Substance Abuse among Veterans

Augustus Zuo

University of Missouri Kansas City

Executive Summary

Substance abuse is a prevalent problem within the veteran population. Veterans

experience a vast amount of stress while deployed, leaving them with stressful experiences and

memories when they return home. Many veterans do not seek or try to get help because of a

stigma which implies that they deal with these issues on their own, leading to attempts to self-

medicate with substances in order to deal with problems or traumatic experiences they

encountered while deployed. Treatment options are available through the Veteran Affairs

Medical Center in Kansas City, Mo.; however, daily problems, such as work, bills,

transportation, and home environment, may get in the way of seeking help.

The proposed program will offer education of services provided through the VA, which

can help the veteran not only with substance abuse treatment, but also provide many other

resources the veteran may need. Transportation has proven to be a burden among many veterans

seeking treatment, so the proposed program will offer transportation services for the veteran

participants who need it. There will also be monthly mixers to provide education for

participants, track progress, and supply an environment for veterans to talk and counsel with one

another, along with licensed counselors on staff as well.

By implementing this program, veterans can get the help they need to live a happy, drug-

free life. Increasing the utilization of services provided by the VA will decrease the amount of

veterans suffering from substance abuse, decrease crime rate, and improve quality of life for

those who have served our country. No one who has risked their lives for their country should

be suffering from mental health or substance abuse issues, especially when they acquired these

problems protecting the United States.

Rationale

Substance abuse is an ongoing problem throughout the United States, especially among

the veteran population. The National Institute on Drug Abuse confirms that substance abuse

costs the United States over $600 billion every year in costs related to substance abuse (“Trends

& Statistics,” 2012). There are 23 million veterans nationwide, and among the veteran

population, 514,724 veterans reside in Missouri (“State Summary,” 2010). According to the

National Coalition for the Homeless, at least half of the veteran population suffer from substance

abuse addiction, indicating a need for effective substance abuse treatment (“Homeless Veterans,”

2009).

Substance abuse can lead to many problems, including behavioral disorders; problems

with existing relationships as well as forming new ones; difficulties finding employment; legal

problems; and can also lead to serious health issues. Symptoms of substance abuse include

“tolerance, which is the ability to drink or use greater quantities over time, compulsive behavior,

which is the inability to stop drinking or using in spite of negative life consequences, and

withdrawal, which includes feeling sick and distressed when attempting to quit drinking or using

drugs” (“Mental Health,” 2014).

The Veteran Affairs Medical Center in Kansas City, Mo. has all the resources veterans

need to overcome substance use disorders including proven methods to help veterans overcome

substance use disorders. The VA has a program locator, which aids in helping the veteran find

local programs to fit their needs. They also have available treatments which address all types of

problems related to substance use, from unhealthy use to life-threatening addictions (“Mental

Health,” 2014). “Make the Connection” is also available through the VA, which allows veterans

to view hundreds of stories from veterans who have overcome their substance use as well as

mental health challenges. “MakeTheConnection.net is a one-stop resource where Veterans and

their families and friends can privately explore information on mental health issues, hear fellow

Veterans and their families share their stories of resilience, and easily find and access the support

and resources they need” (“Mental Health,” 2014).

The proposed program will offer transportation for the veteran in Kansas City Mo. in

efforts to transport them to substance abuse treatment along with other resources and education

supporting the needs of the veteran population in Kansas City, Mo. This program will also

include mixers once a month at the Veterans Affairs Medical Center for support, resources and

education focused on the needs of the veteran.

There is ample amount of research on the topic of substance abuse among veterans. The

Veterans Affairs Medical Center in Kansas City Mo. provides all resources needed to help

veterans overcome substance use disorders. The treatment is available, however there is a need

for reliable transportation to receive this help. Statistics for veterans abusing substances are

declining; however, there is still work to be done. Effective implementation of this program will

also reduce current costs for the city and taxpayers, as veterans who abuse substances incur a

significant amount of costs associated with medical treatment and incarceration, which add up

quickly (“Cost of Homelessness,” 2014).

