SECTION II: ADDICTIONS
Therapist’s Overview
HOW MUCH DOES IT COST?
GOALS OF THE EXERCISE
1. To help break through the level of denial to addiction.
2. To increase motivation to achieve and/or maintain sobriety.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO ALCOHOL ABUSE
• It’s Us Against the Anxiety Page 38
• Creating a Positive Outlook Page 227
• What Am I Thinking? Page 128
ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL
• Activity/Family Imbalance
• Anger Management
• Blaming
• Compulsive Behaviors
• Jealousy/Insecurity
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH CLIENT
Individuals who struggle with addictive-like behaviors often justify to themselves why the behavior is okay. This exercise can be used to help individuals challenge such rationalizations and increase their awareness of reality. It can also be used with individuals who feel stuck or doubt the purpose of changing a behavior.
EXERCISE II.A
HOW MUCH DOES IT COST?
Have you ever wondered how much your behavior costs you? In addition to financial cost, addictive behavior can also cost you in many other ways. To find out how, complete the following exercise.
In any addictive process, individuals will spend time thinking about the behavior, conjuring rationalizations to try to make the behavior occur, engage in the behavior, experience the effects of the behavior, and experience the after effects. As in any situation, what one does will have an effect on those around him or her. When someone is in a bad mood, and they respond to you in a grouchy tone of voice or with short one-word answers, this will affect you. Perhaps it will make you want to respond in a similar manner. Perhaps it will make you want to leave and not be around that person. In a similar fashion, addictive behaviors affect others.
Think about the last time you engaged in your addictive behavior. Describe what the behavior was/is.
a. Approximately how much time did you spend thinking about it before you actually did it?
b. What else could you have been doing?
c. How much time did you spend doing the behavior?
d. What was your support system doing while you were engaging in your addictive behavior? (Ask them if you don’t know.)
e. How much money did it cost you?
f. What else could you have purchased with that amount of money?
g. What were the PHYSICAL effects of your addictive behavior?
h. How long did the PHYSICAL effects last?
i. What else could you have done with that time?
j. How has your addictive behavior affected you at work? Relationships:
Productivity:
Health:
Attendance:
Other:
k. How has your addictive behavior HURT your relationships with family members?
l. How has your addictive behavior HURT your relationship with friends?
m. How has your addictive behavior hurt your body?
n. How has your addictive behavior affected your decision making/choices?
Therapist’s Overview
STAYING CLEAN
GOALS OF THE EXERCISE
1. Identify triggers to relapse.
2. Provide greater understanding and insight for nonaddicted family members.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO STAYING CLEAN
• What Am I Thinking? Page 128
• Creating a Positive Outlook Page 227
ADDITIONAL PROBLEMS FOR WHICH THIS EXERCISE MAY BE USEFUL
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH CLIENT
When a member of the family has an addiction, it affects the entire family in a variety of ways. There are many ways in which family members can help the individual who is in recovery. One of the steps to recovery is for the addicted individual to identify specific triggers to substance use. After identifying these triggers, they should be shared with the family. This provides greater insight and understanding for the nonaddicted members of the family. It also helps the recovering individual begin to take control of his/her life by becoming aware of and acknowledging those factors that lead his or her behaviors to be out of control.
In the exercise that follows, the recovering member is asked to answer a number of questions. Once completed, his/her answers should be shared with the therapist during an individual session and then with other family members.
EXERCISE II.B
STAYING CLEAN
FOR THE RECOVERING FAMILY MEMBER
One of the best ways for you to prevent relapse is to become aware of the triggers to your need to use. Once you can identify these triggers, you may begin to feel more control over your life. Knowing what the triggers are can aid you in developing a stronger preventative plan to relapse. In this exercise, answer the following questions. Once completed, this exercise should be shared during an individual session with the therapist and then with other family members.
