OT Interventions and Substance Abuse

Transcription

1 OT Interventions and Substance Abuse By Rick Klimowicz, MDiv MHS OTR/L Objectives Consider a recent narrative review on psychosocial OT interventions for Substance Use Disorders Consider how to adapt or evolve your behavioral health OT program to enhance functional independence and occupational performance for individuals with Substance Use Disorders Consider evidence-based interventions, which fall within the scope of OT for SUD treatment Considering facilitating or co-facilitating special groups on Making Choices: Substances and You and on Recognizing and Responding to Relapse Consider 12 Step vs SMART Recovery Philosophy and Practices when designing and implementing activities to facilitate abstinence

2 Psychosocial Occupational Therapy Interventions for SUDs Catrinna R. Amorelli s recent narrative review of articles published by psychosocial OT s and by an allied health professional, that discusses OT performing the intervention (OT in Mental Health, 2016, Vol. 32, No ) In the 10 studies Occupational Therapists worked with individuals to agree-upon what life skills they needed to remain abstinent and what additional tools they had at their disposal to prevent addiction relapse. But the life skills and the additional tools varied some according to population and setting Residential programs Supportive housing community Halfway house Recovery center An outpatient psychiatric facility An inpatient forensic psychiatric ward A prison A Sample Comparison Halfway House Stress management Anger management Behavior modification Work exploration and skill building Leisure exploration Parenting skills Transitional Living Center Career counseling Pain management Nutrition Goal setting

3 The Need for Further Research Effectiveness of the Living Skills Recovery Curriculum on Dual Diagnosis Clients by Pat Precin, Phd, PsyaD,OTR/L, NCPSYA, FAOTA Evidence-Based Interventions, which fall within the scope of OT for SUDs treatment Brief intervention Cognitive behavioral therapy* Motivational strategies* 12 step programs* Harm reduction Community reinforcement approaches

4 Making Choices: Substances and You and Recognizing and Responding to Relapse 2 workshops available on-line from Lilly Pharmaceuticals Team Solutions Making Choices: Substances and You Week One How Substances Affect People Alley by John M. The Bar by a convict serving a life term Your Door to Recovery Substances and Mental Illness Effects of Substance Use on Mental illness Co-Occurring Disorders Psychiatric Symptoms Dual Recovery Anonymous Behavioral Addictions (new dependencies) GA, OA, LSA, WA Compulsive spending or recklessness associated with Mania? Week Two Common Reasons for Using Substances relapse thinking, early warning signs, being prepared, lifestyle change The Effects of Substances Relationships, functioning, financial-legal, housing, health and safety Name that Stage Substance Use and Goals Choosing New Ways to Have Fun My Activity Plan and Fun Things to Do Getting High, Without Alcohol or Street Drugs (natural highs) Leisure Counseling Staying Away from Substances There s a Hole in My Sidewalk by Portia Nelson Ways to Maintain Sobriety and the Serenity Prayer

5 Week Three Having Meaningful Roles in Life Getting Support to Stay Sober Coping with Internal and External Triggers Socializing Sober & Planning a Safe Holiday Party Coping with Uncomfortable Feelings Anxiety & Worry, Anger, Boredom, Depression, Emptiness, Guilt & Shame, Loneliness Emotions Worksheet Sand in the Engine of Recovery Finding Healthier Coping Skills Drugs, Alcohol and Anger Myths about anger, the aggression cycle, relapse potential, domestic violence Assertiveness, thought stopping, ABCDE Model, conflict resolution, anger control plan Week Four Finding Sober Friends Spending More Time with People Who Are Sober Let s Pretend a Healthy Friend (not a family member) Improving Friendship Skills Managing High-Risk Situations Refusing to Use Dealing with Boredom or Nothing to Do Coping with Cravings to Use Anti-Social Behavior Planning for a Sober Lifestyle & Looking Ahead My Healthy Coping Strategies My Accomplishments My Personal Hopes and Dreams Using My Free Time in Healthy ways Week Five (extra) Preventing Addiction Relapse Maintaining Sobriety Planning a Sober Lifestyle Surveying Alcohol and Other Specific Drugs of Abuse Considering Substance Abuse Programs

6 Recognizing and Responding to Relapse Week One What Does Relapse Mean? What Does Addiction Relapse Look Like to Me? Components of Recovery The Personal Cost of Relapse Medication Changes Can Cause a Relapse Substances Make Relapse More Likely About Multiple Substance Abuse Street Drugs May Cause or Exacerbate Hallucinations Too Much Stress Can Lead to Relapse Looking Out for Symptoms and Avoiding Hospitalization Week Two Health, Wellness, and Relapse Reducing Your Risk of Relapse A Recovery Lifestyle How to deal with dangerous people, places and things Medication Adherence Stress and Stimulation Management (bored vs. overwhelmed) A Nontoxic Home Environment A Sample Recovery Plan Week Three Recognizing Relapse Understanding the Relapse Process Monitoring Your Symptoms On your own and with your clinician or treatment team Dangers of Ignoring Relapse Stages of Change A Summary of Treatment Needs and Strategies Gaining Independence from Your Addiction Post Acute Withdrawal Syndrome Where Are You in Your Recovery Process? Responding to Relapse Controlling Cravings Thought Stopping Asking for Help

7 Week Four Help That You Prefer Phone Numbers and Websites Support Groups Getting the Most Out of Treatment Answers to Common Questions Ace the Quiz Tic-Tac-Dope, and Substance Abuse Recovery Bingo Questions What s the Matter When You Are Feeling Best 90 Tools for Sobriety 12 Step Philosophy and Practices

8 Week One Identifying Warning Signs and Handling a Lapse or Slip Preventing a Full Relapse Abstinence Places, People, and Dealing (vs. people, places and things) 12 Step Meetings Keeping in Touch HALT Working the Steps Phrases and Prayers Literature and DVD s Week Two Chemical Dependency Leading Up to Drinking and Drugging Exploring AA and NA Tools of Recovery Sponsor The 12 Steps & 12 Traditions Higher Power Getting and Keeping Commitments Personal Stories The 12 Step Journal Week Three Your 5 Senses Triggering Your Disease Past & Present Understanding of Higher Power 5 Life Areas Affected by Addictive Behavior Lifestyle Balance Grief Counseling Assessing Tangible and Intangible Losses Grieving the Substance and Filling the Empty Void Pleasurable Activities The Real You (without chemicals) Medicating Emotions

9 Week Four Staying Clean and Sober 12 Step Programs (AA, NA, CA) Faith Based Services (celebrate recovery) Evidence-Based Recovery (SMART) Recovery Clubs and Clubhouses Week Five (extra) Substance Use as A Family Disease Al Anon/ Alateen Family Groups Adult Children of Alcoholics Co-Dependency (CoDA) Improving Relationships SMART Recovery Philosophy and Practices

10 Screenings and Evaluations Alcohol, Marijuana, Cocaine, and Heroine

11 A Second Degree or Certification Some Recommended Publications Books and Pamphlets on 12 Step Philosophy and Practice CBT Workbooks Hazelton Publications The Illness Management and Recovery Workbook from SAMSHA Website The Recovery Book by Mooney, Eisenberg, and Eisenberg Scriptographic pamphlets Wellness Reproductions Workbooks