Archive for January, 2007

Relapse Prevention Planning

There are various forms of relapse prevention training. Most follow a similar pattern with and employ the following common elements:

  • Identifying high-risk situations: Symptoms are often initiated by particular times, places, people, or events. For example, a person with agoraphobia is more likely to experience symptoms of panic in a crowded building. An essential key to relapse prevention is to be aware of the specific situations where one feels vulnerable. These situations are called “triggers,” because they trigger the onset of symptoms. While people with the same mental disorder may share similar triggers, triggers can also be highly individual. People tend to react sometimes unknowingly to negative experiences in their past. For example, a woman who was sexually abused as a child may have negative emotions when in the presence of men who resemble her abuser. Because some triggers occur without conscious awareness, individuals may not know all their triggers. Many relapse prevention programs encourage individuals to monitor their behavior closely, reflecting on situations where symptoms occurred and determining what was happening immediately before the onset of symptoms. With this kind of analysis, a pattern often emerges that gives clues about the trigger.
  • Learning alternate ways to respond to high-risk situations: Once triggers have been identified, one must find new ways of coping with those situations. The easiest coping mechanism for high-risk situations is to avoid them altogether. This may include avoiding certain people who have a negative influence or avoiding locations where the symptom is likely to occur. In some instances, avoidance is a good strategy. For example, individuals who abuse alcohol may successfully reduce their risk by avoiding bars or parties. In other instances, avoidance is not possible or advisable. For example, individuals attempting to lose weight may notice that they are more likely to binge at certain times during the day. One cannot avoid a time of day. Rather, by being aware of this trigger, one can purposely engage in alternate activities during that time. Strategies for coping with unavoidable triggers are generally skills that need to be learned and practiced in order to be effective. Strategies include but are not limited to discussion of feelings, whether with a friend, counselor, or via a hotline; distraction, such as music, exercise, or engaging in a hobby; refocusing techniques, such as meditation, deep-breathing exercises, progressive muscle relaxation (focusing on each muscle group separately, and routinely tensing then relaxing that muscle), prayer, or journaling; and cognitive restructuring, such as positive affirmation statements (such as, “I am worthwhile”), active problem solving (defining the problem, generating possible solutions, identifying the consequences of those solutions, choosing the best solution), challenging the validity of negative thoughts, or guided imagery (imagining oneself in a different place or handling a situation appropriately).
  • Creating a plan for healthy living: Besides being prepared for high-risk situations, relapse prevention also focuses on general principles of mental health that, if followed, greatly reduce the likelihood of symptoms. These include factors such as balanced nutrition, regular exercise, sufficient sleep, health education, reciprocally caring relationships, productive and recreational interests, and spiritual development.
  • Developing a support system: Many research studies have demonstrated the importance of social support in maintaining a healthy lifestyle. Individuals who are socially isolated tend to display more symptoms of mental disorders. Conversely, individuals with mental disorders tend to have more difficultly initiating and maintaining relationships due to inappropriate social behavior. For such people, a support system may be nonexistent. Research suggests that support systems are most effective when they are naturally occurring in other words, when a circle of family and friends who genuinely care about the individual is already in place. However, artificially created support systems are certainly better than none at all. For this reason, relapse prevention programs strive to involve family members and other significant persons in the addiction treatment program. Everyone in the support system should be knowledgeable about the person’s goals, what that person is like when he or she is doing well, and warning signs that the person may be on a path toward relapse. The support system agrees on who will take what role in encouraging, confronting, or otherwise caring for that person. Self-help groups such as Alcoholics Anonymous or Moderation Management are often examples of artificially created support systems.
  • Preparing for possible relapse: Although the ultimate goal of relapse prevention is to avoid relapse altogether, statistics demonstrate that relapse potential is very real. Individuals need to be aware that, even when exerting their best efforts, they may occasionally experience lapses (one occurrence of a symptom or behavior) or relapses (return to a previous, undesirable level of symptoms or behavior). Acknowledging the potential for relapse is important, because many people consider a lapse or relapse as evidence of personal failure and give up completely. In their widely acclaimed book for professionals, Motivational Interviewing, William R. Miller and Stephen Rollnick cite a study by Prochaska and DiClemente that found that smokers typically relapse between three and seven times before quitting for good. From the perspective of Miller and Rollnick, each relapse can be a step closer to full recovery if relapse is used as a learning experience to improve prevention strategies. Although some argue that such a tolerant attitude invites relapse, general consensus is that individuals need to forgive themselves if relapse occurs and then move on. Some relapwe prevention programs include designing a crisis plan to be put into effect if a relapse occurs. The crisis plan involves specific actions to be taken by the individual or members of the support system.

