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Counselor's Manual for Relapse Prevention With Chemically Dependent Criminal Offenders

Technical Assistance Publication Series

19

Terence T. Gorski, M.A.
John M. Kelley, M.A., C.S.W.

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Substance Abuse and Mental Health Services Administration

Rockwall II, 5600 Fishers Lane
Rockville, MD 20857

This publication is part of the Substance Abuse and Mental Health Services Block Grant technical assistance program. All material appearing in this volume except quoted passages from copyrighted sources is in the public domain and may be reproduced or copied without permission from the Center for Substance Abuse Treatment (CSAT) or the authors. Citation of the source is appreciated.

This publication was prepared under contract number 270-93-0004 from the Substance Abuse and Mental Health Services Administration (SAMHSA). Gayle J. Saunders, of CSAT, served as the Government project officer.

The opinions expressed herein are the views of the authors and do not necessarily reflect the official position of CSAT or any other part of the U.S. Department of Health and Human Services.

Introduction

This publication is intended for use by people who are interested in working with criminal offenders who are chemically dependent (addicted to alcohol and/or drugs). It focuses on chemical dependency and the criminal offender, and will present you with information you may not have been exposed to before.

Research tells us that most criminal offenders have alcohol or drug problems. It also tells us that traditional forms of treatment for chemical dependency are not very successful with these offenders. Many of them return to using alcohol or drugs after treatment. When this happens, most of them become repeat offenders. This publication is designed to help you teach criminal offenders how they can stay sober and clean.

This publication is designed for the paraprofessional counselor. A paraprofessional counselor is someone who wants to help others, but who has little or no professional counselor training. This publication explains basic counseling information in simple terms. It is also designed to help you work with people who are using the Appendix—Relapse Prevention Workbook for Chemically Dependent Criminal Offenders. It explains the purpose of each exercise in this workbook and tells you how to help the patient use and understand the exercises.

This publication is based on information that has had better than average results in treating chemically dependent criminal offenders. This information is called relapse prevention therapy. Relapse prevention therapy is based on experience with patients who generally fail in traditional treatment. The techniques in this publication were developed through experience with these patients.

Relapse prevention therapy breaks down the recovery process into specific tasks and skills. Patients must learn these skills in order to recover. It also shows patients how to recognize when they are beginning to relapse, and how to change before they start using alcohol or drugs again.

It is important that you read the entire publication to understand the basic information and how it all fits together. When you read the section that explains how to use the exercises from the Appendix—Relapse Prevention Workbook for Chemically Dependent Criminal Offenders, read the workbook at the same time. If you are a recovering person yourself, fill in the workbook as you go through it. This will help you understand how the exercises work.

It is important to tell your patients (the offenders with whom you are working) that they may get frustrated or discouraged at times when they are completing the workbook. The main reason for this is that chemically dependent people, especially criminal offenders, want immediate payoffs and results. Recovery doesn't give immediate results. Encourage them to continue with the exercises, and give them positive feedback for each step they complete along the way.

It is also important for you not to get discouraged. Talk with other people who are doing the same kind of work. Find out what is working and what is not working for them. Tell them the same things. Encourage one another.

How will you know when patients are making progress? You will know by seeing how they change the way they think, feel, and act toward themselves and others. If you try to control your patients, they will either drop out of treatment or simply manipulate you by telling you what they think you want to hear.

It is important that you view your patients as people whose disease of chemical dependency and way of thinking prevent them from acting in a socially acceptable manner. These patients may want to be full members of society, but they do not have the skills to do so. In some cases, they have given up hope.

It is your job to help your patients understand more about themselves and the world, help them learn new skills, and give them hope, so that they are motivated to change. You cannot do this by telling them what they are or what they must be. It is one thing for you to know, but unless the patient comes to an understanding based on changes in his or her own thinking, treatment will fail.

You do not have all the answers. Even professional counselors do not have all the answers. Most answers come from listening carefully to what patients say and how they think. If you do not know something, be honest. Patients will respect you for this and be more willing to work with you if you are honest about what you do and don't know. When you don't know an answer, try to find the information and share it with the patient.

Most of all, give patients your best effort. If you do this and learn from your mistakes, you will become a better counselor. Read as much as possible about chemical dependency and counseling for chemically dependent people. Get all the training you can. Remember, your best source of information is your patients. When you make a mistake, admit it and learn from it. Even if you don't succeed with one patient, what you will learn will help other patients in the future.

You may never know for sure if you have helped most of your patients. Some patients will not use information you give them now, but will use it at some point in the future. Also, remember that every patient you help will have a positive impact on everyone with whom they come in contact.