Alcoholism: A Diagnosis or Layman’s Term

Often we refer to a person with a drinking problem as ‘alcoholic’ afflicted with ‘alcoholism’. However, these are layman’s terms and are not recognized by the American Psychiatric Association. As a result, ‘alcoholism’ is not a diagnosis found in the Diagnostic and Statistical Manual-IV (DSM-IV). However, the DSM-IV has two diagnoses dealing with alcohol abuse.

1) Alcohol Abuse is described as a maladaptive pattern of substance use leading to clinically significant impairment or distress; as manifested by failure to fulfill major role obligations, entering in physically hazardous situations, related legal problems, and social or interpersonal problems; all occurring within a 12-month period.

2) Alcohol Dependence is described as a maladaptive pattern of substance use, leading to clinically significant impairment or distress; as manifested by increased tolerance, withdrawal symptoms, loss of control, attempts to control the alcohol intake, preoccupation with alcohol, physical isolation, and physical or psychological problems; all occurring within a 12-month period.

When a person no longer abuses or has a dependence on alcohol, the diagnoses no longer apply. Instead, people have a history of alcohol abuse or dependence.

[DSM-IV, Diagnostic and Statistical Manual of Mental Disorders, ed. 4. Washington DC: American Psychiatric Association (AMA). 1994.]

How Important are Vocational Interests and Aptitudes When Choosing a Career?

Aptitudes are natural abilities that we develop with minimal effort or training. People display various aptitudes, from motor abilities (finger dexterity, manual dexterity, foot-hand-eye coordination) to verbal, numerical, and clerical aptitude, etc. It is important to consider aptitudes when selecting a job/career because certain aptitudes will help us succeed in certain occupations by making it easy to acquire career skills and knowledge and increase our career opportunities.

Of course, to identify a satisfying career a person must not only have the needed aptitudes, but also have interest in the occupation, or the work will become boring or meaningless in time. Interest leads to increased competence, high motivation, and creativity. Aptitudes are sometimes linked with interests in that our interests often develop along our natural abilities. A person might decide to become a pianist because she has the finger and manual dexterity necessary and values self-expression. And, a bank teller might be happy in his job because he likes paying attention to detail and has the clerical and numerical aptitude to succeed.

If you are unclear what your vocational interests and aptitudes are, a vocational evaluation might be in order. Many adult programs (non-profits), which provide job placement and career training offer vocational evaluation services. Some community colleges and public vocational/technical schools also offer these services. For more information call your local adult education program.

Evaluate The Internal and External Rewards of a Job When Making a Change

People make job and career changes for many reasons. Maybe you're making a job or career change because you no longer find it meaningful (lack of internal reward). Perhaps you're making a job or career change for financial reasons (lack of external reward). Or perhaps because you're burned out due to that demanding job or career; although these stressors are the result of the work environment, it's a well known fact that it's easier to burn out in a job or career with limited internal rewards.

Most of you know someone who has a low paying job (maybe working for a non-profit) which they find meaningful and are very happy; many even restructure their lives so that they can live on what they earn as long as they can continue to work in the job or career they love. But this is not for everybody. What you need to do is find a happy medium. That is, find a job and career where you feel you are making a significant contribution to your company, your profession, or society. And as long as the new job or career allows you to earn what you need to maintain the lifestyle you desire, then you've hit a wining combination and are ahead of the pack.

Have you evaluated the internal and external rewards of the new job or career you're considering?

Qualify For Vocational Rehabilitation Services?

If an individual has a medically or psychologically determined disability, she would qualify for vocational rehabilitation services from her state office.

Vocational rehabilitation services provided range from medical services to sheltered employment, employability skills training, job placement assistance, on-the-job training, and vocational or academic training, etc. Once an individual has completed the application process (a lengthy one unfortunately) and has qualified for services, a vocational rehabilitation counselor will help write a rehabilitation plan. The particular services provided depend on individual needs and help the client achieve an optimal level of functioning.

Usually this program is the Department of Vocational Rehabilitation (DVR) in many states and is usually within the office of the Department of Education. The program is available to all legal residents of the United States. To find the office in your community, contact your local Department of Education or the Department of Vocational Rehabilitation.

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Adjustment to Physical Disability

The field of rehabilitation recognizes that people who become physically disabled go through two emotional stages, denial and mourning, before adjusting to their disability. Negative aspects of these stages, such as dependence and hostility, are viewed as logical outcomes within a society such as ours that perpetuates an ideology of normality. Although denial and mourning are natural responses to a disabling event, sometimes the denial (thinking one will get well in time or is able to physically do more than in actuality) and mourning (sadness and depression), take longer to overcome and impede the rehabilitation process and eventual reintegration into society.

If you have prolonged difficulties with these negative aspects, let your doctor know. Most major hospitals have support groups of individuals experiencing similar difficulties. If not, perhaps a referral to a mental health professional might help.

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Make Temporary Employment Agencies Work for You

Have you considered a temporary job to help pay the bills while you land that permanent position? Nowadays, temporary agencies specialize and can place people in just about every career field.

There are long term assignments and, in many cases, temporary agencies may provide benefits to their employees: paid holidays, medical & dental coverage, life insurance, and 401K plan. Ask a lot of questions about the cost of the benefits to you.

Temp jobs can provide you with experience in industries and careers you where you might not worked before. This is a good way to enhance your resume. If you are not happy with the assignment or the employer, you can move on to your next position and start fresh.

A temp job can also be a foot-in-the-door at a company you are interested in. And temporary assignments can turn to permanent employment. It is estimated that 90% of all companies use temporary employees. More and more, companies use temporary agencies to screen their employees and to send them the best candidate for their ‘temporary’ assignment. If the company likes the employee, he/she may end up with a permanent position. If they don’t like the employee, they can request another be sent, without any commitment on their part. So, what are you waiting for?

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Chronic Pain, Addiction, and Depression

Chronic pain is defined as pain that lasts longer than 3 months. Some experts define it as lasting longer than 6 months. Chronic pain is different than acute pain in that it is not easy to find the cause. Diagnosis can reveal no injury in the body at all, and yet the patient can be experiencing very debilitating pain.

One way that chronic pain begins is from an injury. Scientists have found that repeated pain from an acute injury changes the way the brain lets you know you have pain. Even after the injury has healed, pain messages replay over and over again. Chronic pain may worsen in response to environmental and/or psychological factors such as depression and addiction. Chronic pain may also be related to a number of different medical conditions including (but not limited to) diabetes, arthritis, migraines, fibromyalgia, cancer, shingles, sciatica, besides injury or trauma.

There are a variety of treatment options for chronic pain. The goal of pain management is to provide symptom relief and improve an individual's level of functioning in daily activities. A number of types of medications have been used in the management of chronic pain, including acetaminophen, ibuprofen, aspirin, COX-2 inhibitors, antimigraine medications, sedatives, opioids, and antidepressants. Many people have become addicted to narcotic pain medication. Nonmedicinal treatments for chronic pain can include exercise, physical therapy, counseling, electrical stimulation, biofeedback, acupuncture, hypnosis, chiropractic medicine, and other treatments.

For more information contact the American Pain Society.

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