Expert tips on running chemical addiction group
Recovery’ means multiple things to some patients
Rehab facilities often have a substantial population of patients who were injured during accidents, including accidents involving substance abuse.
It’s not unusual, then, for rehab staff to work with people whose primary problem may be an addiction to alcohol or drugs rather than a physical injury. One rehab and substance abuse expert recommends that facilities incorporate into their treatment plans a program for chemically addicted patients.
As simple as a workshop
Such a program could be as simple as holding a workshop for patients with addictions, says Pat Precin, MS, OTR/L, clinical director of occupational, recreational, and creative arts therapies for St. Luke’s-Roosevelt Hospital in New York City. Precin has written a book on the topic, called The Living Skills Recovery Workbook, published in 1999 by Butterworth-Heinemann in Woburn, MA.
The workshop could be held after clinic hours and facilitated by a therapist who is knowledgeable or trained in substance abuse issues. The purpose would be to help rehab patients with substance abuse problems develop living skills that help them sustain their recovery efforts, Precin says.
Program needs three features
Precin recommends such a program incorporate these main features:
1.
Develop a needs assessment for group or individuals. "To do that, look at time management from a 12-step treatment perspective," Precin says. "Also look at stress management for recovery, social skills for sobriety, and activities of daily living [ADLs] for abstinence."
Precin recommends having the group decide which of these four areas — time management, stress management, social skills, or ADLs — they are most interested in pursuing first. Rehabilitation patients may have limitations from their physical disability, but they also have limitations in those four areas because of their addiction, she adds.
Precin uses a needs assessment she developed for her workbook to find out where the group should start first. Perhaps there are 25 people in the group, and 10 have indicated that time management is their top priority. That would be a good place to begin. If stress management was a second choice, it could be covered in a later workshop. If one person felt a particular need for social skills, a therapist could work with that person individually on that issue.
2.
Start workshop program. The program may include an introduction and brief quiz that will be compared with a quiz given after the workshop ends.
Clients could be asked to complete assessment forms designed to help them make priorities in their lives. For example, one tool listed in Precin’s workbook is called "What I Have to Do Versus What I Like to Do (P.S. Things I Hate to Do)." This is designed to encourage people to look at their priorities in how they spend their time. By taking time to write down their particular interests and dislikes, they may find it easier to make changes in daily schedules.
(See Precin’s questionnaire on likes and dislikes, p. 116.)
The program helps clients identify their problems, find solutions, and understand how their substance abuse only makes things worse.
"The program goes into symptoms of illnesses and how this affects their functioning and how to problem-solve around these things so they can develop skills and awareness," Precin says.
3.
Measure group members’ progress. Precin uses a quality assurance data sheet to keep track of how each person is doing during the program. The sheet, which has a column in which each client’s name can be listed, includes columns for listing information on these topics: pretest score, post-test score, attendance, objectives met, goals met, new material learned, changes made in life, staff observations, and "clean time" (time spent sober).
That helps rehab staff measure outcomes and see benefits to the program, Precin says.
"I’ve done three years of outcomes studies, and I have found that the program is effective with substance abuse patients and a mentally ill population," Precin says.
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