Recovery Life Skills Program

1 Integrated Dual Disorders TreatmentRecovery life SkillsProgramA Group Approach to Relapse Preventionand Healthy LivingFacilitator ManualLindy Fox SmithHazelden PublishingCenter City, Minnesota 2011 by DartmouthAll rights reserved. Published 2011 Revised and updated for DSM-5edition published in 2015 Printed in the United States of AmericaUnless a statement on the page grants permission or permission has been obtainedfrom the publisher, no part of this publication may be reproduced, stored in aretrieval system, or transmitted in any form or by any means electronic, mechanical,photocopying, recording, scanning, or otherwise without the express written per-mission of the publisher. Failure to comply with these terms may expose you to legalaction and damages for copyright : 978-1-61649-644-9 Passages from Integrated Dual Disorders Treatment (IDDT): Best Practices, Skills ,and Resources for Successful Client Care(Center, City, MN: Hazelden, 2010) arereproduced with the permission of the Weiss AAA Method and mnemonic appear with permission from Roger D.

2 Weissand Hilary Smith Connery. Originally published in Integrated Group Therapy forBipolar Disorder and Substance Abuse(New York: Guilford Press, 2011). 20 19 18 17 16 15 1 2 3 4 5 6 7 Cover design by Terri KinneInterior design and typesetting by Madeline BerglundThe Dartmouth PRC Hazelden imprint was formed as a partnership between theDartmouth Psychiatric Research Center (PRC) and Hazelden Publishing, a divisionof the Hazelden Betty Ford Foundation nonprofit leaders in the research anddevelopment of evidence-based resources for behavioral health. Our mission is to create and publish a comprehensive, state-of-the-art line ofprofessional resources including curricula, books, multimedia tools, and staff-development training materials to serve professionals treating people with mentalhealth, addiction, and co-occurring disorders at every point along the continuumof care. For more information about Dartmouth PRC Hazelden and our collection ofprofessional products, visit the Hazelden Behavioral Health Evolution website this page is illegal.

3 Do not copy this material without written permission from the manual is dedicated to all the people with co-occurring disorders who have shared their Recovery with me. I have learned so much from all of you. Thank you for sharing a part of your journey with this page is illegal. Do not copy this material without written permission from the ..ixIntroduction ..1A Key to the Session Outlines ..17 Session Checklists ..27 Session OutlinesSession 1:Orientation and Working on Goals ..31 Session 2: Recovery and Goal Identification ..43 Session 3:Preventing Relapse I: Triggers for Substance Use ..51 Session 4:Preventing Relapse II: Early Warning Signs of Mental Health Disorders ..61 Session 5:Coping with Negative Feelings I ..69 Session 6:Coping with Negative Feelings II ..83 Session 7:Developing Leisure and Recreational Activities ..95 Session 8:Dealing with Social Situations Where Alcohol and Drugs Are Offered ..105 Session 9:Open Topic.

4 117 Session 10:Developing a Social Network ..125 Session 11:Relationship Skills ..133 Session 12:Communication Skills ..141 Session 13:Peer Recovery support Groups ..151 Session 14 Open Topic ..165 Session 15:Spirituality and Inner Peace ..173 Session 16:Developing a Positive Self-Image ..185 Session 17:Healthy Lifestyles ..193 Session 18:Review Personal Recovery Plan ..205 References ..209 Thumbnail Views of IDDT Recovery life Skills Program Handouts ..211 About the Author ..227C ON T E N T S Duplicating this page is illegal. Do not copy this material without written permission from the C K N O W L E D G M E N T SI would like to acknowledge all the facilitators and group members at my pilotsites. Without their help in piloting and giving me feedback in the Recovery LifeSkills Program Group curriculum, it would not be as complete and comprehensivea Program as it now below are the original pilot sites:Community Connections, Washington, Drug Recovery Centers, Hartford, CTBirmingham Group Health Services, Ansonia, CTCapitol Region Mental Health Center, Hartford, CTConnecticut Renaissance, Waterbury, CTRegional Network of Programs, Bridgeport, CTSouthwest Connecticut Mental Health, Bridgeport, CTMental Health Center of Greater Manchester, Manchester, NHI would also like to acknowledge my first two facilitators in Washington, ,Chad Holm and Roxanne Talbott, as well as all the other Community Connectionsstaff who helped me develop the first group and offered ideas and support to theoriginal group manual.

