Pub Date : 2006-06-01DOI: 10.1093/MED:PSYCH/9780195307733.003.0018
D. Daley, A. Douaihy
Any client who attempts to modify alcohol, tobacco, or drug use behavior faces the possibility of lapse or relapse. A lapse refers to the initial episode of use following a period of abstinence. A lapse may be quickly stopped by the client or it may lead to a relapse or continued use of a substance. How a client interprets and responds to a lapse plays a significant role in whether or not it leads to a relapse. The risk of lapse or relapse is highest in the first 3 months of recovery, when most relapses occur. Low motivation and poor participation in therapy or mutual support programs can raise the risk of relapse, even for clients who recently completed a residential or ambulatory treatment program. Other precipitants of relapse include psychiatric illness or an inability to cope with the challenges of recovery. Helping clients remain in therapy and identify and manage early relapse warning signs and high-risk situations are ways to lower the client’s risk of relapse.
{"title":"Reducing the Risk of Relapse","authors":"D. Daley, A. Douaihy","doi":"10.1093/MED:PSYCH/9780195307733.003.0018","DOIUrl":"https://doi.org/10.1093/MED:PSYCH/9780195307733.003.0018","url":null,"abstract":"Any client who attempts to modify alcohol, tobacco, or drug use behavior faces the possibility of lapse or relapse. A lapse refers to the initial episode of use following a period of abstinence. A lapse may be quickly stopped by the client or it may lead to a relapse or continued use of a substance. How a client interprets and responds to a lapse plays a significant role in whether or not it leads to a relapse. The risk of lapse or relapse is highest in the first 3 months of recovery, when most relapses occur. Low motivation and poor participation in therapy or mutual support programs can raise the risk of relapse, even for clients who recently completed a residential or ambulatory treatment program. Other precipitants of relapse include psychiatric illness or an inability to cope with the challenges of recovery. Helping clients remain in therapy and identify and manage early relapse warning signs and high-risk situations are ways to lower the client’s risk of relapse.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":"1112 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122927212","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/9780195307733.003.0008
D. Daley, A. Douaihy
Recovery is the process of managing a substance use disorder (SUD) and making changes in oneself and one’s lifestyle to improve the quality of life. Recovery involves four major dimensions: (1) health, (2) home, (3) purpose, and (4) community. The objectives of this chapter are to help the client learn that there are different paths to recovery, to help the client learn about the various domains of recovery, to help the client identify specific recovery goals, and to help the client develop strategies to reach the identified goals.
{"title":"Goal Planning in Recovery","authors":"D. Daley, A. Douaihy","doi":"10.1093/MED:PSYCH/9780195307733.003.0008","DOIUrl":"https://doi.org/10.1093/MED:PSYCH/9780195307733.003.0008","url":null,"abstract":"Recovery is the process of managing a substance use disorder (SUD) and making changes in oneself and one’s lifestyle to improve the quality of life. Recovery involves four major dimensions: (1) health, (2) home, (3) purpose, and (4) community. The objectives of this chapter are to help the client learn that there are different paths to recovery, to help the client learn about the various domains of recovery, to help the client identify specific recovery goals, and to help the client develop strategies to reach the identified goals.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123460392","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/9780195307733.003.0016
D. Daley, A. Douaihy
Co-occurring disorders (CODs) refers to the occurrence of both a substance use disorder (SUD) and a psychiatric disorder, such as mood disorder, anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, eating disorder, antisocial personality disorder, and borderline personality disorder. This chapter reviews the prevalence, patterns, and effects of CODs. Next, the relationships between psychiatric disorders and SUDs, challenges for practitioners, and types and causes of psychiatric disorders are discussed. The chapter continues with the process of conducting a comprehensive and thorough assessment using the format of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The authors also discuss the importance of conveying assessment findings to the client and/or family and concerned significant others, as well as getting the client to accept help.
