Question

1) Adolescents (12 to 20y/o) -when a teen uses alcohol do you believe that it could interfere with brain development, especially in the frontal cortex (decision making area)? Why is it important that family members/guardians become involved in their children's treatment?

2)Elderly (65 and up) - why should a psychiatric evaluation be required for this population in treatment?

3) LGBTQ - why is it important to have treatment staff undergo sensitivity training before working with this population?

4) African- Americans/Hispanics - do you believe that a white counselor can effectively work with either of these group in the treatment setting? Why? why not?

Answer 1

1. Initiation of alcohol consumption in adolescence has definite risks associated with them.

• Since the adolescent brain is still developing, it's further development can be affected. This is proven in mice and possibly the same applies for humans.
• Earlier initiation can be associated with future addiction and excessive consumption.
• Chronic alcohol consumption can lead to cerebral atrophy.
• Earlier initiation indicates novelty seeking and risk taking behaviour.

2. Old age is associated with

• Higher incidence of manifestations of psychiatric illnesses.
• Illnesses like stroke have psychiatric illnesses
• Higher incidence of depression

Hence, psychiatric evaluation will help if there are symptoms

3 and 4 - Both these issues fall under the purview of cultural humility.  

Culture humilty defined in simple terms is a process of self- reflection and self-critique that will lead to respect and empathy for individuals of all cultures and background. It has 4 elements:

• self reflection/critique
• learning from patients
• partnership building
• lifelong process

Staff should be trained to LGBTQ issues.

Similarly when there are patients from different cultural backgrounds, it is important that the healthcare workers workers understand the issues beyond the illnesses. If possible, workers from similar backgrounds should be made part of the team that takes care of the patient.