Client Participation: Case Study

In today’s session, group members were to complete the handout and identify their motivations for seeking treatment. Then each group member took turns sharing their list of prioritized values and activities they did that support their values. PO attended group on time and well engaged in the group activities. PO identified “my sobriety, my goals for myself, my children and family” as motivations for engaging and continuing treatment and recovery. PO stated her six prioritized values as “faithfulness, family, God’s will, honesty, inner peace, and responsibility”. PO had a positive response to treatment, and demonstrated an ability to continue making changes to support her recovery.

However, the client stated that because of his addiction, "I hit rock bottom before I got locked up this time around". The client expressed that he was homeless, living in the woods, overdosed several times, has a lengthy criminal record. He was informed by his father that if he doesn’t get "clean" he would not let him see his son again. The client expressed that if he doesn’t maintain sobriety, "I could die". The client has developed insight into his addiction and has identified several triggers and relapse warning signs. The client has identified and developed several coping skills. The client expressed the importance of aftercare to maintain long-term sobriety. The client attends weekly AA/NA and Big Book meetings in the PWC ADC. The client has picked and is currently working with a

D: Pt. attended group on time and moderately participated in the group activity. Pt. was able to identify her personal relapse triggers and share positive coping skills that can be used to avoid and prevent future relapse. Stated “Once I know my weaknesses and vulnerabilities, I can make healthy lifestyle changes in order to avoid certain behaviors, people, and places that can trigger relapse”.

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.

Individuals who have just been let out of rehab, should reflect on their lives. Reflection should include reminders of reasons to stay sober, since motivated individuals are less likely to experience relapse. Reasons that can help prevent relapse include legal reasons, desire for social acceptability, improved health, increased self-image and self-confidence, and the drive to have better interpersonal relationships. Reflection time can also help reduce stress to allow better decisions when faced with possible triggers to abuse substances. Daily reflection should include positive reinforcement as individuals consciously praise themselves for things that they have done well after rehab (7 Warning Signs You Are Heading for a Relapse).

The group topic was on “Looking at Urges and Cravings” (U&C). Activities included learning and identifying the patterns/signs of U&C, and learning steps and strategies for handling U&C to avoid/prevent unnecessary relapse. Mr. Christensen moderately participated in the group process today. He identified his personal patterns and signs of relapse are “thinking of using”, “seeing the drugs”, “someone using in front of me”. Stated that he uses Consequences Thinking and “walk away” to cope with U&C to use. It appears that Mr. Christensen is utilizing learned skills to eliminate personal triggers that may endanger his recovery.

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

Relapse prevention treatment for adolescents must be addressed. However, it must be addressed in a much different way than adults. Adolescents understanding of relapse prevention takes on a totally different meaning to them than adults do. The two case studies on page 303-308 made this very clear.

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.

One of the most important constructs associated with the treatment of the addicted population is relapse. While treatment does occur with inpatient facilities, due to the prevalence of relapse with this population, much of treatment occurs in outpatient settings. Consequently, these treatment environments and models actively engage a client’s self-efficacy for continued sobriety. Sklar, Annis, and Turner (1999) stated that, “in the addictions field, where the primary clinical issue is maintenance of change over time, a high sense of self-efficacy would be expected to decrease relapse vulnerability,” (p. 123). It is evident that an assessment model must be used to investigate and explore a clients’ recovery environments, confidence of sobriety maintenance, and coping strategies. This is necessary, in order to develop treatment plans that focus on sustained abstinence and sobriety, all while minimizing relapse.

Relapse prevention has not been steadily practiced or openly accepted as a form of treatment, until more recent years. It was originally introduced in the 1980’s, by Alan Marlatt, but was not held in the highest regard because the general concept or purpose of relapse prevention was not yet understood. However, as time passed, a better understanding of RP treatment has been established and both professionals and clients can better cope with relapse related issues without the overwhelming negativity that was once associated with it. Even though, different versions of RP have evolved through research by other professionals, the main goal of RP has remained the same, teaching individuals who suffer with addiction disorders and changing their behaviors how to foresee and cope with relapse (Donovan & Witkiewitz, 2012). Therefore, counselors and patients should be

Our textbook states that, “System theorists strongly believe in the concept of homeostasis, the tendency of systems like families to balance themselves in response to change. Whenever there is a disruption in one family member, other members react to return the overall family dynamics to something that resembles normal functioning” (Capuzzi, 2016). When creating a relapse prevention plan, any goals that would be set is entirely up to Robert and his therapist. “Relapse prevention planning probably won’t work unless the relapse is sober and in control of themselves. Detoxification and a few good days of sobriety are needed in order to make relapse prevention planning work” – Terence Gorski (Leipholtz). If Robert is seriously in staying sober for his family and friends, he needs to identify some factors that will assist him in recovery. Robert needs to identify the recovery motive (why do you want to recover?), relapse triggers (what situations make you want to drink?), warning signs, and well-being needs (medical, physical, psychological and social). He then needs to put the plan him and his therapist put together into action

Today’s group topic was focused on the principals of recovery. PO was present for group on time and moderately participated in the group activity. PO was attentive and engaged well in the group activity. Demonstrated an understanding of the topic by engaging in the group discussion on how to understand what the truth is and connecting with reliable sources. PO also shared how to achieve small goals or take on challenges by working on one step at the time with the group. PO makes consistent behavior change in group, and appears to be committed to his recovery.

The success of Healthcare Management Information System (HMIS) projects is essential in health care delivery. However, system implementation is a challenging task and the success of the project depends on multiple factors (Safdari, Ghazisaeidi, & Jebraeily, 2015).To attain success, critical success factors need to be addressed for HMIS implementation. These factors can prevent issues in the implementation of the system. There are three characteristics of success factors: characteristics of the users, characteristics of the system design, and characteristics of the organization.

The PLDP is designed for leaders that are within Mississippi Action for Progress that consist of the Human Resource Department, Region 8 supervisor, Yazoo Center Director and Assistant Director. Those group of people decides what is best for employees and who gets hired and terminated. According to Proverbs 12:1 (NIV), “He who loves instruction loves knowledge, but he who hates correction is stupid” and “For lack of guidance a nation falls, but victory is won through many advisers” (Proverbs 11:14, NIV). Getting these leaders to use the PLDP to improve valuing their employees and effectively selecting employees can improve the organization but without change failure can occur.