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Self Intelligence and Spiritual Interventions as CURE ​

for the collateral damage in the wake of codependency

Recoverees participate in education-based groups which incorporate interaction and discussion, designed to facilitate recoverees' self-awareness of their own processes. The focus here is to identity signs, symptoms and patterns of relapse, and explore effective strategies to prevent or reduce the frequency and/or intensity of future relapses

Goals of Social Recovery and Relapse Prevention Support Group Systems

1.   Provide a safe discussion group where clients practice re-socialization skills.
2.   Provide opportunities for clients who are advanced in treatment and recovery to serve as role models for clients who have been in recovery for less time.
3.   Encourage clients to broaden their support system of abstinent, recovering contacts with whom they can attend 12-Step or mutual-help meetings.
4.   Provide a less structured and more independent group environment that helps clients progress from treatment in the more structured environments of Early Recovery Skills and Relapse Prevention groups to recovery maintained with group support but without clinical support.

Session Format and Counseling Approach

The Social Support component of the INTELLIGENT INTERVENTIONS model is comprised of 36 group sessions that are held once a week over 36 weeks. Social Support group sessions overlap with the final 4 weeks of the intensive phase and allow clients to continue group work for nearly 9 months after the conclusion of major treatment components (Early Recovery Skills, Relapse Prevention, and Family Education). Clients who have attained a stable recovery and have completed 12 weeks or more of Early Recovery Skills and Relapse Prevention group sessions should begin attending Social Support group sessions. Social Support groups are primarily discussion sessions. They are 90 minutes long and should be limited to 10 people per group so that each client has time to participate.

Clients who have been co-leaders during Early Recovery Skills or Relapse Prevention group meetings can act as facilitators, under the counselor’s supervision. Client–facilitators should be screened carefully for emotional stability, intellectual competence, and strength of recovery. They should commit to attending regularly for 6 months and should meet with the counselor before the group session to be briefed on the topic and issues relevant to individual clients.

The client–facilitator’s job is to help the discussion run smoothly so that clients can get the most benefit from the Social Support group. The counselor should provide the client–facilitator the following guidelines for aiding the discussion:

1  Listen to clients, help them clarify what they are saying, but do not speak for them or provide answers.
2  Encourage group members to accept and support one another.
3  Focus on the members; do not assume a position of authority or monopolize the discussion.
4  Permit clients to depart briefly from the session’s topic if the discussion seems beneficial to all clients in the group.
5  Steer participants away from lengthy stories of using that might act as triggers for others.
6  Ensure that the group is not dominated by one or two members and that everyone in the group gets time to speak.
7  Avoid making generalizations.
8  Avoid asking “why” questions of members (e.g., questioning their actions or motivations).

The counselor opens the group session by welcoming clients and introducing the topic for the session. The counselor then facilitates a discussion that can include the session topic, abstinence issues, and problems the clients are experiencing in establishing a substance-free lifestyle. The following section lists the one-word session topics, along with questions, that the counselor and client–facilitator use to encourage discussion. If clinical issues arise that require the counselor’s attention before the end of the session (e.g., a client has relapsed recently or is going through a personal crisis that places recovery in jeopardy), the client–facilitator should notify the counselor privately. If the group is broken into smaller discussion groups, the counselor should reconvene the larger group 5 or 10 minutes before the end of the session to recapitulate important issues relevant to the session’s topic and to address any problems or concerns that arose during discussion.

Social Support Group Topics

The 36 topics below address key concepts in recovery and are suggested focal points for discussion in the Social Support groups. Each topic includes questions that the counselor and client–facilitator can pose to initiate and sustain group discussion. Relevant session descriptions and handouts from the Early Recovery Skills and Relapse Prevention portions of treatment are listed after the questions for some topics. During the course of discussion, the counselor may wish to refer to information included in the session descriptions or the handouts.

​The counselor may choose to use topics that are not listed here, as the needs of the clients in the groups dictate. The topics are presented alphabetically and can be used in any order the counselor deems most useful to the group.

