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Where To Begin

​Substance abuse is a dangerous situation in one’s life.  It has the ability to steal and destroy careers, friend and family relationships, and even lives.  Knowing and having the correct tools to intervene in someone’s life, when the time is right, is crucial. Many times when working with individuals you do not know what to say or even ask. Many obstacles can stand in the way to an addicted individual surrendering to say they are powerless.  When they do surrender, this is the time the therapeutic process can begin.  There are many dynamics that need to be addressed through the recovery process.  Many people have done damage to their mind, body, and family.  A recovery process, I feel, should involve helping the individual to obtain skills to help all areas of their life affected by the substance abuse. Families should determine how willing the family member is to begin recovery and to build a treatment plan for their future. 
Starting this journey in substance abuse ministry I always had a problem of knowing if a person was ready for recovery, what stage of help they are in, pre-contemplation, contemplation, preparation, action, or maintenance stage. Learning about motivational interviewing and what the stages are will broadened a families understanding of where their family member is in the recovery process.  Motivational interviewing will help the treatment process to begin and find the path for the journey. Guiding them to see the need for abstinence would be a goal, but it will occur when they are ready. Walters says, “People with advanced addiction may feel like their actions are simply beyond their control.” (Walters and Rotgers, 2012 pg. 12)
A sensible understanding of how the brain functions with and without substance abuse helps to conceive the addictive behavior one goes through.  A cornerstone to recovery is education on the effects of drugs and alcohol. Irrational thinking begins while someone is intoxicated.  The stress is depleted, rational thinking is hindered, and reality is blurred.  The effects of drugs has hindered the ability to make intelligent decisions.  Spontaneous decision making becomes the norm, retraining the thinking process is crucial to help addicts to make logical choices for the future. 
Cognitive-behavioral theories will help a person to regain proper steps to making wise decisions, hopefully, eliminating future stress.  Helping individuals to realize the need to make decisions about their environment, relationships, lifestyle, and recovery process is centered in cognitive-behavior therapy. “The three core tasks of treatment from a CB perspective-functional analysis, skills training, and relapse prevention-are accomplished both by individual work with the client and by helping the client make active attempts to change environmental factors that may be triggering or maintaining substance use.”  (Walters and Rotgers, 2012 pg. 129)  Assisting the family and addicted family member to establish foundation is imperative for their future.  
Treatment plans are important for the family and addicted family member.  A treatment plan is called, “hallmark of behavioral treatment.” (Walters and Rotgers, 2012 pg. 141)  Walter and Rotgers goes on to say, “The traditional disease model has historically prescribed a generic treatment plan for all.  From this traditional perspective, treatment typically includes confrontation of patient denial, education about the disease concept of addiction and facilitation of the patient into a 12-step-oriented program such as Alcoholic Anonymous or Narcotic Anonymous.” (Walters and Rotgers, 2012 pg. 142)  The treatment plan will include goals set for the family and addicted family member.  The treatment plan, including obtainable goals, will allow them to see measurable progress.  The treatment plan and goals will be decided on ultimately by the one being helped.    
Part of one’s treatment plan may consist of 12-step-oriented treatment.  Alcoholic Anonymous and Narcotic Anonymous has been beneficial sense its inception.  “The 12-step approach to the origins, maintenance, and modification of addictive behaviors has long constituted an informal bio-psycho-social-spiritual model of addiction. (Wallace, 1989a)” (Walters and Rotgers, 2012 pg. 167)  All a person needs to do to enter AA or NA is to quit drinking alcohol or using drugs.   The first step to a person’s recovery is to admit they are powerless.  The individual has to admit the substance has taken control over their life and they know it is hindering their well being.  Walters and Rotgers say, “People who cannot consistently control when, where, and how much they drink and use drugs and/or cannot guarantee their actions once they start must recognize that they are powerless over this behavior.” (Walters and Rotgers, 2012 pg. 173)  The key I feel to getting help, is the person knowing they are powerless and something has control over them.  They must come to understand the danger drug and alcohol is doing to them physically, mentally, relationally, and spiritually.  12-step programs want the individual to identify with others with similar problems.  This will help the family and addicted family member to know they are not alone in this journey.  When connected with others on the same path it will help reduce guilt, shame, anger, anxiety, and remorse while building the skills to overcome hardship.
While being director of Families Fighting Addiction my passion has grown deeper for the family who deals with lost loved ones in addiction.  There are more people effected in substance abuse than just the addict.  The whole family has been effected.  Walters and Rotgers gives great detail on helping the family and intertwining recovery so the family can heal.  The writers of Treating Substance Abuse, Theories and Techniques give understanding to three models that are effective to helping the family: family disease model, family systems models, and behavioral models.  Helping the addict along with the family understand the dynamics that have caused or does cause substance abuse can be beneficial to the helping process.  Walters and Rotgers says, “Family-involved treatments may offer unique opportunities for engaging clients in therapy.” (Walters and Rotgers, 2012 pg. 239)  Walters and Rotgers goes on to give, “Three different reasons to involve families in treatment: (1) to help the user change his or her substance use, (2) to change family members’ own behavior and patterns of coping, and (3) to modify dysfunctional patterns of interaction.” (Walters and Rotgers, 2012 pg. 240)  When working with the family, the helper does need to be aware of the complexity involved.  More people involved will mean more dynamics to work with.  

Resources:
Rotgers, Fredrick and Walters, Scott T. (2012). Treating Substance Abuse: Theory and Technique (3rd ed.). New York: Guilford Press.
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