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Clinical Social Worker/Therapist

People generally have no idea what addictions counseling is about. I’ve had countless people ask me, “I know I’m not supposed to do drugs/drink. What else is there to talk about?” I give them my Mr. Mackey (South Park) impression and jokingly agree, “Drugs are bad, mmkay. You can go now.”

At the opposite extreme, I’m often asked, “How am I supposed to not do drugs/drink?” At face value, the question is, how do I not do something? What’s really being asked is, “What am I going to do instead of doing drugs/drink and how am I supposed to deal with life, problems, and my emotions without them?” So this is often where we start in addictions counseling:

  1. How to achieve and maintain abstinence
  2. How to move from sobriety to recovery
  3. How to deal with life on life’s term

Getting Clean & Sober

Keeping it simple, a person who has become dependent on a drug should always consult with their primary care physician (PCP) before they begin to withdraw from a substance. It’s common sense and it ensures safety. In some cases, medical support will be necessary to monitor the body as it goes through detoxification. An addictions counselor will consult with your PCP and can make referrals as needed.

Generally, the first seven days are pretty rough. It gets easier as we go and after 30 days we experience notable improvement physically, emotionally, and mentally. Our health continues to improve for at least twelve months.

Maintaining Sobriety

Relapse prevention plans are a vital piece of addictions counseling. These are very pragmatic and specific plans that describe how we will respond to urges and triggers that tempt us to resume using/drinking. The plans are custom made to suit the individual but should always include:

  • Skills & Strategies for maintaining awareness of our thoughts, feelings, and behaviors (remember were accustomed to ignoring much of them).
  • Implementing immediate steps to be taken when triggered/feeling the urge to use (phone contacts, coping mechanisms that can be used in any setting/environment, ways to refocus and identify what is needed to avoid further wrestling with the urge).
  • Habits and routines that reduce stress and promote healthy actions
  • Planning for known stressors. (Times when we have to be amongst people or places that we associate with using/drinking due to work or family obligations).
  • Back up plans and emergency plans. (Measures we’ll take to ensure safety and abstinence when all seems lost).

Regardless of your confidence level in your ability to stay abstinent, having a solid relapse prevention plan will serve you well if you view it as an investment in your overall well being. The strategies outlined do more than keep us sober; they improve our overall health and quality of life.

Moving from Sobriety to Recovery

All that is required to be sober is that we not drink/use. By the time a person reaches addiction, there is assuredly wreckage in their lives. Some of us lost friends, family, jobs, money, and/or material possessions. To regain what was lost is a major undertaking and simply must be done with support. For all of us, the wreckage includes the loss of self, the destruction of self, and the emotional fallout of having succumbed to the disease of addiction.

We seek to change, to transform and to become something greater than we are. Most of us are simultaneously overwhelmed and in a hurry. This is a very problematic combination.

Addiction counseling is a process of prioritizing. After sobriety is attained, we need to make choices regarding what’s most important and develop manageable plans on how to attain it.

  • Treatment plans are developed collaboratively in counseling and should accurately represent what our goals are. Goals are broken down into short (generally 90 days) and long term (generally one year) measurable achievements. They are further broken down into objectives. Step by step we incrementally achieve the results we seek.

Recovery has been defined as “awareness of the attitudes, beliefs, and behaviors that block change.”

A good addictions counselor will call us out on these. It’s uncomfortable to be confronted, but the use of subtlety or handling a person in recovery with “kid gloves” is ill advised. Those of us in early recovery remain very adept at lying to ourselves. We need to have it pointed out to us when we rationalize or justify because these undermine our ability to trust ourselves and our perceptions.

Emotional Immaturity

“It takes courage to grow up and become who you really are.”
~ E.E.Cummings

Courage is the choice not to allow fear to stop us from learning, growing, and healing. For most of us, we don’t know what we don’t know. We feel much older than we are due to the impact of past experiences and we feel much younger than we are due to our development being arrested by abuse, neglect, and substance abuse.

Addiction treatment supports us in learning to be more mature in our perception and behavior. We learn that we have emotional reflexes and that we must get to a place in which we respond instead of reacting.

Integrating Addiction Treatment & Natural Supports

The goal of any good addictions professional is to put themselves out of a job at the earliest safe juncture. This is achieved most readily when natural supports are integrated into treatment.

  • Involving family, friends, and supportive others (sponsors, contacts, recovery coaches) in the process of implementing change ensures mutual understanding and cohesion toward shared goals.

When progress is made in this direction, we move away from the need for professional service and toward living more authentically. It’s common that folks fear this loss of support and so this can be done incrementally.

Moving On

Aftercare plans are a compilation of resources, ongoing goals and planned steps to be taken following discharge from treatment. There should be contingencies in place for returning to treatment if needs arise.

Addiction treatment is simply a linear progression. It’s common that folks come in and out as they meet new challenges and milestones.

Check out part 1 of this article - Choosing the best alcohol addiction treatment for your needs.

About the author Jim LaPierre:
My story is I'm forever a work in progress and I love connecting with REAL people who are doing great things. I'm blessed to be making a living doing something I love. I'm a proud dad and the luckiest husband ever. I'm an aspiring author - check out my recovery blog at: recoveryrocks.bangordailynews.com Thanks! Jim
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Page last updated May 18, 2015

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