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Clinical Institute Withdrawal Assessment for Alcohol

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London: Guilford Publications. Motivational Interviewing: Helping People Change. New York: Guilford Publishing. New York: Columbia University.

The Essential Handbook of Treatment and Prevention of Alcohol Problems by Nick Heather

Your Bibliography: Murdock, N. Theories of counseling and psychotherapy. Boston: Pearson.

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The Essential Handbook of Treatment and Prevention of Alcohol Problems

Your Bibliography: Treasure, J. Motivational interviewing. This is the hardest part of dealing with an alcoholic. The disease is so strong that the individual is unable to see what is happening to himself or herself. If an employee chooses to use the EAP at your urging, he or she may enter some type of treatment program as described earlier in this booklet.

If the employee does not choose to go into treatment, the next step will be to take any disciplinary or corrective actions that are necessary. One technique which can be used to confront the employee is called intervention.


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It generally consists of scheduling a session with the employee where a number of people significant in his or her life are present, including you, the spouse, children, clergy, other family members, co-workers and other friends. The session must be led by a trained professional, such as the EAP counselor. If the. It is extremely important that such an intervention be led by a trained professional and not by a lay person, such as a supervisor, because it can be a very emotional and powerful event and, if not conducted properly, may very likely backfire.

Supervisors should contact an agency EAP counselor for more information about the intervention technique. During the period of time that the employee is away from work receiving treatment, he or she will usually be carried in some type of approved leave status. In most cases, it would be appropriate for the employee to be carried on any available sick leave.

Otherwise, annual leave or leave without pay would be appropriate. Check with the Human Resources office about the rules and policies regarding approval and denial of leave. When the employee has completed any treatment requiring extended absence and is ready to return to work, it is a good practice to have a back-to-work conference.

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These sessions should cause only minimal disruption to the work schedule. Generally, agencies do not have the authority to conduct mandatory alcohol testing. Although some agencies may have the equipment and trained personnel to administer an alcohol test, such a test would be voluntary.

Most alcohol testing would probably be conducted with an evidentiary breath testing device EBT , commonly referred to as a breathalyzer. While there are other methods of testing for alcohol, including blood or saliva tests, an EBT is the predominant method because it is less invasive and is already in use by law enforcement personnel. Law enforcement personnel on Federal property may administer alcohol tests to drivers when there is an accident or reasonable cause to do such testing.

However, cause for such testing must be based on a violation of motor vehicle and traffic rules and not mandatory testing by the agency. These rules call for mandatory alcohol testing, using EBTs, of applicants for identified positions and in cases of reasonable suspicion of alcohol use, and for random testing of employees in these positions.

Any agencies conducting this type of testing will have a specific program spelled out in agency policy. An agency may conduct voluntary alcohol testing. An example of this might be an instance where you think that an employee is intoxicated but the employee denies it. If intoxication is indicated by the test, the agency may use it as a basis for some type of administrative action, such as sending the employee home, or taking disciplinary action. An agency may not take disciplinary action solely because an employee declines to undergo a voluntary alcohol test.

An area that is often troublesome for supervisors is what to do when an employee is apparently under the influence or intoxicated at work. Agencies have a fair amount of latitude about what to do in these situations. The following is a list of steps you should take in dealing with such a situation. Though not all steps would be appropriate in all situations, most would be applicable. If the employee is performing, or required to perform, safety-sensitive duties such as driving vehicles, using heavy equipment, working around explosives or weaponry, or performing patient care activities, he or she must be restricted from performing these duties.

If the employee is willing, he or she may be sent to the health unit for observation or a possible assessment. Health unit personnel may be able to offer a medical judgment that, in their opinion, the employee is intoxicated. They may also be able to conduct a voluntary alcohol test, most likely an EBT. Unless the employee is in a job with specific medical or physical requirements, you cannot order the employee to undergo any type of medical examination, including an EBT.

Examples of the types of jobs that may have specific medical requirements include police officers, certain vehicle operators, air traffic controllers, and various direct patient-care personnel. The EAP should be contacted.

Alcoholism - causes, symptoms, diagnosis, treatment, pathology

The counselor may be able to assist in any immediate assessment or may be at least able to talk to the client immediately. Even if the EAP counselor is unable to see the employee immediately, EAP personnel should be informed of the situation. You should refer the employee to the EAP after the employee returns to duty. If the employee is disruptive to the workplace, you should remove him or her from the immediate worksite.

This may involve taking the employee home or at least taking him or her to the health unit, the EAP office, or some other safe location. An employee who is physically resisting should be dealt with by agency security or local police. The employee should not be sent home alone or allowed to drive. It would be appropriate to consider having a family member take the employee home. A taxi is also an option. It is important to immediately and accurately document in writing what has transpired. Record all the events that led to sending the employee home, especially if any disciplinary action is necessary.

It is important to work with the EAP and employee relations staff and keep them informed of such events because the quality of the information they receive from you impacts on the quality of their advice and service. Avoid being an "enabler. Supervisors often think that they are being kind, when actually they are hurting the alcoholic employee by letting him or her continue to engage in self-destructive behaviors. Examples of supervisory behavior that might be considered enabling include:. Alcoholism is a disease.

However, sometimes that compassion has to be firm in order to communicate that, while the agency is willing to help the employee get assistance, the employee is ultimately responsible for his or her own rehabilitation, recovery, and performance. The best help that you as a supervisor can offer is to learn something about the disease, refer the employee to the EAP, and hold him or her accountable for his or her conduct or performance.

This is just a brief road map for dealing with alcohol problems in the workplace. There are, and have been, many theories about alcoholism. The most prevailing theory, and now most commonly accepted, is called the Disease Model. Its basic tenets are that alcoholism is a disease with recognizable symptoms, causes, and methods of treatment.