TABLE OF CONTENTS PAGE SENIOR HIGH INTERVENTION CURRICULUM INTRODUCTION ......................................i LESSON 1 Profile of a Chemical Abuser................................................................ 1 LESSON 2 Profile of a Chemical Abuser Part II ..................................................... 6 LESSON 3 Profile of a Chemical Abuser Part III .................................................. 12 LESSON 4 Chemicals and Defenses: Part I......................................................... 20 LESSON 5 Chemicals and Defenses: Part II........................................................ 25 LESSON 6 What is a Feeling................................................................................ 30 LESSON 7 Dealing with Feelings ......................................................................... 35 LESSON 8 Chemicals and Feelings and Chemicals............................................ 39 LESSON 9 Leveling .............................................................................................. 44 LESSON 10 Self Concept and Chemicals.............................................................. 47 LESSON 11 On Values...and Chemicals................................................................ 52 LESSON 12 On Needs...and Chemicals ................................................................ 60 LESSON 13 Chemicals and the Family Part I ........................................................ 66 LESSON 14 Chemicals and the Family Part II ....................................................... 70 LESSON 15 Recovery and Relapse ....................................................................... 77

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SENIOR HIGH INTERVENTION CURRICULUM

Introduction

The lessons and activities presented in this curriculum are intended for use by Dade County Public Schools TRUST Specialists when working with senior high school students who have been identified as potential or actual chemical abusers/dependents. Because of the diversity of our student population, no single teaching technique, course of instruction or counseling curriculum can address all students' needs. The following lessons are therefore presented as guidelines and suggested activities that may be modified by the TRUST Specialist; based on his or her know-ledge and expertise in counseling, group work, chemical dependency, and outcome assessment. Some lessons may be collapsed into one while others may be extended over two group sessions. No specific introductory lesson, group-building exercise or ice breaker is included; these are left entirely up to the TRUST Specialist's personal preferences, available resources, and particular group needs. A small group format is advised based on its recognized merits in dealing with the identified target population. Additional modalities (individual sessions, family interventions, teacher conferences, etc.) shall be determined and provided as the need arises. The didactic/experiential duality of each lesson will also be recognized as the approach of choice for the target group. However, unless highly motivated and focused on personal growth, students will tend to gravitate toward the informational, cognitive, "them" level of functioning at the expense of an experiential, feelings, "me" level of growth. Every effort should be made in order to help students move through the necessary didactics to reach adequate and satisfactory personalization. Otherwise, the entire group experience will have simply duplicated corresponding life management and social studies curriculum. Other assumptions inherent in the curriculum include the prediction that the group(s) will be mostly voluntary (within the context of chemical dependency and its defenses), closed (all members moving through the curriculum at the same time and in the order given), and structured (of a pre-determined number of sessions, frequency of meetings, etc.). The TRUST Specialist may deviate from one or more of these assumptions based on particular school, group or counselor needs; however, care must be taken to maintain the integrity, effectiveness and flow of the counseling process. A word of caution: Do not be overly eager to "break through the defenses" of the students. The very didactic nature of the curriculum may induce a tendency to "teach" the students that they are chemically dependent, as compared to allowing them the opportunity to discover reality for themselves through participation in a TRUST group characterized by safety, empathy, acceptance, respect...in a word, trust.

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Lastly, two words on humor: Use it. Although humor can be a self-deceptive defense against facing reality, an inappropriate way to obtain attention or acceptance, or an attempt to monopolize and manipulate the group (You still think it's funny?), it can most certainly serve to lower defenses, reduce tension, aid in the formation of group cohesiveness, keep group members interested and attentive, and make the impact of your work more thorough and long-lasting. Constantly assess its consequences, adapt as necessary, and enjoy this otherwise rather serious, often trying attempt To Reach Ultimate Success Together with our "kids.

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LESSON 1 PROFILE OF A CHEMICAL ABUSER PART 1 PURPOSE: To provide factual information about chemical abuse and dependence, and initiate the process of gaining knowledge and understanding of self. OBJECTIVES: Define chemical dependence, explain its disease nature, identify its characteristics, and present an overview of its signs and symptoms. Personalize information. MATERIALS: Handout: Chemical Abuse and Dependence Exercise: Chemical Abuse and Dependence PROCEDURE: Distribute Handout, Chemical Abuse and Dependence. Have students read and discuss points I through V; process for comments and questions at each point. Please Note: At point III, Disease Concept, stress that chemical dependency can be compared and contrasted to any disease. Encourage students to provide examples from their own experience as you discuss Section V. Process for comments. Distribute Exercise, Chemical Abuse and Dependence. Have students complete Exercise. Assist students by helping them translate the experiences discussed under Section V into written responses. Encourage honesty in responses.

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Collect Exercises for students' file. CLOSURE: Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

CHEMICAL ABUSE AND DEPENDENCE I. RELATIONSHIP Chemical dependence results from continued, untreated chemical abuse. II. DEFINITION Chemical dependence is a condition in which the use of alcohol or other mood-

altering chemical is associated with problems in any area of one's life, culminating in continued use in spite of these problems.

III. DISEASE CONCEPT Chemical dependence is a disease -- a disease is a particular destructive process in

an organism (person), with a specific cause or causes (either known or unknown), and with characteristic symptoms.

IV. CHARACTERISTICS Chemical dependence is a disease that is:

Primary: First in importance; must be treated first; causes other, secondary diseases or symptoms.

Progressive: Has a predictable continuation of symptoms which get worse

in severity and frequency if left untreated. Chronic: Continuous, perpetual, on-going, incurable. Acute: Marked with severe, periodic episodes (incidents with harmful or

undesirable consequences) that occur throughout the chronic progression. Potentially fatal: Can directly (cirrhosis, cardiac arrest) or indirectly (car

accident) cause death or insanity. Treatable: Treatment doesn't cure it, but it can arrest the progression,

allowing the person to address and deal with the symptoms and consequences.

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HANDOUT

V. SIGNS AND SYMPTOMS A change in values and priorities: for example, preoccupation with getting and

using chemicals; selecting friends and activities around the use of chemicals. Loss of control over chemical use: for example, excessive use, use alone,

experiences where even the user regrets having used, failed attempts to control intake.

A rigid defense system: employing such defenses as denial, rationalization,

blaming and/or minimizing to serve the primary purpose of justifying continued use. Serious problems with family, friends, school: for example, fights at home,

broken friendships, school absences or suspensions. Serious problems with health, the law, and/or other areas of one's life: for

example, disturbed sleep or nutrition; arrests or other encounters with the police; feelings of isolation, mood swings, discomfort when not using, etc.

The "clincher" consideration: continued use of chemicals in spite of one or more

of the above problems associated with that use.

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EXERCISE EXERCISE: CHEMICAL ABUSE AND DEPENDENCE After discussing the signs and symptoms of chemical abuse/dependence in today's group session and referring to the information summarized in the handout, I realize that I have had the following specific experiences: A change in values and priorities: Loss of control over chemical use: A rigid defense system: Serious problems with family, friends, school: Serious problems with health, the law, and other areas of my life: Continued use of chemicals in spite of one or more of the above problems:

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LESSON 2 PROFILE OF A CHEMICAL ABUSER PART II PURPOSE: To provide information about chemical abuse and dependence, and to facilitate gains in self-knowledge/understanding. OBJECTIVES: Identify some common myths and misconceptions which may be serving as obstacles to the understanding of chemical dependence. Assist students in gaining further and more precise under-standing of their chemical abuse/dependence. MATERIALS: Handout: The Myths and Misconceptions of Dependency Exercise: Self-Assessment PROCEDURE: DISTRIBUTE Handout, The Myths and Misconceptions of Dependency. READ AND DISCUSS each section. POINT OUT that section I describes some of the defense mechanisms (myths and misconceptions) that are so destructive to the chemically dependent person. STATE that defense mechanisms are ways of dealing with conflict and tension, distorting reality. CONTINUE processing sections II and III for comments and questions. DISTRIBUTE Exercise, Self-Assessment. Point out its dual purpose, didactic ("List of Symptoms") and self-assessment ("Which apply to me?"). HAVE students complete Exercise.

