I'm a clinical counselor, educator, writer and tarot reader. My specialty is substance use, but I no longer work in the treatment industry due to creative differences. My practice website: welcome.genova-lcpc.com
Reader Requests
"It was as if they were trying to use the techniques on clients, trying to hoodwink them into changing. The words were there, but the music was wrong." -William R. Miller, 2023 William Miller originated the technique he called "motivational interviewing" (MI) in the early 1980s.
Insurance
"I have tried so many times..." I feel really bad about the fact that I don't take Medicaid. (Here we call it MaineCare.) Providers and facilities not accepting Medicaid has created an artificial shortage of care for Medicaid members. It also creates class-based segregation in
Mandated Treatment
The classic visual for addiction treatment is a circle of chairs, like so: As little as most people know about our world, pop culture has this one right! Just about everything is done in groups—same for other intensive mental health services, including hospitalization. And it’s absolutely for reasons
The Kansas City Star just published a series on 7-OH, which is a gray market synthetic derivative of the opioid kratom. When I saw the headline about “a growing opioid epidemic,” I didn’t expect much nuance, but was I pleasantly surprised! If you’re not familiar with kratom,
Mandated Treatment
Does this look like someone with too many rights? The notion of people “dying with their rights on” comes from arguments for forced psychiatric hospitalization, dating back to the 1970s. As the rhetoric goes: a desperately sick person who refuses services, and doesn’t meet criteria for involuntary admission, will
Working
Last week’s post was about moral injury in addiction treatment. Earlier in my career I did not yet have this term to describe my distress, but I recognized that the system I worked in devalued my clients’ lives and ignored their wishes. Today we’re picking up where that
Mandated Treatment
Moral injury is the psychological or spiritual pain of your morality being violated. Whether you have actively participated in, allowed, or only witnessed the acts in question, you are morally injured if you feel ongoing distress in conviction that the acts were (or are) wrong. It may bring guilt, despair,
This is the third and final post in my series on how we talk about addiction. So far we have discussed Essentialism and Pity, and today we conclude with Respectability. “Respectability politics” is a theory of putative worthiness from Black political struggles. The idea is that by dressing, speaking or
Mandated Treatment
This is post 2 of 3 in a series on how we talk about addiction. Last week’s post discussed the judgments and generalizations we are all familiar with. Today we turn to pity. Pity toward people with addictions may seem like an improvement over condemnation, but when translated into
Mandated Treatment
This post is first in a series on how we talk about addiction. Stigma and stereotypes are never helpful. While perhaps this should go without saying, a strong contingent in the public mistakenly believes that stigma (shaming, shunning, exclusion, judgment) discourages substance use. In fact, transnational comparative research shows that
Mandated Treatment
Welcome! I’m Rosalie, or Rosey, and I’m a therapist in the specialty usually called “substance use disorders.” “Addiction” is a subjective experience, not a clinical label, and I find it more human than the diagnostic language my clients never use. I worked in treatment and recovery services for