These elements are common to all relapse prevention programs, but programs can be further customized to meet the particular characteristics of a disorder. For example, prevention of depression or anxiety may focus on becoming aware of thoughts as passing mental events rather than facts about self or reality. Learning to identify bodily sensations that accompany maladaptive thoughts is also important for preventing depression and anxiety. Addictive disorders concentrate on reactions to social pressure, interpersonal conflicts, and negative emotional states as part of a relapse prevention plan.

 

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Relapse Prevention Information

Definition of Relapse


 

In the course of illness, relapse is a return of symptoms after a period of time when no symptoms are present. Any strategies or treatments applied in advance to prevent future symptoms are known as relapse prevention.

 Purpose of Relapse Prevention
When people seek help for mental disorders, they receive dual diagnosis treatment that, hopefully, reduces or eliminates symptoms. However, once they leave dual diagnosis treatment, they may gradually revert to old habits and ways of living. This results in a return of symptoms known as relapse.
Relapse prevention aims to teach people strategies that will maintain the wellness skills they learned while in treatment.

Relapse prevention in mental disorders is crucial not only because symptoms are detrimental to quality of life but also because the occurrence of relapse increases chances for future relapses. In addition, with each relapse, symptoms tend to be more severe and have more serious consequences.

 

Description of Relapse


 Relapse is a concern with any disorder, whether physical or psychological. Cancer is a prime example of a physical condition where relapse is common, either after a short period or many years of remission (being symptom-free). Psychological disorders can follow a similar pattern, and certain psychological disorders tend to have a higher rate of relapse than others.
Addictive disorders, such as alcohol and drug abuse, smoking, overeating, and pathological gambling, are well known for high levels of relapse. Many addictions involve a lifestyle centered around the addictive behavior. In such cases, individuals must not only discontinue the addictive habit, they must also restructure their entire lives in order for changes to last. Such vast changes are difficult at best, approaching impossible in the worst scenarios. For example, an individual with a drug addiction may live in a neighborhood where drugs are prevalent but may lack the resources to move. According to recent statistics, relapse rates are approximately 33% for people who gamble pathologically (within three months of treatment), 90% for people who quit smoking, and 50% for people who abuse alcohol. Within one year of treatment, people struggling with obesity typically regain 30% to 50% of the weight they lost.
Affective disorders, such as depression and anxiety, also have high rates of relapse. People with affective disorders are thought to engage in self-defeating, negative thought patterns that occur more or less automatically. These thought patterns affect behavior, resulting in unproductive or negative consequences. Negative consequences are regarded by such individuals as proof that their original self-defeating thoughts must be correct. The thought-behavior pattern becomes a repetitive cycle, with negative thoughts resulting in negative behavioral outcomes, and consequences of negative behavior encouraging more self-defeating thoughts. This cycle is extremely difficult to break because it becomes a habitual way of responding to the world that occurs almost without awareness. Relapse rates for depression are reportedly as high as 80% so relapse prevention is critical..
Relapse among people who commit sex offenses is a constant safety concern for those in the community. However, some statistics show that this population has a very low rate of relapse. A recent report by Robin J. Wilson and colleagues indicated rates as low as 3.7% to 6.3%. This same report stated that, among various criminal offenses, those who commit sex offenses relapse at lower rates than those who commit general offenses. Other professionals may not necessarily agree with this study, however. Those who commit sex offenses are considered at a higher risk for relapse if they display little insight into the impact of their crime. Those at high risk of committing a sex offense are not typically released back into the community.

For many types of disorders, initial dual diagnosis treatment is often effective at eliminating the unwanted behavior. However, these effects are rarely maintained long-term without some type of relapse prevention planning. Results of medications are similar; symptoms are alleviated, but once the medication is discontinued, symptoms return unless the individual has had some type of training in coping with his or her disorder and that training has been effective.

 

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The Costs of Alcohol and Drug Treatment

How much does a drug rehab center cost?

“How much does it cost?” is often one of the first questions asked by anyone who is looking for alcoholism or drug addiction help.

The price tag for drug abuse & alcoholism treatment is presented in many different formats. You need to know what is included, what will be added to your bill as a fee-for-service program, and what services your health insurance will cover (if you have any). This makes it extremely difficult to compare prices by simply asking the question - “What does drug rehab costs?”

If you are seeking the best value for your money, remember: Price can be meaningful only in the context of quality and length of the program.

Is the drug rehab treatment program medically based?

