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Competency 2: Identification of FASD and Diagnosis of FAS

Issues Related to Professional Values and Ethics

Having an FASD can affect recovery. Women with an FASD might have trouble processing the steps in a 12-step program. They might have difficulty remembering appointments. In addition, they can be easily exploited and influenced by peers. They may relapse if they return to an environment in which friends or relatives drink. It is important that clients suspected of having an FASD be assessed so that treatment plans can be tailored accordingly.

Woman holding baby

Having a child with an FASD can also affect a woman's recovery process. Raising a child with an FASD can be extremely stressful and may trigger drinking episodes or relapse. Children suspected of having an FASD should be evaluated. An early diagnosis can help in obtaining needed services, thus decreasing stress and increasing the woman's chances of continuing her recovery process.

Receiving a diagnosis of an FASD for oneself or one's child can be upsetting. Some people are relieved to have an explanation for their or their child's problems. Others may feel shame or embarrassment. Many mothers face social stigma associated with drinking while pregnant and internalize feelings of blame, shame, and guilt. Their families might also feel ashamed. Partners might feel guilty for not knowing about FASD or not trying harder to keep the woman sober during her pregnancy. Counselors need to be mindful of such feelings so that they can assist clients and their families in processing their reactions.

Dealing with FASD is complex and difficult and requires open, honest, and sensitive communication. Counselors need to work especially hard to establish trust and rapport with clients who may have been prenatally exposed to alcohol or have children with an FASD. Sensitivity to the client's family situation and cultural values is key. For example, some cultures believe that pregnancy is a sacred time and that drinking while pregnant breaks the sacred trust. Clients within these cultural groups who believe in these values may need spiritual guidance to cope with this knowledge, while others may want a more secular approach.

Counselors need to be culturally competent. They need to have substantive, accurate knowledge of the client's background and beliefs. They also need the skills to use this knowledge to form a productive relationship that will support ongoing recovery.

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