Aging​
1. How do you view the aging process? What negative aspects do you see? What positive developments come with age?
2. How does getting older affect your staying abstinent and in recovery?
3. Is this your first time in recovery? If not, have you approached recovery differently this time?
4. As you grow older, is it important for you to find a 12-Step meeting or mutual-help group that has people your own age?
5. As you spend more time in recovery, how will you keep your recovery strong?​

Anger​
1. How do you feel about the way you handle your anger?
2. How do you feel when anger is directed at you?
3. Is anger a relapse trigger for you? In what ways?
4. What strategies or behaviors help you cope with anger?
5. How do you avoid being passive–aggressive when someone angers you?​

Relapse Prevention Session 23: Managing Anger
Handout RP 23—Managing Anger

Codependence​
1. How do you understand the concept of codependence?
2. With whom do you have codependent relationships?
3. How do these relationships affect your recovery?
4. During recovery, what changes have you made to address codependent relationships?
5. What strategies and techniques will you use to avoid codependence in the future?​

Commitment
1. What does commitment mean to your recovery?
2. What people or things have you been committed to in the past? What are you committed to now?
3. How important is the commitment of family and friends to your recovery?
4. How important is your commitment to friends and fellow clients who are in recovery?
5. How will you maintain your commitment to recovery?​

Compulsions​
1. What have you done to avoid transferring your substance dependence to other compulsive behaviors?
2. To what compulsive behaviors are you vulnerable?
3. Are all compulsive behaviors bad?
4. How has being in recovery helped you get your life under control?
5. What can you do to avoid abstinence violation syndrome?​

Relapse Prevention Session 28: Compulsive Behaviors
Handout RP 28—Compulsive Behaviors

Control​
1. How do you distinguish between things that you can control and things you cannot?
2. How do you respond to things you cannot control?
3. How has attending 12-Step or mutual-help meetings helped you address these issues?
4. What actions do you take to achieve balance and inner calm in your life?
5. What aspects of your life do you still need to change to remain abstinent and in recovery?​

​Relapse Prevention Session 27: Serenity Prayer
Handout RP 27—Serenity Prayer

Cravings​
1. Do you still experience cravings for substances? How have the cravings changed since you’ve been in recovery?
2. Do you feel as if your recovery is in jeopardy because of cravings? Why or why not?
3. When are you aware of cravings?
4. What changes have you made to reduce cravings?
5. What strategies and techniques will you use to keep cravings under control?​

​Early Recovery Skills Session 1: Stop the Cycle
Handout ERS 1A—Triggers
Handout ERS 1B—Trigger–Thought–Craving–Use
Handout ERS 1C—Thought-Stopping Techniques

Depression​
1. Is depression a trigger for you? How do you recognize that you’re depressed?
2. How have your feelings of depression changed as you’ve been in treatment and recovery?
3. What people, events, and feelings contribute to your depression?
4. How do you respond when you recognize that you are depressed?
5. What strategies and techniques help you avoid becoming depressed? What strategies and techniques help you get over depression?

Relapse Prevention Session 29: Coping With Feelings and Depression
Handout ERS 5—Roadmap for Recovery
Handout RP 29—Coping With Feelings and Depression

Emotions​
1. Do certain emotions act as triggers for you? Which emotions?
2. How has the process of recovery helped you become more aware of your emotions?
3. How do you cope with dangerous emotions, such as loneliness, anger, and feelings of deprivation?
4. During recovery, what have you learned about separating emotions from behavior?
5. What strategies and techniques help you maintain an emotional balance?

