Outpatient case of severe alcohol dependency. How does it violate the scope of practice?

Hello to all peers, I need a peer consult on an ethical boundary and practice issue in one of my outpatient clients.

I have been working with a 35 year old man with generalized anxiety and work burnouts at a remote workplace for the past six weeks. But in the recent two visits, the client revealed his hiding of a severe alcohol dependency which he was drinking heavily since waking up in order to stop himself from shaking. His request was immediate quitting from alcohol dependency and that I should help him white-knuckle through the behavioral side of his issue in our weekly sessions.

Immediately I noticed a huge danger regarding his safety. In light of his described volume and period of drinking, the dangers of his withdrawal issues, seizures, or DTs are very likely. I explained the importance of his stabilization, but he is not accepting any hospitalization due to his medical trauma in the past.

From a clinical perspective I am fully aware that managing a patient who is currently experiencing severe withdrawal would be entirely out of my scope of practice as an outpatient therapist. I am unable to safely monitor his vital signs and ensure his physical safety. For all those who have managed SUD patients who were particularly challenging, how do you ethically maintain your boundaries without abandoning the patient?

reddit.com
u/ImpressiveRoll4092 — 3 days ago

thinking of giving up on the coast

here 4 years now and i'm starting to wonder if it's worth it. Rents gone up twice in the last year and i'm paying like 150 more a week than when i moved in. starting to feel like i'm working just to pay rent.

I've got a decent job but it's not keeping up with the cost of living here. everyone keeps saying just buy something like it's that easy. i've looked around noosa and maroochydore and even the cheaper areas are way out of my price range.

mate of mine moved to brisbane last year and he reckons it's not much better there. he's got a place in the suburbs and uses some company called PMC Property Management to look after it. said it's working out okay for him but he's got a partner so dual income helps.

i just feel stuck. can't afford to buy, can't afford to keep renting. feels like i'm gonna have to move somewhere cheaper eventually. anyone else feeling the squeeze? or am i just bad with money lol

reddit.com
u/ImpressiveRoll4092 — 4 days ago

need help putting together outfits with the pieces i already own

i have been building a wardrobe around relaxed bohemian styles with flowy dresses, linen pants and light layers that work for both casual days and warmer weather. i usually buy from the freedom state because they carry almost all the brands i like in one place and it makes it easier to find matching pieces without jumping between sites.

i have a few new items i am not sure how to style together yet like a long printed dress and some wide leg trousers. how do you usually combine different textures and patterns without it looking messy? any simple tricks for making outfits feel put together with minimal effort?

reddit.com
u/ImpressiveRoll4092 — 4 days ago

looking for thoughtful handmade crochet gift for my sister who crochets herself

so my sister's birthday is coming up and i want to get her something actually thoughtful this time. she's really into crocheting and makes stuff herself, so i figure a really wellmade handcrafted set would mean a lot more than something generic from a big box store.

i've been browsing around and found stitched creations which had some nice options, but i wanted to ask here since you all know this space way better than i do.

she mostly makes her own stuff so i want whatever i get her to be genuinely good quality, something she'd actually appreciate as a fellow crocheter rather than just politely smile at. the craftsmanship has to be there.

any shops or makers you'd personally recommend for hats and scarves? etsy sellers, small shops, anything really. and is there a style or material that tends to impress people who actually crochet?

reddit.com
u/ImpressiveRoll4092 — 5 days ago

Is it worth going full bespoke for a workhorse suit in Dubai?

