13 Models of Treatment Addiction Counselor Exam Review

13  Models of Treatment Addiction Counselor Exam Review

Hi everybody and welcome to today’s
presentation of the Addiction Counselor Exam Review. We’re going to be talking
about models of treatment. Subscribe to the Addiction Counselor Exam Review. Podcast. Over the next little while we’re going
to review the premises of behavioral self-control, dialectical behavior
therapy, the matrix model, motivational enhancement, family behavior therapy,
medication assisted therapy, relapse prevention, and harm reduction
approaches. So basically what we’re talking about in this presentation are
the psychological models of treatment if you believe in the biological model then
obviously you’re not going to be looking at behavioral self-control you’re going
to be looking at pharmacotherapy or something else so what is the
psychological model well basically the premise of this model is that addiction
and mental health issues result from deficits in learning we
don’t learn the coping skills we need we don’t learn how to become aware of what
we need we don’t learn effective communication skills etc deficits in
thinking which are our cognitive errors or deficits and emotion regulation where
you go from 0 to 150 and you know no time flat and it can be any combination
of these things so the psychological or self medication model basically posits
that there are a bunch of different approaches you can look at behavioral
self-control you can look at individual and group counseling that has have
multiple evidence-based practices and then you can also look at
pharmacotherapy especially for mental health issues but also in some cases for
substances now we know that medication assisted there are only medications that
are out there right now for nicotine alcohol and opiates some other
medications have been shown to be moderately effective with some other
drugs but they’re not FDA approved for that yet so let’s move on so behavioral
self-control training is exactly what it sounds like it helps people strengthen
their internal mechanisms their self-awareness in order to control their
behavior it also helps them establish external controls so when I feel this
way what can I do what tools do I have in my toolbox to help me control this
motion this urged this feeling this thought so behavioral self-control
teaches coping skills goal-setting it helps people develop behavioral
contracts so what kinds of things would you contract for you would contract for
helping people stay clean and sober you would contract for when the person is
feeling anxious what will they do behavioral contracting is a lot like
treatment planning we’re developing a or relapse prevention planning more like
we’re developing a contract when adversity steps in your path what are
you going to do but behavioral contracting can also be
used for positive behaviors so encouraging the person they’re going to
make a contract with you that they are going to get adequate sleep every night
that they’re going to eat a healthy diet that they’re going to keep their therapy
appointment all of those things can be contracted and when there is a contract
it helps people stay a little bit more on target if you will or on task if they
feel like they have made a promise or a or or they told somebody else that they
were going to do something behavioral self-control also helps people identify
triggers that will cause a relapse so we talked a lot about triggers in substance
abuse counseling and people places things yada-yada-yada we also need to
pay attention to mental health triggers because when somebody’s depressed
they’re going to be more likely to relapse when somebody’s anxious or angry
they’re going to be more likely to relapse so what things trigger those
mental health issues and this can be people this can be situations this can
be times of day or holidays or just about anything that can trigger a
substance relapse contributing health relapse but we need to make sure that
neither one relapses because it relapse with their addiction it’s going to
impact their mental health negatively if they relapse with their mental health
it’s going to set them up for a relapse in their addiction so we need to deal
with both behavioral self-control also uses a tool called functional
analysis and when we do a functional analysis what we’re really doing is
asking ourselves or asking the person what led up to this behavior and what is
the function of this behavior so if Johnny’s in the in the grocery store and
he has a complete meltdown because he wants cocoa puffs and mom says no you
can’t have cocoa puffs well let’s do a functional analysis what was it that he
wanted was he hungry did he want you know did he just want cocoa puffs what
was it what was the hoped-for benefit of this behavior and how did we get to this
point where he’s throwing a tantrum well there may not be cocoa puffs in the
house but maybe somebody maybe mom or grandma or you know somebody else has
given in before and gotten him cocoa puffs when he threw a tantrum so it
rewarded that behavior so a functional analysis remember asks what is the
function of this behavior and how did we get to this point
