DBs Unit 2

DB 2.1: Therapeutic Factors in Different Settings

According to Stevens and Smith (2018), group treatment can occur in various settings, with two of the most significant being Residential Treatment Programs and Outpatient Treatment Programs. In Residential Treatment Programs, where clients live full-time within the facility, Yalom’s therapeutic factors, such as group cohesion, universality, and instillation of hope, are essential. Group cohesion plays a vital role in this setting as clients come together and share daily experiences. The development of a sense of unity and mutual support is key to creating a therapeutic environment where clients hold each other accountable and progress together. Universality is equally important in residential settings. When clients realize they are not alone in their struggles with substance use, they feel less isolated, which can significantly bolster their engagement in treatment. Finally, the instillation of hope occurs as clients witness others making progress in their recovery, which reinforces the belief that they, too, can succeed in overcoming their addiction (Stevens & Smith, 2018).

In contrast, Outpatient Treatment Programs allow individuals to live at home while attending group sessions. In this context, interpersonal learning, socialization techniques, and the development of insight are more in focus. Interpersonal learning allows the client to get feedback from their peers about how their behaviors and attitudes affect others, which can immediately be applied in their current lives outside of treatment (Marmarosh et al., 2022). Socialization techniques help clients learn how to rebuild their social networks in healthy ways, which is critical in preventing relapse. Insight development is important in outpatient settings because such settings allow clients to understand the core issues that created their addiction and teach them how to monitor and manage their triggers within natural environments (Islam et al., 2023).

References

Islam, M. F., Guerrero, M., Nguyen, R. L., Porcaro, A., Cummings, C., Stevens, E., Kang, A., & Jason, L. A. (2023). The importance of social support in recovery populations: Toward a multilevel understanding. Alcoholism Treatment Quarterly, 41(2), 222–236. https://doi.org/10.1080/07347324.2023.2181119

Marmarosh, C. L., Sandage, S., Wade, N., Captari, L. E., & Crabtree, S. (2022). New horizons in group psychotherapy research and practice from third wave positive psychology: A practice-friendly review. Research in Psychotherapy: Psychopathology, Process and Outcome, 25(3). https://doi.org/10.4081/ripppo.2022.643

Stevens, P. W. & Smith, R. L. (2018). Substance use counseling: Theory and practice (6th ed.). Pearson Education, Inc.

DB 2.2: Reactions to Detoxification and Aftercare

After watching the detoxification and aftercare videos, I gained new insights into the complexities of both processes. The first video by Hazelden Betty Ford Foundation (2019) explains that some of the symptoms of withdrawal from alcohol, such as seizures and delirium tremens, DTs are life-threatening and are usually medically monitored with care. In addition, it shows that professional detox is rather important in managing the life-threatening effects of withdrawal from substance use. Notably, before viewing the video, I did not know how deadly a withdrawal process might be, especially when there is a lack of proper medical care where complications spiral out of control within a short period of time and become life-threatening (Hazelden Betty Ford Foundation, 2019).

Other useful information from the video was the use of medications, which alleviate withdrawal symptoms; hence, detoxification would be safer and less humiliating for patients. Such an approach to detoxification is critical in providing the possibility of successful completion of the process by minimizing discomfort and medical risks for individuals. Medications regulate the body’s systems so that severe complications during the early stages of recovery do not occur.

The second video by Dr. Drew (2017) highlights the significance of aftercare, particularly through structured programs like sober living homes. These ensure accountability and a structure through which to rebuild a sober lifestyle. They provide a transitional environment where individuals can put into practice some of the skills they learned in treatment, such as maintaining responsibilities and reestablishing relationships, yet still be accountable to their peers and counselors. Aftercare is an integral part of relapse prevention in that it provides continued support following the initial detox and rehab stages. The chances of relapse grow overwhelmingly without structured aftercare.

Detoxification and aftercare are crucial to sustain the patient for a long time. Detoxification attends to the immediate physical risks of withdrawal, while aftercare provides continued care that is essential for the maintenance of sobriety and the integration back to life. The therapeutic factors are central to effective therapy both in inpatient and outpatient settings since they aid in personal development, responsibility, and long-term sobriety (Mayo Clinic, 2022).

References

Dr. Drew. (2017, November 21). The last house sober living with Chris Kirby and Dr. Drew [Video]. YouTube. https://www.youtube.com/watch?v=ybAQczO-zlM

Hazelden Betty Ford Foundation. (2019, June 26). Alcoholism: A doctor discusses alcohol withdrawal, detox and treatment [Video]. YouTube. https://www.youtube.com/watch?v=CX1U23kB9ls

Mayo Clinic. (2022). Alcohol use disorder – Diagnosis and treatment. Mayoclinic.org; Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/diagnosis-treatment/drc-20369250

DB 2.3: Treatment Plan for Sam

Sam, a 35-year-old male with a severe alcohol use disorder, requires immediate, medically monitored inpatient detoxification. Given his daily alcohol consumption and multiple failed attempts at rehabilitation, inpatient detox is essential to prevent life-threatening complications such as seizures or delirium tremens (Galbicsek, 2019). Inpatient care will provide the medical supervision necessary to manage withdrawal symptoms and stabilize his condition, ensuring he safely navigates the initial stages of sobriety, which is particularly important considering his history of relapse and resistance to previous treatments.

