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C42. It’s not denial, it’s stigma: A case study on the legacy of confrontational treatment approaches to alcohol use disorder

C42. It’s not denial, it’s stigma: A case study on the legacy of confrontational treatment approaches to alcohol use disorder

Learner category:

  • Beginning Level

Learning objectives:

  • Participants will be able to describe stigma and selfstigma as it relates to alcohol use disorder
  • Participants will be able to discuss the implications of past client experiences with addiction treatment systems for future assessment and intervention
  • Participants will be able to synthesize elements of recovery orientation with the role of the addictions nurse to promote client engagement

 

Abstract

This presentation will utilize a case study format to demonstrate and discuss concepts related to client engagement in recovery. Laura, a 65-year-old female, presents with a worsening of her alcohol use disorder in the setting of a recent retirement, worsening symptoms of major depressive disorder, and the stressors associated with COVID-19 pandemic. She presents for her depression and is reluctant to discuss her alcohol use since she has past experience in a program that utilized a confrontational approach several years ago. Her primary care provider describes her as “in denial”, but this case study will discuss elements including stigma, self-stigma, and the culture of addictions treatment and their impact on recovery. Finally, this presentation will describe how the addictions nurse can leverage a person-centered and recovery-oriented approach to promote engagement and positive problem-solving with the client and the rest of the care team.

Authors

Shari Harding
DNP, CARN-AP, PMHNP-BC, CPRP, University of Massachusetts Medical School

Dr. Shari Harding is a psychiatric-mental health nurse practitioner (PMHNP) and CARN-AP with experience providing direct care and consultative services for individuals, programs, and systems. She is an assistant professor at the University of Massachusetts Medical School Graduate School of Nursing. She maintains a clinical practice at Reliant Medical Group, providing behavioral and addictions health care, consultations, and trainings within a primary care setting. Shari is a certified psychiatric rehabilitation practitioner (CPRP) and emphasizes a person-centered approach including outreach and engagement strategies as well as collaboration with other disciplines and key stakeholders.

Comments (13)

  1. Dennis Hagarty

    Thank you so much for this presentation. Often we want to put labels on issues and this limits our ability to be patient centered.

    1. Shari Harding

      Hi Dennis, thank you for your kind comments – I definitely agree, labeling has both risks and benefits and it’s great when we can be flexible in our work.

  2. erika.leon3

    Thank you! Great presentation!

    1. Shari Harding

      Thank you Erika, I appreciate it! Shari

  3. Rachel Shuster, BSN, RN, CARN, CAAP

    Thank you so much for this presentation. It was great to see information about stigma presented alongside a case study, helping your audience to really understand the effects of stigma and self-stigma. I also appreciated hearing about self-stigma; it was something I had done a little reading on before, but I’m sure not all have heard this [very relevant] term quite yet. Lastly, thank you for recognizing that recovery is more than just the absence of illness/symptoms but rather the development of a fuller life (improving quality of life overall). I think the term “recovery” is often used interchangeably with “abstinence” for many, but we need to avoid doing this. Thanks again!

    1. Shari Harding

      Thank you, Rachel, I really appreciate your post. I found that the concept of self-stigma really resonated with what I see clinically, so I’m glad you find it helpful to consider too.

  4. Joycelyn Iheanacho

    Thank you for your insightful presentation!

    1. Shari Harding

      Thank you very much, Joycelyn.

  5. Oluremi Adejumo

    Thank you so much for raising our awareness of stigma.

    1. Shari Harding

      Thank you so much, Oluremi.

  6. Andrea Krasno

    A

  7. Andrea Krasno

    Good presentation

    1. Shari Harding

      Thank you, Andrea, I appreciate it.

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