TrTreating Lindsay Lohan

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Treating Lindsay Lohan [Your Name]

Treating Lindsay Lohan Executive Summary

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Celebrities are often unprepared for the prestige and wealth that they acquire. Many adopt self destructive behaviors, including substance abuse and disrespect for the law. Such behaviors pose a risk to the celebrity as both an individual and professional. A growing trend has been for celebrities’ management companies to require celebrities to accept a certain level of intervention or face cancellation of their contracts. This study examines the case of Lindsay Lohan. Lohan has exhibited exactly the behaviors listed above, and, as a result has not only damaged her career, but also acquired a criminal record (Heger 2014). This study combines an abstract discussion of celebritycentric treatment approaches with a discussion specific to what might be done to mitigate Lohan’s career self immolation. Celebrity Parameters Celebrities often lead very busy lives. In addition to their work, which may consist of activities such as musical performance tours or shooting motion pictures, they may also lead rather frenetic social lives. Celebrities are also very much under the “social microscope”their fans want to know every detail of their life. The journalists who cover celebrities know that even a minor infraction, such as a parking ticket can be made into a very interesting story whereas acts of kindness and professionalism, such as taking the time to speak to a disabled fan, are not. Given these considerations, the majority of celebrities refuse to participate in “traditional” interventions due to the time commitment they require. The basis for this refusal is twofold. First of all, it interferes with their professional and social lives.

Treating Lindsay Lohan 3 Secondly, and possibly more importantly, the more time spent in “treatment” increases the chance that the “treatment” will be detected and then become the topic of a great deal of negative publicity. Breaking With Tradition Many courses of treatment for substance abuse take place over several months if not years, and require a substantial investment of time. Alcoholics Anonymous, for example, awards “sobriety coins” at various milestones, such as six months of sobriety. Even though, as will be discussed below, Alcoholics Anonymous and organizations like it can often play a key role in a celebrity intervention, they cannot be relied on alone, due, if nothing else to the time commitment required. Fortunately, celebrities are not the only ones with schedules that essentially preclude the use of long term or time intensive interventions. An employee with a long commute is most likely going to miss sessions because he or she will be tired as the result of a commute. A person struggling financially may not be able to make the time commitment necessary, especially if the fundamental tradeoff is one of attending some form of counseling or treatment as opposed to working enough hours to put food on the table and to pay the rent and utilities. As a result, the discipline of brief interventions and brief therapies (BIT) has emerged. BIT, as will be discussed below, has not only been successful, but is also supported by a broad theoretical foundation.

Treating Lindsay Lohan BIT: Theoretical Foundations

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Brief interventions for substance abusers have been the tool of choice for many years by alcohol and drug counselors, social workers, psychologists, physicians, and nurses, as well as by social service agencies, hospital emergency departments, court-ordered educational groups, and vocational rehabilitation programs. Primary care providers have determined that many brief intervention techniques are effective in addressing the substance abuse issues of the client who is either unable or unwilling to access specialty care. Examples of brief interventions include asking clients to try nonuse to see if they can stop on their own, and encouraging interventions directed toward attending a self-help group (e.g., Alcoholics Anonymous or Narcotics Anonymous). Even though, as mentioned above, Alcoholics Anonymous and similar organizations do operate on long time spans, they do provide benefits when used discontinuously. In addition, even discontinuous attendance provides a rehabilitative framework that supports other approaches being used. Brief interventions are procedures, supported by research, for working with individuals with both at-risk use and abuse behaviors. They can be successful when morphed into specialist treatment settings and conducted by alcohol and drug counselors. As described in the relevant literature, brief interventions to change or otherwise ameliorate substance abuse behaviors can, and typically do, involve a wide variety of approaches, ranging from unstructured counseling and feedback to formal structured therapy (cf., ad seriatrum., Chick et al., 1985; Fleming et al., 1997; Kristenson et al., 1983; Persson and Magnusson, 1989). Brief interventions, as defined and discussed in this TIP are time limited, structured, and