how what led up to throwing a full-out tantrum and so we can help figure out
ways to intervene along the way because people’s relapses what they identify as
their relapse generally starts a long time before they pick up again or before
they have their clinical depressive episode so we want to look back and see
what the steps were that kind of led up to where we’re at right now that way we
can help the person identify early warning signs of relapse and intervene
sooner and behavioral self-control takes all of this information coping skills
goal-setting contracting trigger management and functional analysis and
puts it together to help people develop a relapse prevention plan which will
look very similar for mental health and for substances if people are using
substances are engaging in addictive behaviors it’s going to mess with their
neurotransmitters and make it harder for them to be happy make it harder for them
to be emotionally balanced if people are having difficulty with their mental
health is going to be harder for to stay clean and sober because they’re
feeling really lousy so we want to look at the things like vulnerability
prevention making sure they’re getting enough proper nutrition
remember hungry angry lonely and tired we want to make sure that they’ve
addressed all of those things so behavioral self-control is really a
comprehensive system for helping the person develop the skills and tools they
need identify when and how to use them and prevent as many problems as possible
now dialectical behavior therapy is newer but a lot of us are really
familiar with it why would you use dialectical behavior therapy
well clients may unintentionally reward ineffective treatment while punishing
their therapists for effective therapy so if we use DBT we’re going to be more
aware of that and if you think of when you’ve worked with the client before
when you start pushing those buttons when you start getting into those tender
emotional areas they may withdraw which punishes the therapist the therapist
goes oh you know that makes me unhappy that this client withdrew from treatment
because you know he was making progress but it got too painful and they hit the
road now how do they reward ineffective treatment because clients keep coming if
you are not pushing those hot buttons and making them uncomfortable
occasionally then they may keep coming because they’re like okay you know I can
do this this isn’t so bad DBT helps therapists become aware of
when a client is sort of lulling them into a false sense of laziness if you
will because you know things seem to be going swell for the patient quite
honestly if patients don’t occasionally get grumpy with you you’re probably not
pushing them or finding all of the buttons so dialectical behavior therapy
encourages therapists to get together in a group once a week and do case staffing
so you can get a fresh pair of eyes that may be saying that may be able to tell
you you know I think he’s avoiding this path right
here or I think this reaction of you know suddenly not showing up for
appointments maybe because you touched on this particular issue and in DBT
there’s a lot of functional analysis that goes on you’re going to see overlap
in these theories because DBT therapists really look at what’s the function of
this behavior is it they’re not making progress and they’re unhappy and they
left is it became because they left because but they became too
uncomfortable what are the reasons for this behavior and how can we maybe
create an environment that brings them back in or keeps them moving forward the
sheer volume and severity of problems presented by clients often makes it
impossible to use the standard cognitive behavioral format you know some clients
will present and they will have pain they will have anxiety they will have
depression they will have PTSD they will have cocaine abuse they will have a
history of sexual abuse they will have relationship issues I could go on and
cognitive behavioral therapy is really awesome for addressing thoughts but
cognitive behavioral therapy doesn’t help as much with some of the other bio
psychosocial issues so DBT can step in and help clients generalize some of
those skills they’re learning and develop more effective methods clients
who have engaged in cognitive behavioral therapy found the focus on change in
validating because we’re telling them what you’re doing right now is wrong in
cognitive behavioral therapy it’s often our unhelpful thoughts are called
irrational thoughts well you know that’s kind of hurtful if somebody says you’re
just being irrational which is why I use the word unhelpful but either way in
addiction people have may have difficulty with cognitive behavioral
because addiction is a solution to a problem it’s a bad solution but it’s a
solution to a problem so if we’re saying you’re not making the right choice here
the person’s going ah tried everything else and it hasn’t
worked so what am I supposed to do dialectical behavioral therapy provides
a lot of alternatives cognitive behavioral therapy often makes clients
feel like their suffering is being underestimated or their therapists are
overestimating their own helpfulness so we need to make sure to validate the
