Substance abuse counseling has many counselors and supervisors who are in recovery from a personal history of substance abuse. Approximately 37% of supervisors in the substance abuse field reported being in personal recovery (Eby, Burke, & Birkelbach, 2009). Little is known about how a clinical supervisor’s personal recovery influences his or her clinical supervision. The purpose of this phenomenological research study was to investigate the perceived lived experiences of clinical supervisors’ in recovery during the clinical supervision of substance abuse counselors working towards a license or credential in Louisiana. A qualitative phenomenological methodology, Interpretative Phenomenological Analysis (IPA) was used to analyze data from six clinical supervisors in recovery using semi-structured interviews. Themes emerged from the data, which resulted in 13 categories: 1) functions of supervision; 2) factors influencing the supervision relationship; 3) insight into addiction; 4) factors pertaining to self-disclosure; 5) managing dual relationships; 6) recovery isn’t enough; 7) relapse potential and management; 8) stigma of addiction; 9) structure of supervision; 10) countertransference; 11) feelings about self-disclosure; 12) importance of self-care; and 13) supervisors need supervision and consultation The categories provide increased understanding and insight into how recovery influences and were used in supervision by supervisors in recovery. Implications for supervisors in recovery, supervisees of supervisors in recovery, and clinical supervisor educators are also addressed.

Abstract EXPLORING SUBSTANCE USE DISORDERS COMMUNITY OUTPATIENT COUNSELORS’ EXPERIENCES TREATING CLIENTS WITH CO-OCCURRING MEDICAL CONDITIONS. AN INTERPRETATIVE PHENOMENOLOGICAL ANALYSIS Lauretta Anne Cathers, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2013 Major Director: Amy Armstrong, PhD, Chair, Rehabilitation Counseling The Interpretative Phenomenological Analysis study presents the findings from a qualitative study examining substance use disorders (SUD) community outpatient treatment counselors’ experiences treating clients with co-occurring medical conditions. Interviews from five SUD community outpatient treatment counselors resulted in four emerging super-ordinate themes. The findings illustrate the relationships between SUDs, medical conditions and other predisposing, enabling and need factors. In order to assist clients in focusing on therapy, counselors work to identify resources to treat the basic needs of the clients, including medical care. Challenges included limited resources, complex system processes, and client fear and apathy. In addition, various unique challenges related to medical conditions treated by potentially habit forming medications and traumatic brain injury were identified. Counselors discussed how their roles and responsibilities have expanded to include case management and additional responsibility for the overall well-being of the clients they serve. They encouraged SUD educators to include more education on counselor self-care, trauma, pain conditions and the assessment process. Implications from the study highlight the need for integrated behavioral and physical health care.

Approved for public release; distribution in unlimited. / Activity-based costing (ABC) has been widely adopted by the Marine Corps to organize cost management information. The primary focus of ABC is to provide accurate information on the cost of providing a good or service. This thesis presents the application of the ABC methodology to the operations of the Substance Abuse Counseling Center (SACC) aboard Marine Corps Base Hawaii (MCBH). Activities have been examined for a three-year period from fiscal years 2000-2002. The ABC analysis identifies average total resource consumption over the three-year period of $747,099. Detailed information is provided for determining the cost to counsel a Marine, which is $85.84 for a clinical evaluation, $60.57 to provide substance abuse prevention, and $495.35 for a professional consultation. Additional information is provided on SACC value-added and non-value-added activities and how these activities ranked in terms of resource consumption. Finally, the core competencies of the SACC are discussed and a comparison of counseling costs to outside vendors was used to determine if outsourcing of certain SACC processes or activities is an option. / Captain, United States Marine Corps