Treating Lindsay Lohan 5 directed toward a specific goal. They follow a specific plan (and in some cases a workbook) and have timelines for the adoption of specific behaviors. Several studies have attempted to identify the factors that result in differential responses to brief interventions by varying, to the extent possible, client characteristics or by conducting subgroup analyses. The majority of the studies of brief interventions to date are inherently limited by their intrinsic lack of sufficient subject assessments. Findings from the available research strongly, but not definitively, suggest that individual client characteristics are not good predictors of a person's response to a brief intervention and that brief interventions may be applicable to individuals from a wide range of cultures and backgrounds (Babor, 1994). BIT: Goals The basic goal for a client in any substance abuse treatment program-BIT based or otherwise- is to mitigate the risk of harm from continued use of substances. The greatest degree of harm reduction would clearly result from abstinence, however, the specific goal to be established for each individual client is determined by his/her consumption pattern, the consequences of his use/her, and the setting in which the brief intervention is being delivered. A focus on intermediate goals allows for the realization of more immediate successes in the intervention and treatment process, regardless of what the long-term goals have been identified as. In specialized treatment modalities, intermediate goals might include quitting one substance (i.e., someone abusing 5 substances would quit them one at a time),

Treating Lindsay Lohan 6 decreasing frequency of use, attending the next meeting or session, or doing the next homework assignment. Immediate successes are important in keeping the client motivated to continue his or her treatments. Setting goals for clients is particularly useful in specialized substance abuse treatment facilities. Performing brief interventions in such settings requires the ability to simplify and reduce a client's treatment plan to smaller, measurable outcomes, often expressed as "objectives" in the Joint Commission on the Accreditation of Healthcare Organizations' (JCAHO) language of treatment planning. The clinician must be aware of the many everyday circumstances in which clients with substance abuse disorders face ambivalence during the course of treatment. The key to success for brief interventions is the extraction of a single, measurable behavioral change from the broader recovery process that will allow the client to experience a series of small, incremental successes. It stands to reason that clients who succeed in making small changes generally return for more successes. The clinician will often have no choice but to temporarily set aside the final goal (e.g., accepting responsibility for one's own recovery) in order to to focus on a single behavioral objective. Once this objective is established, it is clear that a brief intervention can be used to reach it. Objectives can, and will, vary greatly according to factors such as the client's stage of recovery and readiness to change, but brief interventions can be useful at any stage of recovery. Treating Lindsay Lohan

Treating Lindsay Lohan “Traditional psychology” might claim that Lohan’s behavior is the result of her

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victimization in several areas: the “pressure” of being a “child star” making the transition to adulthood and apparent familial abuse and other complications. This, in a “traditional” view, would lead to the substance abuse, criminality, general disrespect for authority and the other self destructive behaviors that have become synonymous with Lohan’s name. Seligman and Csikszentmihalyi’s positive psychology (Seligman and Csikszentmihalyi, 2000, generally) almost certainly does not have the “power” to predict Lohan’s theft of the jewelry, it certainly offers an alternative treatment modality. The first step would be identifying, through guided interviews, why Lohan committed the theft. Given her relative success, it is unlikely she stole it due to lack of funds. Likely motivations could be a desire for attention, the feeling that her prominence allows her to “get away” with things (and this may have been reinforced by her short jail stays) or an overall need to rebel. These interviews could be conducted on a flexible schedule; if need be, Lohan’s clinician could travel to wherever she was working in order to conduct them. Such extreme steps might be needed in order to ensure her participation in the rehabilitative process. Whatever Lohan was thinking, it is clear that possession of the jewelry really did not make her happy (she almost certainly has a large collection of jewelry). Using her selfdescribed motivation (as identified through interviews) as a starting point, positive psychology would seek to determine what behavior or behaviors, at thetime of the theft, would have made Lohan genuinely happy. Lohan would be asked to reflect on these

Treating Lindsay Lohan behaviors and report her resulting feelings; this would be the first of one of several

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incremental processes making up her therapy. In a slightly more extreme approach, Lohan might be asked to actually do these things (depending, of course, on what they were), and evaluate the results (this being done, of course, according to the tenets of the scientific method, as that is at the very core of positive psychology). In all likelihood, this could be used as the second incremental component. Even though this is largely speculative, it is almost certain that this approach would achieve better results than those ordered by the court-performing public service at a morgue. Even though making her work at a morgue may address an “I am a celebrity so I don’t do what others do” attitude, it does nothing whatsoever to address the root causes of Lohan’s self-destructive behavior. It is also a one time event, which runs counter to the tenets of BIT. It could (and, once again, this is speculative) make her even more rebellious, prompting even larger scale acts of criminality or self-destructive behavior. Positive psychology would almost certainly facilitate the identification of behaviors that would make Lindsay Lohan genuinely happy. She would then cease the negative behaviors that have gotten her into so much trouble. She would then be in a position to make the difficult transition from child star to adult actress, which others before her have found so difficult. The BIT Clinician’s Skill Set One of the most important skills for brief interventionists is "active listening". Active listening is the ability to accurately restate the content, feeling, and meaning of the client's

