This course provides training and CEUs for addicitons counselors and LPCs working in Addictions, Mental Health and Co-Occurring Disorders will help counselors, social workers, marriage and family therapists, alcohol and drug counselors and addictions professionals get continuing education and certification training to aid them in providing services guided by best practices. AllCEUs is approved by the california Association of Alcohol and Drug Abuse Counselors (CAADAC), NAADAC, the Association for Addictions Professionals, the Alcohol and Drug Abuse Counseling Board of Georgia (ADACB-GA), the National Board for Certified Counselors (NBCC) and most states.

1. Models of Treatment for Co-Occurring Disorders 38 Hours Instructor: Dr. Dawn-Elise Snipes Executive Director, AllCEUs.com

2. Identify the main points of relapse prevention therapy Discuss the theory and purpose of step-down services Identify ways to establish linkages in the community to facilitate the accessibility of wrap-around services. Learner Objectives

3. Main Points Recovery and relapse can be described as related processes that unfold in six stages: Abstaining from alcohol and other drugs Separating from people, places, and things that promote the use of alcohol or drugs Establishing a social network that supports recovery Stopping self-defeating behaviors that prevent awareness of painful feelings and irrational thoughts Learning how to manage feelings and emotions responsibly Learning to change addictive thinking patterns that create painful feelings and self-defeating behaviors Identifying and changing the mistaken core beliefs about oneself, others, and the world Relapse Prevention Therapy

4. Have a mistaken belief that causes irrational thoughts Begin to return to addictive thinking patterns that cause painful feelings Engage in compulsive, self-defeating behaviors as a way to avoid the feelings Seek out situations involving people who use alcohol and drugs Find themselves in more pain, thinking less rationally, and behaving less responsibly Find themselves in a situation in which drug or alcohol use seems like a logical escape from their pain, and they use alcohol or drugs. Signs of Relapse

5. Stabilization Detoxification from alcohol and other drugs Solving the immediate crises that threaten sobriety Learning skills to identify and manage Post Acute Withdrawal and Addictive Preoccupation Establishing a daily structure that includes proper diet, exercise, stress management, and regular contact with treatment personnel and self-help groups. Principle 1: Self-Regulation

6. Self-Assessment Taking a detailed reconstruction of the presenting problems and the alcohol and drug use history. Identifying critical issues that can trigger relapse. In reconstructing the recovery/relapse history, it is important to identify the recovery tasks that were completed or ignored, and to find the sequence of warning signs that led back to drug or alcohol use. Principle 2: Integration

7. Relapse Education Learning accurate information about what causes relapse and what can be done to prevent it. This information should include, but not be limited to A bio/psycho/social model of addictive disease Common “stuck points” in recovery Complicating factors in relapse Warning sign identification Relapse warning sign management strategies Effective recovery planning Principle 3: Understanding

8. Principle 4: Self-Knowledge Warning Sign Identification Learning to identify the sequence of problems that has led to alcohol and drug use in the past and then recognizing how those steps could cause relapse in the future. Developing a personal relapse warning sign list (1) reviewing warning signs (2) making an initial warning sign list (3) analyzing warning signs (4) making a final warning sign list. The patient develops individualized warning sign list by thinking of irrational thoughts unmanageable feelings self-defeating behaviors.

9. Stabilization Detoxification from alcohol and other drugs Solving the immediate crises that threaten sobriety Learning skills to identify and manage Post Acute Withdrawal and Addictive Preoccupation Establishing a daily structure that includes proper diet Exercise stress management regular contact with treatment personnel and self-help groups. Principle 1: Self-Regulation

10. Self-Assessment Taking a detailed reconstruction of the presenting problems and the alcohol and drug use history. Identifying critical issues that can trigger relapse. In reconstructing the recovery/relapse history identify the recovery tasks that were completed or ignored find the sequence of warning signs that led back to drug or alcohol use. Principle 2: Integration

11. Relapse Education Learning accurate information about what causes relapse and what can be done to prevent it. This information should include, but not be limited to A bio/psycho/social model of addictive disease Common “stuck points” in recovery Complicating factors in relapse Warning sign identification Relapse warning sign management strategies Effective recovery planning Principle 3: Understanding

12. Principle 4: Self-Knowledge Warning Sign Identification Learning to identify the sequence of problems that has led to alcohol and drug use in the past and how to prevent them in the future Developing a personal relapse warning sign list (1) reviewing warning signs (2) making an initial warning sign list (3) analyzing warning signs (4) making a final warning sign list. The patient develops individualized warning sign list by thinking of irrational thoughts unmanageable feelings self-defeating behaviors.