clients experience help them help them understand the function of their
reactions their urges their behaviors their thoughts and figure out a better
way a more helpful way to help them meet their goals you know and that means we
have to define or help the client define what their goals are not all clients
want to stay clean and sober forever you know so let’s look at what can we do in
this particular situation overriding themes in DBT mindfulness helping people
become aware of what they need what their thoughts are what their feelings
are and be aware of the difference between being in the emotional mind
which is the impulsive mind that typically reaches out for numbing and
the wise mind that can make more cognitive decisions based on facts that
are before them DBT teaches to stress tolerance and urge surfing so people can
get through those cravings they can get through the emotional surges that may
make them want to go use it teaches emotion regulation so people learn how
to dampen some of those surges a little bit by living healthier getting enough
sleep getting proper nutrition having positive social supports etc and finally
it teaches interpersonal effectiveness and problem-solving recognizing that a
lot of people who have emotional dysregulation who have you know
emotional upheaval have pushed away or overwhelmed people or felt like they
have been abandoned by other people in the past so we need to help them learn
how to identify what they need and effectively communicate their needs
so it’s not overwhelming to the other person but so the other person can
understand what’s going on and can help them problem-solve
the next model we’re going to talk about is the matrix model for stimulant use
now this one has been generalized I believe for cannabis use as well it’s
completely manualized it’s on the Samsa website it is a 45 session treatment
program that’s a long treatment program even if you’re going five days a week
that’s nine weeks every single day so 45 session treatment program that teaches
people about issues critical to addiction and relapse people receive
direction and support from a trained therapist and become familiar with
self-help programs the therapists in the matrix model functions simultaneously as
teacher coach both fostering a positive and encouraging relationship and
empowering the person to make the next right step motivational enhancement
therapy is the next technique and you’re gonna be kind of surprised with this one
it’s designed to help resolve ambivalence about treatment and
abstinence now motivational enhancement therapy is different than motivational
interviewing now you use some motivational interviewing techniques
when you do motivational enhancement therapy but motivational enhancement
therapy itself is a three to five session treatment program that’s it not
45 not a year three to five sessions it helps resolve ambivalence about
treatment and abstinence and empower people to make the next right choice for
them therapy consists of an initial assessment battery followed by two to
four individual sessions with the therapist so obviously you’re not
probably doing weekly sessions here you’re gonna do an assessment and then a
follow-up and then probably your next appointment two weeks later and your
next appointment a month later etc that way you’re staggering the time
motivational and Herot enhancement therapy your first treatment session
consists of something called the frames approach the person has provided
feedback about the initial assessment they’re encouraged to take
responsibility for their own actions thoughts and behaviors we encourage them
to elicit self motivational statements so recognizing what parts of this they
have the ability and desire to change and it strengthens motivation and builds
a plan for change so we’re working with the client we’re not telling them you
need to do this we’re saying okay now that you’ve heard the good the bad and
the ugly with the initial assessment where is it that you want to go from
here and let’s work together to make a plan I’m not gonna force you to do
anything we provide advice you know when you’re making that plan the client may
not have all the tools that they need or may not be thinking of creative ways to
use the tools they have so we can provide information or advice about
coping strategies for high-risk situations we then provide a menu of
options we help them figure out you know in this big scheme of things to address
your goals what is it that you need to do you know it’s kind of like going to a
restaurant and reading a menu and picking your first course your second
course etc the same thing is true here we can say all right well the first step
you want to do is what you have all these options out here you can do
self-help you can do outpatient intensive outpatient residential what is
it that you need but we want to focus on things other than just treatment we want
to say what are your options for overcoming your obstacles notice I say
obstacles not barriers you can scale obstacles barriers you can’t get around
so what can you do what are your options for working around the fact that you’re
you’re an hourly employee and if you’re not at work you don’t get paid so you