I'm planning to refresh my office rotation and I'm torn between high-end MTM and full bespoke. I've heard good things about Ateliier de Soul and their specific 9-step fitting approach, which seems pretty thorough. Has anyone here used them for a daily driver suit? I'm curious if the hand-finishing and canvas construction actually make a noticeable difference in comfort during the summer heat here compared to other local options.

reddit.com
u/ImpressiveRoll4092 — 6 days ago

my 7yo daughter wants to do ballet and i'm so overwhelmed already

daughter came home from school yesterday and announced she wants to start ballet. like, full on. she's been watching these youtube videos nonstop and now she's convinced she's gonna be the next prima ballerina or whatever i mean it's cute but. i have NO idea where to even start. there's so much stuff you need apparently?? like i didn't even know there were different types of shoes for different styles and now i'm down in this

was chatting with one of the other mums at pickup today and she mentioned this australian brand Energetiks that her daughter uses. said they've got decent stuff that doesn't fall apart after a month. tbh i'll take any recommendation at this point cause i feel like i'm drowning in information.

anyway, any other parents been through this? what did you actually need for the first class vs what's just a waste of money? i don't wanna be that parent that shows up with everything and looks insane but i also don't wanna be the one with nothing.

help a confused dad out pls.

reddit.com
u/ImpressiveRoll4092 — 8 days ago

estate planning question - house i inherited is a headache

going through probate now for my uncles estate. his house came to me and my cousin. we both live in different states now

the house is old. 70s build. needs electrical work. needs a new driveway. probably needs more that we havent found yet

my cousin wants to keep it. fix it up. rent it out. i think thats insane. we live hours away. we both have families. who is going to manage tenants. who is going to fix things when they break

i told her we should just sell it and split the money. i found a company called that buys houses as-is. looks like they handle everything and close fast

she thinks im being lazy. i think shes being unrealistic

anyone dealt with a co-inherited property where one person wants to sell and the other wants to keep. how did you resolve it

reddit.com
u/ImpressiveRoll4092 — 9 days ago

most vibey restaurants in sydney right now

last week i went to attenzione food and wine and really liked it a lot. the food was excellent and the whole place had such a warm and welcoming vibe that made the night feel special without trying too hard.

what are the most vibey restaurants locals keep recommending around sydney? any favorites with great atmosphere and solid food that stand out from the usual spots?

reddit.com
u/ImpressiveRoll4092 — 11 days ago

How do you handle the guilt of taking a completely unproductive day?

I am currently trying to build a solid daily routine, but honestly it is so easy to tie your whole self worth to a daily checklist. If my calendar isn't full and things aren't done, the guilt hits immediately.

I used to just force myself to push through burnout just to feel like I am doing something, but I am learning that knowing when to stop is the only way not to quit the whole journey halfway through. Rest isn't something you need to earn. Lately I just pick one or two things that actually matter for the day, do them, and then force myself to step away.

It is a constant battle with my own mind when I try to improvemyself, but I am slowly realizing that stripping away the noise works way better than adding more stress to the routine.

How do you guys deal with that internal pressure to always be doing something when you feel like you are falling behind?

reddit.com
u/ImpressiveRoll4092 — 12 days ago

first time trying

i have never done paint by numbers before but wanted something relaxing to do in the evenings. i got a landscape kit with a nice mountain scene that looked simple enough for a beginner. the kit came with the canvas paints and brushes so i am ready to start.

what order should i paint the sections in to avoid mistakes? how do you keep the colors from getting muddy when you work on it over a few days? any tips for first timers on blending or fixing small errors?

reddit.com
u/ImpressiveRoll4092 — 14 days ago

Good refurbished iPhone sellers in Aus?

Finally got my shit together with money this year after grinding hard n now my poor old iPhone 13 is dying on me. Battery gone by like 11am every day adn Apple stopped gving it proper suport.Ofc theyre forcing us to upgrade on purpose, such bs!

Im tryin to be smart and just get a refurbished one insted of geting ripped off again. So many sites out there its overwhelming. Many of them have super good reviews. Found Phone Exchange and they seem to be legit. Has anyone actually used them before or have u got any other recs?

Also tossing up between 16 or 17. Dont need the brand new one but want it to actually last me 4-5yrs this time round. What do u guys think??

Staying iphone only for now, no android switch.