There is an advantage to including on-site medical care in a Drug Rehab. Physicians and nurses provide 24-hour hospital services to monitor and ensure a safe withdrawal from alcohol and other drugs. We need to remember that improper or unsupervised detox can jeopardize the patient’s life. In addition, a medical staff specializing in addiction medicine can oversee the progress of each individual and make necessary adjustments to the treatment plan.
Medical credentials and accreditation are also important. For example, a chemical dependency Drug Rehab that earns JCAHO accreditation (Joint Commission on Accreditation of Healthcare Organizations) meets national standards for providing quality medical care. Appropriate state licensing is also an important consideration. We strongly suggest you choose a facility that has the gold seal of approval from JACAHO.

Be sure to ask which medical costs are included in the price of treatment at the drug rehab.

What is the degree of family involvement in the treatment program?

Drug abuse and alcoholism affects the entire family, not just the alcoholic or addict. Quite often family members do not realize how deeply they have been affected by chemical dependency. Family involvement is an important component of recovery. For example, Lakeview Health Systems offers a family component in the treatment of substance abuse. We take in consideration that at some point, the recovering addict will integrate with the family again. This is why the family also needs treatment in order to understand the disease and help their family member with his or her recovery from alcohol or drugs within a supportive environment.

Drug Rehabs vary in the degree and quality of family involvement opportunities. Some offer just a few lectures and others offer family therapy. Ask if there is any time devoted to family programs and if group therapy is included.

Does drug rehabilitation include a quality continuing care program?

There are no quick fixes for the diseases of drug abuse and alcoholism. Recovery is an ongoing process. The skills one learns during intensive rehabilitation treatment must be integrated into everyday life and this takes time.Some drug addiction treatment programs will offer a follow-up program but only in one location which may make it difficult to use.

Drug rehabilitation treatment programs should include a quality, continuing care program that supports and monitors recovery.

The decision to enter a drug rehab program can be a very difficult and painstaking process. If you are confused by the many choices offered on the internet, and need trustworthy advice, please call one of our organization at 1-800-993-3869. We will answer all of your questions so you can make a good choice, absolutely free. Most of the people answering the phone have many years clean and sober after recovering from alcoholism and drug addiction. They can give you the best  advice. Please visit www.recoveryconnection.org for more information.

*SAMSHA Releases Data on Average Cost of Services

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Catholic Bishops Shut Gay Families Out of Church Again

Catholic Bishops Shut Families Out of Church Again
PFLAG Statement on New Guidelines for Gay Americans
 
Washington, D.C.Jody M. Huckaby, executive director of Parents, Families and Friends of Lesbians and Gays (PFLAG), issued the following statement regarding the adoption of guidelines by the U.S. Conference of Catholic Bishops today:
 
“Today, the U.S. Conference of Catholic Bishops helped advance the message of isolation, shame, and rejection that gay, lesbian, bisexual and transgender (GLBT) Catholics have been subjected to for many years. The newest guidelines, however, take this message several steps further than they have gone in the past, in spite of glaring evidence of how this treatment destroys spirits, tears families apart. Priests will now be encouraged to perpetuate a culture of being in the closet and of shame when they minister to their GLBT parishioners and the people who love them.

Need a GLBT friendly alcohol rehab program or GLBT drug rehab program, click on www.gay-rehab.com   or   www.lakeviewhealth.com.  
GLBT Catholics have been subjected to negative treatment from the Church. The message to them has been clear: unless you are straight, you are not welcome to full participation in your faith. Today’s announcement strengthens this contention that GLBT people are not welcomed to live authentically within the Catholic Church.
 
In the past year, Americans have watched the destruction that individuals and their families suffer when they are not permitted to be honest about their God-given sexual orientation. Rather than speak to people to help them overcome shame and the closet, the Catholic bishops will encourage behaviors that will guarantee incidents like these will happen for years to come.
 
Faith and spirituality should be accessible to all people, regardless of sexual orientation, and the denial of this participation is contrary to the very Catholic ideal of compassion and justice. A sense of spiritual community is critical to the lives of many people, and the denial of this connection is yet another inequality and injustice that GLBT people and their families must face.
 
Fair-minded straight people, together with GLBT people, should call on their local bishops to express their condemnation of this latest statement. Catholic leaders need to understand that their condemnation of our families only serves to perpetuate discrimination against millions of people of faith across this country. Discrimination should not be among the values that the Catholic Church upholds for its people.”

If require assistance locating a gay friendly drug rehab program or gay friendly dual diagnosis treatment program in your area, you can call the natinal addiction treatment helpline at 1-800-511-9225. 

 
 
 

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