3 Month Quarterly Review

Met with client for ISP review and to discuss treatment progress. Client appeared to be stable and engaged in the conversation. Client reported that she completed the FAFSA and is planning to go to Everette Community College in the summer. Client reported no use of substances. Client reported coping with temptation by walking away from the situations. Client was reminded that her relapse potential was moderate to high at this time and that she thus would be cautioned to avoid any unintended consequences; with help and support from treatment and her family, client would make his treatment a success. Reviewed ISP in Dim.5 dated 11/29/17, reported completion on approach C, but was unable to identify which peer pressure could be positive (approach

Regardless, it was so inspiring when I did hear some good reports, and I noticed how eager those former clients were to share about what was working for them. In fact, at times it was hard to tell who was more excited about their success, me or the former client. It is sobering to know that this is how working in this field is likely to pan out. What I mean by saying this, is that I must get used to the possibility that most of the clients who pass through whatever facility I am at, are more likely not to succeed (succeed per the agency’s follow-up requirements), than to succeed, and I must not take the client’s shortcomings as a personal failure of sorts. For this reason, I now realize that this is one of the reasons that I hate this disease with such passion, and want to work in my community to improve these statistics, and remove the stigma that has been attached to Substance Use Disorders for far too long.

Donald has explored his criminal thinking patterns and had developed insight into his thinking errors. Donald has attempted an MRT step each week and has provided thoughtful answers in each step. Donald is currently on step 11 in MRT. Donald stated "I was stealing items from friends and family in order to support my drug habit. I was not stealing until I started using heroin". Donald expressed the need to move out of Manassas, Virginia and live with his father and son in North Carolina in order to avoid triggers that lead to his criminal thinking. Donald has expressed regret and shame on how he has treated others. Throughout his time in the program, the client has been reaching out to the people he has victimized to amends what he has done in the past. The client stated, "there is a lot of people that I need to amends with". The client plans to attend trade school with the intentions to open his own brick and mortar company in the future.

And to get a better result of sobriety find the best theory approach the will help the client see and understand what technique will best fit he/she in the recovery process. I think for me to help this client I would look at the femalists theory and cognitive behavior theory because we have to find out what is the cause of the addiction either pain or

Client has no know history of previous treatments. Client desires treatment due to unhappiness with current life style. Client states that his longest abstinence from alcohol is 4 days, nicotine an hour, and marijuana and cocaine 1-2 years over the last 5 years. Client recognizes several triggers for drinking episodes (social anxiety, loneliness, fear, feelings of inadequacy, and guilt). Client is not experiencing any cravings for chemicals at this time (currently using nicotine). Client states he has current problems with family resentments and anger, self-esteem, and anxiety that are unresolved. At this time, potential for relapse is moderate to severe. Client a limited support network and no relapse prevention plan.

The third and final stage of recovery is known as late recovery, and involves a client finding growth and meaning in life. In this stage, relapse may be less frequent as a sense of purpose is found. As this stage is found only by enduring great challenges, a client may not be as tempted by relapse and the act of back tracking in their recovery may seem tiresome and unworthy of their time. However, though a deep awareness of the consequences of substance abuse is profound, relapse is still possible if an addict forgets that he or she has a disease that is incurable and succumbs to the enticement of “just this one time can’t hurt” or has the thought that “I have been clean for so long. I am cured.” Bill W. stated in his book Alcoholics Anonymous that “This is the baffling feature of alcoholism as we know it-this utter inability to leave it alone, no matter how great the necessity or the wish” (pg. 34). Complete abstinence is the only choice for those with the disease of addiction, and so many recovering addicts forget this simple realization in the late recovery stage.