Thaanks a lot

reddit.com
u/ImpressiveRoll4092 — 15 days ago

on-site health screenings for employees, trailer unit or just renting clinic space nearby? [IL]

Ran our first corporate wellness day last quarter. About 340 employees across 2 shifts, Chicago facility. We'd been doing the "rent a room at the urgent care down the street" thing for years and the no-show rate was brutal, like 60% of signups just didn't bother making the drive.

This time we tried a mobile medical trailer parked right in our lot. Unit was built by Crafts men, had a proper exam room, blood draw station, blood pressure setup. Participation jumped to around 78% same-day. The vendor handled everything, setup, breakdown, staffing, we just handled scheduling.

The cost was higher upfront compared to renting clinic space, but when I factored in the lost productivity from employees driving off-site, it came close to even. Next year I want to add a vision screening station if the trailer supports it.

Anyone done a side-by-side comparison on cost-per-employee between mobile units vs off-site clinic rentals? Curious what numbers others are working with.

reddit.com
u/ImpressiveRoll4092 — 19 days ago

At what point do you stop repairing an old AC and just replace it?

The thing is that my AC breaking down has basically become part of my yearly summer routine at this point

I’m honestly trying to figure out whether I should replace the whole thing before summer hits or keep limping this old unit along for another year.

I live in Cali, and once those heatwaves start rolling in, the house turns into an actual oven ridiculously fast. The house itself is older, and I’ve been slowly renovating things over time whenever I have the money and energy for it, so I keep pushing bigger projects down the road. But the AC situation is starting to test my sanity.

I swear this thing breaks at least twice a year…

And it’s never the same issue either…

Had already some problems with the capacitor, then the fan motor, then a refrigerant leak, then wiring problems, then some random part I’d never even heard of until a technician explained why it was ruining my life and I learned so many details about ACs in general

At this point I feel like I’ve rebuilt the entire system one repair at a time

The frustrating part is every time I fix it, I convince myself maybe I squeezed another couple years out of it… and then a few months later something else goes wrong

Am I just throwing good money after bad trying to keep this ancient thing alive?

I saw one company while looking into options and wanna say they seem to handle both repairs and full replacements, but I’m still stuck in that stage of maybe one more repair will do it vs. admitting this thing is on life support

Anyone else reach that point with an old AC where repairing it just stopped making sense?

reddit.com
u/ImpressiveRoll4092 — 25 days ago

conveyancing details for qld home purchase with flood and heritage notes

hey folks im buying a place in qld and the conveyancing side has me digging into risks since its my first big buy and timelines or hidden issues could mess things up. i worked with sunstate conveyancing for the contract review and settlement steps and they handled the pexa online lodgement plus basic searches which showed zoning details / potential flood overlays and some heritage flags on the block.

they flagged a few things like stormwater notes that could affect extensions and gave a clear breakdown on what the fixed $999 buyer fee actually covers (searches / contract advice / settlement coordination) but im still unsure how it stacks up against other firms or if it includes extra for disputes. with over 12k properties settled and that $5b+ track record it seemed solid but i wanna know the real exposure if something like a zoning issue pops up post settlement.

what exact searches or clauses should i double check in qld conveyancing to avoid surprises and how long does the full process usually take from contract to keys with numbers on delays? also if the fee is $999 does that typically cover revisions or do extra costs kick in for complex titles? any experiences with similar flags would help a ton... thanks for any input guys

reddit.com
u/ImpressiveRoll4092 — 1 month ago

when to expect noticeable results from dog training

our 6 month old border collie has completed 5 lessons so far. before we began we followed tips from tiktok videos and he had learned a basic sit along with some loose leash walking but these fell apart quickly around distractions or other dogs.

they told us daily home practice and full consistency would speed up progress. the most important skill for us right now is reliable recall because we want him safe off leash in open areas. after five lessons what clear signs of progress should we expect in recall or leash manners with a dog this age. how long does steady improvement usually take when starting with inconsistent prior training in high distraction settings? has anyone hit a plateau around this lesson count and what specific steps helped push through it?