13. Identify two different types of warning signs Those related to core psychological issues (problems from childhood) Those related to core addictive issues (problems from the addiction). When patterns of addictive thinking that justify relapse are reactivated, a return to using alcohol and drugs occurs. Self-Knowledge Cont…

14. Warning Sign Management Learning how to manage or cope with their warning signs as they occur. Management on three distinct levels. #1 is the situational-behavioral level. Patients are taught to avoid situations that trigger warning signs, and how to modify their behavioral responses when needed #2 is the cognitive/affective (thoughts and feelings) level, where patients challenge their irrational thoughts and deal with their unmanageable feelings when triggered #3 is the core issue level, where patients are taught to identify the core addictive and psychological issues that initially create the warning signs Principle 5: Coping Skills

15. Recovery Planning Development of a schedule of recovery activities that will help patients recognize and manage warning signs as they develop Reviewing each warning sign on the final warning sign list and ensuring that there is a scheduled recovery activity for each. Principle 6: Change

16. Inventory Training Completing daily inventories to monitor compliance with the recovery program and check for the emergence of relapse warning signs. A morning inventory is used to plan the day An evening inventory reviews progress and problems that occurred during that day. A typical morning inventory asks the patient to identify three primary goals for that day, create a to-do list, then schedule time for completion of each task The evening review inventory, the patient should review the to-do list to determine whether he or she completed the required activities and if he or she experienced relapse warning signs. Principle 7: Awareness

17. Involvement of Others Individuals cannot recover alone. Family members, 12-step program sponsors, counselors, and peers are just a few of the many recovery resources available. The more psychologically and emotionally healthy the significant others are, the more likely they are to be helpful. The more directly the significant others are involved in the relapse prevention planning process, the more likely they are to become engaged in supporting positive efforts and intervening when necessary Principle 8: Significant Others

18. Relapse Prevention Plan Updating Updated on a monthly basis for the first 3 months, quarterly for the remainder of the first year, twice a year for the next 2 years, annually thereafter Nearly two thirds of all relapses occur during the first 6 months of recovery. Less than one quarter of the variables that actually cause relapse can be predicted during the initial treatment phase. A relapse prevention plan update session involves the following: A review of the original assessment, warning sign list, management strategies, and recovery plan. An update of the assessment with progress or problems since the previous update. Incorporation of new warning signs and management strategies for them Elimination of activities that are no longer needed. Principle 9: Maintenance

19. Gradual movement from a more intensive level of care helps prevent people’s new coping skills from being overwhelmed. Residential care often protects people from the daily stresses of bills, traffic and dysfunctional others. Intensive outpatient provides a place to receive support, hope and encouragement on a daily basis Outpatient is appropriate once the patient has a reliable, healthy support network outside of therapy Theory and Purpose of Step-Down

21. Electricity

22. Housing

23. Childcare

24. Telephone

25. Education

26. Legal assistance

27. Food

28. Prosocial activities

29. Employment

30. ClothingYour consumers probably need the same things.

31. Churches Thrift shops Workforce development Transportation United Way Information and Referral Department of Children and Families 12-Step groups Resources

32. Relapse prevention therapy involves 9 principles Self Regulation Integration Understanding Self-Knowledge Coping Skills Change Awareness Significant Others Maintenance Step-down services are necessary to prevent straining the effectiveness of new coping skills Wrap-around services to assist consumers in meeting basic needs and reducing stress are vital Summary