Pub Date : 2019-09-01DOI: 10.1093/med-psych/9780190926670.003.0014
D. Daley, A. Douaihy
There are many paths to recovery, and mutual support programs (MSPs) are one of the most common paths taken. MSPs offer a community of recovery in which individuals with substance abuse disorders (SUDs) help and support each other in numerous ways. The most widely available MSPs are the 12-step programs of Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Cocaine Anonymous (CA), Crystal Meth Anonymous (CMA), Marijuana Anonymous (MA), and Heroin Anonymous (HA). AA and NA are available throughout the world, whereas the other 12-step programs are less accessible. Although some clients participate throughout their lives in MSPs, others use them for only a specific period of time. Clients vary in their needs for involvement in MSPs. The objectives of this chapter are to provide clients with information about mutual support programs and recovery clubs, to help clients identify drawbacks and benefits of attending MSPs and recovery clubs, and to help clients identify specific MSPs that can enhance their recovery.
{"title":"Mutual Support Programs and Recovery Clubs","authors":"D. Daley, A. Douaihy","doi":"10.1093/med-psych/9780190926670.003.0014","DOIUrl":"https://doi.org/10.1093/med-psych/9780190926670.003.0014","url":null,"abstract":"There are many paths to recovery, and mutual support programs (MSPs) are one of the most common paths taken. MSPs offer a community of recovery in which individuals with substance abuse disorders (SUDs) help and support each other in numerous ways. The most widely available MSPs are the 12-step programs of Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Cocaine Anonymous (CA), Crystal Meth Anonymous (CMA), Marijuana Anonymous (MA), and Heroin Anonymous (HA). AA and NA are available throughout the world, whereas the other 12-step programs are less accessible. Although some clients participate throughout their lives in MSPs, others use them for only a specific period of time. Clients vary in their needs for involvement in MSPs. The objectives of this chapter are to provide clients with information about mutual support programs and recovery clubs, to help clients identify drawbacks and benefits of attending MSPs and recovery clubs, and to help clients identify specific MSPs that can enhance their recovery.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124793154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1093/med-psych/9780190926717.003.0003
D. Daley, A. Douaihy
Screening is a process used to identify individuals who may be at risk for a substance use problem by having them answer a few questions about their use of alcohol, tobacco, or other drugs. An extensive assessment of substance use disorders (SUDs) requires a multidimensional approach and differs from other mental health assessments in that detailed information is obtained on patterns of alcohol or other drug use, negative consequences of use, physiological and behavioral dependence, cognitive impairment, motivation for change, potential effects of substances on psychiatric disorders, attitudes and beliefs about continued use and abstinence, and the client’s strengths, resources, and social support networks. Diagnosis determines whether a client meets criteria for a SUD, which in turn may affect treatment planning and access to services. The best approach to diagnosis is through a comprehensive clinical interview and identifying criteria that match a client’s symptomatology.
{"title":"Screening, Assessment, and Diagnosis","authors":"D. Daley, A. Douaihy","doi":"10.1093/med-psych/9780190926717.003.0003","DOIUrl":"https://doi.org/10.1093/med-psych/9780190926717.003.0003","url":null,"abstract":"Screening is a process used to identify individuals who may be at risk for a substance use problem by having them answer a few questions about their use of alcohol, tobacco, or other drugs. An extensive assessment of substance use disorders (SUDs) requires a multidimensional approach and differs from other mental health assessments in that detailed information is obtained on patterns of alcohol or other drug use, negative consequences of use, physiological and behavioral dependence, cognitive impairment, motivation for change, potential effects of substances on psychiatric disorders, attitudes and beliefs about continued use and abstinence, and the client’s strengths, resources, and social support networks. Diagnosis determines whether a client meets criteria for a SUD, which in turn may affect treatment planning and access to services. The best approach to diagnosis is through a comprehensive clinical interview and identifying criteria that match a client’s symptomatology.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133009489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1093/med-psych/9780190926717.003.0021
D. Daley, A. Douaihy
Progress in recovery is measured according to the client’s goals. It is helpful for clients to periodically review their progress and check it against their goals. This helps clients see if they are making progress and to identify new goals and recovery strategies. Viewing progress realistically helps improve client motivation to continue working toward recovery and reinforces positive changes, no matter how small. In some cases, progress is significant and obvious. In other instances, it has to be measured in small changes. Progress can be measured in terms of cessation or reduction of substance use as well as in improvement in other areas of life or quality of life. The objectives of this chapter are to help clients evaluate progress against goals identified in their change plan, to help clients be realistic about ways in which to measure progress, and to help clients modify all-or-none beliefs about progress in order to appreciate small changes.
