DECISIONAL BALANCING CHANGE NO CHANGE YOUR ARE HERE

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1 DECISIONAL BALANCING You are starting a treatment program that wants YOU to make the DECISIONS and take the lead. We will help you along the WAY but it is up to you to CHART your own course and stick to your RESOLUTIONS. CHANGE NO CHANGE YOUR ARE HERE THIS HANDOUT IS INTENDED TO HELP YOU: Identify situations which may lead you to abuse drugs or alcohol Become aware of the decision you make and the consequences that follow Think about the costs and benefits of your use of alcohol and other drugs Think about what is involved in your decision to change your problem alcohol or drug use

2 Before going on, it would be helpful to explain some of the terms that will be used. WEIGHING DECISIONS When you weigh decisions, you are looking at the costs and benefits of whatever you are doing whether it is deciding to go to school, deciding to get married, or deciding to stop abusing alcohol or other drugs. You may have been drinking heavily taking drugs up to because you believe the benefits of your alcohol or drug use outweigh the costs of quitting or reducing. Weighing decisions involves personal choices. What may be a benefit to you may be a cost to someone else. When weighing decisions, having mixed feelings is normal. CONSEQUENCES Consequences are the results of your drinking or drug use. Consequences can be both negative and positive. For example, in the shortterm, the use of alcohol or drugs may help you relax, but in the long run this behaviour could ruin relationships or affect your job. * * * * * * * * * * * * * * * Surprisingly, many people are able to change their alcohol or drug problem without treatment. When people who change on their own are asked what brought about the change, they often say they just thought about it. People often do things as a result of decisions they make. The following are descriptions from clients who made a decision to change and were successful: Client 1: Evaluated the pros and cons of his drinking (actually made a list, and when he finished, the list was overwhelmingly in favour of his stopping drinking): things had built up over the year work, family, healthy problems. The trigger was an incident with his son who called him the town drunk and that night he quit.

3 Client 2: Looked at the buildup of negative events she felt her life was falling apart: health, work, personal life. She realized in the year prior to the resolution of her drinking problem, that drinking was getting the best of her, it had taken her up and down. Client 3: Looked at herself in the mirror while in a sleazy bar, drunk, and realized she had to change and decided to quit abrupt evaluation of affects of her drinking on her life: selfesteem, occupationally and financially insecure, and she was turning 50. For the next three weeks she was abstinent. Then on New Year s Eve, friends persuaded her to drink and she had her one and only blackout. This scared her to death and stopped her for good from drinking. All three people evaluated the consequences of drinking (decisional balancing) before making the final decision to change their use of alcohol. This is exactly what we want you to do over the next few weeks. Look at the scales below the one in the middle is balanced. The costs and benefits of alcohol and drug use are pretty equal. This suggests that nothing is compelling the person to change their current behaviour. If you keep adding weights to either side of the scale, an imbalance will occur. To change, you need to tip the scale. You need to personally evaluate your alcohol or drug problem so the negatives of such use come to outweigh the positives. Negatives of alcohol/drug use outweigh the pluses TIME FOR A CHANGE UNSURE WHETHER TO CHANGE Pluses of alcohol/drug use outweigh stopping NOT TIME FOR CHANGE

4 This process is called DECISIONAL BALANCING. We do it all the time: weighing the pros and cons of change. For example, weigh the pros and cons of making changes in their jobs or relationships. Making decisions about whether to use alcohol or drugs or not to use them and how much, is the same as making decisions about other areas of your life. Your drinking or use of drugs has become a very part of your life and you may think that giving it up would be like giving up a good friend. You have to weigh the real benefits and costs. In DECISIONAL BALANCING ask yourself: What do I stand to lose (and gain) by continuing problem drinking or using drugs? What is a benefit to you may not be to someone else. Also, what once was a benefit may be a cost. At some point you may have received real benefits from your problem drinking or drug use relaxation, fun, stress reduction. However, since you are reading this handout, you are reconsidering these benefits and focusing on the costs of your behaviour. You are the only one that can decide what the cost is to you. To change is your choice What will it take for you to tip the scale and change your problem drinking or drug use? You have to decide when enough is enough!