Relapse Prevention Session 18: Emotional Triggers
Relapse Prevention Session 29: Coping With Feelings and Depression
Handout RP 18—Emotional Triggers
Handout RP 29—Coping With Feelings and Depression

Fear​
1. When you entered treatment, what aspects of recovery were you afraid of?
2. Have your fears about recovery changed since you’ve been in treatment?
3. What helped you move past your fear?
4. What things concern you when you think about leaving treatment?
5. As you move forward with your recovery, what strategies and techniques will help you minimize your fears?​

Friendship​
1. How has your understanding of friendship changed since you’ve been in treatment?
2. Before you entered treatment, what were your friendships based on?
3. Now, what qualities do you look for in a friend?
4. What has being a friend to others contributed to your recovery?
5. What plans do you have for making new, supportive friends and maintaining current friendships?​

​Relapse Prevention Session 25: Making New Friends
Relapse Prevention Session 26: Repairing Relationships
Handout RP 25—Making New Friends
Handout RP 26—Repairing Relationships

Fun​
1. How have your fun and relaxing activities changed since you’ve been in treatment?
2. What do you do now to have fun and relax?
3. With whom do you have fun?
4. What role does having fun play in staying abstinent and in your recovery?
5. How will you incorporate new activities and hobbies into your life?​

Relapse Prevention Session 31: Looking Forward; Managing Downtime
Elective Session C: Recreational Activities
Handout RP 31—Looking Forward; Managing Downtime
Handout RP Elective C—Recreational Activities

Grief​
1. What experience have you had with grief?
2. Is grief a trigger for you? In what ways?
3. How has the way you cope with grief changed since you’ve been in recovery? How do you cope with feelings of grief now?
4. To whom do you turn when you experience grief?
5. What strategies or techniques do you use to keep grief from disrupting your recovery?​

Guilt​
1. How is guilt different from shame?
2. Can guilt be a positive factor in your recovery? In what ways?

3. How can guilt derail your recovery?
4. What can you do to reduce the guilt you feel?
5. What role has taking responsibility for past actions played in your recovery?

Relapse Prevention Session 5: Guilt and Shame
Handout RP 5—Guilt and Shame

Happiness​
1. Since you’ve been in treatment, when have you been happy? What made you happy?
2. Since you’ve been in treatment, how has what makes you happy changed?
3. Do you feel that happiness is essential to your recovery? Why or why not?
4. How have friendships helped you be happy?
5. What strategies or techniques can you use to help you through unhappy times?​

Honesty​
1. How important is honesty to your staying abstinent and in recovery?
2. In treatment, how have you learned to be honest with yourself?
3. In treatment, how have you learned to be honest with others, especially family and friends?
4. How does honesty relate to your self-esteem?
5. What strategies or techniques will you use to continue being honest in your recovery?​

Relapse Prevention Session 8: Truthfulness
Handout RP 8—Truthfulness

Intimacy​
1. Since you’ve been in treatment, how has your understanding of intimacy changed?
2. What concerns or fears do you have about intimacy?
3. Does sex function as a trigger for you? In what ways?
4. What do you look for in an intimate, caring relationship?
5. In what ways can intimate relationships support your recovery?​

Relapse Prevention Session 10: Sex and Recovery
Handout RP 10—Sex and Recovery

Isolation​
1. Are free time and being alone triggers for you? In what ways?
2. How was feeling isolated related to your substance abuse?
3. In what ways has scheduling activities helped you avoid isolation?
4. How has attending 12-Step or mutual-help meetings helped you avoid isolation?
5. What activities can you pursue on your own that will help keep you from isolation?​

Relapse Prevention Session 2: Boredom
Relapse Prevention Session 6: Staying Busy
Handout RP 2—Boredom
Handout RP 6—Staying Busy

Justifications​
1. What relapse justifications are you vulnerable to?
2. What emotions make you more likely to try to justify a relapse?
3. What are the dangers of assuming that your substance dependence is under control?
4. How is being smart important to your staying abstinent and in recovery?

