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

More documents

Recommendations

Info

Maintenance StageThe maintenance stage is the life-long process of continued growth and development, copingwith adult life transitions, managing routine life problems, and guarding against relapse. Thephysiology of addiction lasts for the rest of a person's life. Any use of alcohol or drugs willreactivate physiological, psychological, and social progression of the disease.The major causes of relapse during the maintenance stage are the failure to maintain a recoveryprogram and encountering major life transitions.Stuck Points in RecoveryAlthough some patients progress through the stages of recovery without complications, mostchemically dependent people do not. They typically get stuck somewhere. A Astuck point" canoccur during any period of recovery. Usually it is caused either by lack of skills or lack ofconfidence in one's ability to complete a recovery task. Other problems occur when therecovering person encounters a problem (physical, psychological, or social) that interferes withhis or her ability to use recovery supports.When recovering people encounter stuck points, they either recognize they have a problem andtake action, or they lapse into the familiar coping skill of denial that a problem exists. Withoutspecific relapse prevention skills to identify and interrupt denial, stress begins to build.Eventually, the stress will cause the patient to cope less and less well. This will result in relapse.The Developmental Model of Recovery Compared WithTraditional ModelsTraditional models of treatment are based on the idea that once a person is detoxified, he or shecan fully participate in the treatment process. Although this is true for many patients in the earlystages of addiction who have had functional lives before their addiction progressed, it is not truefor most of the criminal justice population. In addition, most traditional programs have aprogram format that is applied to all people regardless of their education, personality, or socialskills. Patients whose needs fit within the program usually do well. But those whose needs do notfit, such as criminal justice patients, generally do not do well.The DMR recognizes that there are abstinence-based symptoms of addiction that persist well intothe recovery process. These symptoms are physical and psychological effects of the disease ofchemical dependency. In the DMR, these symptoms must be stabilized and the patient must betaught how to manage them before general rehabilitation can take place. This model identifiesthe specific symptoms that a patient needs to overcome.This model also contains methods and techniques that recognize the learning needs,psychological problems, and social skills of the patient.
Post Acute WithdrawalSome of the symptoms of withdrawal from alcohol or drugs are the result of the toxic effects ofthese chemicals on the brain. These symptoms are called Post Acute Withdrawal (PAW). PAWis more severe for some patients than it is for others. Other factors cause stress that aggravatesPAW. Below is a list of conditions affecting the criminal justice population that tend to worsenthe damage and aggravate PAW.Physical conditions that worsen PAW through increased brain damage or disrupted brainfunction:Combined use of alcohol and drugs or different types of drugsRegular use of alcohol or drugs before age 15 or abusive use for a period of more than 15 yearsHistory of head trauma (from car accidents, fights, falling, etc.)Parental use of alcohol or drugs during pregnancyPersonal or family history of metabolic disease such as diabetes or hypoglycemiaPersonal history of malnutrition, usually due to chemical dependencePhysical illness or chronic pain.Psychological and social conditions that worsen PAW:Childhood or adult history of psychological trauma (participant in or victim of sexual or physicalviolence)Mental illness or severe personality disorderHigh stress lifestyle or personalityHigh stress social environment.Addictive PreoccupationThe other major area of abstinence-based symptoms is addictive preoccupation. This consists ofthe obsessive thought patterns, compulsive behaviors, and physical cravings caused oraggravated by the addiction. These behaviors become programmed into the patient'spsychological processes by the addiction. They are automatic and can cause the recoveringpatient to return to use unless he or she has specific training to identify and interrupt them.Addictive preoccupations are activated by high-risk situations and stress. Because of theenvironment surrounding most criminal justice patients, they often experience high-risksituations and stress. These situations and stresses can includeExposure to alcohol or drugs or associated paraphernaliaExposure to places where alcohol or drugs are usedExposure to people with whom the patient has used in the past or people the patient knowswho are actively usingLack of a stable home environmentLack of a stable social environmentLack of stable employment.
Page 1: Counselor's Manual for Relapse Prev
Page 4 and 5: Criminal behaviors. Chemical depend
Page 6: Transition StageThe transition stag
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 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
Page 80 and 81:
. .. .. .. .6. Adult Work. .. .. ..
Page 82 and 83:
Purpose. There are many ways you ca
Page 84 and 85:
it, but the feelings do not go away
Page 86 and 87:
___ 39. Deep resentments: I feel an
Page 88 and 89:
Phase II: External Dysfunction: In
Page 90 and 91:
___ 30. Believing "just this time":
Page 92 and 93:
A. TitleB. Write the words you unde
Page 94 and 95:
3. Write down any new thoughts, fee
Page 96 and 97:
H. The next thing I felt wasI. The
Page 98 and 99:
9. Finish the following sentence fi
Page 100 and 101:
5. Warning Sign:Summary Title:6. Wa
Page 102 and 103:
14. Warning Sign:Summary Title:Revi
Page 104 and 105:
Warning Sign Sentence:5. Summary Ti
Page 106 and 107:
14. Summary Title:Warning Sign Sent
Page 108 and 109:
3. When this warning sign happened
Page 110 and 111:
Summary Title of the Warning Sign _
Page 112 and 113:
B. High-Risk Situation:C. High-Risk
Page 114 and 115:
5. Critical High-Risk Situations: A
Page 116 and 117:
E.F.G.H.I.J.Exercise No. 19: Combin
Page 118 and 119:
2. List the injunctions you think m
Page 120 and 121:
2. The worst that can happen?3. Mos
Page 122 and 123:
If I change the way I think, I will
Page 124 and 125:
If I change the way I think, I will
Page 126 and 127:
A.B.C.4. List three ways that you c
Page 128 and 129:
E. What I will do in the future to
Page 130 and 131:
People who will help me with this p
Page 132 and 133:
Purpose: Make as many copies of thi
Page 134 and 135:
2. How did you handle them? How did
show all

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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?