{"title":"Assessment of Co-occurring Psychiatric Disorders","authors":"D. Daley, A. Douaihy","doi":"10.1093/med:psych/9780195307733.003.0016","DOIUrl":"https://doi.org/10.1093/med:psych/9780195307733.003.0016","url":null,"abstract":"Co-occurring disorders (CODs) refers to the occurrence of both a substance use disorder (SUD) and a psychiatric disorder, such as mood disorder, anxiety disorder, obsessive-compulsive disorder, posttraumatic stress disorder, schizophrenia, eating disorder, antisocial personality disorder, and borderline personality disorder. This chapter reviews the prevalence, patterns, and effects of CODs. Next, the relationships between psychiatric disorders and SUDs, challenges for practitioners, and types and causes of psychiatric disorders are discussed. The chapter continues with the process of conducting a comprehensive and thorough assessment using the format of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The authors also discuss the importance of conveying assessment findings to the client and/or family and concerned significant others, as well as getting the client to accept help.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":"40 1-10","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114048372","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/9780195307733.003.0013
D. Daley, A. Douaihy
Family stress and problems are common with substance use disorders (SUDs) and co-occurring psychiatric disorders. Family stability, parental competence, how the family communicates and functions, family mood, roles assumed by members, and family cohesion may be adversely affected by a parent’s or other member’s SUD. Parental absence, separation or divorce, violence or neglect, poverty, incarceration, and loss of a family member through death are more serious types of problems that create additional stress for family and marital systems. Individual members may experience health, mental health, and substance use problems. Friendships and other relationships are also harmed by SUDs. The objectives of this chapter are to identify the effects of the SUD on family and interpersonal relationships, to help the client identify strategies to cope with family and interpersonal problems caused by the substance use, and to help the client improve relationships and interpersonal behaviors.
{"title":"Dealing with Family and Interpersonal Problems","authors":"D. Daley, A. Douaihy","doi":"10.1093/MED:PSYCH/9780195307733.003.0013","DOIUrl":"https://doi.org/10.1093/MED:PSYCH/9780195307733.003.0013","url":null,"abstract":"Family stress and problems are common with substance use disorders (SUDs) and co-occurring psychiatric disorders. Family stability, parental competence, how the family communicates and functions, family mood, roles assumed by members, and family cohesion may be adversely affected by a parent’s or other member’s SUD. Parental absence, separation or divorce, violence or neglect, poverty, incarceration, and loss of a family member through death are more serious types of problems that create additional stress for family and marital systems. Individual members may experience health, mental health, and substance use problems. Friendships and other relationships are also harmed by SUDs. The objectives of this chapter are to identify the effects of the SUD on family and interpersonal relationships, to help the client identify strategies to cope with family and interpersonal problems caused by the substance use, and to help the client improve relationships and interpersonal behaviors.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129724360","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/9780195307733.003.0017
D. Daley, A. Douaihy
Effective treatment of clients with co-occurring disorders (CODs) requires the practitioner to be familiar with the continuum of care so that clients become engaged in services needed to address their disorders and related problems. Evidence suggests that clients receiving integrated treatment have higher rates of treatment adherence and improved clinical outcomes, particularly those with more persistent and chronic forms of psychiatric disorders. Therefore, it is best to provide integrated care that focuses on both types of disorders, regardless of whether the client is in an inpatient, residential, or ambulatory treatment setting. Given that clients with CODs have higher rates of problems with treatment adherence compared to those with a single type of disorder, this chapter reviews strategies to improve adherence. It also delineates recovery issues in the domains of physical/lifestyle, psychological, behavioral/cognitive, family/interpersonal/social, and personal growth/maintenance. The authors stress the potential helpfulness of mutual support programs and discuss clinical challenges such as suicide, violence, HIV/AIDS, and hepatitis C.
{"title":"Treatment of Co-occurring Psychiatric Disorders","authors":"D. Daley, A. Douaihy","doi":"10.1093/med:psych/9780195307733.003.0017","DOIUrl":"https://doi.org/10.1093/med:psych/9780195307733.003.0017","url":null,"abstract":"Effective treatment of clients with co-occurring disorders (CODs) requires the practitioner to be familiar with the continuum of care so that clients become engaged in services needed to address their disorders and related problems. Evidence suggests that clients receiving integrated treatment have higher rates of treatment adherence and improved clinical outcomes, particularly those with more persistent and chronic forms of psychiatric disorders. Therefore, it is best to provide integrated care that focuses on both types of disorders, regardless of whether the client is in an inpatient, residential, or ambulatory treatment setting. Given that clients with CODs have higher rates of problems with treatment adherence compared to those with a single type of disorder, this chapter reviews strategies to improve adherence. It also delineates recovery issues in the domains of physical/lifestyle, psychological, behavioral/cognitive, family/interpersonal/social, and personal growth/maintenance. The authors stress the potential helpfulness of mutual support programs and discuss clinical challenges such as suicide, violence, HIV/AIDS, and hepatitis C.","PeriodicalId":326572,"journal":{"name":"Managing Substance Use Disorder","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2006-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123500191","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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