{"title":"Measuring Progress","authors":"D. Daley, A. Douaihy","doi":"10.1093/med-psych/9780190926717.003.0021","DOIUrl":"https://doi.org/10.1093/med-psych/9780190926717.003.0021","url":null,"abstract":"Progress in recovery is measured according to the client’s goals. It is helpful for clients to periodically review their progress and check it against their goals. This helps clients see if they are making progress and to identify new goals and recovery strategies. Viewing progress realistically helps improve client motivation to continue working toward recovery and reinforces positive changes, no matter how small. In some cases, progress is significant and obvious. In other instances, it has to be measured in small changes. Progress can be measured in terms of cessation or reduction of substance use as well as in improvement in other areas of life or quality of life. The objectives of this chapter are to help clients evaluate progress against goals identified in their change plan, to help clients be realistic about ways in which to measure progress, and to help clients modify all-or-none beliefs about progress in order to appreciate small changes.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128149033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1093/med:psych/9780195307733.003.0002
D. Daley, A. Douaihy
This chapter provides an overview of substance use, substance use disorders (SUDs), and co-occurring disorders (CODs, or SUDs combined with psychiatric illness). The authors address current trends in substance use, challenges for practitioners, the importance of a therapeutic alliance with clients, causes and effects of SUDs, classification of SUDs based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and specific symptoms of a SUD. A substance problem exists when an individual experiences any difficulty or adverse effect caused by the use of alcohol, tobacco, or other drugs. These include illicit street drugs and prescription drugs with addiction potential used for pain, anxiety, sleep, and attention deficit disorder.
{"title":"Understanding Substance Use Problems","authors":"D. Daley, A. Douaihy","doi":"10.1093/med:psych/9780195307733.003.0002","DOIUrl":"https://doi.org/10.1093/med:psych/9780195307733.003.0002","url":null,"abstract":"This chapter provides an overview of substance use, substance use disorders (SUDs), and co-occurring disorders (CODs, or SUDs combined with psychiatric illness). The authors address current trends in substance use, challenges for practitioners, the importance of a therapeutic alliance with clients, causes and effects of SUDs, classification of SUDs based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and specific symptoms of a SUD. A substance problem exists when an individual experiences any difficulty or adverse effect caused by the use of alcohol, tobacco, or other drugs. These include illicit street drugs and prescription drugs with addiction potential used for pain, anxiety, sleep, and attention deficit disorder.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128862594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1093/med:psych/9780195307733.003.0010
D. Daley, A. Douaihy
Helping clients to become aware of and challenge thoughts of using substances reduces the risk of relapse and raises the client’s level of self-confidence. Clients who experience a high-risk relapse situation and have positive thoughts of using are more vulnerable to taking a drink, smoking, or using other drugs. This is especially true if the client has little confidence in his or her ability to manage thoughts of using. The objectives of this chapter are to help the client become aware of how thoughts of using substances can contribute to relapse, to help the client identify common thoughts and apparently irrelevant decisions that precede substance use, and to help the client learn strategies to manage and challenge thoughts of using alcohol, tobacco, or other drugs.