*References located in Appendices A

Needs Assessment

Volunteer for Veterans will focus on veterans ranging from 25 to 35 years old. The

reason is that, at this age, the risk of using different substances is very high. According to the

National Coalition for the Homeless, at least half of the veteran population suffer from substance

abuse addiction, indicating a need for effective substance abuse treatment (“Homeless Veterans,”

2009). Volunteer for Veterans will provide education, services through the VA to help veterans

change their behavior and obtain resources provided. The main focus group for Volunteer for

Veterans will be veterans 25 to 35 years old, have use control substances. Volunteer for Veterans

will focus mainly on veterans in Jackson County, Missouri. There are 23 million veterans

nationwide, and among the veteran population, 514,724 veterans reside in Missouri (“State

Summary,” 2010). The VA and other organizations in Jackson County provide different

educational programs and services to veterans. Volunteer for Veterans will use the conference at

the VA center and all educational services that will be provided will be at the VA center.

Organizational Information

● Jane Collins, VA Administrator

Jane Collins will serve as the chairperson and leader for this program. She will be

responsible for delegation of tasks and has a vast array of knowledge in regards to all

resources and services the VA provides. She will serve as a decision maker, evaluator as

well as defining roles and responsibilities and providing oversight.

● Demitria Chapple, Health Programs Manager

Demitria Chapple will be in charge of public relations for this program. This includes

texts and emails sent once a week to the priority population with encouraging messages;

tracking statistics of the program; and presenting information to participants at the

mixers. She will also serve as a decision maker and be active in the planning process.

● Vickie Thompson, Health Programs Manager

Vickie Thompson will serve as project manager to ensure that all tasks meet deadlines.

She will also present information at the mixers. She will also serve as a decision maker

as well as being active in the planning process.

● Kelsey Volle, Health Programs Manager

Kelsey Volle will be the creative director for this program. This includes planning

mixers, creating flyers, and using creative processes to get veterans to become

participants in this program. She will also be active in the planning process as well as be

a decision maker.

● Augustus Zuo, Health Programs Manager

Augustus Zuo will serve as a financial manager, ensuring the budget is not exceeded and

the budget is used wisely for the benefit of the veteran. He will also be active in planning

and serve as a decision maker.

● Veteran Affairs Medical Center in Kansas City, Mo.

The VA will provide a room within the VA (usually used for conferences) for mixers

once a month free of charge for this program.

● VA Case Managers

VA case managers will provide a variety of services to the veteran participants, including

ways to cope with their medical situations, identifying goals and needs, and providing

resources for participants. The case manager acts as an advocate on behalf of the veteran

to help them obtain resources while maintaining communication with the veteran and

evaluating the effectiveness of the plan for the veteran, ensuring that the veteran’s needs

are being met.

● VA Hospital Administrator

Paper, printers and ink will also be provided through the VA for flyers and office material

for this program. Postage will also be provided if needed for this program. The VA

administration will be a sponsor for a program, supplying all supply and equipment costs.

● John Doe

John Doe is a veteran who has suffered from substance abuse since he returned from

overseas. Treatment options he has tried have failed, but he is yet to enroll in the

treatment option at the VA. John Doe will provide insight from our priority population,

as he understands what they are going through. His insight and ideas will be taken into

account during the duration of this program, along with hurdles he has faced over the

years in effort to help us ensure that participants do not experience these setbacks or, if

inevitable, the program can be prepared for these challenges within the program.

● Veteran Volunteers

A total of 10 volunteer veterans with a Class E driver’s license will be driving the van for

this program. They will all rotate shifts, only volunteering once a week every 4 weeks.

Two veteran volunteers have agreed to be on call in the instance that something may

happen and the volunteer veteran for that day cannot make it.

● United Way

United Way has agreed to match every penny we spend on gasoline for this program in

efforts to help with the needs of veterans who suffer from substance abuse.

● Onlinecardonation.com

Onlinecardonation.com is a nonprofit organization which takes donated vehicles and

donates them to those in need. This organization has agreed to partner with us and

donate a van for this program.

