Traditional Program Overview

I. Addiction/Alcoholism Defined

• Definition
• Addiction is a condition in which a person develops bio-psycho-social dependence on any mood-altering substance.
• Addicts use for the effects or short-term gratification.
• The addicted person uses the drug to relieve the pain created by using the drug.
• Factors
• Hereditary: Genetic factors.
• Developmental: Childhood neglect, physical, emotional, and/or sexual abuse.
• Environmental: Drug use and accompanying behaviors.
• Mood Disorders/Personality Disorders/Substance Abuse.
• Progression of Dependency
• Short-Term Gratification
• Long-Term Pain
• Addictive Thinking
• Increases Tolerance
• Loss of Control
• Bio-psycho-social Damage
• Drug Classification/Drugs of Abuse
• Depressants
• Stimulants
• Narcotics
• Marijuana
• Hallucinogens
• Inhalants
• Psychopharmacology
• Neurotransmitters and brain chemistry
• Physical withdrawal vs. mental 

II. Recovery Dynamics

• History
• Beginnings of AA and the origin of the steps.
• Treatment
• 12-Step fellowships
• Recovery Stages
• Pre-treatment: Recognizing the problem
• Stabilization: Withdrawal and Crisis management.
• Early Recovery: Acceptance and non-chemical coping
• Middle Recovery: Balanced Living
• Late Recovery: Personality Change
• Maintenance: Growth and Development

• Powerlessness and Unmanageability
• Define powerlessness’ two components.
• mental obsession
• physical cravings
• Relate addicts’ powerlessness to family dynamics.
• Unmanageability: “The Life Circle”
• Instinct-cognitive-behavioral model

III. Family Dynamics

• Family systems: natural social systems, organized power structure; assigned roles, intricate forms of communication
• The Diseased family
• Denial
• Anger: displaced anger
• Bargaining
• Depression
• Acceptance

C.   Family roles: survival roles; roles can change with time

• Chief enabler
• Family hero               
• Family scapegoat
• Lost child
• Family mascot
• Family rules: 1-10
• System Dynamics
• Review chart of survival roles, predominant feelings, etc.
• Changing role behaviors
• Effects of addiction on the Family; family where chemical dependency is prevalent tend to be dysfunctional even before onset of addiction
• Codependency: the whole family becomes addicted to the dysfunctional family system.
• Codependency messages 1-25
• Resultant feelings & dynamics: stress, anger, displaced anger, denial, frustration, depression, fear, tension, rejection, blame, hurt, “no talk rules”, control issues, isolation, compulsion, mistrust, suspicion, enabling behaviors...both ways, etc.

IV. Relapse Prevention

• Developmental Model of Recovery
• Post Acute Withdrawal Symptoms
• Relapse Warning Signs
• Daily Relapse Prevention Plan
• Mistaken Beliefs About Recovery
• Functional Analysis of Triggers

V. Process Groups

• Processing of Emotions
• Interpersonal Communication
• Projection and Identification
• Social Anxiety
• Codependency
• Honesty

Types of Process Groups

• Psychotherapy groups: Checking in with clients, encouraging discussion among group members.
• Gender Groups: Clients are split into male/female and gender specific issues are processed.
• Feelings: Teaching clients to identify and positively cope with emotions.
• Letting go: Identifying situations and relationships that are impeding one’s recovery.
• Managing high stress situations: Identifying high stress situations, developing a positive coping mechanism and strategies for dealing with them successfully.
• Facades: Identifying and understanding the masks used as defensive mechanisms.
• Communication Skills: Discovering positive communication methods and developing interpersonal skills.
• CBT Cognitive Behavioral Therapy group. Understanding how thoughts produce emotions and emotions determine behaviors. Challenging maladaptive schemas.

VI. Mood Disorder Group: is an interactive psycho-educational group for the purpose of educating clients about dual diagnosis. The goal is for clients to understand and be better able to deal with the presented disorder(s). Also, the client's own strengths, resources and coping skills are reinforced, in order to avoid relapse and contribute to their own health and wellness on a long-term basis.
Example topics and processes are as follows:

• Symptoms of mood disorders such as, Depression and Bipolar, as well as other DSM-IV disorders commonly associated with Substance Abuse.
• Effect of alcohol and drug abuse on brain chemistry
• Treatment options
• Recommended behavioral solutions to increase coping skills

VII. Traditional Group: is a process group focusing on the fundamentals of AA/NA meetings and the process of working the steps. The goal is to meet clients where they are in this process and familiarize them with AA/NA program.  Clients will be given opportunity to disclose their current work on steps 1, 2, and possibly step 3, and any difficulty they may be having. Also, clients can work though ambivalence about going to meetings and getting a sponsor as recommended for aftercare.

VIII. Changes In Recovery

            This group is designed on the Transtheoretical Model of Change which allows clients to create a strategy to facilitate change. This group focuses on:

• Communication
• Effective refusals
• Relationships
• Managing thoughts and emotions
• Developing an Action Plan
• Social Support

IX. Life Skills

• Nutritional & Physical Exercise
• Employment & Finances
• Communication Skills
• Conflict Resolution
• Decision Making Skills
• Stress Management/Relaxation
• Goal Setting/Time Management
• Support Systems/Work & Family Life