Clinical Associates Counseling Services, LCSW, PC
CACS serves the function of providing Anger Management and Domestic Violence Services for clients that require this form of treatment. Clients for the most part are Court Mandated or referred by an Adjunct connected with the Courts or with Corrections, Parole or Probation. Some clients may come through self-referral by friends, spouses, family or attorney.
The function of CACS is to provide competent treatment for the anger and domestic violence conditions that present themselves in the Court systems and are mandated into a treatment environment. Currently treatment available for these cases in New York and its surround is ineffective. There is no treatment strategy or method to measure improvement. Mandated cases are required to sit in a class room with other cases while being subjected to teachings about anger management and domestic abuse. There is no formal therapy or treatment required for these cases. Often the classes segue into racial discussions and police related issues. As a result there is a high rate of recidivism and sometimes [these poorly treated conditions can lead] to serious exacerbated consequences that border upon or effect homicide. The problem is that we are dealing with a Fighting Addiction. Unless this is identified, treatment results are questionable.
CACS also takes into account that anger management and domestic violence cases frequently involve a dual diagnostic picture. In addition to the diagnostic categories of Disruptive, Impulse-control, and Conduct Disorders [DSM IV: 219] we also have Substance Related and Addictive Disorders [DSM IV: 227]. Ergo many of these cases involve serious chemical addictions. It is our belief that the anger management or domestic violence problems cannot be treated effectively unless the addiction is treated first or simultaneously. For this reason we work directly with AA and other addiction recovery methods in tandem with the treatment process. Point: There is no chance of symptom relief [the ability to manage and neutralize primitive rage] unless the client is in sobriety during the treatment process.
The theory behind this is simple: as long as there is an addiction, something in the client’s personality is being anesthetized, most probably trauma. We will not be able to do therapy with the client if only part of their personality is present. It is necessary to observe the psychological structures that emerge out of the anesthesia created by the chemical addiction in order to effectively treat the whole person. Attempting Anger Management without this criteria is futile.
Fighting Addictions As Cause
What is a fighting addiction. This is a term developed by Michael Fischman, MA, MSW, LCSW-R, CGP, DVS I, CAMS II, the founder of CACS. A fighting addiction is a compulsion to fight, developed on the basis of internalized experiences with trauma-related events that befall the subject during formative years. For example: a child that observes his parents involved in continuous domestic violence. These events become internalized into the unconscious mind and act like a program in a computer. Soon the traumatized individual begins to act out these behaviors with others in his/her life as if it were a script.
In addition to the internalization of these traumatic experiences, there are also chemical factors involved. During heights of anger arousal, the chemical cortisol is released along with adrenalin. These chemicals likewise become addictive and play a significant role in the complex arrangement of chemical and unconscious internalizations of the trauma moments.
How does the process of treatment work
Through our method we get to the ‘root’ of the problem. Only through reaching ‘cause’ can the condition be modified permanently. Through evidence based protocol the client is carefully diagnosed. After it is clear what is causing the problem, the client is then carefully apprised of ‘cause’ and then told how the problem can be remediated and what is required to reach this level. Soon thereafter the client will enter Individual therapy with a CACS therapist who will refine the diagnostic picture and proceed with treatment. When the client is deemed ‘ready’ he/she will be referred to group treatment.
The group will deal with the client’s problem in depth and within an environment where anger is used constructively; not destructively. Under optimal conditions the client is seen twice a week; once for individual therapy and once for group. During this time the therapist doing the treatment will maintain a close relationship with the court or the client’s attorney, probation officer, etc.
Points about Court Involvement
In order for us to be fully effective, we require court participation. Meaning: we prefer to have monthly reports sent to the court indicating whether the client is treatment compliant. If the client is non- complaint [does not show for appointments, remains addicted to substance, does not cooperate to improve his condition] it is necessary to report this to the court. If the client proves to show a lack of interest, motivation or authority related resistance then he/she will be given a warning that referral back to the court will be necessary since they are not responding to the help given. They will be further apprised that if they are referred back to the court they may have to serve jail time in lieu of therapy. Again, in our opinion, having a relationship with the court is a sine qua non for successful outcome as is complete sobriety.
In order to treat these cases effectively, it is essential to have knowledge concerning the cause of the condition. We have developed a treatment approach which involves a combination of individual and group therapy. The treatment takes time but is effective. Each client is carefully diagnosed and the central cause of the condition is identified. When the client is apprised of what is compelling him/her to engage in this behavior we then have a beginning of consciousness. This awareness, in most clients, serves as a motivator to work upon change.
Who are we
All therapists associated with CACS are New York State licensed and trained by CACS. In order to become a therapist certified by CACS, it is necessary to undergo training in anger management and have either a CASAC or substantial training and experience with chemical, food, and fighting addictions. All therapists must undergo a period of supervision before being certified. In addition, all therapists must be certified by NAMA either as a Anger Management Specialist or a Domestic Violence Specialist or both. The therapist is later certified by CACS.
Clients who are referred for this form of treatment almost always come from a background where they witnessed this behavior during childhood [domestic violence, uncontrolled rage, sexual molestation, alcoholism, other addictions etc]. As a result of this they became traumatized and thus compelled to repeat what they experienced as children. Most importantly these people grew up in a hateful environment; a war zone sp to speak. As a result of this they were emotionally taught that this is the only way to make ‘contact’.
So, what is missing in client’s life that gives cause to fighting-as-contact? What is it that he/she doesn’t know about? Perhaps never experience in vivo. The answer: how to make contact through caring. To connect with caring feelings, even LOVE. So part of our work with the client is to introduce them to connecting with caring feelings and learning how to use their anger to foster caring connections. This is how the groups are structured and run; analogues to a ‘healthy family’ where you are listened to, understood and where anger is expressed in a constructive manner. When this can be done there is no longer a ‘need’ to connect with anger, anger can then be used within a different value system, to build healthy contact or to help others etc.
This therapeutic procedure takes time, so it is recommended that each client be in treatment, twice a week, for a minimum of a year. Most clients will want to continue on their own after the court mandate is lifted. Here we have the opportunity to turn potential criminals into healthy citizens who have something to say about living in a psychologically healthy way. Perhaps some of them will become motivated to help others with similar problems with addictions, violence, abuse etc. In the addiction community it is well known that previously addicted people become some of the best addiction counselors.
How to be referred
Clients can be self-referred, referred by their attorney, by their correction officer, parole officer or by the court. All potential clients are carefully assessed during a structured intake interview. After the assessment interview the case goes into conference and then the client is referred to an appropriate therapist.
All insurances are accepted. When there is an insurance problem, an affordable fee is arranged for the client.
Services, LCSW, PC
Anger Management and Domestic Violence Services