5 During decisional balancing, expect to have mixed feelings. Feeling uncertain is normal. Change should be thought of as longterm. Throughout your journey towards your (i.e. no further drinking or drug problems), you can expect to encounter many crossroads where a decision has to be made. All individuals embarking on change will encounter challenges to their resolutions. Like New Year s resolutions, some challenges are resisted, and some are not. The thing is your strength of commitment to your resolution. PRACTICE CHANGING Now you should be ready to identify the benefits and costs of your alcohol or drug use. Over the next couple of days set aside a few hours to carefully examine the pros and cons of your use of alcohol or drugs. Choose a time when you will not be disturbed or distracted, and when you can seriously and honestly list the pros and cons of your drinking and drug use. If you are feeling a bit uncertain, it s okay. Relax, take your time and don t rush through this exercise. Your drug or alcohol problem didn t develop overnight it may take awhile to examine the costs and benefits. When you have decided that you are ready, complete the attached Homework Assignment.

6 DECISIONAL BALANCING EXERCISE REASONS FOR CHANGE EXERCISE The most reasons why I want to change my problem use of alcohol or drugs are:

7 DECISION TO CHANGE EXERCISE One of the things that might help you make a change in your drinking or drug use is listing all of the benefits and the costs that relate to changing your drinking or drug use as well as the benefits and costs of continuing your alcohol or drug use. Use the chart below to list the benefits and costs of changing your drinking or drug use and the benefits and the costs of continuing to use alcohol or drugs. CHANGING MY CURRENT ALCOHOL OR DRUG USE CONTINUING TO USE ALCOHOL OR DRUGS IN A PROBLEMATIC MANNER BENEFITS OF: COSTS OF:

8 GOAL STATEMENT ALCOHOL PART 1 What is your? To not drink at all? To drink, but only in certain ways and under certain conditions? My current is (Check either Box 1 or Box 2): Box 1 NOT TO DRINK AT ALL (If you checked this go to Part 2 on the next page.) OR Box 2 TO DRINK IN CERTAIN WAYS (If you intend to drink in certain ways, you should k that: 1 standard drink is equal to v 12 oz. of beer (45%) v 11/2 oz. of liquor or spirits v 5 oz. of table wine (1112%) v 3 oz. of fortified wine (20%) If your is to drink in certain ways, please complete the following four statements: (1) On the average day when I do drink, I plan to drink no more Than Standard drinks per day. (2) During an average week, I plan to drink on no more than days. (3) I plan to drink ONLY under the following conditions: (4) I plan NOT TO DRINK AT ALL under the following conditions: Date:

9 PART 2 People usually have several things that they would like to change in their lives. Changing their drinking can be one of those things. Please answer the next two questions with regard to the drinking you just described on the previous page. 1. At this moment, how is it that you achieve your stated? Using the following scale, answer the question by writing a number from 0 to 100 in the designated space below Not at all Less than most of the other things I would About as as most of the other things I would like to achieve More than most of the other things I would The most thing in my life I would Write your importance rating (from 0 to 100) here: 2. At this moment, how confident are you that you will achieve your stated? Using the following scale, answer the question by writing a number from 0 to 100 in the designated space below I do not think I will achieve my I have a 25% I have a 50% I have a 75% I think I will definitely achieve my Write your confidence rating (from 0% to 100%) here:

10 GOAL STATEMENT DRUG USE PART 1 Illegal drug us constitutes a risk situation, and is not recommended. However, this recommendation is not always followed. As part of your selfchange program, it is that you indicate how you intend to change your drug use. If you intend to gradually reduce your drug use rather than discontinue immediately, it is that you specify the limits and conditions you place on your reduction. My primary drug is What is your? Is it to stop immediately, or to reduce gradually? My current is (Check either Box 1 or Box 2): Box 1 TO IMMEDIATELY STOP ALL DRUG USE (If you checked this go to Part 2 on the next page.) OR Box 2 TO REDUCE MY DRUG USE GRADUALLY IN THE FOLLOWING WAYS: (1) During an average week, I plan to use drugs on no more than days. (3) I plan to use drugs ONLY under the following conditions: (4) I plan NOT TO USE DRUGS AT ALL under the following conditions: Date:

11 PART 2 People usually have several things that they would like to change in their lives. Changing their drug use can be one of those things. Please answer the next two questions with regard to the drug use you just described on the previous page. 1. At this moment, how is it that you achieve your stated? Using the following scale, answer the question by writing a number from 0 to 100 in the designated space below Not at all Less than most of the other things I would About as as most of the other things I would like to achieve More than most of the other things I would The most thing in my life I would Write your importance rating (from 0 to 100) here: 3. At this moment, how confident are you that you will achieve your stated? Using the following scale, answer the question by writing a number from 0 to 100 in the designated space below I do not think I will achieve my I have a 25% I have a 50% I have a 75% I think I will definitely achieve my Write your confidence rating (from 0% to 100%) here: Adapted from Guided Self Change material, CAMH