Effective Treatment of Substance Use Disorders and Trauma in Older Adults: Clinical and Spiritual Perspectives

Transcription

1 Effective Treatment of Substance Use Disorders and Trauma in Older Adults: Clinical and Spiritual Perspectives Dr. Kenneth Chance, D. Div. Mr. Robert Potter, M.A., LISAC, CSAT October 19, 2016

2 Thomas Durham, PhD Director of Training NAADAC, the Association for Addiction Professionals

3 Produced By NAADAC, the Association for Addiction Professionals

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6 Cost to Watch: Free CE Hours Available: 1 CEH CE Certificate for NAADAC Members: Free CE Certificate for Nonmembers: $15 CE Certificate To obtain a CE Certificate for the time you spent watching this webinar: 1. Watch and listen to this entire webinar. 2. Pass the online CE quiz, which is posted at 3. If applicable, submit payment for CE certificate or join NAADAC. 4. A CE certificate will be ed to you within 21 days of submitting the quiz.

7 Using GoToWebinar (Live Participants Only) Control Panel Asking Questions Audio (phone preferred) Polling Questions

8 Webinar Presenters Ken Chance, D. Div. Bob Potter, LASAC, CSAT Your arrowheadlodgerecovery.com

9 There s got to be more to life than fighting for fish heads! Jonathan Livingston Seagull

10 The wound is the place where Light enters you.

11 Webinar Learning Objectives 1. Consider a hypothesis about why many older adults relapse after multiple attempts at treatment. 2. Gain greater awareness of the challenges of treating older adults diagnosed with SUD s and trauma co-morbidities. 3. Identify typical symptoms and chief complaints reported by older adults who suffer from SUD and trauma.

12 Webinar Learning Objectives 4. See the similarities in the neuroscience of addiction and trauma What occurs in the brain during trauma. What occurs in the brain in active addiction. 5. Understand the clinical and spiritual benefits of mindfulness and meditation. 6. Learn why a spiritual awareness of one s Authentic Self is vital for long-term recovery.

13 Some Stats U.S. population % % % U.S. Department of Health and Human Services - Administration on Aging (AoA)

14 Some Stats 6-11% of all elderly patients admitted to hospitals exhibit symptoms of alcoholism 14% of all elderly patients in ER exhibit symptoms of alcoholism Problem drinking in nursing homes is as high as 49% in some studies NCADD: An Invisible Epidemic: Alcoholism and Drug Dependence Among Older Adults

15 Some Stats 17% (8 million) older adults abuse alcohol and drugs - SAMHSA Less than 2% of all admissions for alcohol and drug treatment are people over age 55 Illicit drug use among seniors is projected to double by 2020 to 3.5 million NCADD: An Invisible Epidemic: Alcoholism and Drug Dependence Among Older Adults

16 Co-morbid PTSD and SUD Clients Greater difficulty maintaining sobriety Increased difficulty in healing traumatic memories. (Ford, Hawke, Alessi, Ledgerwood & Petry, 2007; Peirce, Kindbom, Waesche, Yuscavage, & Brooner, 2008; Schumacher, Coffey& Stasiewicz, 2006)

17 (American Journal of Psychiatry: Substance use disorders in patients with PTSD: a review of the literature (Jacobsen, Southwick and Kosten) Clients with PTSD Men #1 Alcohol abuse/dependence #2 Depressive Disorders #3 Anxiety Disorders Women #1 Depressive Disorders #2 Anxiety Disorders #3 Alcohol abuse/dependence

18 (American Journal of Psychiatry: Substance use disorders in patients with PTSD: a review of the literature (Jacobsen, Southwick and Kosten) Clients with PTSD Men #1 Alcohol abuse/dependence #2 Depressive Disorders #3 Anxiety Disorders Women #1 Depressive Disorders #2 Anxiety Disorders #3 Alcohol abuse/dependence

19 (American Journal of Psychiatry: Substance use disorders in patients with PTSD: a review of the literature (Jacobsen, Southwick and Kosten) Clients with PTSD Men #1 Alcohol abuse/dependence #2 Depressive Disorders #3 Anxiety Disorders Women #1 Depressive Disorders #2 Anxiety Disorders #3 Alcohol abuse/dependence

20 Addiction + Trauma + Older Adults

21 35 30 Suicide Among Adults Aged Years US, Men Women Men Women CDC Morbidity and Mortality Weekly Report, May 3, 2013 / 62(17);

