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Substance Abuse, (• Stop, look, and listen, • Make an immediate plan…

- - - - Susceptibility Camp (Genetic/Biological)
      - Expose Camp (Illicit Substance, Disease Brain)
    - - Intervention (Prison/Jail)
    - - Drug
      - Person
      - Environment
  - - - Autonomy
      - Non-malfeasance/wrong act
      - Justice
      - Beneficence/ action taken to prevent harm
- - - - Cognitive Development
      - Behavioral Learning
      - Social Cognitive
      - Social Interdependence
  - - - Creating Enactments
      - Segmenting
      - Asking Tasks
      - Family Sculpting
      - Joining
      - Drawing
      - Solving Circle
- - - - Method for eliciting change talk
        
        Handling resistance
        
        Problem recognition
        
        Optimism
        
        Intention to change
- - - - Strengths, Limitations, and Ethical Issues Related to Group Therapy Strengths
        
        Considered standard care in substance abuse
        Based on one theoretical research base
        Cost effective
        Provides a setting to share emotions, suggestions and support
        Can be conducted using a variety of formats
        Effective at treating problems associated with addictions
  - - - Psycho-educational group
      - Skill-building groups
      - Cognitive-behavioral groups
      - Support groups
      - Interpersonal process groups
      - Linking, Blocking, Conveying focus and discipline
  - - - Limitations
        
        May not be suitable for clients who need one-on-one work
        Additional training may be needed to effectively run groups
        Leaders can become overwhelmed by the complex nature of group content and process
  - - - Ethical Issues
        
        Considerable skill and understanding is necessary to effectively implement group therapy
        Ethical issues (e.g. confidentiality) can arise within groups
        Multicultural issues
- - - - Limitations
        
        Too simplistic
        
        Limited empirical support
        
        Does not sufficiently address the physiological aspect of addiction
        
        Ethical issues
        
        Requires sufficient training
        to be used ethically
        
        Fails to take physiological aspects into account
  - - - to request a client to draw or
        write about one of the following
        
        When is the happiest you have been recently and what was different about it compared to others?
        
        Draw a picture of their miracle
        
        Something the client is great at
    - - Have a client focus on a time when they felt
        their strongest.
        
        Asking the client what strengths were
        present when things were going well.
        
        This can be an illuminating activity that helps clients focus on the strengths they
        already have inside of them.
    - - creative way to guide a client into a brainstorm
        of solutions is by mind mapping.
        
        From the center, have a client create branches of
        solutions to make that miracle happen.
        
        By exploring solution options, a client will selfgenerate and be more connected to the outcome.
    - - Client keeps track of what works from an approach
        perspective.
      - Variety of experiments is a helpful approach
      - Encourage clients to do experiments in real-life settings concerning the presenting
        problem.
  - - - "How have you managed to prevent things from becoming worse?”
      - “How have you managed to carry on?”
  - - - Figure out the client's wants
        
        Clarify and define goals
        
        Focus on the present and future
        
        Look for solutions by asking questions when the problem is not happening
        
        Pay attention to what works rather than
        what does not work
        
        Use verbs to highlight problems as changeable and
        temporary
  - - - Step two: Develop treatment goals.
        
        Make them:
        Small
        Relevant
        Start at the beginning
        Reasonable to client abilities
        
        ◦Step three: Orient the client toward a solution to substance
        use
  - - - Designed for combatting problematic drinking but is useful in all areas of change
      - State your desire for something in your
        life to be different.
        
        Envision a miracle happening, and your
        life IS different.
      - Make sure the miracle is important to you.
        
        Keep the miracle small.
        
        Use language that is positive and specific.
        
        State how you will start your journey and not how it will end.
        
        Be clear about who, where, and when, but not
        the why.
- - - - CENAPS Model of Relapse Prevention
    - - • Relapse taxonomy - According to Marlatt and Gordon's RP model, immediate determinants as well as covert antecedents may cause relapse
  - - - • Include lifestyle modification and balance, stimulus control, proper urge/craving management and relapse road maps and apparently irrelevant decisions (AIDs)
      - • Assisting clients in minimizing lapses to prevent relapses
      - • Goal is to help clients get back on track while minimising the severity of setbacks
      - • Encourage a nonconfrontational attitude and incorporate clients’ perspective in the relapse plan
  - - - Six steps:
      - • Identify the target behaviour
      - • Identify prompting events
      - • Identify vulnerability factors
      - • Link the chain of events
      - • Identify consequences of substance abuse
      - • Generate hypotheses
  - - - Strengths
- - - - Benzodiazepines + opiates (such as heroin): breathing difficulties; an increased risk of overdose and death
  - - - • Barbiturates
- - - - memory impairment
      - slower reflexes
      - increase heart rate
      - mild anxiety and paranoia
- - - - Anxiety
      - High temperature
      - Panic
    - - Talkative
      - Euphoria
      - High heart rate