Describe the last five situations in which you used substance by answering the following questions:
3. What time of the day was it?
4. How were you feeling before you chose to get high?
5. What were you thinking about before you got high?
6. What were your thoughts/feelings about that person or those people you were with?
7. What did the substance do for you?
8. What were you able to avoid by using the substance (e.g., feelings, hassles, people, situations, responsibilities)?
9. How much do you believe others are responsible for your addictive habits?
Therapist’s Overview
WHAT ELSE CAN I DO?
GOALS OF THE EXERCISE
1. Identify alternative strategies to dealing with triggers to relapse.
2. Create reasons to remain clean.
3. List those thoughts and behaviors that you need to change.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO CLIENTS WITH AN ADDICTION
• What Am I Thinking? Page 128
• Creating a Positive Outlook Page 227
ADDITIONAL PROBLEMS IN WHICH THIS EXERCISE MAY BE USEFUL
• Eating Disorders
• School Problems
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH CLIENT
Once triggers are identified, new coping skills and strategies must be implemented to reduce the chances of relapse. Addiction is overwhelmingly powerful and can destroy individual lives and families. This cannot be emphasized enough. When an individual in recovery begins to have cravings or experience stress/triggers, the thoughts and desires to use quickly reappear. During these times individuals must be reminded of the benefits of staying clean and that other options are available for dealing with whatever problems they are encountering.
EXERCISE II.C
WHAT ELSE CAN I DO?
FOR THE RECOVERING FAMILY MEMBER AND HIS/HER FAMILY
As a family project, select a stack of index cards. Each family member should write down one or more reasons s/he doesn’t want the recovering member to relapse and how s/he feels about the recovering person when that individual is clean. The recovering member should do this as well. In the next family session, each person will take turns reading his or her card aloud.
Another way to help someone remain clean is by instituting “Caring Days.”
3 Every so often, a family member does something caring for the recovering person (as well as for any other family member). The member who is in recovery can also participate by doing something caring for him or herself as well as for someone in the family in order to invoke an ongoing exchange.
One other family project can be to use another stack of index cards or select a family member to record on a legal pad a list of activities to do when experiencing cravings/urges to engage in an addictive/compulsive behavior.
Therapist’s Overview
KEEPING BUSY
GOALS OF THE EXERCISE
1. Addicted or compulsive behavior is reduced or eliminated.
2. Family members feel that their concerns have been validated by the efforts of the addicted member to follow the activity schedule.
ADDITIONAL HOMEWORK THAT MAY BE APPLICABLE TO CLIENTS WITH AN ADDICTION
• What Am I Thinking? Page 128
• Creating a Positive Outlook Page 227
ADDITIONAL PROBLEMS IN WHICH THIS EXERCISE MAY BE USEFUL
• Depression
• Obsessive Type Behaviors
• Stealing Behaviors
SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH CLIENT
When a family member’s behavior becomes so excessive or obsessive that it interferes with their daily or weekly activities or functioning, it can be an addiction. Various inventories can be used (such as the Daily Activity Sheet or Addictive Behaviors Scale) in order to identify a level of severity. Once this is accomplished and the addictive behavior is identified, family members need the opportunity to voice their perspectives on the negative effects that the addictive behavior has had on the family in general. This can be done in a family session. Usually, family members then want the identified behavior to be eliminated or at least reduced. One way to do this is by following a structured format to regulate behaviors.
EXERCISE II.D
KEEPING BUSY
FOR THE RECOVERING FAMILY MEMBER
One way for you to reduce or to hopefully eliminate unwanted behaviors is to create a daily activity schedule. Having a daily activity schedule or action plan allows you to schedule activities that you know are good for you.
Make a list of healthy activities. This can be done with the support of others by brainstorming together as many activities as you can generate. Once you have composed a list, select several activities and schedule them for the next week. After engaging in each activity, discuss what you liked and disliked about it. If it wasn’t as good as you had hoped, describe what you could have done to improve it. Share your activity schedule and your responses to each activity with your support system.
Activities that I can choose to do:
ACTIVITY SCHEDULE FOR THE WEEK
ACTIVITY RATING CHART
Date | Activity | What was good? How could it have been better? |
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