Another potential issue facing this project is the development of program guidelines for the facility itself, and situations that may arise involving relapse. Giordano, Clarke, and Furter (2014) noted that relapse is normal to the recovery process, especially early on, and that of “1,222 adults receiving outpatient treatment for substance abuse, only 34% of the sample remained abstinent for 12 or more months,” (p. 114). Due to the variety of working parts and multitude of stakeholders outside of the facility itself, including treatment providers, community health centers, and legal entities (i.e. probation), there is a strong likelihood that people will be on different pages in terms of their approach and handling of relapse. It can absolutely be detrimental to the living environment, and not only place the individual at risk, but also others at the home. When factoring in the limited treatment options, discharge from a facility would be a huge blow to the continuity of care for that individual. I recently had a client discharged from an intensive outpatient program, for simply admitting purchasing a Suboxone film strip from another client. She wrote a letter of admission to the facility,

al, 2015). Relapse prevention offers a framework for identifying cues and stressful situations that precipitate relapse and teaches cognitive and behavioral skills to reduce risk (Bowne, et. al, 2014). Bowen has proposed that to increase effectiveness in dealing with situation that are potential relapse events, treatments must address avoidance of affective or cognitive discomfort, develop skills to recognize and endure these events, and identify the cues related to substance abuse

“First and foremost, programming for parole violators should specifically focus on cognitive-behavior treatment that involves coping strategies” (Champion, 2007) this will be beneficial with their transition back into society. Cognitive-behavioral programming is an effective model of treatment for offender. Cognitive-behavior program can help with social skills which will help offenders aim to increase self-esteem through heightening their own sense of values, worthiness, adequacy, and competence, in addition to helping one perceive a casual relationship between one’s behavior and its consequences. Cognitive behavioral therapy reduces recidivism in adults whereas the therapy assumes that the offender can become conscious of their own thoughts and behaviors and then make a positive change. It is believed that a person thoughts are often the result of what they have experienced, and behavior is often influences by those thoughts. In most cognitive beahvior

A: Client appears to understand that being able to break out of the cycle of lies brought on by addiction is crucial to a lasting and successful recovery.

It’s important that the information provided is limited to substance abuse. Although many areas of the client’s life have been affected, client educations as a core function are educating the client on different resources provided by the community such as AA/ NA. Relapse prevention is another way to educate clients helping them identify people places and things that may cause triggers. Educating political leaders, schools and the community on substance abuse can help bridge a gap in community support and people in recovery. There are many areas on which we need to be familiar in such as cultural identity, health, sexual promiscuousness, and stress management, biological, medical, social and physical aspects of substance abuse.

D: Group topic was focused on Dim 5. Group activity included the following: learning personal high risk situations and early warning signs of relapse, identifying personal internal and external relapse triggers and strategies to cope/prevent relapse. Client attended group on time, demonstrated an understanding of the topic by sharing what influenced the last relapse and what he can do differently to stay clean and sober, “I need to go to meeting and develop a regular sleep pattern, so I can focus on my recovery. I really need to make so changes. I probably should not hang out with my old friends anymore.”

When client was asked about her sobriety and any issues that may be arising for her she reported not having any and seeing people she used to smoke PCP with still stuck in the same lifestyle was motivation enough for her to leave drugs

This therapist conducted a progress group exploring the group’s criminal thinking. The client identified in his treatment plan that he wants to explore his criminal thinking and to change his criminal thinking patterns. The client appeared anxious about attempting the MRT step 3 as evidenced by the client’s constant leg shaking. The client stated his freedom ladder and step with no issues. The client discussed his worries/wants/needs and in the second part answered questions in the book. The group confirmed that the client is trying to change his criminal thinking and has already made improvements. The client will attempt step 4 next

“Cognitive approaches confront the way offenders think, their criminal values and attitudes, and their decision making. Behavioral approaches, by contrast, seek to model, reward, and reinforce prosocial behavior. Numerous studies show that cognitive-behavioral strategies work better than other intervention strategies for offenders, including nondirective talk therapy and psychoanalytic approaches. Nondirective approaches do not tend to work with most offenders because they are usually concrete in their thinking and not always able to think rationally.” (J. Wright, 2012)