Counselor's Manual for Relapse Prevention With Chemically ...

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Group sessions are 2 hours in duration. Patients should be on time and plan on not leaving thesession before it is over. Smoking, eating, and drinking are not allowed in group sessions.Responsibilities of patients in the group include the following:Listen to other group members' problems.Ask questions to help clarify problems or proposed solutions.Give feedback about what you think and feel about a problem and the personal strengths yousee in the person that will help him or her solve the problem. Also give feedback about theweaknesses you see that may set the person up to fail to solve the problem.Share personal experiences with similar problems when appropriate. Self-disclosure must becarefully managed to keep the primary focus on the patient who is working on the issue.Problem-Solving Group Counseling FormatThe Preparation SessionBefore the group session begins, the counselors must prepare. Counselors meet as a group. Abrief written description of each patient (a Athumbnail" sketch) is presented, and the patient'sprogress is reviewed. An attempt is made to predict the assignments and problems that patientswill present.The Opening Procedure (5 Minutes)During the opening procedure, the counselor sets the climate for the group, establishesleadership, and helps patients warm up to the group process.The counselor enters the group room. He or she makes sure that the room is set up with a circleof upright chairs arranged close enough for the members to touch each other. The counselorgreets each member informally by talking to them before the group starts.The counselor asks the members to touch the person on either side and while doing this makeeye contact with each person in the group. He asks them to make sure the other person seesthem by nodding or giving another response.The counselor completes a centering technique (see Counseling Techniques). This is designed toget the patient in touch with himself or herself and leave nonrelated problems outside thegroup room.The counselor then takes attendance. During the attendance procedure, the counselor makeseye contact with each patient, engages in a brief social greeting, and tries to get an idea of eachpatient's attitude and mood before going on.Reactions to Last Session (15 Minutes)A reaction is a brief description of (1) what each group member thought during the last groupsession, (2) how the group member felt during the last group session, and (3) identification of thethree persons who stood out from the last session and why they were remembered.
All group members are required to give a reaction to the last session. This accomplishes a varietyof goals:It forces each patient to talk in the first phase of the group session.It breaks the tendency toward isolation and self-centeredness by forcing the patient to noticeand comment on at least three other group members. This reaction forces group involvement.It provides training in basic communication and on how to give feedback.It provides feedback to other group members about who stood out from the last session andwhy.It puts pressure on group members to recall important events from previous group sessions. Asa result, it serves as a memory training device.It tests a group member's motivation. Members who refuse to give reactions or repeat whatothers say generally have problems cooperating with other aspects of treatment.It provides an opportunity for the counselor to reflect on the last group and compare his or herpersonal memory with the group members' memories.It is important to remember that a reaction is a one-way communication. Other group membersare not permitted to comment on the reactions. If someone is upset by what another groupmember says, it is that person's responsibility to volunteer to work on the issue when the agendais set.A reaction is also a no-fault communication. There are no right or wrong reactions. The onlyfeedback the counselor and other group members generally give is on the format andcompleteness of the reaction. In other words, the group member is reporting on his or herthoughts, feelings, and at least three persons who stood out to them in the last session.A typical reaction should have three parts:What I thought about during the last group session.How I felt during the last group session.Three people that stood out to me in the last group session.A counselor must help patients by coaching their responses.Typical problems that patients will have areThey will say what they thought about or felt about the last session, instead of what theythought or felt during the last session.Example:Patient—I thought last week's session was good. (Incorrect)Counselor—You misunderstand. What I would like you to do is tell what conversations orpictures went on in your head.Patient—What I thought about during last week's session was how my drinking and drug use hasaffected my life. (Correct)
Page 1: Counselor's Manual for Relapse Prev
Page 4 and 5: Criminal behaviors. Chemical depend
Page 6: Transition StageThe transition stag
Page 9 and 10: Post Acute WithdrawalSome of the sy
Page 11 and 12: Unstabilized relapse-prone patients
Page 14 and 15: which provide specific information
Page 16 and 17: ecovery plan to determine whether h
Page 18 and 19: "When you said that, I began to thi
Page 20 and 21: Have the patient form a sentence st
Page 22 and 23: There are many models for the stage
Page 24 and 25: e assertive in setting limitsprovid
Page 26 and 27: Time-Limited or Open-Ended Group?It
Page 28 and 29: The abstinence goal. The first focu
Page 32 and 33: They will confuse thoughts and feel
Page 34 and 35: Step 3: Identification of Alternati
Page 36 and 37: Opening Procedure—PurposeEstablis
Page 38 and 39: G—GENERALIZE: "What did you learn
Page 40 and 41: they really understand each exercis
Page 42 and 43: Early Recovery Patients: These pati
Page 44 and 45: Instructions. Again, it is best to
Page 46 and 47: Exercise No. 17: Identifying High-R
Page 48 and 49: eading the cards and also carries t
Page 50 and 51: Dysfunctional: Unable to function i
Page 52 and 53: The purpose of this workbook is to
Page 54 and 55: Read This Workbook. By reading and
Page 56 and 57: ________9. Do not listen: Other peo
Page 58 and 59: Part of the Relapse Prevention Work
Page 60 and 61: personality, it is important for yo
Page 62 and 63: treat someone else badly.____ ____
Page 64 and 65: 2. Unless I really want to give up
Page 66 and 67: 1. I stopped using on _____________
Page 68 and 69: B. Problems with situations:1.2.3.4
Page 70 and 71: E. What happened to you or other fa
Page 72 and 73: C. What did alcohol or drugs help y
Page 74 and 75: C. What did alcohol or drugs help y
Page 76 and 77: D. What thoughts, feelings, problem
Page 78 and 79: Exercise No. 7: Life History Summar
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. .. .. .. .6. Adult Work. .. .. ..
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Purpose. There are many ways you ca
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it, but the feelings do not go away
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___ 39. Deep resentments: I feel an
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Phase II: External Dysfunction: In
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___ 30. Believing "just this time":
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A. TitleB. Write the words you unde
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3. Write down any new thoughts, fee
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H. The next thing I felt wasI. The
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9. Finish the following sentence fi
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5. Warning Sign:Summary Title:6. Wa
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14. Warning Sign:Summary Title:Revi
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Warning Sign Sentence:5. Summary Ti
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14. Summary Title:Warning Sign Sent
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3. When this warning sign happened
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Summary Title of the Warning Sign _
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B. High-Risk Situation:C. High-Risk
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5. Critical High-Risk Situations: A
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E.F.G.H.I.J.Exercise No. 19: Combin
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2. List the injunctions you think m
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2. The worst that can happen?3. Mos
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If I change the way I think, I will
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If I change the way I think, I will
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A.B.C.4. List three ways that you c
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E. What I will do in the future to
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People who will help me with this p
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Purpose: Make as many copies of thi
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2. How did you handle them? How did
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