Reading Chapter 12:
Treatment and relapse prevention:
- 1960- 1980
- Therapeutic communities
- Addicts helping addicts
- Group therapy and 12 steps
- Same guidelines as individual counseling
- Provides a positive and safe environment to explore individual and interpersonal issues.
- Counselors who are trained and experienced in the field of addiction lead therapy
- Most widely used approach for recovery from alcoholism and drug addiction is self help
groups (Ex. AA, it is believed that will power is not enough to keep you from using)
- This type of recovery (self –help groups) allow people to support each other through
- Social support empowers people to better themselves; this is a strong factor in recovery.
- Explicit Perspective
- Primary Therapist
- Peers and staff
- Social and psychological change
- Being expanded to physicians instead of just methadone treatment centers.
- Synthetic opioid used to treat opiate addiction/ used to treat withdrawal symptoms of
- Don’t get a high from this it just gives your body what it’s used to getting from the drug
- Used during detox and maintenance
- Crisis- oriented, used for detox and overdose
- Drop- in counseling centers, community based, usually found in low- income
Changes in the 80’s:
- There was a cocaine epidemic
- High risk of aids
- Treatment turned into 90+ days
- Started looking at things such as :
- Eating disorders
- Family systems
- Gambling Alcoholics Anonymous:
- Dry drunk: someone who is abstaining from alcohol but is unaware of the problems
with the relationships, which surround them. Behavior patterns are very similar to when
they are drinking.
- AA has both open meetings and closed meetings
- Everything that goes on at alcoholics anonymous is kept completely confidential
- Their cant be any romantic involvement
- Different types of meetings, Speaker meetings, Discussion meetings, step meetings,
- Created as a alternative to AA and other self help meetings.
- Major focus is changing the way people think and feel about themselves.
- Taught to take control of emotions so you don’t have to reach for the anesthetic.
- Addictive voice recognition technique (AVRT)
- “Beast brain” and the “Healthy adult brain”
- For- profit motive
Stages of alcohol/ drug recovery:
- Feeling very emotional, feeling depressed
- Patients require education and direction during this phase
- Once people go through initial physical withdrawal they usually want to leave so they
don’t have to del with the emotional side.
- Opposite of withdrawal
- Feel energetic, confident, and optimistic
- Cravings are reduced and mood is much improved.
- This gives clients the feeling that recovery was easier then they thought it would be and
usually this is when they stray from the program, which helps them, stay sober. This is
when the patient is most at risk to return to old ways
- Personal and interpersonal issues experience more during this phase.
- Relapse and vulnerability increases as patients start feeling strong emotional issues.
- This is a time where supportive elements of the recovery plan need to be strengthened
- Group counseling is especially helpful at this stage
- Patients have new hope of recovery not that they have moved through the wall stage.
- Achievement of being sober for this long affirms addict’s ability to be sober. Resolution stage:
- A shift to learn new skills
- Some clients may need individual relationship work.
- Might need more in-depth counseling to pinpoint other issues Counseling:
Safety and stabilizing
- Most important for counseling is that the client feels safe, and that the counseling is a
safe place for them to stabilize themselves.
- Be able to maintain sobriety and a basic sense of balance in his or her life.
- Opening up wounds in an attempt to find the deeper problem is a bad idea at this stage,
as the addict may not have the emotional strength or support system to deal with this.
- Ultimately relapse could occur from this.
- You want to work with them to strengthen their system (family system)
- You need to be an active therapist, active in conversation
- You need to help addict break through denial
- You need to concentrate of affect, recognition and modulation
- You need to help addict recognize triggers
- Learn how to modulate those feelings, to label them and tolerate them
- Model used in addictive field
- Focuses on all different areas of self
- Identifying how you are to yourself and other people
Areas such as:
- Public self (what other see, who you are to them ex. The partier)
- Private self (what other people don’t see, private thoughts, sexual practices ect.)
- Blind self (Things individual is not consciously aware of about himself/ herself)
- Discovery self (Part of you which you haven’t yet discovered)
Some Other Techniques:
- Skills training
- Stress reduction
- Anger management
- Problem solving
- Coping skills
- Communication skills
- Life management
- Work Therapy:
- Max of 10 people
- More than one therapist
- This is helpful because there’s two sets of eyes looking for problems
- Also another partner in action, having two people stand behind one theory is more
reassuring with one
- Works especially well if addicts don’t connect with one therapist they might connect
with the other
- Family treatment
- Reestablishing homeostasis
- Family systems mode
- Developing a Family commitment to recovery
- Identify enabling behaviors and counter them
- Encourage communication
- Educate the family with the family disease concept
- Changes for each member
- Relapse prevention guidelines are established
- Preventing any sort of lapse, a slip like having one drink
- A relapse is going back into full blown addictive cycle
- Successfully managing any sort of lapses
- Maintaining change is an ongoing process for addicts to choose to not engage in the
behavior, 1 day at a time sort of struggle
Causes of Relapse:
- If someone does relapse you want to look at causes of relapse, like a negative e