Treating Lindsay Lohan statements. This is also called "reflective listening," "reflecting," or sometimes

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"paraphrasing." Active listening is one of the most direct ways to rapidly form a therapeutic alliance. When done well, it is a powerful technique for understanding and facilitating change in clients. Active listening goes beyond nonverbal listening skills or responses such as, “Yeah,” “Right,” “Really?,” "Hmmm," "Uh-huh," "I see," "I hear you," or "I understand where you're coming from." None of these short statements demonstrates that the clinician actually understands what the client is saying. Counselors should also make extensive use of open-ended questions to which the client must respond with a statement, rather than a simple yes or no. Instead of summarizing a situation and then asking, "Is this correct?" “That’s it, right?” ask the client something like, "What do you think? How do you feel about the situation?" Open-ended questions are invitations to share and provide a means to probe for important information that emerges in the interview. Another important skill is the ability to help clients explore and resolve ambivalence. Ambivalence is the rubric of a person in the contemplation stage of readiness. It is, notably, one of the most prevalent clinical challenges encountered in brief interventions. Whether it takes 1 minute or 1 hour, the goal is to help clients become more aware of their position and the discomfort that their ambivalence creates. Increasing awareness of this discomfort within an understanding and supporting relationship can inspire the client to progress to a stage of preparation or action. For example, a client might be willing to go to counseling but not an AA meeting; in that case, the clinician should work with the client's motivation and focus on whatever positive step the client is willing to make.

Treating Lindsay Lohan 10 One way to help a client recognize his ambivalence is to ask him to identify the benefits and costs of the targeted behavior (e.g., using alcohol) and the benefits and costs of changing the behavior. The clinician listens and summarizes these benefits and costs, then asks the client if any of them is more important than the others. This helps identify values that are important to the client and can therefore increase or decrease the chance of changing. Clinicians might also ask if any of the pros and cons is more or less accurate than others. This provides an opportunity for irrational thoughts to be refuted, which can help remove barriers to change. Conclusion Substance abuse treatment programs frequently use brief interventions, although they might not be called that. Brief interventions can be, and often are, effectively integrated into more comprehensive treatment plans for clients with substance abuse disorders. These approaches can be particularly useful in treatment settings when they are used to address specific targeted client behaviors and issues in the treatment process that can be difficult to change using standard treatment approaches. Brief interventions can be used with clients before, during, and after substance abuse treatment; they can also, as discussed here, be the framework on which all work is based. To integrate the use of brief interventions into specialized treatment, counselors and providers should be trained to provide this service. It is also extremely important for substance abuse treatment personnel to collaborate with primary care providers, employee assistance program (EAP) personnel, wellness clinic staff, and other community-based

Treating Lindsay Lohan service providers with respect to the formulation of plans that include both brief

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interventions and more intensive care to help keep the client focused on treatment and recovery.

Treating Lindsay Lohan REFERENCES

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Babor, T.F. (1994). “Avoiding the horrid and beastly sin of drunkenness: Does dissuasion make a difference?” Journal of Consulting and Clinical Psychology. 1994;62(6):1127–1140. Chick, J.; Lloyd, G.; and Crombie, E. (1985). “Counseling problem drinkers in medical wards: A controlled study”. British Medical Journal. 1985; 290:965-967 Fleming, M.F.; Barry, K.L.; Manwell, L.B.; Johnson, K.; and London, R. (1997). “Brief physician advice for problem drinkers: A randomized controlled trial in community-based primary care practices.” JAMA. 1997; 277(13):1039–1045. Heger, Jen (2014). “Lindsay Lohan’s Diva Antics & Unprofessional Behavior Are Making It Hard to Secure Financing and Insurance for Her Upcoming Movie.” RADAR. April 28, 2014. Kristenson, H., and Osterling, A. (1994). “Problems and possibilities.” Addiction. 1994;89(6):671–674. Persson, J., and Magnusson, P.H. (1989). “Early intervention in patients with excessive consumption of alcohol: A controlled study.” Alcohol. 1989;6(5):403–408. Seligman, M.E.P., & Csikszentmihalyi, M. (2000). “Positive Psychology: An introduction.” American Psychologist, 55(1), 5-14.