Once stabilized, Sam should transition to a long-term residential treatment program. This structured setting will enable him to work through not only the alcohol use disorder but also any underlying psychological issues. Cognitive behavioral therapy (CBT) will be crucial in helping Sam identify and change the thoughts and behaviors that drive his drinking. Group therapy will be equally crucial in that it allows patients the opportunity to develop a support network with others who struggle with similar problems (Nakao et al., 2021). This type of peer support will keep him responsible and help him work on his social interaction skills in a healthier way, which is a major factor in sustaining long-term sobriety.

Additionally, it is also important that family therapy be incorporated into the treatment package for Sam, as the family is an essential aspect of his life and could provide important support. Family involvement will address enabling behaviors and improve communication, thus enhancing a more supportive home environment that complements his recovery. In addition, it is vital to incorporate the family into understanding the process of recovery and how they may help Sam maintain his sobriety (Varghese et al., 2020).

Although Sam’s treatment is court-ordered, providing an external motive, the long-term success will have to come from developing internal motivations. A combination of structured group and family therapies will play an essential role in making sure Sam remains sober after treatment by equipping him with recovery-sustaining tools and preventing him from relapsing.

References

Galbicsek, C. (2019). Alcohol withdrawal and detox. Alcohol Rehab Guide. https://www.alcoholrehabguide.org/treatment/alcohol-detox/

Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive–behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial Medicine, 15(1), 1–4. https://doi.org/10.1186/s13030-021-00219-w

Varghese, M., Kirpekar, V., & Loganathan, S. (2020). Family interventions: Basic principles and techniques. Indian Journal of Psychiatry, 62(2), 192–200. https://doi.org/10.4103/psychiatry.indianjpsychiatry_770_19

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 Unit Objectives:

• To learn more about the various drug treatment settings where group and family treatment can take place;
• To learn more about different challenges that exist between court ordered and voluntary treatment settings.

DB 2.1

• From reading more about group treatment and the different settings in which is can take place this unit according to Stevens & Smith (2009), please pick at least 2 settings (discussed pg 221-224) and think about at least 3 of Yalom’s therapeutic factors that might be unique in each setting. Please be sure to pick 2 different settings AND 3 different factors that might apply. Please discuss in detail how the therapeutic factors are essential in successful treatment in the setting in which you identify.

NOTE: You must make at least 1 substantial posting and 2 substantial replies to this thread. You must participate in the Unit discussion board (making postings/replies) at least 3 days per unit to qualify for full credit and also have at least 1 posting by Wednesday at midnight. You also must use APA style in your posting and replies so please use in-text references and provide a reference to give proper credit to the authors.

DB 2.2

• In viewing the required videos, what were your reactions to both the detoxification process, after care, and other important concepts illustrated? What did you learn about the detoxification process that you didn’t know before (please aim for at least 2 points)? In viewing the information about the aftercare program, why do you think it is such an important part of the treatment process? Any other thoughts you wanted to share about what you learned during this process?

NOTE: You must make at least 1 substantial posting and 2 substantial replies to this thread. You must participate in the Unit discussion board (making postings/replies) at least 3 days per unit to qualify for full credit and also have at least 1 posting by Wednesday at midnight. You also must use APA style in your posting and replies so please use in-text references and provide a reference to give proper credit to the authors.

DB 2.3
Sam is a 35 year old African American male arrives at the ER escorted by his grandparents who stated that they arrived at his apartment and found him generally unresponsive although they could help him to the car to transport him to the hospital. They report that Sam is a regular drinker, but that his home was particularly filled with empty beer cans. They stated it was not uncommon for him to drink over 24 beers daily and that he has been “in and out” of rehab centers over the past 2 years with little success. He does not have any known medical conditions and he is financially supported by his family (grandparents, mother, father, and 1 sister although he lives alone). He is also on probation and his officer has been called. His grandparents stated that he was court ordered for treatment but his intake session was not scheduled until next week.

• -Based on your reading this unit, which level of care do you think that Sam is most appropriate for based on his present symptoms and why?
• -After Sam is stabilized, what are your basic treatment plan impressions to help him remain sober?
• -What are you general thoughts about Sam and that he is being court-ordered for treatment?
• -What are your general impressions about family and group therapy in helping Sam remain sober?

NOTE: You must make at least 1 substantial posting and 2 substantial replies to this thread. You must participate in the Unit discussion board (making postings/replies) at least 3 days per unit to qualify for full credit and also have at least 1 posting by Wednesday at midnight. You also must use APA style in your posting and replies so please use in-text references and provide a reference to give proper credit to the authors.

DBs Unit 2

Readings:

• Please review Chapter 8 in Stevens and Smith (2018) to learn more about the etiological theories of substance abuse.
• Please read SAMSHA’s Principles of Drug Addiction Treatment: A Research Based Guide to learn more about the different types of treatment settings by clicking HERE.  https://nida.nih.gov/sites/default/files/podat-3rdEd-508.pdf
• Please read about Advances in Psychiatric Treatment (2002) by clicking HERE (or copying and pasting the URL into your browser: http://apt.rcpsych.org/content/8/1/34.full)
• Please view this short video discussing the detoxification process and demonstrating briefly an inpatient hospital setting as shown: https://www.youtube.com/watch?v=CX1U23kB9ls
• Please view a short video that discusses sober living as shown on Celebrity Rehab with Dr. Drew at: https://www.youtube.com/watch?v=ybAQczO-zlM