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

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Step 3: Identification of Alternatives.What are some options for dealing with the problem? Ask the patient to list them on paper sothey can readily see them. Try to have the group come up with a list of at least five possiblesolutions. This will give them more of a chance of choosing the best solution and give themsome alternatives if their first choice doesn't work.Step 4: Projected Consequences of Each Alternative.What are the probable outcomes of each option? Have the group ask the person the followingquestions:What is the best possible thing that could happen if you choose this alternative?What is the worst possible thing that could happen?What is the most likely thing that will happen?What is your reaction (thoughts, feelings, memories, and future projections) when you thinkabout implementing that alternative?Step 5: Decision.Have the group ask the person which option offers the best outcomes and seems to have the bestchance for success. Ask them to make a decision based upon the alternatives they have.Step 6: Action.Once they have decided on a solution to the problem, they need to plan how they will carry itout. Making a plan answers the question, "What are you going to do about it?" A plan is a roadmap to achieve a goal. There are long range goals and short range goals. Long range goals areachieved along with short range goals. One step at a time.Step 7: Followup.Ask the person to carry out his or her plan and report on how it is working.Most problems will not be solved by presenting them one time in group session. Personalproblem solving is a process that requires time. It may require three to six presentations of aproblem, accompanied by specific assignments completed between group sessions to bring aproblem to full resolution. Patients should be given a limited time to present a problem or thesummary of an assignment. As a general rule, patients should not work in group for more than 20minutes.Not every person will work on a problem during each session. There is an 80/20 rule for grouptreatment. Eighty percent of the benefit of group treatment occurs from learning how to becomeresponsibly involved in helping others to solve their problems. Only 20 percent of the benefit isderived from working on personal problem issues.
FeedbackWhen you reach a point where part of the problem solving process is completed or an assignmentis presented, group members and the counselor should give feedback. The counselor should golast. Feedback should be given by having the members complete the following:My gut level reactions is . . . (A feeling, thought, or how members can identify with the patientwho presented)I think that how this affects your recovery is . . .What I think of you as a person is . . . .The purpose of this feedback exercise is to practice communication skills, learn to give and takefeedback, and use the group for problem solving. The counselor may give an assignment to thepatient if it would be helpful to continue to learn more about how to solve this issue.The Closure Exercise (15 minutes)When there is approximately 15 minutes left in the group session, the counselor will ask themembers the following:What is the most important thing you learned in group this evening? It is important to write thisdown in your notebook.What are you going to change about your behavior? Write this down in your notebook.Share with the group what you learned and what changes you are willing to make.Each participant will then briefly review his or her answers to those questions with the group.The counselor then adjourns the group.The Debriefing SessionThe debriefing session is designed to review the patient's problems and progress, preventcounselor burnout, and improve the group skills of the counselor. If this can be done with othercounselors running similar groups, it is especially helpful. A brief review of each patient iscompleted, outstanding group members and events are identified, progress and problems arediscussed, and the personal feelings and reactions of the counselor are reviewed.Outline for Group Counseling SessionsOpening Procedure—Format (5 minutes)Form a tight circle.Do physical and eye contact exercises.Do centering (breathing) exercise.Take attendance to identify moods.
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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 30 and 31: Group sessions are 2 hours in durat
Page 32 and 33: They will confuse thoughts and feel
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
Page 80 and 81: . .. .. .. .6. Adult Work. .. .. ..
Page 82 and 83: 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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