5. In treatment, what strategies or techniques have you learned to help counter relapse justifications?​

Relapse Prevention Session 16: Relapse Justification I
Relapse Prevention Session 21: Relapse Justification II
Handout RP 16—Relapse Justification I
Handout RP 21—Relapse Justification II

Masks​
1. How do you use masks to hide the way you feel, presenting yourself as feeling one way when you really feel another?
2. In what circumstances do you mask your feelings?
3. How has the masking of your feelings changed since you’ve been in treatment?
4. How does masking your true feelings affect your recovery?
5. How is being honest with yourself and others important to your recovery?​

Relapse Prevention Session 8: Truthfulness
Handout RP 8—Truthfulness

Overwhelmed​
1. What contributes to your feeling overwhelmed?
2. How does feeling overwhelmed affect your behavior?
3. How has your response to being overwhelmed changed since you’ve been in treatment?
4. What risk does feeling overwhelmed pose to your recovery?
5. What can you do to ensure that you do not feel overwhelmed?​

Relapse Prevention Session 20: Recognizing Stress
Relapse Prevention Session 22: Reducing Stress
Handout RP 20—Recognizing Stress

Handout RP 22—Reducing Stress

Patience​
1. How has patience helped you in your recovery?
2. When is it hard for you to be patient?
3. Are there situations in which you can be too patient? What are they? Why can it be bad to be too patient?
4. How has attending 12-Step or mutual-help meetings helped you be more patient?
5. What strategies and techniques have you learned to help you be more patient?​

Physical​
1. How is your recovery related to your self-esteem?
2. During recovery, how has your body changed?
3. What new exercise or activity have you begun since entering treatment?
4. How have you begun to take better care of your health?
5. Why is it important to stay healthy to keep your recovery on track?​

Relapse Prevention Session 19: Illness
Relapse Prevention Session 17: Taking Care of Yourself
Handout RP 19—Illness
Handout RP 17—Taking Care of Yourself

Recovery​
1. Has your motivation for recovery changed since you’ve been in treatment? In what ways?
2. What has been your biggest challenge in recovery so far? Your biggest triumph?
3. From whom do you draw inspiration and encouragement in your recovery? Do you have a recovering role model?
4. How has attending 12-Step or mutual-help meetings helped you in your recovery?
5. As you move forward with recovery, what are the most important aspects for you to focus on?​

Relapse Prevention Session 7: Motivation for Recovery
Handout RP 7—Motivation for Recovery

Rejection​
1. Did feeling rejected contribute to your substance abuse? In what ways?
2. How have the ways you cope with rejection changed since you’ve been in treatment?
3. How has support from friends and family helped you cope with rejection?
4. As you make amends and repair relationships, some people may refuse to forgive you. How will you cope with this rejection?

5. What strategies and techniques will you use to address rejection as you go forward with your recovery?​

Relapse Prevention Session 26: Repairing Relationships
Handout RP 26—Repairing Relationships

Relaxation​
1. How have the things you do to relax changed since you’ve been in treatment?
2. Are leisure and downtime triggers for you?
3. How have you managed to separate relaxing from substance abuse?
4. Do you prefer to relax alone or with friends and family? Why?
5. How have you used scheduling and islands of enjoyment to help you relax and keep your recovery on track?​

Relapse Prevention Session 31: Looking Forward; Managing Downtime
Elective Session C: Recreational Activities
Handout RP 31—Looking Forward; Managing Downtime
Handout RP Elective C—Recreational Activities

Rules​
1. How do you respond to rules in general? How have you responded to the rules you’ve encountered in treatment?
2. What rules do you impose on yourself?
3. How do you balance the structure that rules provide with the need to relax and enjoy yourself?
4. How have the guidelines of 12-Step or mutual-help programs supported your abstinence and recovery?
5. What rules will be important for you as you move forward with your recovery?​

Scheduling​
1. In what ways have you used scheduling during your recovery? How has it helped support your recovery?
2. Do you use scheduling all the time or only once in a while? At what times do you find it is helpful to use scheduling?
3. What makes scheduling difficult for you?
4. How have friends and family supported your use of scheduling?
5. Do you think you will continue to use scheduling after you leave treatment? Why or why not?​

Early Recovery Skills Session 1: Stop the Cycle
Handout SCH 1—The Importance of Scheduling