● VA Mental Health Division

The VA Mental Health Division will provide substance abuse treatment along with

counseling for the veteran suffering from substance use disorder. Treatment will be

provided twice a week on an outpatient basis. Psychiatrist Nancy Jones, who aids in

counseling for the veteran, will attend twice a month mixers as well.

● Hy-Vee

Hy-Vee has agreed to donate pastries, snacks, and beverages once a month for

Mixers at the VA.

Mission Statement, Goals and Objectives

Mission Statement

The mission of “Volunteers for Veterans” is to provide transportation to obtain resources and

education to the veteran population in Kansas City, Mo., including proven, effective substance

abuse treatment for veterans suffering from substance use disorder.

Goals

● To reduce prevalence of veterans suffering from substance abuse in Kansas City, Mo. by

providing transportation to and from treatment.

● Provide education of resources and services available at the Veteran Affairs Medical Center

in Kansas City, Mo.

Objectives

● By January 2016, 50% of participants will have gained knowledge of the resources available

at the Veteran Affairs Medical Center.

● By June 1st, 2015, 40% of participants will be educated on the transportation available to

them through “Volunteers for Veterans.”

● By January 2016, “Volunteers for Veterans” will have transported 60% of veteran

participants in Kansas City, Mo. to the Veteran Affairs Medical Center to obtain resources,

education, and substance abuse treatment.

Theory

The Theories which are the foundation of the program intervention are the Trans theoretical

Model and the Cognitive-Behavioral Model of the Relapse Process. Different aspects will be

taken from each model to correspond with and tailor to this particular program. The Trans

theoretical Model will be applied to veterans suffering from substance abuse in an attempt to

change the behavior of the suffering addict. Changing behavior is very difficult, however,

maintaining behavioral change is much more difficult; this is where the Cognitive-Behavioral

Model of the Relapse Process will be of use to this program. Once participants take active roles

in changing their behavior, the Cognitive-Behavioral Model of the Relapse Process will help the

priority population avoid falling back into their previous behaviors.

Logic Model

ASSUMPTION

The veteran population in Kansas City, Mo. Need transportation to substance abuse treatment. Intended outcome is that at least 25% of program participants will successfully complete treatment.

OUTCOMES – IMPACT

Immediate Intermediate Long-Term INPUTS

OUTPUTS

Activities Participation

What we invest:

Time

Flyers

Postage

Resources

What we do:

Provide transportation

Provide education

Monthly educational

mixers

Weekly text messages

Who we involve:

Veterans and veteran volunteers

VA staff

Health program

managers

United Way

Hy-Vee

What results:

Participation

Realization of behavioral

problems

What results:

Increase in participation

Increase in knowledge

of resources

Increase of knowledge regarding substance

abuse

What results:

Understanding health literacy

Understanding substance

abuse, triggers, and

relapse process

Understanding of resources

available through the

VA

Intervention

Project goals and objectives are to be met in a variety of ways, including volunteer services,

activities and educational tools. Methods to recruit participants include mail, email and postal

mail, which will contain a survey to complete by the potential participant (Appendices B).

Based on certain criteria, fifty veterans will be chosen to participate in the program.

Twice a week for the duration of ten months, transportation will be provided for participants

for substance abuse treatment. Information regarding treatment will not be made available to the

program per HIPAA laws, however, participants agree to complete surveys once every two

months at mixers to track progress on a strictly anonymous basis (Appendices C).

Transportation will also be available to the monthly mixers. Inspiring messages sent via text or

email will also be sent once a week to those who agree to this option.

Mixers will be held every third week of the month throughout the duration of this program at

the VA medical center. At each mixer, discussions will be led by Health Program Managers on a

variety of topics relevant to the veteran, including substance abuse and resources provided

through the VA (Appendices I). Mental health staff, volunteer veterans who have overcome

substance abuse, and social workers will be present for all mixers. After the presentations, group

discussion will take place in efforts to counsel with the veterans and answer any questions they

may have. Snacks and beverages will be provided by Hy-Vee. At the end of the mixer, veterans

will fill out a survey in regards to education retained for that mixer (Appendices G), which will

also be on a strictly anonymous basis.

