Substance Dependence

• Each substance is different & has a different effect
• There are a wide variety of treatment approaches
• The central issue is abstinence
• Wet and dry approaches-dry approaches emphasize abstinence during and after treatment  
• Underscores the question of change and how change occurs-substance difficulties emphasis the change involves the cessation of the problem 
• Symmetrical and complementary approaches to people who are dependent on substances  
• Systemic view emphasizes constraint over causation
• Does the person choose the substance or does the substance choose the person?
• Causation: What has led to this person to become dependent upon this substance? a) Causation tells us how this person got to be the way they are
•  Constraint: What has & does prevent this issue being resolved? a) Constraint tells us how this person can stay the way they are b) Constraint tells us how the circumstances of this person can stay the way it is c) Constraint provides the best guide to change
•  An in-depth assessment of each individual’s unique situation is required in order to develop a personalized and comprehensive treatment approach a) Individual life circumstances vary widely
•  Need to develop flexible strategies to achieve treatment goal
• . Professional care and self-help approaches integrated into the model
•  Goals: a) To help patients achieve and maintain abstinence b) Reclaim a sense of self worth c) To learn to manage the stresses of an active life without returning to substance dependence`
•  For individuals who are dually diagnosed with substance dependence and other psychiatric illness, the program draws upon its expertise in this area, as well as the comprehensive mental health services of the hospital. a) Requires comprehensive consultation and evaluation
•  Assess and address related family and vocational issues
•  Identify relapse triggers and develop coping skills
•  Designed to be short term with longer-term treatment through appropriate community resources and some longer-term treatment in the form of group psychotherapy