{"title":"Managing Thoughts of Using Substances","authors":"D. Daley, A. Douaihy","doi":"10.1093/med:psych/9780195307733.003.0010","DOIUrl":"https://doi.org/10.1093/med:psych/9780195307733.003.0010","url":null,"abstract":"Helping clients to become aware of and challenge thoughts of using substances reduces the risk of relapse and raises the client’s level of self-confidence. Clients who experience a high-risk relapse situation and have positive thoughts of using are more vulnerable to taking a drink, smoking, or using other drugs. This is especially true if the client has little confidence in his or her ability to manage thoughts of using. The objectives of this chapter are to help the client become aware of how thoughts of using substances can contribute to relapse, to help the client identify common thoughts and apparently irrelevant decisions that precede substance use, and to help the client learn strategies to manage and challenge thoughts of using alcohol, tobacco, or other drugs.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133334449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1093/med-psych/9780190926717.003.0001
D. Daley, A. Douaihy
Chapter 1 provides an introduction to the practitioner guide and the corresponding client workbook, outlining the sessions and topics to be covered. There are many different types of substance use problems in terms of severity and adverse effects on the client, family, and significant others. Therefore, treatment will be more effective if the approach is tailored to the needs and problems of each client. A challenge for practitioners is to adapt treatment strategies for each client to address the substance use problem and other medical, psychiatric, family, or social problems.
{"title":"Introductory Information for Practitioners","authors":"D. Daley, A. Douaihy","doi":"10.1093/med-psych/9780190926717.003.0001","DOIUrl":"https://doi.org/10.1093/med-psych/9780190926717.003.0001","url":null,"abstract":"Chapter 1 provides an introduction to the practitioner guide and the corresponding client workbook, outlining the sessions and topics to be covered. There are many different types of substance use problems in terms of severity and adverse effects on the client, family, and significant others. Therefore, treatment will be more effective if the approach is tailored to the needs and problems of each client. A challenge for practitioners is to adapt treatment strategies for each client to address the substance use problem and other medical, psychiatric, family, or social problems.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123871416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-01DOI: 10.1093/med:psych/9780195307733.003.0019
D. Daley, A. Douaihy
Even if clients are working toward total abstinence, they should be prepared to handle setbacks. Many clients who attempt to quit substance use will use again. Knowing how to interrupt a lapse or relapse can help clients minimize the damage associated with a return to substance use. Lapses and relapses can be viewed as opportunities to learn from mistakes. Clients can use them to get back on track, change their recovery plan, or focus on learning new skills. How a client responds to an initial lapse plays a significant role in whether the lapse leads to a relapse. Clients who lapse and then judge themselves harshly as failures or have strong feelings of demoralization are at risk for continuing to use substances. The objectives of this chapter are to help the client identify strategies to interrupt an actual lapse or relapse, to raise the client’s awareness of her or his emotional and cognitive reactions to a lapse and how these reactions may lead to a relapse, and to complete a “relapse debriefing” to help the client learn from a lapse or relapse.
{"title":"Relapse Management","authors":"D. Daley, A. Douaihy","doi":"10.1093/med:psych/9780195307733.003.0019","DOIUrl":"https://doi.org/10.1093/med:psych/9780195307733.003.0019","url":null,"abstract":"Even if clients are working toward total abstinence, they should be prepared to handle setbacks. Many clients who attempt to quit substance use will use again. Knowing how to interrupt a lapse or relapse can help clients minimize the damage associated with a return to substance use. Lapses and relapses can be viewed as opportunities to learn from mistakes. Clients can use them to get back on track, change their recovery plan, or focus on learning new skills. How a client responds to an initial lapse plays a significant role in whether the lapse leads to a relapse. Clients who lapse and then judge themselves harshly as failures or have strong feelings of demoralization are at risk for continuing to use substances. The objectives of this chapter are to help the client identify strategies to interrupt an actual lapse or relapse, to raise the client’s awareness of her or his emotional and cognitive reactions to a lapse and how these reactions may lead to a relapse, and to complete a “relapse debriefing” to help the client learn from a lapse or relapse.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121371076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-06-01DOI: 10.1093/MED:PSYCH/9780195307733.003.0014
D. Daley, A. Douaihy
Healthy and supportive relationships with family, friends, and peers or other recovering individuals offer many potential benefits. The pressure to use substances decreases, the tendency to isolate oneself lessens, there are opportunities to reach out for help and support in times of stress or need, and there are opportunities to share mutual interests or experiences. Organizations can also be a major part of a client’s recovery support system. There are, however, numerous barriers to asking for help and support. The objectives of this chapter are to review the client’s social support system to identify the nature of current relationships, to identify the benefits of a recovery support system, to identify specific individuals and organizations that the client can include in his or her support network, and to help the client become aware of and overcome barriers to asking for help and support.