At the end of the program, a ceremony will take place to acknowledge and reward

participants for completion of the program. Participants will be awarded a plaque (provided by

the VA) as well as a $50 visa gift card. A $50 visa gift card will also be awarded to the 10

veteran volunteers who took time to transport their fellow veteran in need.

Marketing

The Veteran Affairs Medical Center in Kansas City, Mo. has provided information of

veterans between the ages of 25-35 whom have already indicated through previous

questionnaires obtained through the VA that they would be interested in and consent in receiving

promotional information regarding VA resources. This program will offer augmented products,

services provided to help veterans change their behavior and obtain resources provided through

the VA. There is no money cost for participation in this program, however, the veterans

participating in our program will have the cost of time, and a change of mindset. Also, donations

for gasoline will be accepted, but are not required. All program elements, including obtaining

resources, treatment, and attending monthly mixers, will all take place at the VA. Our service

will provide transportation two times a week, and we will also be sending the veterans

inspirational texts once a week. These texts will keep our participants inspired and open to

getting the treatment they need. The Proposed program will be promoted by word of mouth, but

also through flyers via email and postal mail (Appendices E).

Implementation

First, assemble necessary resources and conduct an initial evaluation of the program

layout for the first 2 weeks of the program. Over the next 2 weeks, the program will be marketed

via mail, email or postal mail. At the beginning of February, the program will begin to select

participants based off of completed surveys. The beginning of the third week of February, the

program will notify participants who have been selected. The program will begin on March 3rd,

2015. Participants will be picked up for treatment beginning at 10 am and taken back home once

treatment is finished for the day. Treatment will resume on March 5th. Every week, participants

will attend treatment twice a week, on Tuesdays and Thursdays. On the third Friday of every

month, a mixer will be held at 6:00 pm. Transportation will be provided to the mixers every

month. Every 2 months, participants will complete surveys at the end of the mixers on an

anonymous basis. After these surveys are completed every 2 months, program planners will

evaluate progress and obstacles within the program and make changes where needed. January

9th of 2016, a reception will be held at the VA and a plaque and a $50 gift card will be awarded

to participants who have completed the program. A $50 gift card will be awarded to the 10

veteran volunteers as well, for committing time to this program and driving the van to commute

the veterans to and from treatment and mixers.

*Implementation model in appendices D

Evaluation

Engaging stakeholders:

VA medical staff will be involved with the treatment, transportation, and education

process along side with Volunteers for Veterans, veteran volunteers, the United Way, and Hy-

Vee. The committee will be providing and educating veterans on help and access to resources

available to them through the VA Medical Center.

Describing the program:

This program will be evaluated every two months, by an internal evaluator, to evaluate

progress and or obstacles within the program, and make changes when needed. The program is

looking to have 25% of participants to complete the program by January 2016. Volunteers for

Veterans will be providing transportation and education to veterans receiving treatment from the

VA Medical Center in hopes to increase the participant’s knowledge on resources available for

veterans through the VA, knowledge of effects and outcomes of substances, and an increase in

participation of staff and veterans.

Evaluation design:

Substance abuse is a prevalent problem amongst the veteran population between the ages

of 25-35. Due to many health disparities, lack of transportation, and lack of knowledge of

resources available many veterans tend to not want to seek help for many medical, or behavioral

problems, which later escalates to substance abuse. Our evaluation will measure the impact of

the program on program participants; awareness, knowledge, attitudes, and behaviors. Our

program is focused on behavioral change, so impact evaluation will be utilized in this programs

evaluation.

Gathering credible evidence:

Mixers will have veterans complete post surveys every two months in order to measure

the programs progress. This will be conducted after every treatment sessions.

