Harm Reduction in the Brickyard of Chicago - Greg Scott and Jacque Elder

click here to listen to show

This was a show on NPR that my friend, Greg Scott, a sociologist from De Paul, asked me to join in as the "addictions expert".  I know the host was expecting a Treatment As Usual (TAU) practioner yet that ain't gonna happen.  I met Greg through Chicago Recovery Alliance, the US's largest mobile needle exchange where I am a volunteer and Captain of their Chicago AIDS Foundation Team.

Never thought I would get to see the inside of WBEZ, and it was beautiful.  I loved our "experts", one woman and two men who lived in the Brickyard, a illegal homeless shantytown in Chicago.  It has since been bulldozed.

Greg has some great videos on You Tube so search for Sawbuck Productions and Greg Scott.  It is very graphic video of folks shooting up heroin yet the Change Talk as he talks to them is lovely.

Brickyard Residents and Drug Counselors Address Treatment Options

Brickyard Residents and Drug Counselors Address Treatment Options

Helping folks learn MI

It took me several years to find out what the mystery was about in learning MI.  I wish I could write that I do perfect or even really good work often yet I don't.  I like being in kindergarten, getting cookies and milk, and naps and recess!  So, I don't mind letting other people hear and code my work as I learn something every time I allow my work out there.

When I was at The Family Institute, we used to have to do "live sessions" and those are more vulnerable than taping an audio session with a client.  I made mistakes yet I watched my peers make mistakes as well, and it level the playing field.

I think Change Talk is becoming increasingly important, and I introduce early on in my trainings.  Learning what is sounds like, learning what Sustain Talk is and what to do with it.  If Change Talk is the jewel in the crown, I need to be polishing that jewel every chance I get.  Change Talk is language that indicates Desire, Ability, Reason or Need to change.  "I like my drinking and I ain't giving it up but those hangovers are killing me!"  Ding, ding, ding! "Tell me more about those hangovers. They don't sound fun at all."  First there is Identifying Change Talk, Eliciting it if need be, Reinforcing it with directive questions or a reflection (I tend to use questions), and then taking it some where.

I was telling my students at Argosy that we do want to create cognitive dissonance if they are in our office for some reason, and yet doing it gently and carefully is an acquired skill.  My own agenda sneaks out at times to this day, as (here is some Freud here), I have counter-transference.  With them all!  And some I like more than others.  Yet, I have this willingness to approach each one with an open mind, and what a lovely thing when they allow us to enter their word.  I am becoming more curious and adventurous in my personal life, and it is seeping into my clinical world, affecting my empathy so that I am listening more (duct tape over my mouth).

I am working with a couple that is considering splitting up, and I am grateful  for having experience with being both the dumper and dumpee.  The dumper has all the power and so extra loving-kindness is what I give to the dumpee.  There is just something about getting dumped that taps into every abandonment issue you have had since you popped out of your mom's uterus.  It taps into "Who will be my mommy?" or "My Daddy" or as Pema Chodron puts it "There is no babysitter."  What, no babysitter?  That sure burst my bubble, and working from that awareness now means I have a different perspective than I used to.  Things don't get better very quickly.  Getting sober is hard work and takes a long time.  Getting fit through exercise - long time, hard work!  If behavior change were easy, I wouldn't have a job.

So, Change Talk is the word for the day, and we have an advanced coding course coming up  this week and next where we are also going to try out the MISC 1.1, which codes...Change Talk!  I am excited about checking out the perspective of the client, especially with my training I am doing with Scott Miller on Feedback Outcome Treatment.  The MISC coding results may give us an idea of what the client is thinking about the session.  What a novel idea.