know you can’t be taking a whole lot of time off for treatment what can you do
to work around the obstacle of finances or childcare or whatever it is so we
help them identify the options and the resources they need we
provide empathy this is a big step no matter what problem they’re addressing
this is a big step you know crisis causes change and change causes crisis
whether you’re trying to lose 20 pounds or get clean and sober or address your
depression your going to be uncomfortable you’re going to have to
address some things that may make you uncomfortable for a little while and it
can be scary a lot of people when they start substance abuse treatment are
afraid they’re gonna relapse because that’s what they hear everywhere you
know you’re going to relax you can’t just start and work all the way through
well I’m here to dispel the myth that you cannot get through treatment without
a relapse people have done it does it happen a lot no but people have done it
we want to provide empathy for people because it’s scary we want to help them
understand you know what if you relapse if you slip that’s a learning
opportunity and we can figure out how to prevent that in the future and as you
get healthier and happier those slips and those regressions will be fewer and
farther between and we want to provide self-efficacy that is we want to
encourage the client to believe they can make this change when I work with people
who are trying to quit smoking a lot of times they’re looking at me like doc I
don’t I don’t know that I can do this I’ve tried 17 times before and I failed
every single time what’s gonna make this time different
and so we want to inspire self-efficacy we want to help them see how their
motivation is different we want to help them see how this
situation is different than the past but we also want them to look back over the
past and realize how much strength they actually have maybe they stayed clean
they didn’t smoke for six months well that’s great
you know that was really hard so you know you can do it it’s just a matter of
building on what you’ve learned from past attempts to quit in subsequent
sessions so this all takes place in the first session after the assessment in
subsequent sessions the therapist monitors change reviews the change
strategies being used and continues to encourage chain
this is a lot of coaching here you’re not going to be delving into deep dark
issues that may be underlying behavior motivational enhancement therapy is not
psychodynamic you know we’re not going to be looking at how your childhood is
impacting your presence or resolving issues from childhood we’re going to be
talking about focusing on behavior change and helping you see or helping
the client see positive forward progress in achieving that goal and there may be
some things that are needed with that there may be some counseling that goes
with it but remember you’ve only got like four
sessions to work with so you’re not going to be spending a lot of time like
we do in humanistic or psychoanalytic approaches family behavior therapy has
demonstrated positive results in both adults and adolescents so score this one
works with both age groups address is not only substance use and mental health
problems but also other co-occurring issues such as conduct disorder child
mistreatment family conflict unemployment chronic pain the list can
go on family behavior therapy involves having the patient along with at least
one significant other such as a cohabitating partner or parent work
together so you don’t have to have the whole family together and a lot of times
in addiction it is not possible to get that whole family together because there
are too many people who are hurting and you know there are going to be some
people who have their own stuff and they’re not able to come to the table
right now but so it’s the patient and at least one other person family behavior
therapy combines behavioral contracting with contingency management so you have
the patient who says I’m going to stay clean and sober I’m going to start doing
these positive health behaviors yadda yadda yadda it makes the Contract and
then you have the family member who is going to basically be the holder of that
contract and when things go well you know there are going to be contingencies
that are applied either additional privileges or
Ward’s or whatever the case may be whatever that person decides when I work
with families and we do but family behavior therapy I generally have the
contract go both ways so the person who’s the identified patient also holds
a contract on the loved one because loved ones are going to have to change
their behavior too when people are in dysfunctional relationships you have one
person who may kind of start it if you will but other people change their
behavior in a way to try to maintain balance in the family so we need to help
the enabler the codependent the mascot the hero whatever role this person takes
we need to help them change their behavior generally it revolves around
open communication and not nagging and some other things but I want the
identified patient to feel like they’ve got some element of control as well I
don’t want them to feel like they’re being ganged up on so both parties have
