Transcript LRAES of Recovery - Florida Alcohol and Drug Abuse Association

P R E S E N T E D BY:
D R . L O R N A T H O M A S , L M H C , C A P, R D
J A S O N TA N N E R , L M H C , A N D
ANN CHAPMAN, LMHC, CAP
Overview
This workshop will introduce the LRAES approach of
recovery and allow clinicians to discover the factors that
lead clients to relapse.
You will learn how each client has followed specific
patterns that involve their:
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Lifestyle
Relationships
Attitudes
Emotions
Substance use
Overview/outcome of workshop
Practitioners will gain the skills necessary to
answer the client’s question of “why” in regards
to their self-destructive behaviors.
Clinicians will leave encouraged having not only a
thorough understanding of addiction but also a
clear perspective on how recovery should look
with the individuals in which they serve.
The Betty Ford institute (BFI) in 2007
defines recovery as
a voluntarily maintained lifestyle comprised of:
• Sobriety
• Personal health
• Citizenship
A Journal of Groups in Addiction and Recovery in an
effort to define recovery, say that a large number of
individuals have experienced and successfully
resolved dependence on alcohol and or other drugs,
referring to their new sober productive lifestyle as
being in “Recovery.”
Assesses the lifestyle of someone
in active addiction
The places one would go, and how
they usually spend their days:
• Were you able to keep a steady
job?
• Did you have somewhere safe
& comfortable to live?
• What did you do to have fun?
• Did your job, hobbies, or usual
recreational activities bring you
into contact with others who
used?
Assesses the relationships of someone
in active addiction
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Friendships or romantic
relationships with non-using
adults
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Faithfulness
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Pathological Conflicts
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Violence
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How authentic were you in your
relationships?
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Who did you talk to about your
struggle with addiction?
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What about relationships with
family members?
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Who did you feel you could trust
and be yourself with?
Assesses the attitudes of someone in
active addiction
• about the law
• about drugs/alcohol
• about power,
• about what kind of place the world
is?
• about your beliefs about yourself?
• Do you like yourself, feel proud of
the kind of person you are?
• How did these attitudes and
beliefs affect your behavior?
Assesses the emotions of
someone in active addiction
• What range of emotions
experienced?
• How often did you feel these
emotions?
• Did your emotions get out of
control?
Assesses the substance use of
someone in active addiction
• What was your drug of
choice?
• Why did you choose that
substance?
• How much time did you
spend thinking about drugs
or trying to get your next
fix?
Situations are not the core of relapse, thinking
patterns are – they are the internal dialog that
people tell themselves about the situation.
Addicts and repeat offenders use a pattern of
thinking, a pattern of viewing the world, and a
belief system that makes it likely that they will reoffend, continue to use addictive substances or
relapse after a period of recovery/sobriety.
Discovering Patterns to the Addictive Lifestyle
How to identify these patterns using the LRAES
method
Identifying these patterns is essential
because they are the forces/factors that
lead to relapse.
How to identify cognitive distortions
and thinking errors that contribute to
the patterns while assessing LRAES.
COGNITIVE DISTORTIONS, THINKING ERRORS,
AND PRO-OFFENDING BELIEFS
Cognitive distortions – things people say to themselves to give themselves
permission to do things they know they really shouldn’t do.
Thinking errors – are ways of thinking that are irrational or which tend to
mislead us about how the world really is.
Pro-offending beliefs – are general beliefs or attitudes that make it more
likely to use or re-offend.
Cognitive distortions or “twisted thinking” justify pro-offending beliefs,
which in turn lead to relapse an addiction.
The ten most used forms of twisted thinking
identified by Dr. David Burns, a pioneer in CBT.
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All-or-nothing thinking
Overgeneralization
Mental Filter
Discounting the
Positive
• Jumping to
Conclusions
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Magnification
Emotional Reasoning
Should Statements
Labeling
Personalization and
Blame
Pro-offending beliefs are at the core of
the addiction and when replaced with
pro-social beliefs individuals begin
participating in recovery based thinking.
This process requires that the counselor
instill hope and enhance the client’s faith
in their ability to trust that another belief
system will protect them.
Working with changing Cognitive Distortions,
Thinking Errors, and Pro-offending Beliefs
• Cognitive Distortion Assessment
Tool (discuss)
• Psych-Education
• Group Processing
• Decision Chain
• LRAES Assessment Tool
Psycho-Education
Educate Persons Served how to engage in
Pro-social thinking
Corrective Thinking
Thought Stopping
Self Affirmation
Process Group
Encourage individuals to:
Self Disclose
Discovery
New Insight
New Perspective
1) Situation
2) Thoughts about the situation
3) Feelings about the thoughts
4) Response – behavior
5) Evaluate thoughts for patterns
of CD’s, TE’s, and POB
6) Change thoughts to reflect
more pro-social patterns of
thinking
REFERENCES
Borchard, T. (2011). 10 Forms of Twisted Thinking. Psych Central. Retrieved on July
16, 2014, from http://psychcentral.com/blog/archives/2011/02/26/10-forms-oftwisted-thinking/
Hobson, J. (1997). Cognitive Distortion Checklist. Unpublished Manuscript.
http://www.forensicpsychology.co.uk/wp-content/uploads/2011/10/WebCD.pdf
Laudet, Alexandre. What does recovery mean to you? Lessons from the recovery
experience for research and practice. Journal of Substance Abuse Treatment, 33,
243-256.
West, Rosa. (2014). Cognitive Behavioral Therapy Advanced Tools & Skills. Florida
Department of Children and Families Substance Abuse and Mental Health Program.
White, W. (2007). Special Section: Defining and Measuring “Recovery.” Special article
Journal of Substance Abuse Treatment, 33, 221-228.