Therapist, role

Therapy must address the drug habit before a client with a drug problem can change the behavior. Habit implies a pattern of behavior that may be rote and automatic. Your role as a counselor or therapist is to increase clients awareness... 

Provoking, or the use of paradox, is a special way of eliciting statements from the client. The therapist takes the role of the devil s advocate. He plays the part of denial to elicit from the client statements signifying the opposite. With this method the therapist seduces a client into the role of proving to the therapist that there are problems, and that change is necessary,... 

The following features have been noted by various therapists as characteristic of the relationships and roles in families with a drug abusing member ... 

The therapy model uses elements of both structural and strategic family therapy. Structural family therapy derives its name from the perceived importance of family composition, particularly as a hierarchy, and how this hierarchical system is organised. For example, a family with a weak and ineffectual father would be subject to an imbalance in family structure. The therapist s main objective is to identify the imbalance and to intervene by emphasising the importance of the father and his role in the family, that is, elevating his importance. Structural family therapy is widely associated with Salvador Minuchin, who used it extensively in the treatment of anorectic families . Only a cursory summary is presented here. Interested readers will find these techniques covered more fully in Minuchin and Fishman (1981). 

Therapists can therefore play a vital role in facilitating the substitution of normal physiologic motor control for the previously used spastic tone. This idea seems especially true when one of the parenteral antispasticity techniques is used, such as intrathecal baclofen or botulinum toxin injections. For example, patients who receive intrathecal baclofen through programmable pump systems often require a period of intensive rehabilitation to enable the benefits from decreased spasticity and increased voluntary motor function to occur. Therapists must therefore be ready to use aggressive rehabilitation techniques to help patients adapt to the relatively rapid and dramatic decrease in muscle tone that is often associated with antispasticity drug therapy. 

Rheumatoid arthritis and osteoarthritis represent the two primary pathologic conditions that affect the joints and periarticular structures. Although the causes underlying these conditions are quite different from one another, both conditions can cause severe pain and deformity in various joints in the body. Likewise, pharmacologic management plays an important role in the treatment of each disorder. Because physical therapists and other rehabilitation specialists often work with patients who have rheumatoid arthritis or osteoarthritis, an understanding of the types of drugs used to treat these diseases is important. 

This chapter first discusses the physiologic role of the male hormones and the pharmacologic use of natural and synthetic androgens. The physiologic and pharmacologic characteristics of the female hormones are then addressed. As these discussions indicate, there are several aspects of male and female hormones that should concern physical therapists and occupational therapists. Rehabilitation patients may use these agents for approved purposes, for example, female hormones as contraceptives. These agents may also be... 

Therapists may also play an important role in educating patients about the dangers of androgen abuse. When dealing with an athletic population, physical therapists may serve as a source of information about anabolic steroids. Therapists should advise athletes about the potential side effects, such as liver, cardiovascular, and reproductive abnormalities. Therapists can also monitor blood pressure in athletes who appear to be using androgenic steroids. This interaction may help prevent a hypertensive crisis, as well as illustrate to the athlete the harmful effects of these drugs. 

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