Sunday, December 22, 2013

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

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
          Social competence
          Academic achievement
          Avoiding bad peers

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