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ENCOURAGE questions and honest self-search. COLLECT Exercises to put in students' file. CLOSURE: Students Assessment: I learned... I realized... I was surprised...

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HANDOUT THE MYTHS AND MISCONCEPTIONS OF DEPENDENCY I. MYTHS AND MISCONCEPTIONS

Will Power Myth: They drink and use because of weak wills. No strength of character. Moral Myth: If they were "good" people, they wouldn't drink/use. Moral weaklings. Skid Row Myth: Unable to hold a job, stay in school, etc. Popularity Myth: To be "accepted" by others it helps to drink/use. Prescription Myth: Drugs are safe, if prescribed. I can't get addicted under a physician's care. Self-Inflicted Myth: It's not a "real/true" disease because it's self-inflicted. Only-Hurt-Themselves Myth: Actually, an average of four other individuals are affected by the chemically dependent person. Lack of Self-Respect Myth: They just don't care about themselves or anybody else. It-Can't-Happen-To-Me Myth: Why not?

II. PHYSICAL vs MENTAL DEPENDENCE

Chemical dependence can involve physiological or psycho-logical dependence or both. Physiological dependence indicates bodily reliance on the chemical(s) and is identified by withdrawal symptoms, physical craving, increased tolerance, etc. Psychological dependence indicates mental and/or emotional reliance on the chemical(s) and is identified by use of the chemical(s) to reduce stress, obtain relief, attain a sense of well being, etc.

From the perspective or reality of the drug abuser, it makes very little difference if his/her life is gradually crumbling due to a physiological or a psychological dependence. Any mood-altering chemical is potentially addictive.

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HANDOUT

III. POSSIBLE CAUSE(S)

As with most other diseases, the cause of chemical dependence is largely unknown. Possibilities include: Genetic Causation: inherited predisposition to contract dependence on chemicals. Social Learning Causation: environment reinforces chemical use and dependence. Psychological Causation: chemicals reduce stress, etc. Biological Causation: organic predisposition/chemical imbalance. Spiritual Causation: spiritual separation/bankruptcy. From the perspective or reality of the chemical abuser, it makes very little difference where his/her condition "came from". All energy and concentration need to be devoted to what is being done about it.

EXERCISE

SELF-ASSESSMENT Listed below are some of the typical signs and symptoms of chemical abuse and dependency. As with other diseases, a few of these specific symptoms, by themselves, mean nothing; on the other hand, neither does a person need to give all or most of the symptoms in order to yield a valid diagnosis. It is the pattern -- both quantity and quality -- that you need to discuss with your TRUST counselor in order to gain useful knowledge about yourself. Please mark each item that applies to you and discuss in group and/or individually, as indicated by your counselor. It is imperative that you be as honest and self-searching as you can be! Physical, Emotional, and Behavioral Changes

easily upset; rapid mood swings changes in physical activity general irritability change in eating habits, weight change(s)

change in sleep pattern continuous fatigue or tiredness nervousness; trouble sitting still

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blackouts and memory loss lack of discipline or motivation extreme defensiveness feelings inappropriate to situation holds resentments, especially when confronted with negative attitude or destructive behavior easily becomes angry, especially when confronted with negative attitudes or destructive behavior uses chemical alone goes out of the way in order to acquire chemicals often thinks about using creates opportunities to use chemicals School/Academic Achievement drop in grades (sudden or gradual) skipping classes withdrawal from (or avoidance of) activities defiance of rules using chemicals before or during school unresponsiveness to concern expressed by teachers about any of the above loss of interest in school

Changes at Home changes in attitude toward family members withdrawing from family functions disregard for family rules stealing from family or selling possessions

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manipulating parents; playing one against the other lying; blaming others for irresponsible actions keeping secrets failure to follow through with promises

Changes in Friends change in peer group; dropping old friends taking up with an older crowd choice of friends influenced/determined by their chemical use secrecy about friends and where time is spent involvement in unhealthy relationships using "friendship" to justify continued acceptance of friend's destructive behaviors

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LESSON 3 PROFILE OF A CHEMICAL ABUSER PART III PURPOSE: To provide an understanding of the stages of chemical abuse and facilitate gains in self-knowledge. OBJECTIVES: Identify cognitive/behavioral characteristics of each successive stage of chemical dependence, along with accompanying feelings and corresponding "high" experiences. Facilitate identification of personal standing on the dependency progression. MATERIALS: Handout: Progression of Addiction Exercise: Personal Profile PROCEDURE: Introduce the topic: Stages of chemical abuse and dependence Distribute Handout, Progression of Addiction, and Exercise, Personal Profile. Read and discuss Phase I of Handout. Have students relay examples from their own experiences that relate to that phase. Ask them to record their responses on the worksheet (Exercise). Solicit as much detailed information as possible. Continue same process with remaining Phases. Please Note: Depending on the group's characteristics and needs, consider breaking the

group into dyads or triads to allow more personalization of the given information. (This would require, however, a high-motivation, articulate group of students.) Then, return to large group discussion.

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CLARIFY: One-time use can cause serious problems (e.g. auto accident, panic attack, cardiac

arrest). Dependence involves not just having the problem or undesirable consequence (which could easily be bad enough, e.g., a DUI fatality), but continued use in spite of problems and consequences. And while the experience of most chemically dependent persons rarely includes as drastic a problem as death, problems are significant and they most certainly go from bad to worse. CLOSURE: Key Point: Once I understand the progression, I realize that any sign or symptom I do not have must be qualified as "not yet." Meanwhile, I get to keep the problems, pain and misery I already have. Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

PROGRESSION OF ADDICTION Phase I: Learning the Mood Swing Cognitive/Behavioral: It is easy to get high (low tolerance). It is often unplanned. Relief is obtained/learned. Feelings: Chemicals make me feel good (e.g. grown up). This isn't bad at all! (Defiance) These are O.K. friends! (Belonging, acceptance) The "High": One's mood changes in the "right” direction. Movement is toward pleasure, relief, etc., then back to normal as

the effects wear off.

Phase II: Seeking the Mood Swing Cognitive/Behavioral:

Moves from knowing the effect of the chemical to seeking that effect. A relationship with the chemical begins to form. Seeks to develop opportunities to use. Tolerance begins. One may begin to experience blackouts.

Feelings:

I use chemicals only at safe times and places. (Continued defiance) What they don't know won't hurt them -- or me. (Self-assurance, invulnerability) Chemicals help me relax, think, enjoy, etc. (Pleasure, relief; using for the effect)

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HANDOUT The "High":

As one learns to enhance the desired effect(s), movement may actually be more toward the pleasure end; however, as the first undesired consequences occur (e.g., blackouts, hung-over, lying), the passing of each high leaves one closer and closer toward pain.

Phase III: Harmful Dependence Cognitive/Behavioral:

There is risk-taking (e.g., using at home) and loss of control. One "sneaks" drinking or drugging; much effort is put into fooling parents or teachers when high. Parents become aware of abuse. Lying increases. Non-drug using friends are dropped. One occasionally (almost in spurts) recognizes the harmful consequences of chemical abuse and quickly rationalizes, denies or otherwise defends continued use. Defense mechanisms are now in high gear.

Feelings:

Blew it that time! (Remorse) So-and-so's got it together. (Lower self-image) He/she's not going to put up with this much longer. (Insecurity) But that was fun! (Euphoric recall.) I've had several close calls; it may/should not be long, now. (Fear; self-destructive/suicidal thoughts) But, (Defend, justify!)

The "High":

Attainment of pleasure (desired effects) begins to slip and becomes less frequent. As negative consequences increase, each high leaves one closer to the pain and discomfort of not-high.

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HANDOUT

Phase IV: Using to Feel Normal Cognitive/Behavioral:

Being high becomes normal; one uses chemicals to go to school, watch T.V., attend a game, go to the beach, etc. One lies or hides the drug supply -- even from abusing friends. One may try to cut down or quit to convince self that there is no problem with drugs. Tolerance is reversed. There is a change in weight, frequent illnesses, memory loss. Self-image is lower, self-disgust and guilt/remorse increases; the need ("want") to use cannot be controlled.

