families at risk for discomfort. Therefore, we might offer participants an alternative to describing a dream family, church family, or a family of friends. Alternative selections made are unconditionally accepted, and we see them as healthy choices in self-care.
Discussion: It is essential to allow time at the conclusion of the group for clients to present their creations and process feelings about the activity. We offered clients the opportunity to show their work to the larger group, if desired, or to keep it personal, if preferred. You will find that clients are generally enthusiastic talking about their experiences, expressing the meaning they found in the activity, and showing their artistic creations to others. Some participants want to describe ambivalence, difficulties in becoming engaged, or mistakes made. This is not discouraged, and the group forum is an effective opportunity to reframe negative thoughts in a positive way. The diversity of responses adds enormous depth. Creative ideas generated by the clients are some of the more delightful aspects of this work. All the photographs in this manual illustrate actual client work and show clinicians what results can be expected.
Thank you for selecting this book, and we hope that you find it to be useful!
The activities in this book have been divided into six topic sections and are sequenced accordingly. The activities for each topic are listed at the beginning of that section. A complete alphabetical list of the activities is in the Appendix.
Self-Acceptance: Inventory with Unconditional Valuing of Self
Self-Awareness: Individual Strengths and Areas for Growth
Self-Responsibility: Emotional Regulation of Self Care
Communicating with Others: Expressive
Verbal and Nonverbal Connections
Being Part of a Larger Community: Participation and Developing a Sense of Belonging
Envisioning a Future of Recovery: Anticipation of Holidays and Success Over Time
The inpatient population in a treatment center is often fluid. Groups change from week to week, which presents challenges for group cohesion, as well as for following a sequential curriculum. In many ways, this flux mimics life and adapting to the challenge of change and uncertainty enhances the lessons implicit in this book.
These activities are not meant to be done in any particular order. This book is organized into a framework of six interconnected skill dimensions, each pertaining to essential skills of healthy living. As a facilitator, you may choose any activity that fits your timeframe or meets your needs on a particular day. At the beginning of each section, we have provided a brief overview on the particular topic, as well as additional observations from the authors.
The overall intention is to develop a constellation of skills that facilitate active participation in daily life, functionality, and appreciation for living. These activities encourage a process of learned self-correction, enabling the participant to make ongoing adjustments in life as circumstances change and grow beyond the addictive cycle. The central emphasis is on the growth process, development of internal resources, restructuring of the social context of interactions, and the building of healthy associations.
It is not uncommon to see individuals in early recovery have deficits in basic cognitive abilities. Whether necessary skills were never developed or they were impaired as a consequence of addiction, there is little doubt that skill building in this area enhances and regenerates individual growth and potential.
The activities presented here are intentionally simple and accessible. They rely on ordinary skills and knowledge and require only the most basic of learning. Yet each activity supports a process of change and is a framework upon which participants can continue to build and develop beyond the inpatient phase, beyond an interval of recovery, and in a natural trajectory that leads to sustained well-being.
Self-Acceptance: Inventory with Unconditional Valuing of Self
Addiction is a disorder that occurs as a result of a complex interplay of biological and genetic predispositions, coupled with environmental factors and psychosocial circumstances. Modern neuroscience shows that people with addiction and compulsive behaviors experience strong cravings that can override the rational, reflective, decision-making parts of the brain. This can explain why people with addiction often make impulsive and destructive choices in their lives that hurt themselves and the ones they love. Individuals in early recovery often have strong feelings of regret, shame, and guilt about things they have done in the past. Self-esteem and sense of self are common casualties.
Activities in this section promote an open honest self-inventory and a willingness to accept one’s own history. We encourage examining the past and assessing what was painful and what was of value. Stressed in the assignments is the expectation that participants will be able to find strengths. Those very strengths are witnessed by arrival in a setting that invites recovery, despite all of the trials and hardships that may have been endured on the journey.
Roxanna: I recognize a strong need for people to have the opportunity to tell their story. As a Registered Nurse for many years, I learned patients do better if you listen to the entire story they offer rather than making assessments based on what is evidentially related to clinical symptoms. Sometimes the stories seem disjointed or irrelevant, and yet it is the internal connections that are the most relevant information of all.
While some stories seem to support tragic sequences that understandably lead to misfortune and poor life choices, other stories are completely obtuse. One adolescent with serious Obsessive Compulsive Disorder explained that a teacher had used the word decorum in the context of a class lecture. She attributed the teacher’s use of that uncommon word to have triggered a series of life changes and lost ability to function normally. Acceptance of that strange logic was essential to her sense of being listened to, heard, respected, and treated with dignity. The validity of her commitment to the causality of her condition was not central to her health—being respected and listened to was. Once she was given the opportunity to express this association, and her story was treated with dignity, she was free to make healthier associations. Treatment and support enabled building of associations congruent with a functional future.
Kay: In the recovery community, we talk about how people with addiction are trying unsuccessfully to fill an empty hole in their soul with alcohol or other drugs. I have observed that frequently newly sober clients still feel a general sense of lack in themselves. They must now deal with a variety of uncomfortable feelings without the numbing qualities of alcohol or other drugs. David Loy, a professor of Buddhist and comparative philosophy, speaks eloquently on the sense of self and the “sense of lack” people can feel and the desire to change this by grasping at things to make them feel better, such as getting high. Those with addiction often have a sense of something not being quite right with themselves, and they look to substances to feel more secure. In recovery, one challenge is to reconstruct a healthy sense of self and to develop self-compassion and self-acceptance.
“Accept your yesterdays unconditionally.