5 Thanks also to my pilot site coordinators: Julienne Giard,who is the manager of EBPs in the Connecticut Department of Mental Health andAddiction Services, and Diane Distaso, a coordinator of outpatient services at theMental Health Center in Manchester, New Hampshire. Without their help andcoordinating abilities the pilots would not have happened!Thanks, of course, to all my Dartmouth colleagues who continue to support me inevery way. Special recognition goes to Glenda Madden, who typed many versions ofthis manual and never complained. I still owe you dinner! Along with my Dartmouthcolleagues, I wish to acknowledge the amazing support and hard work of the Hazeldenteam. It has been a real joy and honor to work with you on this project, and a specialacknowledgement to Pat Boland, my editor, who worked tirelessly on the early draftsof the manual. I really appreciated all your hours of revisions after I changed things!Lastly, thanks to my husband, Paul, whose friendship and love sustain methroughout all the work I do.

6 Duplicating this page is illegal. Do not copy this material without written permission from the Integrated Dual Disorders Treatment (IDDT) Recovery life Skills Programis agroup counseling Program for people with dual, or co-occurring, disorders who are inactive treatment or the relapse prevention stage of treatment. This manual is designedto help you, the practitioner, work with group members who have severe mentaldisorders and addiction whether you are newly treating people with co-occurringdisorders, have an established co-occurring disorders Program , or are anywherealong that interventions are the most effective treatments we have to help peoplewith co-occurring disorders. The Recovery life Skills Programincorporates severalevidence-based approaches including psycho-education, social Skills training, andcognitive-behavioral Program was piloted at several sites, both urban and rural, inpatient andoutpatient, and was well received by the group members.

7 Members reported thatthey liked the group and being with peers who were similar to them. Sometimesthe measure of a group such as this is whether or not the members enjoy it, findit useful to their Recovery , and keep coming back. That was the feedback receivedfrom the pilot groups, with several sites having waiting lists of potential memberswanting to Co-occurring DisordersThe term co-occurring disordersgenerally refers to a co-existing mental health dis-order and substance use disorder. Co-occurring disordersis more often used todayinstead of the term dual disorders,which is restricted by use of the word dual,meaning two. Co-occurring disorders may refer to people who have one or moremental health disorders coupled with one or more substance use Need for Integrated TreatmentFor about three decades, the mental health field has recognized the prevalence ofsubstance use disorders among people with a severe mental disorder such as schizophre-nia,bipolar disorder, and major depressive disorder.

8 About half of all adults withsevere mental health disorers also have a substance use disorder at some time inI N T R O D U C T I O NsDuplicating this page is illegal. Do not copy this material without written permission from the lives. The rates are higher for people in acute caresettings (such as emergency rooms and psychiatrichospitals), those involved in the criminal justice system,or people who are this time the mental health field has alsocome to recognize that parallel or sequential treatmentapproaches to these problems are ineffective. For example,treating mental health and substance use disorders separately, either one at atime (sequential) or in separate settings (parallel), never really made sense,since these disorders are experienced together. Indeed, people striving to recov-er from co-occurring disorders experience mental disorders and substance usedisorders as intertwined, interacting, and relatively inseparable.

9 They oftenexperience psychiatric symptoms and substance use at the same time or inclose proximity, and relapses often involve both Dual Disorders Treatment is an evidence-based practice wherea clinician, or team of clinicians, treat a person s mental disorder and substanceuse disorder at the same time. The integrated treatment model addresses theproblem of access by ensuring that one visit, in one setting, is sufficient toreceive treatment for both disorders. It addresses the problem of combiningmessages and philosophies by giving this responsibility clearly to the treatmentprovider instead of the client. One of the key features of Integrated DualDisorders Treatment is motivation-based or stage-wise of Change and the Stages of Treatment ModelFor years, researchers have proposed that people make behavioral changes instages, moving from unawareness or pre-contemplation to contemplation ofchange, then from action to maintenance of change.

10 This approach the stagesof change model developed by James Prochaska and Carlo DiClemente canbe useful when creating treatment plans for people who have a substance usedisorder. Pinpointing where people are in the stages of change process can helpclinicians determine what interventions might be the most beneficial as theperson being treated moves a similar vein, identifying where people are in their stage of treatmenthelps clinicians work with them on developing goals to pursue and determiningwhich interventions to try. The stages of treatment model, while similar to thestages of change model, is specific to co-occurring disorders; it is an intervention-based approach that occurs within the context of the therapeutic this page is illegal. Do not copy this material without written permission from the stages of treatment model includes four stages: engagement, persuasion,active treatment, and relapse table below compares the two effectively address a person s co-occurring disorders, treatment musttarget the person s stage of change, or motivation for Recovery .