didn’t work for me.

“We can accomodate a little over half of our patient population here…up to 49 folks in here. We do very forms of education here, counselors give lectures, videos, dvds. This is our large group room and we can put up to 128 people in here… and we hold the AA meetings in here.”

“If Mary Rose told me to wear a pink dress every day for the rest of my life and that would keep me sober, I hope I look good in it”
“I see miracles every day. It really is about the miracles”

“We’ve been measuring for its effectiveness and across the board we see improvement on pre and post test on the areas of acceptance of diagnosis of a mental illness. In the past we were helping people to see that they had a mental illness, and now they seem to know….We are very connected to both referral sources that refer patients to us, but also referral targets [such as halfway houses].”

“Recovery is how we act. Our values, our morals, our spirituality. I did not have many morals when I came in here.”

“One of the best things you can do is not become a part of their addiction. If you are the family member of somebody who is using I’d encourage you to find some Alanon meetings. Alanon meetings are self-help 12-step based, for people who have a significant other or someone in their life who is actively using or has in the past. In this context you can begin to understand that it’s a disease, and that you don’t want to contribute to it, and learn a concept called ‘loving detachment’.

In a rehab you realize that your very core is addiction.”

NYS OASAS explains how it works and why ‘addiction specialists’ should be managing everything including mental illness with less oversight

On how people get into treatment:

“A doctor has to say that you’re incapacitated and incapable of making decisions”
Using the ASAM tool or the LOCADTR tool.

On the structure of OASAS:

“We have great staff. One of the things about our staff, there’s a lot of people in our agency who are either in recovery themselves or have family members in recovery, they are committed to the mission.”

“It’s not true that if you’re an OMH social worker, that you’re going to be able to treat someone with an addiction problem”

“Our system treats a lot of mental illness”

“These drugs are scary”
“Scary”
“Very scary”

They are trying to create an integrated license so that OASAS is the only license you need to treat both mental health and addiction in a ‘holistic’ manner (and they throw in the possibility of primary care too), because other agencies supposedly can’t treat the addiction part the way they do. Unfortunately, they are just making non-addiction-specialists afraid to handle someone dealing with an addiction. I have personal experience with an actual doctor who was ‘not licensed’ to manage withdrawal (which really is no more than a few days of benzodiazepines and blood pressure monitoring), and a trusted therapist who supposedly could not deal with me because I had an ‘addiction’ (which apparently does ‘pushups in the parking lot’ when I put it aside).

Sounding Board on Merger of Mental Health and OASAS

First Session 7/14/15
Second Session 7/14/15
First Session 7/13/15
Second Session 7/13/15

This is disturbing to me because when we should be considering whether 12-step cultism is a form of mental illness causing confusion, relapse, and suicide, we are instead suggesting that 12-step adherents be put in a position to diagnose not only addiction, but any related mental disorder such as resisting coercion, not quitting the debating team, disrupting the ‘recovery community’ by blaspheming Bill W., etc.

Here are some social work lobbyists going after licensure-exempt state agencies to get better educated, which they have refused to do for a ‘long time’. Exempt agencies overview

There is a follow-up with the other side of the argument. He basically takes takes the attitude of denying there is a problem with the status quo, saying “we have a solution that doesn’t have a problem”.

opposition

And here is my own experience of being funneled by a frightened ‘non-addictions’ LCSW toward a confident ‘addictions specialist’ (although well qualified technically, his entire history is geared toward ways to get people into 12-step rehab) when I was actually trying to get away from 12-step thinking, not further immersed.

Here is a movie about the rehab industry. Don’t think what OASAS does is not related to this industry.

Here is a trailer for a movie about how 12-step based drug treatment programs have worked out in the past.



Straight, Inc.

Here is a movie about the culture of AA

And finally, here is the previous warning about 1st Amendment violations and OASAS’s proper use of government funds: On AA in OASAS . There must be a lot of complexity involved in ‘carrying the message’ without saying it publicly.

Stateside

“I was kind of upset when I found out…”
“How are people not getting this information? He didn’t even know what SMART Recovery was… I literally had a counselor there tell me that if I didn’t get involved in NA I would probably die. That was a counselor, someone with their college degree in the field.”

This was my experience too (being shocked that nobody seemed to be aware that rejecting AA is a real option), except I delved more deeply into how and why this happens, which is the focus of this blog.

Michigan Radio Segment Highlights Secular Alternatives to Alcoholics Anonymous

Samaritan Institute – Complaint Process

update Jan 20 2020: Samaritan Institute is now called Solihten Institute.

olsen

David Olsen is on The Samaritan Institute Board of Directors (or he was when I wrote this), and he’s also the highest paid Executive Director of Samaritan Counseling Centers, which I’m sure has made it awkward for any serious complaint procedure to ensue.

He also supervises therapists (a few hundred supervised hours are needed to gain an LCSW license) and does paid CEU (Continuing Education Units) courses so that therapists across the state can retain their licenses. Yet he refuses to acknowledge very simple facts about 12-step problems. That’s a shady situation, don’t you think?

This is similar to how it was difficult to complain to the New York State Office of Professions about a member of their own board. I haven’t had much luck in general, but I can give a few ideas about who to complain to: Department of Health and Human Services, the state licensing boards, the professional organizations if any (like NASW, AAMFT), Higher Powers in the organization itself, Civil Rights associations, Organizations for Separation of Church and State (AU, FFRF). The Federal Trade Commission. Better Business Bureau, Angie’s List. Local, state, and national politicians. State social service organizations (like OASAS). Heck, I suppose you could file a police report since rehab fraud is most certainly theft by deception. You can also complain to business community networks who may want a heads up about what their members are involved with. Nothing seemed to really get addressed for me, but I still think this is important so I made this website.

Here, though, is how it’s supposed to work with complaints toward an Executive Director at a Samaritan Institute accredited Center. If this process had actually happened, then I would have received some kind of notice from Bev Shrumm, the Chair.

All employees, contractors, and consultants are expected to maintain compliance with the ethical standards of the professional organizations and licensing/credentialing boards with which they and the Center are associated.

Procedure:
1. When an ethical violation is alleged against any employee, contractor, or consultant, the executive director will be notified. The executive director will undertake an initial inquiry and in turn notify the chair of the board or the chair’s designee. When an ethical violation is alleged against the executive director, the board chair will be directly notified and take responsibility for all inquiries and investigations.

2. A process, guided by the procedures of the professional organizations and/or licensing boards with which the Center and/or respondent is associated, will be designed to further investigate the complaint and take appropriate action. This process may include formally notifying the appropriate professional organizations and licensing boards of the allegation. Subsequently, those entities could initiate parallel investigations of their own. The risk manager of the Center’s liability insurance carrier must also be notified.

3. The board, meeting in closed executive session, will in all instances be informed that an ethical investigation is underway. All minutes and other records of the closed executive session will be sealed and not circulated. The board chair at his or her discretion may choose to limit the amount of information given to the board and may elect to consult with an attorney.

4. The confidentiality of all parties involved will be honored in the context of the laws and regulations applicable to the investigation and its outcome.”

Interview with Producer of Business of Recovery – “They are just hoping this goes away”

This is a great interview with Greg Horvath. He explains the motivation behind his movie, to make critical changes in the rehab industry: Regulation, Education, and Science. Because it sadly lacks all three. This is going to be a great movie for anyone who still has faith in this faith-healing industry.

Interview starts after 4 minutes and ends in about 30 minutes (around 34:00)

Link to Audio on WEMF Radio, The Young Jurks