Justifying conclusion:

Surveys concluded an increase in participants who used the resources available through

the VA. Based on these results the VA staff and Volunteers for Veterans will continue providing

education and transportation to veterans, and will also continue to provide incentives for both

volunteers and veterans in hopes to continue to increase veteran involvement, and treating

veterans.

Ensuring use and sharing lessons learned:

To ensure that the program will continue to move forward with helping treat veterans

suffering from substance abuse, the VA staff will continue to tract their progress through

feedback from veterans receiving treatment from services provided through the VA, which will

be evaluated by Jane Collins who will continue to keep services moving steadily while helping

veterans in all aspects of life. Volunteers for Veterans will continue to provide transportation to

and from treatment for veterans through donations. The program will also be reaching out to Hy-

Vee and onllinecarddonations.com for incentives that will be provided to veterans attending

treatment at the VA.

*Evaluation tool in appendices H

Budget

All VA staff who are involved in this program, including Health Program Managers,

Administration, Case Managers, and the Mental Health Division, will participate on VA

company time for this program. Staff will not receive any extra pay, nor will they receive lesser

amounts of pay for involvement in this program, but salary will continue to be paid by the VA

for duration of this program, incurring no cost for the program budget. John Doe, veteran

volunteer drivers, United Way, Hy-Vee and Onlinecardonation.com are all volunteering services

for this program. Veteran volunteer drivers are also welcome to the monthly mixers, at no cost

to them, for a night of education along with snacks and beverages provided and donated by Hy-

Vee.

Equipment, including computer use, printers, internet and cell phone usage will all be

provided through the VA. All supplies, including office supplies, will be free for this program

provided by the VA. Onlinecardonation.com has donated a wheelchair accessible van for the

purposes of this program. Money for gasoline will be needed and will be matched by United

Way (details in appendices F).

Treatment facilities will be used at the VA. A conference room has been provided for once a

month mixers at the VA at no cost to the program. Almost all elements of the program, aside

from the cost of gasoline, will be provided through the VA. Program costs will include gasoline,

which will be matched by United Way, and incentives for program participants and volunteer

veterans.

Appendices

Appendices A

R Alexander-Eitzman, Ben (2009). Substance Abuse, Marginalization, and Homelessness:

Bayesian Perspectives on a Persisting Problem. Electronic Theses and Dissertations.

Paper 878. Retrieved from http://openscholarship.wustl.edu/cgi/viewcontent.cgi?article=

1877&context=etdeferences

Brubaker, M. D., Amatea, E. A., Torres‐Rivera, E., Miller, M. D., & Nabors, L. (2013). Barriers

and supports to substance abuse service use among homeless adults. Journal of

Addictions & Offender Counseling, 34(2), 81-98. doi:10.1002/j.2161-1874.2013.00017.x

Clark, A., & Lee, R. C. (2013). Transitioning through family homelessness and the effect of

substance abuse on social support systems. Western Journal of Nursing Research, 35(9),

1230-1231. doi:10.1177/0193945913487171

Ibabe, I., Stein, J. A., Nyamathi, A., & Bentler, P. M. (2013; 2014). Predictors of substance

abuse treatment participation among homeless adults. Journal of Substance Abuse

Treatment, 46(3), 374. doi:10.1016/j.jsat.2013.10.008

Lee, Y. S., Han, D. H., Kim, S. M., & Renshaw, P. F. (2013). Substance abuse precedes internet

addiction. Addictive Behaviors, 38(4), 2022-2025. doi:10.1016/j.addbeh.2012.12.024

Moorhead, M. (2012). HUD Secretary Says a Homeless Person Costs Taxpayers $40,000 a Year.

Retrieved from http://www.politifact.com/truth-o-meter/statements/2012/mar/12/shaun-

donovan/hud-secretary-says-homeless-person-costs-taxpayers/

National Alliance to End Homelessness (2014). Cost of Homelessness. Retrieved from

http://www.endhomelessness.org/pages/cost_of_homelessness

National Coalition for the Homeless (2009). Homeless Veterans. Retrieved from

http://www.nationalhomeless.org/factsheets/veterans.html

National Institute of Drug Abuse (2012). Trends & Statistics. Retrieved from

http://www.drugabuse.gov/related-topics/trends-statistics

O'Connell, M. J., Kasprow, W. J., & Rosenheck, R. A. (2012). Differential impact of supported

housing on selected subgroups of homeless veterans with substance abuse histories.