Feelings:

I can usually get chemicals whenever I want to. (Security of assured supply) People are so stupid. (Defiance, Me vs. Them) My family doesn't understand. (Self-pity) I sometimes feel very lonely and alone. (Depression) People are so cruel. (Disappointment, dejection) I sometimes wish I could get away, just be left alone. (Flight) I wish I were dead...

The "High":

There is no real pleasure obtained other than the relief of avoiding the pain and discomfort of the not-high. One is unable to engage in most activities without using.

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EXERCISE PERSONAL PROFILE In responding to this exercise, be as concrete as possible. You are basically personalizing the information given in the Handout. I. As I learned the mood swing, these are some of the specific experiences I had:

Cognitive/Behavioral:

Feelings:

The "High": II. While seeking the mood swing, my specific experiences were:

Cognitive/Behavioral:

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Feelings:

The "High":

III. Having crossed the fine line into harmful dependence or abuse, my specific experiences were:

Cognitive/Behavioral:

Feelings:

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The "High": IV. When using to feel normal, my specific experiences were:

Cognitive/Behavioral:

Feelings:

The "High":

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LESSON 4

CHEMICALS AND DEFENSES: PART I PURPOSE: To provide an understanding of defense mechanisms and how they relate to chemical usage. OBJECTIVES: Identify defenses. Describe how the chemical user's self-deceptive defenses can distort reality. MATERIALS: Handout: Defenses and Chemical Abuse Exercise: Defenses PROCEDURE: Distribute and read Handout, Defenses and Chemical Abuse. Introduce concept of defenses, Part I of Handout. Clarify "neutral" nature of defenses, Part II of Handout. Emphasize negative consequences (self-deception, continued use) when it comes to the use of chemicals, Part III of Handout. Encourage active discussion on a personal level when presenting specific defenses, Part IV of Handout. Discuss denial as the major symptom of chemical dependency, Part V of Handout. Distribute Exercise, Defenses, and assist students in completing it. CLOSURE: Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

DEFENSES AND CHEMICAL ABUSE I. CONCEPT OF DEFENSES

Defense mechanisms may be conceived of as "filters" through which all information must pass in order to reach me. The purpose of these filters is to change or adapt parts or all of that information so that it becomes manageable -- so that it makes sense, has value or meaning, and is not threatening. The information may be internal (about self) or external.

II. CHARACTERISTICS OF DEFENSES

They are natural, experienced by all. They are neither "good" nor "bad" in themselves; it is the consequence of the defense that needs to be addressed. When it comes to chemical abuse and dependence, their consequence is mostly harmful self-deception. As with any form of self-deception, dependency's defenses eventually stop working. One must then either face the information or develop a more advanced and complicated deceptive web that appears to give the individual continued manageability.

III. FUNCTION OF DEFENSES IN CHEMICAL DEPENDENCE

They protect the affected person from the realization that continuing to drink and use is at the expense of harmful consequences. They allow the person continued use.

IV. SPECIFIC DEFENSES

Denial is the inability to see the truth, face reality, accept the facts. All other defenses ultimately reduce to this one. Minimizing is admitting to some degree to a problem with chemical usage, but in such a way that it appears to be much less serious or significant than is actually the case. Blaming is denying responsibility for certain behavior and maintaining that the responsibility lies with someone or something else. Projection is justifying what is done by (falsely) believing that everyone or others do it also. Rationalization is offering alibis, excuses, justifications and explanations (other than chemical dependence) for behavior.

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Intellectualizing is separating thought from feeling to avoid the emotional, personal awareness of the problem by dealing with it at a cognitive or intellectual level. Hostility is becoming angry or irritable when reference is made to personal chemical usage and related behavior; it is a way to avoid the issue and serves to back people off. Repression is involuntary and selective forgetting of things one really doesn't want to remember (e.g. painful or shameful awareness). Displacement is feelings from one source that are expressed or taken out elsewhere. Compensation is masking a weakness or making up for something lacking by developing a positive trait.

V. DEALING WITH DEFENSES

Denial is a core component of the illness of chemically dependent persons. The development of a denial system is a cardinal, integral and necessary feature of chemical dependency. It is one of the major symptoms of this disease and develops along with the more visible symptoms. Denial impairs the judgment of the affected individuals and results in self-delusion which keeps them locked into an increasingly destructive pattern. It is for this reason that one needs to become familiar with defenses, at ease in their identification, and comfortable in dealing with them.

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EXERCISE DEFENSES Refer back to Section IV of the Handout and/or the more complete list of defenses that follow:

Rationalization Justifying Projecting Blaming, accusing Judging, moralizing Intellectualizing Analyzing Explaining Theorizing Generalizing Quibbling, equivocating Debating, arguing Sparring Questioning Switching Denying Being smug, superior, or arrogant

Minimizing Evading Defiance Attacking, Aggression Withdrawing Silence Verbalizing, talking Shouting, intimidating Threatening Frowning Glaring Staring Joking Grinning, smiling, laughing Protecting Agreeing Repressing Complying

Think of a specific situation (does not need to seem directly related to chemical usage) which has occurred in the last week in which you found yourself using one of the defenses above. Briefly describe the situation.

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What could you have done differently which would have made it unnecessary for you to use defenses? What do you believe the outcome would be if you did not use defenses in the situation you have described?

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LESSON 5 CHEMICALS AND DEFENSES: PART II PURPOSE: To provide knowledge about self and the progression of disease and/or recovery. OBJECTIVES: Identify the progression of defense mechanisms in chemical dependence. Develop a concrete and personal commitment to staying chemically free. MATERIALS: Handout: Defenses and Chemical Dependence Exercise: "Enough?" PROCEDURE:

Review Lesson 4, Chemicals and Defenses, Part I, if group sequence is open-ended and there are new members in today's session.

Distribute Handout, Defenses and Chemical Dependence.

Read and discuss Handout, Part I: Progression of Defenses in Chemical Dependence.

Describe the progressive nature of the delusional system as well as of the severity/frequency of undesirable consequences and how they stem from each other.

Read and discuss Handout, Part II: Problems are Opportunities.

Emphasize the positive potential of each undesirable consequence as an opportunity to break through my self-deceptive defenses.

Distribute Exercise, "Enough?".

Encourage students to ask questions and engage in personal discussion in order to facilitate honest self-search and augment the probability of breaking through their defenses.

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Please Note: Make every attempt to have students end on the positive note of Item V. CLOSURE: Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

DEFENSES AND CHEMICAL DEPENDENCE I. PROGRESSION OF DEFENSES IN CHEMICAL DEPENDENCE

NO Problem: As the first undesirable consequences of my substance abuse begin to crop up, it is still feasible for me to unconsciously employ any combination of the defense mechanisms in order to deny that there is a problem. Through beliefs or perceptions such as "I never use during school.", "It helps me relax.", "This drug is not addictive.", and/or "I'm too young to be chemically dependent.", I can convince myself that I have no problems with chemicals. "No problem" means I can continue to use…

Not THIS Problem: Eventually, the undesirable consequences become such that I can no longer simply deny that there is a problem. However, the outcome of the defense mechanism in this phase is the perception that my problem is something other than my chemical use. Therefore, I concentrate on changing the pattern of my chemical use, for example, or changing the people, places or things associated with my chemical use. In other words, I change anything but my chemical use....

Not NOW: Once reality has broken through my defenses to the point where I can neither deny a problem nor that it does stem from my chemical abuse, chances are I will go through a postponement-of-recovery phase. After all, I haven't wrecked the car or been expelled from school yet! Postponement may take the form of focusing on other problems (e.g., "I'll quit after dad has moved out" or "I'll quit after graduation") or of placing conditions on my recovery (e.g., "They have to let me borrow the car again!" or "Trust me!").

