adult addiction services calgary alberta health services … · 2020-03-03 · seeking safety a...
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Adult Addiction Services Calgary
Alberta Health Services
Addictions and Mental Health
Caitlin Smid, BSW, RSW
Outreach Addictions Counsellor
Email: [email protected]
Tel: 403.367.5067
Alberta Health Services www.ahs.ca
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Overview
•Adult Addiction Services Calgary (AASC)
•What is addiction?
•Breaking down myths
•Seeking Safety - Paths to Healing
• Harm Reduction
• Present-Focused
• Trauma-Informed Care
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Integrated Treatment
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What is an Addiction?
The continued use of something despite
negative consequences.
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Continuum of Use
Mystification
Knowledge
Experimentation
Social
Habitual
Abuse
Addiction
Physical Dependence
Psychological Dependence
No Use Use
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Myths
• People have to hit “rock bottom” and lose everything before
help is effective.
• There is one type of addiction treatment that works best.
• For treatment to work, you have to really want it.
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People with Addiction
•Are doing the best they can
•May be experiencing pain
•Are capable of recovery
•Have the opportunity to receive treatment
•Are worthy of love and belonging
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• PTSD/Trauma
• Harm Reduction
• Trauma-Informed Care
• Present Focused
• Concurrent Disorders
Terms
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Lisa Najavits
“I am a third generation of women in my family who overcame
posttraumatic stress disorder (PTSD). My mother and grandmother were
Hungarians who survived the Holocaust in the most dismal ways,
experiencing repeated trauma, with my mother only 10 years old when it
began. In New York City in 1987, a stranger slashed my face with a razor
in an attempted rape. I note these histories because the work that follows
comes from the emotional work required to overcome those traumas –
both what I observed in my mother and grandmother and what I
experienced myself…”
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Seeking Safety
A Treatment Manual For PTSD and
Substance Abuse• The first empirically studied, integrative treatment approach developed
specifically for co-occurring PTSD and substance abuse
• Concurrent Treatment
• 25 specific topics
• Each topic provides highly practical tools and techniques to engage patients in
treatment.
• teach "safe coping skills" that apply to both disorders.
• restore ideals that have been lost, including respect, care, protection, and healing.
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Seeking Safety Model
Incorporates:
• Treating PTSD and substance abuse concurrently
• Homework and the practice of new behaviors (“Commitments”)
• Cognitive Behavioral Therapy
• The relationship of trauma and substance abuse
• Skill development and improved coping responses
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Features of Seeking Safety
• Focus on potential rather than pathology
• Use of simple, everyday words
• Emphasis on practical solutions
• Relating the material to current and specific problems in clients’ lives
• Making best use of time available
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Focus on Safety as Primary Theme
•Safety Skills
•Safety Themes
•Grounding Skills
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Safety – Principal Elements
• Discontinuing Use
• Reducing Suicidal Risks
• Minimizing Risks
• Letting Go of Dangerous Relationships
• Gaining Control Over Extreme Symptoms
• Stopping Self Harm
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Topics Include:
Safety
PTSD: Taking Back Your Power
Detaching from Emotional Pain
(Grounding)
When Substances Control You
Asking for Help
Taking Good Care of Yourself
Compassion
Red and Green Flags
Honesty
Recovery Thinking
Integrating the Split Self
Commitment
Creating Meaning
Community Resources
Setting Boundaries in Relationships
Discovery
Getting Others to Support Your Recovery
Coping with Triggers
Respecting Your Time
Healthy Relationships
Self-Nurturing
Healing from Anger
Life Choices Game (Review)
Termination
Seeking Safety
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Paths to Healing Manual
• First stage trauma-informed group for women
• Harm-reduction
• Present-focused
• 5 sessions (3 hours per session) addressing recovery and coping skill
development
• Topics include a safety oriented skill relevant to both PTSD and
substance abuse
• Creative Expression
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As an Effect: As a Behaviour: As a Response:
“Avoiding” or
“Dissociation”
Distancing from
uncomfortable memories
Managing internal and external
reminders to maintain mental
health
Sleeping Disorder Changes in sleeping patternsRemaining wakeful to ensure
safety
HypervigilanceConstantly scanning
environment
Being Sensitive to external cues
of danger
Substance Abuse Drinking or taking other drugs
Seeking ways to: manage
emotions, make connections, or
express yourself
Eating DisordersExtreme changes in eating
patterns
Defying external control of your
body
Isolating,
withdrawing
Limiting connection to other
people
Being selective about people you
choose to associate with
Responses to Trauma:
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Introduction to Treatment Format
Session Format
1. Check-in
2. Quotation
3. Grounding Activity
4. Handout/Discussion
5. Creative Expression
6. Check-out
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Check-In
1. How are you feeling?
2. What good coping have you done?
3. Any substance use or other unsafe behavior?
4. Did you complete your commitment?
5. Community resource update
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Check-Out
1. Name one thing you got out of today’s session (and any
problems with the session).
2. What is your new commitment?
3. What community resource will you call?
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What is the strongest theme of
Seeking Safety?
Empowering patients to have faith, and believe that
their lives can get better by initiating safety as the
central theme in their first stage of recovery:
Instillation of Hope
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Gabor Mate
https://www.youtube.com/watch?v=T5sOh4gKPIg
What is Addiction?
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Community Supports
Rx Recovery/Support Groups