Psychiatric Services (Washington, D.C.), 63(12), 1195.

O'Keeffe, T., Rhee, P., Shafi, S., Friese, R. S., & Gentilello, L. M. (2013). Alcohol use increases

diagnostic testing, procedures, charges, and the risk of hospital admission: A population-

based study of injured patients in the emergency department. American Journal of

Surgery, 206(1), 16-22. doi:10.1016/j.amjsurg.2012.08.014

Padgett, D. K., Henwood, B., Abrams, C., & Drake, R. E. (2008). Social relationships among

persons who have experienced serious mental illness, substance abuse, and homelessness:

Implications for recovery. American Journal of Orthopsychiatry, 78(3), 333-339.

doi:10.1037/a0014155

Pasi, E. (2011). HUD releases 2010 annual homeless assessment report to congress. Journal of

Housing and Community Development, 68(4), 19.

Rocky Mountain Quality Improvement Center (2007). Recovering Together Program. Retrieved

from http://www.americanhumane.org/assets/pdfs/children/pc-rmqic-rtp-guide-

substance.pdf

Therapist Aid (2014). Relapse Prevention Program. Retrieved from

http://www.therapistaid.com/therapy-worksheet/relapse-prevention-plan-2

United States Department of Housing and Urban Development. (2013). The 2013 Annual

Homeless Assessment Report (AHAR) To Congress. Retrieved from

https://www.hudexchange.info/resources/documents/ahar-2013-part1.pdf

US Department of Veteran Affairs (Nov. 2010). State Summary. Retrieved from

http://www.va.gov/opa/publications/factsheets/ss_missouri.pdf

US Department of Veteran Affairs (Oct. 2014). Mental Health. Retrieved from

http://www.mentalhealth.va.gov/substanceabuse.asp

Vayalapalli, S., Fareed, A., Byrd‐Sellers, J., Stout, S., Casarella, J., & Drexler, K. (2013).

Predictors of substance abuse treatment outcome in hospitalized veterans. The American