Selfishness​
1. In what ways did selfishness contribute to your substance dependence?
2. Are there times when it is a good idea to be selfish? What are they?
3. How can selfishness be harmful to your recovery?
4. How have family and friends helped you become less selfish? How have 12-Step or mutual-help programs helped you become less selfish?
5. Do you think it is selfish to take time alone for exercising, relaxing, meditating, or writing in a diary? Why or why not?​

Sex​
1. Is sex a trigger for you? In what ways?
2. What distinguishes impulsive sex from intimate sex?
3. How can impulsive sex lead to relapse?
4. How can an intimate relationship help support your recovery?
5. What will you do to encourage healthy, intimate relationships in your life?​

Relapse Prevention Session 10: Sex and Recovery
Handout RP 10—Sex and Recovery

Smart​
1. Why is sheer willpower not enough to help you stay abstinent and in recovery?
2. How is being smart part of having a strong recovery?
3. How has anticipating situations in which you would be prone to relapse helped you stay abstinent and in recovery?
4. When have you tried to be strong, instead of smart? What were the results?
5. What strategies and techniques will you use to be smart as you go forward with your recovery?​

Relapse Prevention Session 13: Be Smart, Not Strong
Handout RP 13—Be Smart, Not Strong

Spirituality​
1. How would you define spirituality? Has that definition changed as a result of being in treatment?
2. Why is it important for your recovery to have a spiritual component?
3. How has attending 12-Step or mutual-help group meetings helped you stay abstinent and in recovery?
4. What qualities are important to you in choosing a 12-Step or mutual-help group to attend?
5. Aside from attending meetings, what other spiritual elements have you incorporated into your life during recovery? Will you continue these practices?​

Relapse Prevention Session 27: Serenity Prayer
Relapse Prevention Session 30: 12-Step and Mutual-Help Programs
Handout RP 27—Serenity Prayer
Handout RP 30—12-Step Programs

Thought Stopping​
1. How has thought stopping helped you cope with cravings to use? Give some specific examples.
2. Which thought-stopping techniques are most effective for you? Why?
3. What do you visualize when you use thought-stopping techniques?
4. Do you feel that you are more in control of your thoughts now than you were when you entered treatment? Why or why not?
5. What role will thought stopping play in your recovery after you leave treatment?​

Early Recovery Skills Session 1: Stop the Cycle
Handout ERS 1C—Thought-Stopping Techniques

Triggers​
1. What triggers do you still encounter in your daily life?
2. Are there triggers you cannot avoid? How do you cope with those triggers?
3. How has charting your external and internal triggers helped strengthen your recovery?
4. How have family and friends helped you cope with triggers?
5. What strategies and techniques have helped you stop triggers you encounter from becoming cravings for substances?​

Early Recovery Skills Session 2: Identifying External Triggers
Early Recovery Skills Session 3: Identifying Internal Triggers
Handout ERS 1A—Triggers
Handout ERS 2B—External Trigger Chart
Handout ERS 3B—Internal Trigger Chart

Trust​
1. How has lack of trust damaged relationships in your life?
2. Why is it important for your recovery that your friends, family, and others be able to trust you?
3. In addition to staying abstinent, what can you do to earn back people’s trust?
4. If people are slow to trust that you are abstinent and in recovery, how will you respond? What will you do if trust never returns to some relationships?
5. How has placing your trust in fellow treatment group members and 12-Step or mutual-help group members helped your recovery?​

Relapse Prevention Session 12: Trust
Handout RP 12—Trust

Work​
1. How has your work life affected your recovery? Have there been positive effects? Negative effects?
2. What steps have you taken to balance work with recovery? Have they been successful?
3. How has the balance of work and recovery changed since you’ve progressed in recovery?
4. Have you considered leaving your job? What are the potential pitfalls of doing this? What are the benefits?
5. Aside from the money, what do you find rewarding about your work?​

Relapse Prevention Session 4: Work and Recovery
Handout RP 4—Work and Recovery

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