22 Typical Case Study Married Children Career with some success

23 Typical Case Study Compliant Smiles a lot Polite Easy to like

24 Typical Case Study I got this!

25 Typical Case Study Drank X days post D/C

26 WHY?

27 Typical Answers

28 He/she didn t get it the first time Typical Answers

29 He/she didn t do a thorough 1 st. Step Typical Answers

30 He/she didn t participate in group Typical Answers

31 He/she didn t get a Higher Power Typical Answers

32 He/she didn t get a Higher Power Typical Answers

33 What Did I Miss?

34 It s What He Didn t and Won t Talk About

35 Fathers of Baby-Boomers

36 Look at Their Affects

37 Sense any Happiness/Joy?

38 How Did They Parent?

39 Generational Trauma

40 Deeply Engrained Secret

41 Challenges with Older Adults Old ideas and stereotypes Emotionally disconnected Communication Therapeutic alliance

42 The difficulty lies not so much in developing new ideas as in escaping from old ones. John Maynard Keynes

43 Old Ideas - Generational Differences

44 Old Ideas - Generational Differences

45 Old Ideas - Generational Differences

46 Gender Stereotypes

47 Gender Stereotypes

48 Emotionally Disconnected

49 Emotionally Disconnected

50 The worst type of pain is when you are smiling, just to hold back the tears. Unkown

51 Communication Me, me, me, me, me

52 Communication with One Another

53 Communication with Counselor

54 Therapeutic Alliance Older Adults Want to Know their Therapist is Credentialed

55 Therapeutic Alliance - Safety & Trust I m not going to tell him/her about that stuff

56 Assessments What to Look For

57 Typical Complaints/Symptoms

58 Cycle of Addiction and Trauma

59 Neuroscience Addiction & Trauma

60 Neuroscience 101

61 Neuroscience 101

62 What Happens in Early Childhood Trauma Why one reacts with emotion such as angry outbursts rage terror fear and the like. Does not process/sequenc e the traumatic experience. Lights up during a traumatic experience as well as during recall or flashback. Bessel Van Der Kolk, M.D.

63 What Happens in Early Childhood Trauma Why talk therapy is so often ineffective in resolving trauma. Talk therapy uses left hemisphere The emotional and somatic experience is stored in the right hemisphere Bessel Van Der Kolk, M.D.

64 Brain Attempts at Resolution The brain constantly attempts to organize the chaotic mess of trauma and presents either in autoimmune syndromes accidents and attachments. Bessel Van Der Kolk, M.D.

65 Stress Response

66 Fear

67 Why They Can t Remember Trauma

68 Typical Complaints/Symptoms

69 Drugs and the Brain

70 Drugs and the Brain

71 Regulation

72 Mindfulness and the Brain

73 Mindfulness and the Brain

74 Mindfulness and the Brain

75 Mindfulness and 4 Areas of Behavior

76 Meditation and the Brain

77 Mindfulness Helps Change Old Habits

78 Mindfulness & Meditation

79 Mindfulness & Spirituality

80 Mindfulness & Spirituality

81 Mindfulness Awareness of thoughts, emotions and behavior: To consider how what I think, feel and act might impact, positively or negatively, others. To develop compassion and empathy for others. To practice humility through gratefulness. To consciously establish one s intent before initiating action. To become more compassionate in my relationships. To observe chaos rather than create it. To respond rather than react. To allow space before one chooses.

82 Mindfulness

83 214 mph

84 Spirituality Means:

85 Ultimately spiritual awareness unfolds when you re flexible, when you re spontaneous, when you re detached, when you re easy on yourself and easy on others. Deepak Chopra

86 Thank You! Ken Chance, D. Div , ext. 100 Bob Potter, M.A., LASAC, CSAT , ext. 105 Your arrowheadlodgerecovery.com

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88 Cost to Watch: Free CE Hours Available: 1 CEH CE Certificate for NAADAC Members: Free CE Certificate for Nonmembers: $15 CE Certificate To obtain a CE Certificate for the time you spent watching this webinar: 1. Watch and listen to this entire webinar. 2. Pass the online CE quiz, which is posted at 3. If applicable, submit payment for CE certificate or join NAADAC. 4. A CE certificate will be ed to you within 21 days of submitting the quiz.

89 Upcoming Webinars November 2, 2016 Adolescent Development and Susceptibility of Teens Toward Addiction By Beth Donnellan December 7, 2016 Clinical Supervision for a Skill-Based, Client- Centered Program By Thomas Durham November 16, 2016 December 21, 2016 Beyond Getting a Job : Understanding and Ethics Touching Addressing Employment and Career By Francis Patterson Development Issues By Anne-Marie Beck

90 Free CEs for Members Levels: Professional Associate Student /join

91 WEBINAR SERIES Over 75 CEs of free educational webinars are available. Education credits are FREE for NAADAC members. MAGAZINE ARTICLES In each issue of Advances in Addiction & Recovery, NAADAC's magazine, one article is eligible for CEs. FACE-TO-FACE SEMINARS NAADAC offers face-to-face seminars of varying lengths in the U.S. and abroad. INDEPENDENT STUDY COURSES Earn CEs at home and at your own pace (includes study guide and online examination). CONFERENCES NAADAC Annual Conference September 2017 Denver, CO CERTIFICATE PROGRAMS Demonstrate advanced education in diverse topics with the NAADAC Certificate Programs.

92 Contact Us! NAADAC 44 Canal Center Plaza, Suite 301 Alexandria, VA phone: / fax: / naadac@naadac.org NAADACorg Naadac NAADAC