Treatment Strategies For Clients With Substance Abuse Problems

Cognitive-Behavioral Therapies:  Helps clients develop the skills to deal with their addictions (e.g. self-control, coping mechanisms, relapse prevention.)

Individual Psychodynamic/Interpersonal Therapies:  Formulation of the counseling  relationship and skill development.

Group Therapies: Gives support and encouragement and generates problem-solving strategies.

Family Therapy:  Some feel family therapy is necessary as the addiction affects the family and the family affects the addiction.

Stages of Change During Treatment

Precontemplation:  Clients are resistant and deny they have a problem.

Contemplation:  Clients are aware they have a problem and are actively wondering what they should do about it.

Preparation:  Client have taken some action, were unsuccessful, but plan to try again.

Action:  Clients are taking action and are making changes.

Maintenance:  Efforts are on relapse prevention. 

Relapse Prevention

It is estimated that 90% of all clients have a relapse within four years of treatment.

Factors that influence: Changes in lifestyle or stress reduction .

Preventative factors: Coping mechanisms and self-efficacy development.

The Counseling Process

•          Develop trust

•          Assess the problem

•          Establish goals

•          Implement a plan

•          Train for relapse avoidance or minimization

•          Termination

The Counseling Process

Structuring the Sessions:  Most counselors provide strict guidelines (e.g. come straight; do homework etc.)

Assessment:  Examples of questions that need to be answered are:

1. ü  How significant is the problem?
2. How long has the client been a user?
3. Has the client tried to stop?
4. Does the client have a another disorder?
5. How has the client been functioning socially?
   

Goal Setting:  It is usually either abstinence or controlled use.  It might also include behavioral change or lifestyle change.

Plan Implementation:  Implementation of plans to meet goals.

Relapse Prevention:  Relapses are most likely to occur within six months.  Help the client become aware of what his or her triggers for relapse are and develop a plan to deal with these.

Termination:  Termination occurs when both counselor and client feel the client can cope without the substance.

Protective Factors for Adolescents to prevent Drug Addiction

•          Nurturing home with good communication

•          Teacher commitment

•          Positive self-esteem

•          Self-control

•          Assertiveness

•          Social competence

•          Academic achievement

•          Religiosity

•          Intelligence

•          Avoiding bad peers