II. PROBLEMS ARE OPPORTUNITIES

Throughout the progression of my chemical dependence, including the progression of its inherent defenses, undesirable consequences tend to grow in frequency and significance, displaying a progression of their own. Each of these undesirable consequences (from the smallest to the largest) is practically my only chance to break through such a subtle and, there-fore, effective delusional system of defenses. Aside from their undesirable nature, these consequences or problems do indeed serve as opportunities for me to either say "Enough!" or simply spiral further down the progression. A positive response constitutes my "bottoming out" experience: Problem 6 break through defenses 6 decision ("Enough!") 6 acceptance of real problem and the need to change 6 appropriate action. (Welcome to recovery!)

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EXERCISE

"Enough?" In responding to this exercise, be specific and concrete. You must also be as honest and self-searching as possible. Do not hesitate to use your TRUST group to reach these ends! I. Specific ways I have successfully denied the seriousness of my chemical use

(specific beliefs, feelings, actions): II. Specific ways I have attempted to deal with associated problems, while avoiding the

issue of my chemical use and the outcome of these attempts: III. Specific ways (beliefs, feelings, actions) I have delayed a real commitment to

becoming drug-free:

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IV. Brief but specific summary of the undesirable consequences (problems) of my chemical use, how I dealt with each problem, and the outcome.

V. Have I made my decision, "Enough?"

If yes, why? The following are my specific reasons for staying chemical-free:

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LESSON 6

WHAT IS A FEELING PURPOSE: To understand feelings, to become acquainted with their characteristics and comfortable in experiencing them, and to begin the process of dealing effectively with them. OBJECTIVES: Define feelings, describe their characteristics, clarify feelings-related misconceptions common to adolescents, and introduce the students to the practice of identifying their feelings. MATERIALS: Handout: Describing Feelings Exercise: Identifying Feelings PROCEDURE: Distribute Handout, Describing Feelings. Have students read and discuss points I through VIII; process for comments and questions at each point. Please Note: A critical aim of this session is to have students reach a comfortable level of acceptance of all their feelings, including ones formerly thought of as "bad", "ambivalent", etc. Guide discussion toward this end. Emphasize the ineffective nature of "coping" through masking, denying, avoiding or chemical use. Point out the rationale for learning to deal with feelings in a positive way (i.e., point VII). Introduce Exercise, Identifying Feelings, as the first step in dealing with feelings effectively. Have students complete the written and oral parts of Exercise. Collect Exercises for students' files.

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CLOSURE: Students Assessment: I learned... I realized... I was surprised...

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HANDOUT DESCRIBING FEELINGS I. Feelings are our emotional responses to what we're thinking or doing, or to what's

happening to or around us. Chicken-and-egg style, they stem from our perceptions and our perceptions stem from our feelings.

II. Feelings are natural. We have little if any choice over how we feel. Mostly

unavoidable, feelings just are. If something makes us angry, we will feel anger, no matter how much we believe anger (or jealousy, hate, etc.) to be "wrong."

III. Feelings are neither "bad" nor "good". Some feelings are painful (e.g., shame,

anger), so we usually try to avoid them; others are pleasurable (e.g., pride, excitement), so we usually like to experience them. However, since we have no choice over our feelings, it is what we do with or about them that we need to address and judge as good or bad, positive or negative, healthy or not.

IV. It is both possible and common to experience more than one feeling at a time.

Combinations of "opposite" feelings (e.g., love/hate) and "complimentary" feelings (e.g., acceptance/belonging) are just as natural as the individual feelings themselves.

V. Feelings are often masked with other feelings, especially when the latter are more

"acceptable". For example, "wimpy" hurt may be covered up with "macho" anger. VI. Other ineffective ways to "cope" with feelings involve denying them, avoiding them,

or attempting to alleviate them through the use of chemicals. VII. Learning to deal with painful feelings will tend to produce/increase pleasurable

feelings. VIII. The first step in dealing with feelings involves learning to call them by name. The

following exercise is designed to initiate this process.

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EXERCISE

IDENTIFYING FEELINGS Circle the words below that have personal meaning. Discuss the reasons for your choices. AFRAID ALONE ANGRY ANXIOUS ASHAMED BITTER BORED CAUTIOUS CHEATED CONFIDENT CONFUSED DEFEATED DEPRESSED DESPERATE DISAPPOINTED

GLAD GUILTY HAPPY HELPLESS HOPEFUL HOPELESS HOSTILE HURT HYSTERICAL INADEQUATE INFERIOR INHIBITED JEALOUS LONELY LOST

REJECTED RELIEVED REMORSEFUL RESENTFUL SAD SATISFIED SECURE SCARED SHOCKED SHY SMUG STUPID SUSPICIOUS SYMPATHETIC TERRIFIED

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DISGUSTED DISTURBED ECSTATIC EMBARRASSED EXCITED EXHAUSTED FREE FRUSTRATED

LOVESTRUCK LOVING MAD NERVOUS OVERWHELMED PEACEFUL PROUD REBELLIOUS

THREATENED TRAPPED UNEASY UNLOVED USELESS VULNERABLE WORRIED WORTHLESS

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LESSON 7

DEALING WITH FEELINGS PURPOSE: To learn an effective way to deal with feelings. OBJECTIVES: Identify and describe a three-step method of dealing effectively with feelings. Facilitate the students' personal implementation of this method. MATERIALS: Handout: Dealing with Feelings Exercise: Learning to Deal with Feelings PROCEDURE: Distribute Handout, Dealing with Feelings. Allow students to practice the "re-phrasing" suggestion given in Point I. Clarify, in Point II, that "acceptance" of feeling does not mean "learning to live with it" in the sense of doing nothing about it. Acceptance means recognizing, admitting, etc. Explain that Point III's "taking action" does not include hurtful action, vengeance, and the like. Even "limiting" ourselves to constructive, healthy action, our options will range from numerous to infinite. Have students complete Exercise, Learning to Deal with Feelings. Though this is largely an oral exercise, encourage students to take some notes to keep in their files. CLOSURE: Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

DEALING WITH FEELINGS I. Identify the feelings. Give it a name. A. If you can substitute the phrase I think for I feel, it is not a feeling. It is a

thought or judgment. Example: I feel (think) this is an uplifting experience.

B. If you can substitute I am for I feel, it is a feeling. Example: I am (feel) lonely.

II. Accept your feeling. Even if (perhaps especially if) it is an undesirable or

"unacceptable" feeling, do not deny, avoid, mask or attempt to cover it up. Accept the feeling and its causes, so you can move to the next step.

III. Take action. Do something constructive about the situation.

A. If unsure or unclear as to what to do, talk to someone you trust and respect. The two of you will likely come up with a valid action plan.

B. If the external situation cannot be changed, the "take action" step can still be

sufficiently met by letting off steam and ventilating your feeling with that trusted person, thereby relieving the internal situation, the feeling itself.

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EXERCISE

LEARNING TO DEAL WITH FEELINGS Identify one strong feeling you have had in the last day or so, describe the situation around it, and discuss any action you have taken or may take with regards to it. AFRAID ALONE ANGRY ANXIOUS ASHAMED BITTER BORED CAUTIOUS CHEATED CONFIDENT CONFUSED DEFEATED DEPRESSED DESPERATE DISAPPOINTED DISGUSTED DISTURBED

GLAD GUILTY HAPPY HELPLESS HOPEFUL HOPELESS HOSTILE HURT HYSTERICAL INADEQUATE INFERIOR INHIBITED JEALOUS LONELY LOST LOVESTRUCK LOVING

REJECTED RELIEVED REMORSEFUL RESENTFUL SAD SATISFIED SECURE SCARED SHOCKED SHY SMUG STUPID SUSPICIOUS SYMPATHETIC TERRIFIED THREATENED TRAPPED

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ECSTATIC EMBARRASSED EXCITED EXHAUSTED FREE FRUSTRATED

MAD NERVOUS OVERWHELMED PEACEFUL PROUD REBELLIOUS

UNEASY UNLOVED USELESS VULNERABLE WORRIED WORTHLESS

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LESSON 8

CHEMICALS AND FEELINGS AND CHEMICALS... PURPOSE: To understand the interaction between feelings and the use of chemicals, and appreciate the need to learn to deal with feelings without the use of chemicals. OBJECTIVES: Explain the reciprocal interaction between feelings and the use of chemicals. Describe the development of that interaction. Emphasize the need to deal with feelings even after I've quit using chemicals Begin to examine and deal with my own feelings in this regard. MATERIALS: Handout: Chemicals and Feelings Exercises: My Feelings and Chemical Use Who Am I and How Do I Feel? PROCEDURE: Distribute Handout, Chemicals and Feelings. Read and discuss each section, soliciting student reaction, input, personal examples, etc. Choose either or both Exercises, depending on time or group needs. Distribute Exercise(s). Exercise: My Feelings and Chemical Use. Introduce exercise. Encourage questions for clarification. Facilitate personal responses. Return to group discussion; collect exercises for students' files.