{"title":"Building a Recovery Support System","authors":"D. Daley, A. Douaihy","doi":"10.1093/MED:PSYCH/9780195307733.003.0014","DOIUrl":"https://doi.org/10.1093/MED:PSYCH/9780195307733.003.0014","url":null,"abstract":"Healthy and supportive relationships with family, friends, and peers or other recovering individuals offer many potential benefits. The pressure to use substances decreases, the tendency to isolate oneself lessens, there are opportunities to reach out for help and support in times of stress or need, and there are opportunities to share mutual interests or experiences. Organizations can also be a major part of a client’s recovery support system. There are, however, numerous barriers to asking for help and support. The objectives of this chapter are to review the client’s social support system to identify the nature of current relationships, to identify the benefits of a recovery support system, to identify specific individuals and organizations that the client can include in his or her support network, and to help the client become aware of and overcome barriers to asking for help and support.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127295391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-06-01DOI: 10.1093/med:psych/9780195307733.003.0005
D. Daley, A. Douaihy
There are many counseling approaches, treatment programs, and psychosocial interventions for individuals with substance use disorders (SUDs). Although some have been shown in clinical trials to be more effective than others, to date there is no single, superior treatment approach appropriate for all clients. While brief treatments have been successful with alcohol problems, longer term treatments are often needed for drug problems. For clients with more severe SUDs, long-term involvement in professional treatment (including medication-assisted therapies), mutual support programs, or both may be needed. This chapter includes a summary of treatment principles and guidelines that can serve as a framework for helping clients with SUDs.
{"title":"Psychosocial Therapies for Substance Use Disorders","authors":"D. Daley, A. Douaihy","doi":"10.1093/med:psych/9780195307733.003.0005","DOIUrl":"https://doi.org/10.1093/med:psych/9780195307733.003.0005","url":null,"abstract":"There are many counseling approaches, treatment programs, and psychosocial interventions for individuals with substance use disorders (SUDs). Although some have been shown in clinical trials to be more effective than others, to date there is no single, superior treatment approach appropriate for all clients. While brief treatments have been successful with alcohol problems, longer term treatments are often needed for drug problems. For clients with more severe SUDs, long-term involvement in professional treatment (including medication-assisted therapies), mutual support programs, or both may be needed. This chapter includes a summary of treatment principles and guidelines that can serve as a framework for helping clients with SUDs.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127806930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2006-06-01DOI: 10.1093/med:psych/9780195307733.003.0007
D. Daley, A. Douaihy
Motivation is a dynamic process that is affected by interpersonal interactions. A fundamental component of treatment is to strengthen the client’s motivation for change. The objectives of this chapter are to introduce the client to the concept of stages of change and motivation for change, to help the client identify his or her current stage of change and the issues to address in recovery, to review strategies to help the client deal with low motivation, and to identify therapy-sabotaging behaviors and positive coping strategies.
{"title":"Stages of Change and Using Therapy or Counseling","authors":"D. Daley, A. Douaihy","doi":"10.1093/med:psych/9780195307733.003.0007","DOIUrl":"https://doi.org/10.1093/med:psych/9780195307733.003.0007","url":null,"abstract":"Motivation is a dynamic process that is affected by interpersonal interactions. A fundamental component of treatment is to strengthen the client’s motivation for change. The objectives of this chapter are to introduce the client to the concept of stages of change and motivation for change, to help the client identify his or her current stage of change and the issues to address in recovery, to review strategies to help the client deal with low motivation, and to identify therapy-sabotaging behaviors and positive coping strategies.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129207081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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