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)