healthy interpersonal relationships based on openness, respect, and honesty; explain the necessity of sharing feelings to build trust and mutual understanding (or assign the client to complete the honesty exercise in The Alcoholism and Drug Abuse Client Workbook by Perkinson).
Explore the client's pattern of resistance to sharing personal problems and preferring, instead, to focus on helping others with their problems.
Verbalize an understanding of how ACA traits contribute to choosing partners and friends that have problems and need help. (16, 30)
Assist the client in understanding how his/her/their early childhood experiences led to fears of abandonment, rejection, neglect, and an assumption of the caretaker role, which is detrimental to intimate relationships.
Help the client to understand that his/her/their strong need to help others is based on low self-esteem and the need for acceptance, which was learned in the alcoholic family of origin; relate this caretaking behavior to choosing friends and partners who are chemically dependent and/or psychologically disturbed.
Initiate the encouragement of others in recovery, to help reestablish a feeling of self-worth. (31, 32)
Teach the client that active involvement in a 12-step recovery group can aid in building trust in others and confidence in oneself (or assign the client to complete the Step 12 exercise in The Alcoholism and Drug Abuse Client Workbook by Perkinson).
Assist the client in developing an aftercare plan that is centered on regular attendance at Adult Children of Alcoholics, Alcoholics Anonymous, and Narcotics Anonymous (ACA/AA/NA) meetings.
List reasons why regular attendance at recovery group meetings is necessary to arrest ACA traits and addiction. (33)
Assist the client in listing reasons why 12-step recovery group attendance is helpful to overcome ACA traits.
Discuss fears that are related to attending recovery group meetings and develop specific written plans to deal with each fear. (34)
Probe the relationship between ACA traits and the fear of attending recovery group meetings; assist the client in developing coping strategies to cope with the fear (e.g. give self-positive messages regarding self-worth, use relaxation techniques to reduce tension, use meditation to induce calm and support from a higher power [or assign “Safe and Peaceful Place Meditation” exercise in the Addiction Treatment Homework Planner by Lenz, Finley, & Jongsma or “Progressive Muscle Relaxation” in the Adolescent Psychotherapy Homework Planner by Jongsma, Peterson, McInnis, & Bruce]).
Verbalize how a recovery group can become the healthy family that one never had. (35, 36, 37)
Teach the client that active involvement in a recovery group can aid in building trust in others and confidence in oneself.
Discuss how the home recovery group of ACA/AA/NA can function as the healthy family the client never had; help him/her/them realize why he/she/they need such a family to recover (or assign the client to complete the Step 12 exercise in The Alcoholism and Drug Abuse Client Workbook by Perkinson).
Educate the client about the family atmosphere in a home ACA/AA/NA recovery group, and how helping others can aid in recovery and reestablish a feeling of worth.
List five ways in which belief in, and interaction with, a higher power can reduce fear and increase self-worth in recovery. (38, 39)
Teach the client how faith in a higher power can aid in recovery and arrest ACA traits and addiction (or assign the client to complete the Step 2 exercise in The Alcoholism and Drug Abuse Client Workbook by Perkinson).
Assign the client to read the Adult Children of Alcoholics Red Book and the Alcoholics Anonymous Big Book on the topic of spirituality and the role of a higher power; process the material in an individual or group therapy session.
Verbalize the feeling of serenity that results from turning out-of-control problems over to a higher power. (40)
Review problematic circumstances in the client's life that could be turned over to a higher power to increase serenity (or supplement with “Understanding Spirituality” or “Finding a Higher Power That Makes Sense” in the Addiction Treatment Homework Planner by Lenz, Finley, & Jongsma).
Practice assertiveness skills and share how these skills were used in interpersonal conflict. (41, 42)
Use modeling, behavior rehearsal, and role-playing to teach the client healthy, assertive skills (or assign “Becoming Assertive” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce); apply these skills to several current problem situations, and then ask the client to journal his/her/their assertiveness experiences.
Teach the client the assertive formula of “I feel ____ when you ____. I would prefer it if ____”; role-play several applications in his/her/their life and then assign him/her/them to use this formula three times per day.
Share the personal experiences of each day with one person that day. (43, 44)
Teach the client the share check method of building trust, in which the degree of shared information is related to a proven level of trustworthiness; use behavior rehearsal of several situations in which the client shares feelings.
Review and reinforce instances when the client has shared honestly and openly with a trustworthy person.
Cooperate with a physician's evaluation for psychopharmacological intervention. (45)
Refer the client to a physician to evaluate whether psychopharmacological interventions are warranted.
Take medications as prescribed, and report on their effectiveness and side effects. (46, 47)
Medical staff administers medications to the client as prescribed.
Monitor the client's medications for effectiveness and side effects.
Develop a five-year plan to recover from substance abuse and ACA traits. (48)
Assist in the client developing a five-year plan to recover from substance abuse and ACA traits (or assign the client to complete the Personal Recovery Plan exercise in The Alcoholism and Drug Abuse Client Workbook by Perkinson).
Complete a survey to assess the degree of satisfaction with treatment. (49)
Administer a survey to assess the client's degree of satisfaction with treatment.
healthy interpersonal relationships based on openness, respect, and honesty; explain the necessity of sharing feelings to build trust and mutual understanding (or assign the client to complete the honesty exercise in The Alcoholism and Drug Abuse Client Workbook by Perkinson).