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Exercise: Who Am I and How Do I Feel? Introduce exercise Form dyads. Encourage questions for clarification. Facilitate personal responses and accuracy of recordings. Return to large group for presentation of each partner's responses; check for agreement/disagreement feedback. Collect exercises and place in students' files. CLOSURE: Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

CHEMICALS AND FEELINGS

I. Feelings influence chemical use and chemical use influences feelings. Considering

the subtleness and effectiveness of the chemical user's defenses, it is small wonder that the inter-action between feelings and chemical use usually works to keep the chemical user locked into a using pattern. Even after the decision to quit using chemicals has been made, the inter-action between chemicals and feelings tend to undermine and inhibit continued recovery. Together with the fact that feelings are powerful motivators, these considerations highlight the need to address feelings.

II. The interaction between feelings and chemical use operates at different levels.

A. Mood Swing: As we saw in Lesson 3, under "Progression of Addiction," the chemical user first learns/discovers the mood swing, then purposefully seeks it. Right from the start, therefore, the interaction between feelings and chemical use becomes a significant aspect of the use of chemicals.

B. Harmful Dependence: The more the chemical user establishes cause-effect

between using and the desired feelings (e.g., relief, excitement), the harder it is to obtain/experience these feelings without the chemical use.

C. Personality and Feelings: Personality is the sum total of the ways in which

we characteristically act, react and feel about ourselves, others and the environment. Prolonged use of mood-altering chemicals eventually distorts the chemical user's personality. The user develops ways of acting, reacting and feeling which justify and protect continued using behaviors. These behaviors eventually become ingrained patterns within the personality and actually may continue after using itself has ceased.

D. Underlying Theme: Feelings influence chemical use: e.g., superiority will

keep us locked into "Not Me" thinking, defiance may ward off people who could/would threaten our use. Chemical use influences feelings; e.g., the need to highlight accomplishments may yield arrogance or self-centeredness, the discomfort of the not-high may yield impatience or low frustration tolerance.

III. Clearly, the need to learn to address feelings and to practice dealing with them

without the use of chemicals is essential, not only to our recognition and acceptance of a need to change, but also to our continued growth beyond cessation of chemical use.

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EXERCISE

MY FEELINGS AND CHEMICAL USE I. When I used chemicals the first few times, I discovered they made me feel: II. The effects and feelings I sought as I continued to use chemicals were: III. Desirable feelings I think will be difficult to experience without the use of chemicals

include: IV. Possible alternative ways to obtain these desirable feelings or to deal with their

absence (including any alternative suggested by the group during the discussion):

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EXERCISE

WHO AM I AND HOW DO I FEEL? Form dyads (pairs) with a fellow student about whom you know the least. Ask each other the following two questions the indicated number of times. Give a different but true response each time. Your partner will record your answers and then present them to the large group. WHO ARE YOU? Ask ten (10) times. HOW DO YOU FEEL RIGHT NOW? Ask five (5) times.

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LESSON 9

LEVELING PURPOSE: To further develop the feeling part of self and risk expressing feelings. OBJECTIVE: Take the risk of self-disclosure by leveling feelings. MATERIALS: Handout: Discovering True Feelings Exercise: True Feelings PROCEDURE: Distribute Handout, Discovering True Feelings. Read and discuss each point. Introduce Exercise, True Feelings. Note: Experience shows that the first part usually goes fast since students find it "easy".

The second part tends to surprise and challenge them and will take longer. The third part will require your encouragement and guidance, as well as a larger amount of time.

CLOSURE: Students Assessment: I learned... I realized... I was surprised...

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HANDOUT

DISCOVERING TRUE FEELINGS I. People get psychologically and physically ill when their feelings are blocked and

unexpressed. II. Blocking feelings (especially "negative" ones) may lead to any number of self-

defeating behaviors (e.g., drugs, suicide). III. A common way of blocking feelings is to mask them with other, more "acceptable"

feelings; e.g., masking hurt with anger, inadequacy with "showing off." Common terms in this regard are primary (hurt, inadequacy) feelings and secondary (anger, "show-off") feelings.

IV. Understanding feelings and expressing them in an honest and realistic manner is an

important way to learn to cope with the temptation presented in the use of chemicals. Leveling is when you let someone know how you truly feel.

V. Identifying and expressing your secondary feelings is a first step; however, real

headway will not be made until you have unmasked your primary, true feelings, and understood the masking process itself.

VI. It is important to learn to express feelings in appropriate ways without harming

yourself or others.

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EXERCISE

TRUE FEELINGS I. Identify the feelings reflected in these facial expressions.

II. Identify which of the above could be secondary feelings masking true (primary)

feelings. How? Why? III. Level: Identify one meaningful and real example from your own experience and

describe the situation. How did or could you deal with it?

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LESSON 10

SELF CONCEPT AND CHEMICALS PURPOSE: To briefly describe self-concept and how the use of chemicals affects it. OBJECTIVES: Describe self-concept. Demonstrate how the abuse of chemicals affects self-concept. Enhance self-concept without the use of chemicals. MATERIALS: Handout: Self Concept and Chemicals Exercise: How I See Myself How Others See Me PROCEDURE: Distribute Handout, Self Concept and Chemicals. Read and discuss its three points. Please Note: You are now building directly on the information and exercises of

previous lessons. Any new students to the group (if open-ended) will need special assistance. Fellow group members who participated in the previous sessions may provide this assistance.

Select either Exercise. Exercise, How I See Myself, relates to Point II of Handout. Note: The comparison is how I see myself with how I would like to see myself. Exercise, How Others See Me, relates to Point III of Handout. Note: The comparison is how I see myself with how others see me.

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Encourage openness and honesty in students' responses and discussions. Collect Exercises for students' files. CLOSURE: Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

SELF CONCEPT AND CHEMICALS I. Self-concept is how I feel about myself.

As we have already seen (Lesson 3) chemical users first learn to feel good through the use of chemicals, then seek to feel good through the use of chemicals, and eventually need the use of chemicals to feel good. The dependence and subordination involved leave little room for a positive self-concept.

II. Self-concept is determined by the perceptions and feelings I have about myself.

As we have also seen, chemical dependency has a devastating effect on our perceptions (Lesson 5) and feelings (Lesson 8). The resulting self-deceit and self-dislike further diminish our self-concept.

III. Self-concept is influenced by messages, both positive and negative, that we receive

from parents, friends, teachers, employers, and anyone with whom we have a significant relationship. These messages are important to our self-concept in that they are often a good source of reliable, accurate information about ourselves that we would not have seen on our own. These messages are sent in the form of how we are treated by others and what others tell us about our-selves.

Chemical dependence has a devastating effect on our families and significant others. We will explore this in detail later (Lessons 13 and 14).

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EXERCISE

HOW I SEE MYSELF 1. Specify five (5) descriptive adjectives that are positive about you; e.g., smart,

honest. Specify five (5) descriptive adjectives that are, in your own judgment, negative about you; e.g., lazy, short-tempered.

Positive:

Negative: 2. Notice* how each of the positive traits satisfy an ideal (how you would like to see

yourself), and the effect this has on your self-concept. Then notice* how each of the negative traits detract from an ideal, and the effect this has on your self-concept.

3. Select one negative trait, identify it, describe the ideal it goes against or falls short

of, and explain exactly how it deviates from the ideal:

Trait:

Ideal:

How different: 4. How can you change this trait into something more in keeping with the

corresponding ideal? After writing your own plan, discuss it in group and add/subtract from it, depending on suggestions given to you.

