More than three years after the initial COVID-19 outbreak, the dramatic toll of deaths and hospitalizations has thankfully subsided. Other consequences continue to leave their mark on Long Island’s landscape.
One notable area is substance abuse and addiction. Already at crisis levels prior to the pandemic, addiction and substance use has only intensified, according to Dr. Laura Kestemberg, an Associate Professor at Molloy University’s Clinical Mental Health Counseling Graduate Program in the School of Education and Human Services. Kestemberg was one of many Molloy faculty members across various academic disciplines who shared perspectives about the current addiction crisis and how the University prepares students to play a professional role in addressing the scourge and help provide proper support to those struggling with addiction.
Clinical Mental Health Counseling
Dr. Kestemberg, a clinical psychologist and the founding director of the Clinical Mental Health Counseling program and its Mental Health and Wellness Center Clinic, explained how the pandemic might have influenced those already working through addiction. “Those individuals who were already struggling with a substance-related or addictive disorder prior to the pandemic became more vulnerable to resorting to maladaptive coping strategies to help them alleviate stress. Additionally, the fear and isolation that many individuals experienced during COVID-19 exacerbated symptoms of those who were already struggling with anxiety, depression or other emotional disorders, and we further saw a spike in people who started drinking or using substances for the first time."
While mental health providers moved to offer telehealth options, she said, the care and support an individual has access to are directly affected by socioeconomic status, race, age, gender and environment, in addition to many other factors. For example, many individuals were able to benefit from working from home and telehealth options, yet many others on Long Island were not, Kestemberg explained. "Some individuals could not afford the technology or Wi Fi services to allow them to continue their mental health care in the form of individual counseling online, or they could not continue to attend their Alcoholics Anonymous or Narcotics Anonymous groups online."
One direct way that she helps address the needs of Long Island families battling addictions and trains her graduate students to provide evidence-based mental health services to treat substance abuse is through a four-year, nearly $1.2 million federal grant from the Health Resources & Services Administration (HRSA) awarded to Molloy's Clinical Mental Health Counseling program in 2020 and led by Dr. Kestemberg. The grant focuses on increasing the number of well-trained practitioners working in medically underserved communities and vulnerable populations and provides stipends to 70 graduate counseling and psychiatric nursing students during their internship year. The grant focuses on the mental health needs of diverse youth and their families, including those struggling with substance use disorders.
The grant additionally funds training opportunities for students, faculty and clinical supervisors in the community to attend specialized lectures, including those on substance abuse and addictions. These webinars and symposiums enhance the training that Molloy's graduate students are already receiving in their pre-existing curriculum, and better prepares them for employment with these vulnerable populations after graduation.
At Molloy’s Mental Health and Wellness Center, licensed mental health professionals supervise third-year graduate students, who have developed counseling skills in previous course work. The student interns spend three semesters with assigned clients at the center located on Hempstead Avenue in Rockville Centre.
Students begin with practice intakes of client needs and go on to perform assessments and make diagnoses. Sessions where students meet with clients are observed by a supervisor. Students later meet with their supervisor to review the session. A common early emphasis to student interns is to learn how to identify problematic substance abuse as part of a mental health diagnosis.
Nursing
Patricia Mulvaney-Roth, D.N.P., an assistant professor in the Barbara H. Hagan School of Nursing and Health Sciences, said Molloy nursing students, beginning in sophomore year, “absolutely are educated on what to look for and how to intervene on the front line” in cases of addiction.
She cited two of her own courses, Humanistic Psychosocial Concepts of Nursing and Humanistic Nursing Care and Psych Mental Health Nursing Practice, in which addiction is addressed. In the first, it is the subject of two three-hour lectures, and in the latter, discussion delves into areas such as mood disorders, personality disorders, child adolescent disorders and self-medication.
In senior year, nursing students do clinical training, where they closely observe nurses treating patients, including some with serious conditions. They can offer input on patient interventions.
When Mulvaney-Roth meets with students following their clinical rounds, she said they frequently remark that “it is amazing to put what we learn in class in theory and apply it to clinical situations. We saw the symptoms, we spoke to the nurse about it, and she said, ‘You’re right, I agree. Let’s go do this intervention.’”
Understanding that mental health is an important part of good overall health can encourage students to broaden their critical thinking and interventional skills in the best interest of their patients.
“Overall, Molloy nursing students are very receptive to learning about addiction and understanding that it is a Long Island-New York issue,” said Mulvaney-Roth, “It is something they will have to deal with when they graduate and they are eager to learn, critically think about it and intervene for it.”