contracts and both parties have rewards for maintaining those contracts and
consequences for not maintaining those contracts in family behavior therapy
therapists seek to engage families in applying behavioral strategies taught in
sessions and acquiring new skills to improve the home environment so we’re
talking about communication and boundary setting and forgiveness and acceptance
and mindfulness and all those things and we’re helping the family take these
skills and figure out how to apply them to create a more harmonious family
environment seeking safety now I love this curriculum and that’s just a
personal statement that’s not saying it’s necessarily going to be right for
your particular case load seeking safety is a great curriculum for clients who
have issues with trauma PTSD and addiction its present focused so they’re
not going back there you know they’re focusing on what can I do to make my
environment right now if you think of mindfulness
and DBT and a CT and a lot of other theories that are out there that
encourage the person to be aware of how they feel and what their thoughts are
right now and instead of fighting with it saying I shouldn’t be scared
I shouldn’t be anxious I shouldn’t be this just accepting I am this is how I
feel now how can I improve the next moment and seeking safety helps people
learn how to become self-aware and identify ways to improve this up the
next moment while still being compassionate with
themselves and saying you know what you’ve been through a lot and you’re
doing good seeking safety is available as a book
with guidance for clients and clinicians and can be done an individual or group
so it gives you a lot of latitude now on your addiction counselor exam review I
really seriously doubt that they’re gonna ask you about each topic of
seeking safety but just to give you an idea of some of the really awesome
things that it can help you give you ideas for topics to cover in group or
individual the book goes over case management taking back your power when
substances control you using honesty and asking for help setting boundaries
getting others to support your recovery community resources creating meaning out
of what’s happened integrating the split self detaching from emotional pain and
grounding and coping with triggers just to name a few
there’s like I said there’s 25 topics in seeking safety and not all of them are
gonna be appropriate for every single group you don’t have to go through all
25 but it gives you you know a lot of stuff to work with the next model is the
socio-cultural model in this model emphasis is placed on the socialization
process culture observational learning and reinforcement of behaviors so this
model says where are you learning this stuff
who taught you or where did you learn that to cope with stress this is the
best way to act or react recovery involves building new social
and family relationships now that doesn’t necessarily mean discarding
everybody but it does mean learning how to set healthier boundaries some
cultures are not going to be as responsive or this won’t work as well
with some cultures where respect for elders and following the edicts of the
elders is expected no questions asked but for a lot of cultures this can help
people they need to learn how to build new relationships in terms of quality
and what those relationships look like they need to develop social competency
and interpersonal effectiveness so they’re able to identify and communicate
their needs and effectively get them met and it also teaches working within their
cultural infrastructure remember I said culturally some some
cultures are not going to be okay with just a upheaving a peopling
whatever turning family relationships upside down you know they’re going to
say there is a hierarchy in this family so we need to help people identify
alright within the bounds of your cultural infrastructure what can you do
to have healthier relationships and feel more supported empowered and and happy
the next model we’re going to talk about is relapse prevention and I think most
of us are really familiar with that in relapse prevention therapy we help
clients adopt strategies designed to help them become aware of cues or
triggers that make them more likely to abuse substances or become symptomatic
with mental health issues etc so these triggers can be any of the senses smell
taste sight sound touch it can be times of day it can be places it can be
different people there are a ton of things and you’re not going to be able
to help clients identify every single particular trigger what we want them to
do is become aware of you know the big ones but also become aware of how do I
feel when I’m being triggered when when this when I
feel like something’s triggering me what sensations do I notice when they be
stopped becoming more aware of that then regardless of what the trigger is and it
could be a new trigger they recognize and go okay I’m feeling triggered right
now and then they can take the next step which is to engage some of those more
effective alternate coping responses now medication-assisted therapy like I
said there are only a few medications out there and they really only right now
address opiates and alcohol and to a certain extent nicotine they’re working
