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Although treatment programs differ, the basic ingredients of treatment are similar. Most programs include many or all elements presented below.

Assessment

As we discussed earlier, all treatment programs begin with a clinical assessment of a person's individual treatment needs. This assessment helps in the development of an effective treatment plan.

Medical Care

Programs in hospitals can provide this care on site. Other outpatient or residential programs may have doctors and nurses come to the program site for a few days each week, or a person may be referred to other places for medical care. Medical care typically includes screening and treatment for HIV/AIDS, hepatitis, tuberculosis, and women's health issues.

A Treatment Plan

The treatment team, along with the person in treatment, develops a treatment plan based on the assessment. A treatment plan is a written guide to treatment that includes the person's goals, treatment activities designed to help him or her meet those goals, ways to tell whether a goal has been met, and a timeframe for meeting goals. The treatment plan helps both the person in treatment and treatment program staff stay focused and on track. The treatment plan is adjusted over time to meet changing needs and ensure that it stays relevant.

Group and Individual Counseling

At first, individual counseling generally focuses on motivating the person to stop using drugs or alcohol. Treatment then shifts to helping the person stay drug and alcohol free. The counselor attempts to help the person

• See the problem and become motivated to change
• Change his or her behavior
• Repair damaged relationships with family and friends
• Build new friendships with people who don't use alcohol or drugs
• Create a recovery lifestyle.

Group counseling is different in each program, but group members usually support and try to help one another cope with life without using drugs or alcohol. They share their experiences, talk about their feelings and problems, and find out that others have similar problems. Groups also may explore spirituality and its role in recovery.

Individual Assignments

People in treatment may be asked to read certain things (or listen to audiotapes), to complete written assignments (or record them on audio-tapes), or to try new behaviors.

Education About Substance Use Disorders

People learn about the symptoms and the effects of alcohol and drug use on their brains and bodies. Education groups use videotapes or audiotapes, lectures, or activities to help people learn about their illness and how to manage it.

Life Skills Training

This training can include learning and practicing employment skills, leisure activities, social skills, communication skills, anger management, stress management, goal setting, and money and time management.

Testing for Alcohol or Drug Use

Program staff members regularly take urine samples from people for drug testing. Some programs are starting to test saliva instead of urine. They also may use a Breathalyzer™ to test people for alcohol use.

Relapse Prevention Training

Relapse prevention training teaches people how to identify their relapse triggers, how to cope with cravings, how to develop plans for handling stressful situations, and what to do if they relapse. A trigger is anything that makes a person crave a drug. Triggers often are connected to the person's past use, such as a person he or she used drugs with, a time or place, drug use paraphernalia (such as syringes, a pipe, or a bong), or a particular situation or emotion.

Orientation to Self-Help Groups

Participants in self-help groups support and encourage one another to become or stay drug and alcohol free. Twelve-Step programs are perhaps the best known of the self-help groups. These programs include Alcoholics Anonymous (AA), Narcotics Anonymous (NA), Cocaine Anonymous, and Marijuana Anonymous. Other self-help groups include SMART (Self Management and Recovery Training) Recovery® and Women for Sobriety.

Members themselves, not treatment facilities, run self-help groups. In many places, self-help groups offer meetings for people with particular needs. You may find special meetings for young people; women; lesbian, gay, and bisexual people; newcomers; and those who need meetings in languages other than English. Internet chat groups and online meetings are also available for some groups.

Many treatment programs recommend or require attendance at self-help groups. By attending, many people make new friends who help them stay in recovery. The number of meetings required varies by treatment program; many programs require participants to attend "90 meetings in 90 days," as AA and NA recommend. Some treatment programs encourage people to find a "sponsor," that is, someone who has been in the group for a while and can offer personal support and advice.

Self-help groups are very important in most people's recovery. It is important to understand, however, that these groups are not the same as treatment.

There are self-help groups for family members, too, such as Al-Anon and Alateen (see the "Just for You" section of this booklet).

Tags: Addictions

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