Music Therapy
Seung-A Jung, the chair of the Department of Music in the School of Arts and Sciences and director of the undergraduate music therapy program, said one of the graduate courses she teaches, Introduction of Analytical Musical Therapy (AMT), has proven effective in working with people experiencing trauma and addiction.
Clients are helped to “identify underlying issues happening earlier in their lives, particularly in early childhood or as teenagers or young adults,” Jung said.
The model focuses on three important tools to get to the root of the problem and to change behavior. The tools are music, therapies and words.
A primary method of AMT, Jung said, is delivered through improvisation, specifically referential improvisation, meant “to access clients’ minds, unspoken words, any of those traumatic experiences attached to emotions, behaviors, memories, a symbolic way of utilizing music.”
“The purpose of making music…is to help clients uncover unknown areas of their personality, forgotten memories, repressed emotions, or unusually intense emotions. From there we help clients bring from past to present…” Jung explained. “All those areas, relationships, their emotions, could be uncovered through referential improvisation with qualified clinicians, which is analytical music therapists.”
The course has also been increasingly popular with students, and this past spring had its highest enrollment ever. “I’m really happy that more students, more music therapists, are becoming interested in this approach,” Jung said.
Social Work
Melissa McCardle, Ph.D., interim chairperson, and a professor in the Department of Social Work, noted that three specific practice courses, focused on work with individuals, groups and families, and organizations and communities, feature the subjects of substance abuse and addiction.
McCardle spoke about a new class, “A Generalist Practice, Skills Lab,” designed as a lab to help social work students practice the skills they have learned. It utilizes a stages of changes model, recognized as among best practices for addiction.
The model promotes “understanding the challenges, the struggles and challenges go through as they struggle with addiction and work toward sobriety and reducing the harm of the addiction in their lives and families,” McCardle said.
Students are guided on how to develop a relationship with an individual and family struggling with addiction as well as how to do a formal assessment of their needs.
When asked about how the addiction rate will be affected as the pandemic winds down, McCardle said, “We might expect it to recede as time goes on. Unfortunately, the need for treatment has increased, at a time where we’ve had, in some places, greater cuts to funding and service availability. We’re not seeing a decrease.”
Speaking of the opioid and fentanyl crises in the local region, McCardle said the stigma “around using drugs and seeking services is so strong that it doesn’t just impact people’s willingness to get help, it impacts policy. It impacts how much they are willing to fund the services for people.”
Continuing Education
Addiction Studies, along with Medical Records, are the two most popular programs in the Division of Continuing Education and Professional Development, said Vanessa Podesta, the division’s assistant director.
From July 2021 to June 2022, the most recent period available, a total of 31 students enrolled in the Addiction Studies program, a 365-hour, 24-course load designed to be completed in nine to 12 months. Upon completion, students will receive a certificate of completion from New York State and be eligible for trainee status as a credentialed alcoholism and substance abuse counselor.
The program features numerous counseling courses as well as others related to basic knowledge of physiology, psychological and pharmacological effects, case management, treatment planning, integrated care and ethics.
Podesta said many students are licensed social workers who want to be able to assist those with addiction problems. Others are in recovery themselves and want to help others, she said.
“Our goal is to educate the students as best we can, keep them current on the topics they are learning …so they can get out to the real world and not only get hired, but be good at what they are doing,” Podesta said.
Psychology
Jennifer Elliott, Ph.D., an assistant professor in the Psychology department of the School of Arts and Sciences, has received approval to launch a course on Drugs and Addiction planned for the spring 2024 semester.
Enrolled students will receive an overview of illicit and licit drugs of abuse, as well as addiction and treatment. Along with various reading assignments, students will be encouraged to sit in on a Narcotics Anonymous or Alcoholics Anonymous meeting for an immersive learning experience.
A clinical psychologist by training, Elliott has done research on addictions since 2006, with 40 published articles on substance-abuse related topics. She heads two small research groups working on projects at Molloy. One group is writing a literature review on the efficacy of interventions to reduce drinking in liver disease populations, and the other is studying how college substance abuse has changed over the course of the COVID-19 pandemic.
“Substance abuse disorders are among the most common mental health disorders, including in suburban settings and on college campuses,” Elliott said.
“My goal is to help students recognize these disorders, understand how they present and where they come from, and recognize the wealth of resources available for treatment, ranging from social support groups to more formalized treatment,” she said.