on more the ones that you need to know about more than anything are methadone
you know methadone is used for pain management and some people but it’s also
a substitute or a medication assisted I shouldn’t say substitute because it
doesn’t people don’t get high on methadone the dose is very controlled
but it’s a medication that can be used to help people who are trying to recover
from an addiction to opiates suboxone is another one and a lot of people are
really familiar with it suboxone is a combination of buprenorphine and
naltrexone which people take sublingually they take in their mouth
now the suboxone if they try to crush it inject it you know get it some other way
that’s going to get too into their system faster then now Trek’s own kicks
in and it actually prompts and almost immediate detox from the opiates and
they start feeling really crappy really fast so suboxone is
has some of the benefits of methadone one of the main benefits of suboxone is
it can be dispensed from a doctor’s office you don’t have to go to a
methadone clinic vivitrol is another medication that’s out there and vivitrol
can be injectable as well as taking a variety of other ways vivitrol is
actually very useful not only for methadone or not methadone but for
opiates but also for alcohol and they found that people can get an injection
once a month and it helps with alcohol abuse antabuse is the long-standing drug
for people who abuse alcohol and antabuse basically keeps your body from
processing alcohol in the same way so you get to toxic levels of alcohol
byproducts in your system a lot faster which is why people get so deathly ill
on if they drink subsidy if they drink alcohol when they’re on antabuse SSRIs
have also been found to assist people with reducing some of their compulsive
behavior some of their desire to use reduce the urges to go out and and use
substances SSRIs which are your selective serotonin reuptake inhibitors
and your snr is selective norepinephrine reuptake inhibitors your antidepressants
typically is what they’re referred to but these drugs are really helpful for
both anxiety well for anxiety and depression
they found that SSRIs tend to be more helpful with anxiety than depression and
they’re not all created equal there are bunches of SSRIs out there and depending
on your client a each each client will have respond differently to each SSRI so
depending on on what is not in balance in their neurotransmitters one SSRI may
work better than another so we encourage them to be open with their doctor and
commune about side-effects so they can find the
right medication atypical antipsychotics and tricyclic antidepressants are also
out there and can help with moderating anxiety depression and in some cases
bipolar disorder now if somebody has bipolar disorder and they start taking
an SSRI it may trigger a manic episode which is why some doctors will put them
on a mood stabilizer and an SSRI what’s the take-home message here the take-home
message is that if we want somebody to stay clean and sober we need to make
sure that they are not clinically depressed or anxious out of their mind
so we need to help them feel content I mean we don’t need to make them feel
elated but we need to make them feel like they don’t want to crawl out of
their own skin and there are drugs out there that can help with the withdrawals
and help with the urges and cravings for certain substances which can make the
recovery period while the brain is rebalancing the neurotransmitters and
the body is recovering it can make that recovery period a little easier which
reduces the risk of relapse and finally harm reduction harm reduction recognizes
that drug use and mental health issues are a reality the goal of harm reduction
is to prevent harm caused by them in the for l’s and that’s L as in liver lover
livelihood and law so we want to prevent physical problems from use and with
alcohol that cirrhosis of the liver but we also are talking about you know
injectables and and other things so we want to present prevent physical harm
lover we want to prevent harm in interpersonal relationships and that can
be you know friends that can be family that can be spouses that can be children
but they had to find an L so lover liver and lover the third one is livelihood
we want to make sure that people don’t lose their job because of their
substance use and they’re gainfully employed and hopefully thriving at their
job and the fourth one is the law we don’t want people to start acquiring a
rap sheet because of their substance use and the law is not just criminal the law
is also civil so if they’re filing bankruptcy if they are getting judgments
against them so their credit score is like way down in the toilet that is
going to negatively impact them so we want to prevent harm biopsychosocial e
we need to look at how to help this person thrive in their present situation
interventions in harm reduction include low threshold pharmacological
interventions like we just talked about needle exchange programs you might be
saying well doesn’t that encourage it well if people are going to use you know
let’s look at preventing them getting from preventing them from getting HIV