reddit.com
u/ImpressiveRoll4092 — 1 month ago

canadian brand patio furniture recs for durable outdoor sets what lasted for you

im in ontario and looking for sturdy patio furniture that handles snow rain and sun without falling apart fast. need something comfortable for family use with good seating and a table that lasts a few seasons.

i found a patio furniture sale online but still thinking if its the right fit for canadian weather. what canadian brands have you used for outdoor sets and how did they hold up over time? any favorites for quality and easy maintenance?

reddit.com
u/ImpressiveRoll4092 — 2 months ago

How to achieve radiant and glowy skin?

I've started noticing how polished a lot of people look. Their skin looks bright and healthy, they seem in shape, dress well, and overall look refreshed all the time. Then I look at myself and feel dull in comparison, always in simple clothes and somehow looking both skinny and out of shape at the same time.

I'm trying to improve my overall appearance a bit, and honestly, I'm wondering what makes the biggest difference. Is it mostly skincare, eating better, working out, better grooming, expensive treatments, or just having more money and time?

reddit.com
u/ImpressiveRoll4092 — 2 months ago

Adoption seems beautiful but also really complicated

I’ve always thought adoption is a really meaningful thing—giving a child a stable home and a chance at a better life.

But the more I read about it, the more I realize it’s also emotionally complex for everyone involved. Identity questions, attachment issues, background stories, legal processes… it’s not just a simple decision.

reddit.com
u/ImpressiveRoll4092 — 2 months ago

Our site is next to an active construction zone. Who is responsible if their crane drops something on our house?

we bought our first home six months ago in suburban Melbourne. Great little place,only problem is the block next door just got sold and theyve started digging for a three storey townhouse development.

Im not a NIMBY type do whatever you want with your land. but Im worried watching these guys work. crane swings right over our back fence line. weve already had a few bits of timber and a busted brick land in our yard. nothing hit the house yet but feels like its just a matter of time.Ive got kids who play in the backyard. started keeping them inside when the crane is active. Thats not a long term solution. spoke to the site supervisor last week. He was polite enough said we take safety seriously mate don't worry. when I asked about their insurance or what happens if something damages our roof he just shrugged and said talk to the head office. So here I am guuys.

If their crane drops a concrete bucket through my bedroom ceiling who actually pays for that? do I claim on my own home insurance and let them chase the builder? or do I go straight to the builders public liability? curious if I have any right to ask for proof of their safety systems or insurance before something happens. or am I just supposed to wait until my house gets crushed and then fight it out? safety consultant tell me that site supervisors often have no idea about liability for neighbouring properties. their responsibility under WHS laws extends beyond their fence line to anyone who could be affected by their work. That includes my kids in the backyard.

anyone here been through this? did your insurance cover it or did you have to fight the builder? what would you do in my situation. any tips on documenting stuff should I be filming the crane ops every day? taking photos of debris? writing down dates and times of near misses.appreciate any advice from people who've dealt with nightmare neighbours or dodgy builders. thanks boys

reddit.com
u/ImpressiveRoll4092 — 2 months ago
▲ 332 r/Parenting

Finally figured out the "one bite" rule and it actually worked

I’ve been fighting the dinner battle with my 4-year-old for what feels like a century. Every night was a standoff over broccoli or anything that wasn't a chicken nugget. I finally stopped begging and started the "no-thank-you bite." Basically, you have to try one tiny bite, and if you hate it, you can say "no thank you" and we move on. No pressure, no drama, just a tiny taste test.

To my absolute shock, it actually worked. Last night, he tried the roasted carrots, made a face, but then realized they tasted like honey and ended up clearing his plate. I feel like I just won the parenting lottery. If you're currently hiding veggies in smoothies or losing your mind at 6:00 PM, give this a shot. It turns out that giving them a tiny bit of control makes a massive difference!

reddit.com
u/ImpressiveRoll4092 — 2 months ago