*No need to write out these observations--however, do give yourself the time to understand what is being suggested!

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EXERCISE

HOW OTHERS SEE ME 1. What are some of the things your parents tell you about yourself? Do you believe

this about yourself? 2. What are some of the things others (friends, teachers, etc.) tell you about yourself?

Do you believe this about yourself? 3. Which examples are positive and which are negative?

(Suggestion: Underline the positive examples once and the negative examples twice.) Which examples do you believe to be true about yourself? (Suggestion: circle or [bracket] these.)

4. What do these examples and the above considerations (positive or negative, true or

not) tell you about your self-concept?

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LESSON 11

ON VALUES...AND CHEMICALS PURPOSE: To explore students' values and encourage a sense of personal worth, dignity and wellness. OBJECTIVES: Describe values and the effects of chemicals on them. Explore and clarify each student's values. Develop ways to pursue those values after cessation of chemical use. MATERIALS: Handout: On Values Exercise: Exploring My Values PROCEDURE: Introduce concept of values. Suggestion: "You value yourself; you also value your friend. How far would you go in depriving yourself to please your friend? Whatever your answer, it will both reflect and depend on your values and how you rank them." Distribute Handout, On Values. Read and discuss each section. Verbally assess/ensure students' understanding of each point. Distribute Exercise, Exploring My Values, and assist students in completing it. Clarify:

1. The values listed in this Exercise are not the only ones upon which people base their actions. Space is provided for "other" at the end.

2. Students' responses are the values and priorities they have at this time. As we

continue to learn more about ourselves and our environment, our values and priorities may change to reflect/incorporate our new experiences and knowledge. This is part of the life-long growth experience we all enjoy.

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3. Examples of "enhancing behaviors" include staying drug-free, exercising, completing tasks, etc. Examples of "detracting behaviors" include using drugs, breaking promises, stuffing feelings, etc. (Note: This clarification is intended for the counselor, who is asked to avoid leading students' responses by giving them examples before they've had a chance to come up with their own.)

Have students discuss Items #3 and #4 in group and make notes as suggestions are offered. Collect Exercises for students' files. CLOSURE: Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

ON VALUES I. A value is a principle or quality that one believes in and that guides the way one

acts/behaves in his/her daily life. Values encompass and reflect what we believe to be important or unimportant, right or wrong, worthy or not worthy.

II. We prioritize our action/behavior according to our values. III. No matter what our values are or how we prioritize them, they provide meaning and

direction to our lives, guide our decisions, determine our goals, influence our perceptions and clarify our needs. Values are not to be over-looked.

IV. In practice some extreme experiences--such as sickness, hunger, injustice--may

make it difficult for us to live up to or pursue our values. V. Chemicals, too, can affect our value system just as they can affect other areas of

our lives. Values reflecting the need to "be left alone," for example, are common to chemical users, who eventually find acceptance and justification to lying, cheating, or blaming someone else (often a loved one!), even though these and other behaviors ordinarily go against their personal values.

VI. Whenever our values conflict with our behavior, we experience stress, tension and

lowered self-esteem. We may deal with this stress through the use of chemicals, perpetuating and adding to the problem even as we seek relief, or we may deal with it through healthy alternatives.

VII. If we are to stay chemical-free and grow beyond abstinence, we need to explore

and clarify our values, take a more active and purposeful role in their formation (free from the deteriorating effects of chemical use), and develop healthy ways to pursue them.

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EXERCISE

EXPLORING MY VALUES

1. Weigh each value according to its importance to you. Place a check mark next to the phrase which best indicates the level of importance the value has for you. There are no right or wrong answers.

POWER: Possession or control over others. Not important Moderately important Quite important Extremely important AESTHETICS: The appreciation of beauty for beauty's sake. Not important Moderately important Quite important Extremely important HEALTH: Condition of being sound in body; freedom from physical disease or pain; the general condition of the body; well-being. Not important Moderately important Quite important Extremely important

PHYSICAL APPEARANCE: Concern for beauty of one's own body. Not important Moderately important Quite important Extremely important SKILL: The ability to do something well and expertly as a result of training, practice, or experience. Not important Moderately important Quite important Extremely important EMOTIONAL WELL-BEING: Freedom from overwhelming anxieties, tension, and inner conflict of mind; inner security. Not important Moderately important Quite important Extremely important

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LOVE: a strong feeling of affection and fondness; warm attachment, enthusiasm, or unselfish devotion that freely accepts another in loyalty seeking his/her good. Not important Moderately important Quite important Extremely important RELIGIOUS FAITH: Having a belief in a higher being and practicing some form of religion. Not important Moderately important Quite important Extremely important JUSTICE: The quality of being impartial or fair; valuing truth, fact, or reason; having the desire to treat others fairly. Not important Moderately important Quite important Extremely important

MORALITY: The belief in and keeping of ethical and moral standards. Not important Moderately important Quite important Extremely important HONESTY: Fairness or belief in straight forward conduct; sincerity; truthfulness; frankness. Not important Moderately important Quite important Extremely important ACHIEVEMENT: Accomplishment, as a result of one's own effort and persistence; to bring to a successful conclusion; to attain an aim or desired end. Not important Moderately important Quite important Extremely important

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KNOWLEDGE: The seeking of truth, information, or principles for the satisfaction of curiosity, for use, for the power of knowing. Not important Moderately important Quite important Extremely important PLEASURE: The feeling of having delight, joy, satisfaction, contentment, enjoyment or gratification rather than visible happiness. Not important Moderately important Quite important Extremely important WISDOM: The possession of knowledge, good sense, and good judgment. Not important Moderately important Quite important Extremely important

ALTRUISM: Having unselfish concern for the well being of other people. Not important Moderately important Quite important Extremely important RECOGNITION: Being made to feel significant and important; being given special notice or attention. Not important Moderately important Quite important Extremely important LOYALTY: Maintaining faithfulness to a person, group, institution, or political system. Not important Moderately important Quite important Extremely important

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AUTONOMY: The ability to be independent and not be con-trolled by others. Not important Moderately important Quite important Extremely important WEALTH: Large amount of valuable material possession, property, money, or riches. Not important Moderately important Quite important Extremely important

OTHER? : Not important Moderately important Quite important Extremely important

2. Now, go back over the list of values; look closely at those values you checked as extremely important and quite important. On the lines below, write your top five values from the list; number one should be your most important value.

1. 2. 3. 4. 5.

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3. Take your top three values and list behaviors that have enhanced, supported or

matched each value as well as behaviors that have detracted, conflicted or contradicted each value:

Enhancing Behaviors Detracting Behaviors

Value 1

Value 2

Value 3

4. Explain some of the things you realized you need to do as a result of doing this

exercise.

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LESSON 12

ON NEEDS...AND CHEMICALS PURPOSE: To explore needs, how the use of chemicals relates to needs, and discover alternate ways to meet needs. OBJECTIVES: Describe needs and help students explore their own hierarchy of needs. Assist students in determining how their use of chemicals satisfies their needs. Develop and encourage alternative ways other than use of chemicals to meet needs. MATERIALS: Handout: About Needs. Exercise: Exploring My Needs PROCEDURE: Introduce concept of needs. Note: Maslow's Hierarchy of Needs has been selected for this lesson. Explanation and

clarification of the handout will be required ac-cording to the ability of your group members.

Clarify: There is nothing deterministic, mechanical, or exclusive about the sequence

"needs 6 feelings 6 behavior." (For example, other factors--such as perceptions, values, volition, etc.--induce feelings.) However, we cannot deny that this sequence is a powerful guiding/driving force in our lives. Exploring how my chemical use might be meeting (or not) my needs and what alternatives I have to meet those needs can go a long way toward "breaking" my dependence on chemicals.

Read and discuss the Handout, About Needs. Assess and ensure students' understanding of each point and their ability to relate each point to their own experience.

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Distribute Exercise, Exploring My Needs, and allow time for students to complete it. Have students discuss their responses in groups. Note: Items #1 and #2 are intended to induce the students' ability to explore needs and

needs-satisfaction in preparation for Items #3 and #4. However, the first two items may uncover responses that warrant group discussion and clarification. Even so, the counselor needs to guide the discussion towards items #3 and #4 as much as possible, without sacrificing students' needs.