let’s look at preventing them from getting hepatitis you know let’s try to
help them as much as we can and then we can start working on the use issues
provide an emphasis on non injection routes yes it’s not ideal
but the problems caused by inhalation or oral administration are often less
problematic than through intravenous drug use an involvement of those with a
history of use or distress in program development so we want to get people in
recovery to put in their two cents and say all right what are the biggest
challenges to staying clean and sober what are the things that would help
reduce some of these other secondary effects with health relationships
livelihood and legal or to use the for else which you’ll probably need to know
for your test liver lover livelihood and law the multidisciplinary approach kind
of takes everything and lumps it to other and it provides psychotherapeutic
interventions for co-occurring issues so you know each issue like PTSD may need
to be treated one way with the MDR or humanistic or cognitive processing
therapy you know who knows there depends on the person they also may have
relationship issues that need to be addressed through social skills training
they may have medical issues that need to be addressed
so the psychotherapeutic interventions need to look at all of the issues and
help people develop the coping skills and tools that they need to deal with
them medication assisted therapy is used for both addictive and mental health
issues to get people started on a level playing field it doesn’t mean they have
to be on it forever but a lot of times it’s helpful for people in the first six
months to two years to have that additional boost to kind of help
stabilize them until their brain and body fully recovery wraparound services
are provided to ensure people have access to necessary resources to achieve
their goals and that includes housing food financial advice legal advice the
list goes on and family therapy is provided to improve the interpersonal
environment of the person we know it’s easier to stay clean sober and happy
when you’ve got a healthy supportive social environment that may not be your
immediate family but it’s whoever the client defines as their family we want
to help them try to improve those relationships because those people are
going to be in their life and if those people are going to be in their life we
want to make sure that those people are at least not harming ideally they’re
supporting but at least not harming this person’s recovery so we’ve talked about
a lot of different theories behavioral self-control is just what it sounds
think behavior modification dialectical behavior therapy helps clinicians
recognize when they’re being played by clients but it also helps client the
skills and tools to understand their emotional
reactions to things and develop tools to address those the matrix model is
remember a 45 session model but it provides a lot of information about
addiction and triggers and coping skills motivational enhancement therapy is your
you know three to five session therapy that basically focuses on one issue and
says how can we help you achieve your goal to address this issue
it doesn’t look at a bunch of the other stuff that may be going on and the
therapist provides a lot of coaching and encouragement in motivational
enhancement therapy in family behavior therapy the client plus one other person
in the family need to be involved and it incorporates behavioral contracting and
contingency management so they make agreements and then there are
consequences as well as rewards for following the contract or not following
the contract medication assisted therapy is available in terms of addiction for
alcohol and opiates and nicotine but there are also a lot of medications out
there that will help with the emotional issues the depression the anxiety of the
bipolar disorder etc that may be under girding the desire to use relapse
prevention therapy helps people identify their triggers and cues learn to
identify what it feels like when they’re being triggered and how to take positive
steps when they start feeling that way in order to effectively cope with that
high-risk situation and finally harm reduction doesn’t necessarily stop
people from using but it tries to prevent them from having additional
problems in multiple areas including liver love.what lover livelihood and law alrighty thank you for being with me
today on this episode of the addiction counselor exam review I’ll see you next
time all of us at all CEUs wish you great success on your exam once you’re
certified or licensed please remember to visit
all CEUs for all of your continuing education needs we offer unlimited CEUs
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counselor all CEUs offers the training you need in three different formats you
can choose online multimedia self-study self-study plus live webinars or even
face to face weekend intensives which meet one weekend per month for 12 months
we can even present a training series at your facility just email support at all
CEUs calm to schedule it to learn more you can also visit all CEUs dot-com /a
sir that’s all CEUs dot-com /a c e are thank

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