Journal on Addictions, 22(4), 358-365. doi:10.1111/j.1521-0391.2013.12050.x

Appendices B

Appendices C

Appendices D

Task Year 1Months

J F M A M J J A S O N D J

Progress Questionnaire

1. How many drinks have you had in the past 2 months?

2. How many times have you used drugs in the past 2 months?

3. Did you employ any of the strategies learned when craving substances? Did they work?

4. Have you had suicidal thoughts in the past 2 months?

5. Do you find treatment beneficial? How would you rate your treatment?

6. Do you find the monthly mixers educational?

7. Do you have any recommendations for the monthly mixers?

8. Could you rate the transportation and education provided in this program on a scale of 1 to 10?

Assemble

necessary

resources

x

Market

programx x

Selection of

participantsx

Notification of

participantsx

Begin program x

Mixers x x x x x x x x x x x

Survey

handoutsx x x x x x

Completion of

programx

Appendices E

Appendices F

Income

VA Hospital $10,000.00

Transportation

Gas $150 a week x 43 weeks $6,450.00

United Way matches our Gas $150 a week x 43 weeks $6,450.00

Incentives

Gift Card $50 a card x 60 people $3,000.00

Donations

Internet Access $0.00

Conference Room $0.00

Van $0.00

Hy-Vee Snacks and Beverages $0.00

Printer Expenses Flyers $0.00

Paper $0.00

Total Expenses $9,450.00

Remaining Expenses $550.00

Appendices G

Mixer

1. What did you learn at today’s mixer?

Appendices H

1. Have you used other drugs than those required for medical reason? Yes No

2. Have you or do you abuse prescription drugs? Yes No

3. Do you abuse drugs more than once a day? Yes No

4. Can you get through the week without using any drugs? Yes No

5. Are you able to quit abusing when you want to? Yes No

Mixer

1. What did you learn at today’s mixer?

Drug Abuse

Screening Test

6. Have you ever had any “blackouts” or “flashbacks” as a result of drug use? Yes No

7. Does your drug abuse create problems with you and your spouse? Yes No

8. Have you neglected your family because of drug abuse? Yes No

9. Has the use of drugs created problems at your job? Yes No

10. Have you lost a job because of drug abuse? Yes No

11. Have you gotten into any fights due tour drug abuse? Yes No

12. Have you been arrested for possession of illegal drugs? Yes No

13. Have you experience any withdrawal symptoms? Yes No

14. Have you ever reached out and sought help for your drug problem? Yes No

15. Have you ever been to a treatment program for drug abuse? Yes No

16. Have you ever been evicted due to your drug use? Yes No

17. Have you ever been homeless because of drug abuse? Yes No

18. Have you ever been hospitalized because of drug abuse? Yes No

19. Have you lost any friends due to your drug abusing? Yes No

20. Do you ever think about hurting yourself or others when under the influence? Yes No

Each bold- faced yes

answer is equivalent to

1 point. Total greater

than 6 indicates a drug

problem, greater than

16 indicates a severe

problem.

Appendices I

Month 1-March

Introduction and Resources

Introduction to the program

Flyers and discussion of VA benefits

Group discussion

Intro of participants

First name

Why do you want to make a change?

Why did you decide to participate in this program?

Month 2-April

Priorities, Needs and Wants

Introduce the hierarchy of needs. Understand how needs/wants relate to addiction, and

practice noticing the difference between them.

Month 3-May

Self-Concept

Help answer the question "Who am I?" Understand the difference between performing

roles (what they do) and genuinely understanding and expressing themselves as

individuals in a healthy way

Discuss life stories: Group discussion

Month 4-June

Defining your relationship with drugs

Our relationships with alcohol and other drugs progress along a continuum.

Participants personalize and classify their own relationships with various substances:

Group discussion

Month 5-July

Emotion and Addiction

Learn about emotions and how they are connected to addiction. Learn the importance of

identifying, managing and expressing feelings for recovery success.

Group discussion

Month6-August

Relapse and Craving

Relapse is a process, not an event, and craving may be regarded as a warning sign from

your brain of emotional deregulation.

Understanding relapse cycle

Group discussion

Month 7-September

Self-Esteem and Self-Efficacy

Understand that self-esteem grows from messages we tell ourselves and what others tell

us, and how that relates to recovery. Distinguish between self-esteem (regard of one’s

self) and self-efficacy (ability to accomplish specific goal)

Group discussion about participant self-esteem and self-efficacy

Month 8-October

PTSD

What is PTSD?

Signs and Symptoms

Coping with PTSD

Group Discussion

Month 9-

November

Stress Management

Learn about stress and the body.

Understand the relationship between stress, emotions, and addiction.

Learn basic stress management strategies.

Signs of PTSD Nightmare Guilt Intrusive Memories Poor Judgment Flashbacks Insomnia Anxiety Avoidance Startle Response Loss of Motivation Lack of feelings Poor Self-Esteem Negative Self-Image Frustration

Poor Concentration Short-Term Memory Loss Helplessness Depression Hopelessness Apathy Ulcers Physical Pain Mistrust Problems Communicating Stress Isolation Rage Irritability

Stress Management Techniques

Meditate

Breathe Deeply

Reach Out

Decompress

Laugh Out Loud

Listen To Music

Month 10-December

Relapse Prevention

Understand the process of relapse, and the importance of prevention.

Review current and past recovery efforts to identify strengths and weaknesses in

participants’ personal recovery efforts.

Complete Worksheet

Group Discussion

Meditate

Breathe Deeply

Reach Out

Decompress

Laugh Out Loud

Listen To Music

*(TherapistAid, 2014)(RockyMountain, 2007)