Collect Exercises for students' files. CLOSURE: Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

ABOUT NEEDS I. Although it would be inaccurate to say that needs "cause" behavior, needs-

satisfaction/deprivation induces feelings which in turn serve as powerful motivators for behavior. This behavior is the time, effort, and action devoted to satisfy the need(s).

II. Maslow's Hierarchy of Needs:

!Level I. The "lowest" or most basic needs have to do with our biological survival. Examples include the need for air, food, etc.

Deprivation of these needs

results in fear/panic and strong desire to satisfy them, at the exclusion of all else.

!Level II. These are the needs for safety

and security, both physical and psychological. Physically, we need to be free from fear of being mugged going home at night; psychologically, we need to feel free from the threat of ridicule and embarrassment. Also, we need to feel safe in sharing our thoughts and feelings in the TRUST group, that there will be bread on the table tomorrow that important people in our lives will continue to be there for us, etc.

Deprivation of these needs results in fear, anger, resentment,

insecurity, helplessness.

!Level III. This level results from the fact that we are social creatures. Some of these relationship-needs include belonging (to a group, a family, etc.), acceptance and understanding (that it is O.K. to be who we are and that others approve of us as we are), loving and affection (both getting and giving it), and intimacy (to share our inner selves with others).

Deprivation at this level results in feelings of loneliness, pain, sadness,

alienation, unworthiness. !Level IV. These are the needs for productivity, achievement and

accomplishment. Their satisfaction is a source of excitement, pride, and feelings of self-worth.

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Deprivation results in frustration, shame, defeat, disappointment, and lowered self-esteem.

!Level V. These include the need for completeness, whole-ness, joyfulness,

transcendence, unity.

Deprivation results in sadness, nostalgia, uneasiness, vulnerability, longing.

III. Needs are universal; all people have needs. Needs are typically set up in a

hierarchy, an order or sequence from lowest to highest, such that we are likely to attend to "higher-level" needs only after "lower-level" ones have been satisfied.

IV. Needs are integrated. When I feel hungry, I feel hungry--not just my stomach.

Conversely, a feeling of rejection arising from an unmet need for affection may lead to eating--just as a feeling of hunger arising from the need for nutrition.

V. Obviously, not all behaviors are appropriate or healthy ways of meeting needs. An

effective way to change undesirable behavior is to look at the feelings to which it responds as well as the need that gives rise to those feelings. In doing so we can frequently get "unstuck" from a particular behavior and find any number of possible alternatives to meet that need.

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EXERCISE

EXPLORING MY NEEDS

1. Excluding the use of chemicals, list the ten people, places, things or conditions in your life which you consider important (e.g., mom, apple pie, etc.).

2. Take the three that are most important to you and specify what need(s) each meets and how (including the feelings involved).

People, places, things or conditions:

Need(s) it meets:

How/Feelings:

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3. Consider your use of chemicals and specify what need(s) it meets and how

(including the feelings involved).

Needs met by my use of

chemicals:

How/Feelings Involved:

4. Describe some alternative ways (behaviors) to meet those same needs:

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LESSON 13

CHEMICALS AND THE FAMILY PART I

PURPOSE: To develop an understanding of family characteristics and how members interact with each other. OBJECTIVES: Identify and describe family rules and characteristics. Relate family rules and characteristics to chemical abuse. Help students assess their own family rules and characteristics. MATERIALS: Handout: Family Rules and Characteristics Exercise: My Family's Characteristics PROCEDURE: Distribute Handout, Family Rules and Characteristics. Read and discuss the five points. Solicit examples of students' family rules and characteristics. Distribute Exercise, My Family's Characteristics. Encourage students' process of self/family-assessment. Discuss students' responses to individual items as well as their total scores. Note: Most families range between 40 and 80 on an exercise like this, or 4 to eight on any

one item. Discuss the relationship between chemical use and the characteristics of each group member's family. Explore ways to help each student's family become more functional. Collect exercise and place in students' files.

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CLOSURE: Student Assessment: I learned... I realized... I was surprised...

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HANDOUT

FAMILY RULES AND CHARACTERISTICS I. Families usually develop and follow rules, both explicit (clearly stated) and implicit

(unspoken), such as who sets the table, who is responsible for planning activities, with whom I can or cannot discuss personal problems, etc.

II. Rules serve to guide the actions of individual family members, provide information

as to what is expected of them, assess the extent to which individual members "belong" to the family, and form the basis for family characteristics.

III. Family characteristics are the typical, recurring ways family members tend to relate

with each other, deal with internal and external difficulties, function as a unit of individuals, etc. More specifically, family characteristics include the quality of communication among family members; the usual methods and effectiveness of dealing with problems; the sense of pride, belonging, security and support experienced (or not) by the family members.

IV. Families can be structured in many different ways. For example, members can feel

very close to one another, very distant, or somewhere in between. To the extent that a family is flexible and encourages communication and effective problem solving, we can describe it as functional. To the extent that a family is rigid and favors non-communication and "sweeping problems under the rug," we can say it is dysfunctional.

V. There is often a direct correlation (on-going, both-ways) between family

dysfunctionality and chemical dependency (drug abuse).

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EXERCISE

MY FAMILY'S CHARACTERISTICS Instructions: Place a numerical value from 0 (never occurs) to 10 (almost always occurs)

on each line as it applies to your family. Open communication between parents Honesty with family members Love and closeness with family members Family members feel accepted and worthwhile Expression of feelings with family members Problems expressed and accepted Productive solutions to problems sought Family members have equal voice Feelings of security Emotional support for family members Total Now add the numbers that describe your family and place it on the continuum (line) below: dysfunctional average functional 0 50 100

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LESSON 14

CHEMICALS AND THE FAMILY PART II

PURPOSE: To identify the roles in the family system that are typical of and contribute to chemical dependency. OBJECTIVES: Describe the concept and function of roles in family systems. Identify the roles that are typical to families with one or more chemically-dependent members. Facilitate students' assessment of their own families' roles; encourage changes that can and need to be made. MATERIALS: Handout: Family Roles and Chemical Dependency Exercise: My Family's Roles PROCEDURE: Introduce concept of role, for example, "breadwinner." Distribute Handout, Family Roles and Chemical Dependency. Read and discuss each of its four points and the six roles under Point IV. Solicit examples from students' experiences. Distribute Exercise, My Family's Roles. Facilitate students' completion of the exercise through on-going discussion, clarification, feedback, and guidance. Encourage/obtain a commitment to implement the response to Item 4. (Note: This response is in effect an action plan and needs to include a time frame and appropriate follow-ups.) Collect exercises and place in students' files.

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CLOSURE: Students Assessment: I learned... I realized... I was surprised...

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HANDOUT

FAMILY ROLES AND CHEMICAL DEPENDENCY I. Family members not only develop and follow rules, but they also adopt and assume

roles. II. Roles provide the perseverance and clarity with which to define behaviors that are

acceptable/unacceptable, expected/unexpected, etc. Roles also help family members either observe or challenge family rules.

III. Roles are not "carved in stone." Family members may exhibit several roles at the

same time or change roles depending on the situation. In more functional families, roles tend to be less intense and less rigid. Their purpose is to naturally complete the family system and provide healthy stability to the family.

IV. Due to the dysfunctional nature of drug abuse, it is not surprising to find that families

with one or more chemically-dependent individuals tend to develop clear and predictable roles:

A. The Enabler

! Function: Keeps the family together and "going" by sheltering the chemically-dependent (and the rest of the family) from the harmful consequences of the chemical use.

! Feelings: Pain, anger, guilt, fear. ! Defenses: Over-responsible, self-blaming, powerlessness, self-pity. ! Characteristics: Usually closest to the chemically dependent, "sufferer",

"controller", "protector." B. Family Hero

! Function: Assumes responsibility for being the family's measure of self-worth.

! Feelings: Fear of failure, loneliness, anger, confusion, inadequacy. ! Defenses: Successes, accomplishments, approval, hard work,

independence. ! Characteristics: Overachiever, functions well in most situations, acts as

family "counselor" if old enough, develops independent life away from the family.

