Please Note! Due to the high volume of irritating spam and slow-down of participation here, we are no longer accepting new comments, questions, or subjects on this Forum. We are keeping all the subjects and comments for review as there is a lot of good stuff here relating to practice-building subjects. So, dig deep! Thanks to everyone who participated here but it is time to move on to bigger projects educating the public about acupuncture! Matt Bauer
03-Nov-2012 06:02 AM
|Hi Matt. Your post about weight loss treatments also made me curious about how you approach smoking cessation treatments which is another area where patients often come in hoping for a miracle without making any habit changes. Any advice?|
18-Nov-2012 04:59 PM
| Matt, thank you for that detailed and thoughtful response. I think dividing the “roots” of this addiction out is a really helpful paradigm. And I think your third to last paragraph contains invaluable insight. The emotional aspect of smoking is a key reason why even nicotine replacement doesn’t always work.|
I would like to share a personal story. My father-in-law passed away from smoking related cancers several years ago. Throughout his treatments, our family all wore the yellow LiveSTRONG bracelets in support of this arduous struggle. After he passed away, my mother-in-law removed her bracelet and said she no longer felt right wearing it as long as she smoked. As a person with a major mental illness, quitting smoking for her seemed a nearly impossible task. But she utilized a nicotine replacement lozenge regimen and she posted a picture of Lance Armstrong in her room that said, “Put Your Lance Face On”. And she quit. And it was very, very hard for her. I think it “took a village” to get her to maintain a non-smoking life. I guess the message here is that if you do decide to take on a person trying to quit smoking, you may want to recommend they replace their “emotional crutch” with some other inspiration to help them get through the difficulties.
I hope this story was helpful. And as a person who quit smoking herself after fifteen years, I can honestly say you just need to throw the book at it. Don’t rest on any one tool too hard and as with weight loss, remember it is not about you as the practitioner. All you can do is support the person in that process, and find the aspects of treating their addiction that you contribute the most to.
20-Nov-2012 03:14 PM
Thanks for that story and good to hear your mother-n-law was able to quit. To put the difference between a marked chemical dependency and an emotional crutch into perspective, I sometime use the following analogy: Say a loved one of a hypothetical patient was in a terrible accident and their life was hanging by a thread and was undergoing surgery and you and your family members were waiting for the surgeon to come out and tell you what had happened with the surgery. Someone with an emotional crutch would not even be thinking about a cigarette because their thoughts would be overpowered by worry and grief. Someone with a strong chemical dependency would have trouble resisting the urge to go outside and have a smoke. The success rate with acupuncture will usually be higher for the second case – the one with the strong chemical dependency. I tell my perspective patients my job is to ease that craving that would compel someone in that circumstance to go outside for a smoke. If the cravings ease and they decide to smoke anyway, that is on them. If the treatment is not easing the craving, that is on me and I will vary the treatment until we ease that craving.
30-Nov-2012 04:11 PM
Thanks Matt, for the examples on how to explain the difference to patients between chemical and emotional dependency. A logistics question…. at what point are you screening the patient to determine their dependency and readiness? (over the phone, before their first treatment, during their first treatment?) Right now, since I’m the one answering the phone and scheduling my appointments, I usually try to screen the potential patient right then over the phone so that they are thinking about these things ahead of time and/or deciding that this is not the right time for them to start treatment. But once I have a receptionist, I won’t have them do that level of screening, and just schedule the appointment. I’m just curious if you’ve run into situations where the patient decides this isn’t right during their first visit – did you do the first treatment anyway?
30-Nov-2012 05:31 PM
Great question. For quit smoking patients, it makes sense to screen them on the phone call as that is such a straight-forward treatment. You may still be able to do that later with the right kind of receptionist who you trust to learn how to screen. Even when you are busier, you can also have your receptionist take their number and then you call them back to do the screening yourself when time allows. For most any other issue, I think it is better to have them come-in for a free consultation even in those cases you feel you will likely discourage from starting treatment. When you are still trying to build your patient base, you want to meet people face to face and let them get to know you as a caring professional even if they are not the right candidate for treatment. People are very impressed when you tell them – “Sorry, but I don’t think this treatment will be effective for you” – although that won’t happen very often.