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C. Scapegoat ! Function: Diverts attention away from the chemically dependent by

inappropriate behaviors of his/her own. ! Feelings: Anger, hurt, fear, threatened, rejection. ! Defenses: Withdrawn, hostility, defiance, peer-oriented, acting out. ! Characteristics: Seeks "negative" attention, is often in the family public

eye, goes outside the family for belonging and worth, may abuse chemicals or have an unwanted pregnancy.

D. Lost Child

! Function: Takes stress away from family by isolation, emotional and

physical separation, and being "invisible." (This is the one member the family doesn't have to deal with or worry about.)

! Feelings: Different, lonely, distanced, rejected, hurt, anger, unworthy. ! Defenses: Aloofness, withdrawn, super independence, distance,

rejection. ! Characteristics: Avoids close connections in the family, is undemanding,

fantasizes, spends time alone, loves animals or toys. E. Family Mascot

! Function: Diverts attention from the chemically dependent through the use of humor; reduces anxiety and tension in the family. (There is no problem so big that it can't be laughed away.)

! Feelings: Insecurity, confusion, threatened, embarrassment, loneliness,

fear. ! Defenses: Attention-seeking, fragile, immature, superficial, cute,

charming. ! Characteristics: Lots of friends, not taken seriously, fun to be around, life

of the conversation.

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F. The Chemically Dependent

! Function: Justifies continued use of chemicals in spite of negative consequences.

! Feelings: Pain, shame, guilt, low self-esteem, hurt, fear. ! Defenses: Righteousness, grandiosity, charm, aggression, minimizing. ! Characteristics: Makes excuses, places blame, hides use, protects

supply, lies.

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EXERCISE

MY FAMILY'S ROLES

1. Consider each member of your family, including yourself, and the roles described in this lesson. List each family member, the role(s) he or she plays, and explain your observations:

Name/Relation

Role(s) In What Ways?

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2. Is/Are there any role(s) you would like yourself or your family members to change? Which one(s)? Why?

3. What have you done in the past to try to make the changes you describe in Item 2?

4. What can you do now to try to make these changes?

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LESSON 15

RECOVERY AND RELAPSE PURPOSE: To understand the dynamics of relapse. OBJECTIVES: Define and clarify the process of relapse. Describe ways to identify the onset of relapse at an early stage so students can constructively and effectively avoid it and continue in their recovery. Specify concrete warning signals of relapse. List specific methods to avoid relapse. MATERIALS: Handout: Dealing With Relapse Exercise: Ensuring My Recovery PROCEDURE: Distribute Handout, Dealing With Relapse. Have students read and discuss points I through VI. Suggestion: Process for questions and comments, ensuring that each point "sinks in"; nevertheless, do leave time for Point VI, the positive note toward which their lesson builds. Distribute Exercise, Ensuring My Recovery. Assist students in completing the exercise. Suggestion: Allow students to individualize the exercise by relating it to their specific experience. Those students that have experienced relapse should draw from their previous experience in order to foresee potential difficulties, those whose recovery is currently on shaky grounds need to look at their present situation in order to identify difficulties, and those who have not experienced relapse can draw from their self-knowledge in order to foresee potential difficulties. (About the only thing that cannot be allowed is "I'm not gonna have any problems!").

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As in the discussion, make sure individual plans of action (Item 3) are developed. Collect exercises for students' files. CLOSURE: Students Assessment: I learned... I realized... I was surprised...

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HANDOUT

DEALING WITH RELAPSE I. Narrowly conceived, relapse refers to a return to the use of alcohol or drugs after a

period of abstinence. A complete and more accurate picture, however, includes the thoughts, feelings and other behaviors that accompany this specific return to chemical use.

II. A down side to this realization is that such phenomena as the "dry drunk" (a return

of former negative thoughts, undesirable feelings and/or self-defeating behaviors in the absence of a return to chemical use) are possible. A welcome and positive side, however, is that a return to chemical use does not occur in a vacuum or by surprise, but is preceded by the onset of identifiable thoughts, feelings and behaviors that can alert one to the need for appropriate action!

III. In addition to knowing the warning signs of relapse (things that threaten the action of

staying clean and sober), the recovering person needs to be aware of other problems that may affect his or her commitment to recovery (things that threaten the intent to stay clean and sober).

IV. Examples of problems that may affect my commitment to recovery:

A. Negative feelings, attitudes, thoughts or behaviors:

1. Bottled-up anger 2. Boredom or lack of constructive leisure activities 3. Denial 4. Depression 5. Exhaustion (fatigue) 6. Guilt 7. Loneliness or isolating from others

B. Social pressures to use:

1. Being invited to attend a party where drinking or drugging will take

place 2. Difficulty refusing alcohol or other drugs when offered 3. Having a social group mainly consisting of others who abuse

alcohol/drugs

C. Sobriety plan or treatment related problems:

1. Feeling treatment is not helping 2. Not attending counseling sessions 3. Not working recovery program (AA, NA, sponsor, etc.)

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D. Problems in relationships with other people:

1. Being argumentative 2. Having difficulty establishing new relationships 3. Having trouble trusting others

E. Urges, cravings, temptations or testing control:

1. Being around others in places like parties or bars that make drinking

or drugging sound good 2. Having alcohol/drugs in the home 3. Purposely putting self into using situations to test avoidance of using 4. Having a few drinks to test control

F. There are additional high risk situations:

1. Achieving success 2. Difficulty handling evenings or week-ends 3. Difficulty handling anxiety or stress 4. Feeling good and happy about self 5. Lack of constructive ways to spend time 6. Wanting to celebrate special occasions

V. Examples of warning signs of relapse:

! Stuffing feelings (not talking about feelings) ! Blowing up (yelling, feeling frustrated over small problems) ! Negative attitude (being critical and judgmental) ! Bored (thinking there's nothing to do) ! Self-Pity (feeling upset at not being able to drink or drug) ! Denial of drug problem (thinking it can be controlled) ! Aggressive thoughts (thinking about hurting self or others) ! Thinking often about using ! Isolation (avoiding family and supportive friends) ! Blaming (thinking everyone else is to blame for own problems) ! Dishonesty (telling lies to cover for self) ! School or work troubles (skipping class, flunking, tardy) ! Legal troubles (problems with police or probation officer) ! Conflicts with family members ! Rejecting advice ! Poor meeting attendance (skipping AA, NA or aftercare groups) ! Hanging around places where drinking or drugging took place ! Spending time with old friends who use drugs or alcohol

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VI. Having bombarded you with potential obstacles to your continued recovery and personal growth, do not fail to become familiar with the following positive and practical methods to avoid relapse:

A. Talking with others: Talk with someone face-to-face or on the telephone

(friend, AA/NA, sponsor, therapist). Attend AA/NA meetings. Keep names and numbers of other recovering addicts in wallet.

B. Redirecting activities: Get involved in an activity such as working around

home, going for a drive or working out physically. These activities are designed to redirect thought processes away from urges and cravings.

C. Changing thoughts: Think of all the bad things that happen while getting

high. Think positively, "I'm not going to use"; and repeat recovery slogans such as "easy does it" or "one day at a time."

D. Avoid threatening situations: Don't go to parties, bars or clubs where it will

be even more difficult to handle sobriety. Avoid socializing with others who may influence your decisions about remaining drug/alcohol free.

E. Important point: A combination of changes in behavior, attitudes, feelings,

and thoughts could mean that the process of relapse has begun.

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EXERCISE

ENSURING MY RECOVERY

Give as much specific, concrete and personal detail to your responses as possible: e.g., don't just respond "boredom" but "do nothing but watch T.V. all night, even when nothing good's on."

1. Of the problems that may affect my commitment to recovery discussed under Point IV of the Handout, those that give me the greatest concern or are more likely to occur in my situation:

2. Of the warning signs of relapse discussed under Point V, the ones that

give me the greatest concern or are more likely to occur in my situation: 3. As discussed under Point VI, these are the ways I will deal with the above

potential obstacles to my continued recovery: