Assessing Clients with Addictive Disorders
Assessing Clients with Addictive Disorders
Addictive disorders can be particularly challenging for clients. Not only do these disorders typically interfere with a client’s ability to function in daily life, but they also often manifest as negative and sometimes criminal behaviors. Sometime clients with addictive disorders also suffer from other mental health issues, creating even greater struggles for them to overcome. In your role, you have the opportunity to help clients address their addictions and improve outcomes for both the clients and their families. For this Assignment, as you examine the Levy Family video in this week’s Learning Resources, consider how you might assess and treat clients presenting with addiction. Assessing Clients with Addictive Disorders
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N: B EACH OF THE 5 EPISODES TO WATCH (REQIURED MEDIA) FOR THIS ASSIGNGMENT IS DOWNLOADEDN IN WORD FORMAT AS A TRANSCRIPT AND ATTACHED TO THIS ASSIGNMENT.
Learning Objectives
Students will:
· Assess clients presenting with addictive disorders
· Analyze therapeutic approaches for treating clients with addictive disorders
· Evaluate outcomes for clients with addictive disorders
To prepare:
· Review this week’s Learning Resources and consider the insights they provide.
· Review the Levy Family video Episodes 1 through 5. Assessing Clients with Addictive Disorders
The Assignment
In a 2- to 3-page paper, address the following:
· After watching Episode 1, describe:
o What is Mr. Levy’s perception of the problem?
o What is Mrs. Levy’s perception of the problem?
o What can be some of the implications of the problem on the family as a whole?
· After watching Episode 2, describe:
o What did you think of Mr. Levy’s social worker’s ideas?
o What were your thoughts of her supervisor’s questions about her suggested therapies and his advice to Mr. Levy’s supervisor?
· After watching Episode 3, discuss the following:
o What were your thoughts about the way Mr. Levy’s therapist responded to what Mr. Levy had to say?
o What were your impressions of how the therapist worked with Mr. Levy? What did you think about the therapy session as a whole?
o Informed by your knowledge of pathophysiology, explain the physiology of deep breathing (a common technique that we use in helping clients to manage anxiety). Explain how changing breathing mechanics can alter blood chemistry.
o Describe the therapeutic approach his therapist selected. Would you use exposure therapy with Mr. Levy? Why or why not? What evidence exists to support the use of exposure therapy (or the therapeutic approach you would consider if you disagree with exposure therapy)? Assessing Clients with Addictive Disorders
· In Episode 4, Mr. Levy tells a very difficult story about Kurt, his platoon officer.
o Discuss how you would have responded to this revelation.
o Describe how this information would inform your therapeutic approach. What would you say/do next?
· In Episode 5, Mr. Levy’s therapist is having issues with his story.
o Imagine that you were providing supervision to this therapist, how would you respond to her concerns?
· Support your approach with evidence-based literature. AND INCLUDE INTRODUCTION, CONCLUSION WITH REFERENCES.
Required Readings
Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (2nd ed.). New York, NY: Springer Publishing Company.
- Chapter 7, “Motivational Interviewing” (pp. 299–312)
- Chapter 16, “Psychotherapeutic Approaches for Addictions and Related Disorders” (pp. 565–596)
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Required Media
N: B EACH OF THE 5 EPISODES TO WATCH (REQIURED MEDIA) FOR THIS ASSIGNGMENT IS DOWNLOADEDN IN WORD FORMAT AS A TRANSCRIPT AND ATTACHED TO THIS ASSIGNMENT.
Laureate Education (Producer). (2013c). Levy family: Episodes 1 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
Laureate Education (Producer). (2013c). Levy family: Episodes 2 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
Laureate Education (Producer). (2013c). Levy family: Episodes 3 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 6 minutes.
Laureate Education (Producer). (2013c). Levy family: Episodes 4 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 5 minutes.
Laureate Education (Producer). (2013c). Levy family: Episodes 5 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
Laureate Education (Producer). (2012c). In their own words [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 23 minutes
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EPISODE2.docx
Laureate Education (Producer). (2013c). Levy family: Episodes 2 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
Levy Family: Episode 2
Levy Family: Episode 2
Program Transcript
FEMALE SPEAKER: I want to thank you for getting me this Levy case. I think it’s so interesting. Just can’t wait to meet with the client.
MALE SPEAKER: What do you find interesting about it?
FEMALE SPEAKER: Well, he’s just 31. Usually the vets I work with are older. If they have PTSD, it’s from traumas a long time ago. But Jake, this is all pretty new to him. He just left Iraq a year ago.
You know, I was thinking he’d be perfect for one of those newer treatment options, art therapy, meditation, yoga, something like that.
MALE SPEAKER: Why?
FEMALE SPEAKER: Well, I’ve been dying to try one of them. I’ve read a lot of good things. Why? What are you thinking?
MALE SPEAKER: I’m thinking you should really think about it some more. Think about your priorities. It’s a good idea to be open-minded about treatment options, but the needs of the client have to come first, not just some treatment that you or I might be interested in.
FEMALE SPEAKER: I mean, I wasn’t saying it like that. I always think of my clients first.
MALE SPEAKER: OK. But you mentioned meditation, yoga, art therapy. Have you seen any research or data that measures how effective they are in treatment?
FEMALE SPEAKER: No.
MALE SPEAKER: Neither have I. There may be good research out there, and maybe one or two of the treatments that you mentioned might be really good ideas. I just want to point out that you should meet your client first, meet Jake before you make any decisions about how to address his issues. Make sense?
FEMALE SPEAKER: Yeah.
Levy Family: Episode 2 Additional Content Attribution
© 2016 Laureate Education, Inc. 1
Levy Family: Episode 2
MUSIC:
Music by Clean Cuts
Original Art and Photography Provided By:
Brian Kline and Nico Danks
© 2016 Laureate Education, Inc. 2
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EPISODE4.docx
Laureate Education (Producer). (2013c). Levy family: Episodes 4 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 5 minutes.
Levy Family: Episode 4
Levy Family: Episode 4 Program Transcript
FEMALE SPEAKER: So do you want to try to go back to what you’re telling me before?
LEVY: I can try. It was night. We were out on patrol. I remember it was so hot packed in our vehicle. Suddenly there was an explosion. We got tossed into a ditch. And somehow I made it out, and I could see it was the Humvee behind us. It’s whole front end was gone. It had hit a roadside bomb. Our vehicle had just driven past it, just mistriggering it. But not them. They didn’t make it.
FEMALE SPEAKER: Remember how we practiced. Slow your breathing down. Inhale and exhale from your abdomen.
LEVY: Thank you.
FEMALE SPEAKER: And just take your time. Whenever you are ready.
LEVY: So the bomb went off. I managed to get out. I had my night vision goggles on. And I could see the Humvee, the one that got hit. It’s whole front end was gone. And there’s this crater in the road. And inside it I could see– I could see Kurt’s– our platoon Sergeant, he was lying there everything below his waist was gone, blown off. And he was screaming. Screaming like nothing you’d ever heard.
And then he was looking at me. And he was screaming for me to kill him. To stop his suffering. He was yelling, please. Please. And someone tried putting tourniquets on him. But the ground just kept getting darker with his blood. And I was staring into his face.
I had my rifle trained on him. I was going to do it. You know. He was begging me to. I could feel my finger on the trigger. And I kept looking into his face. And then I didn’t have to do nothing. Because the screaming had stopped. He’d bled out. Died right there.
And all I could think was I’d let him down. His last request, and I couldn’t do it. I couldn’t put a bullet in him so he could die fast not slow.
FEMALE SPEAKER: I can see and hear how painful it is for you to relive this story. Thank you for sharing it. Do you think this incident is behind some of the symptoms you’ve been telling me about?
LEVY: When I go to sleep at night, I close my eyes, and I see Kurt’s there staring at me. So I don’t sleep too good. That’s why I started drinking. It’s the only way I
© 2016 Laureate Education, Inc. 1
Levy Family: Episode 4
can forget about that night. So I drink too much. At least that’s what my wife yells at me.
We’re not doing too well these days. I’m not exactly the life of the party. I left Iraq 10 months ago. But Iraq never left me. I’m afraid it’s never going to leave me alone.
Levy Family: Episode 4 Additional Content Attribution
MUSIC:
Music by Clean Cuts
Original Art and Photography Provided By:
Brian Kline and Nico Danks
© 2016 Laureate Education, Inc. 2
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EPISODE3.docx
Levy Family: Episode 3
Levy Family: Episode 3
Levy Family: Episode 3
Laureate Education (Producer). (2013c). Levy family: Episodes 3 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 6 minutes.
Levy Family: Episode 3
Program Transcript
JAKE LEVY: We’d be out on recon in our Humvees, and it would get so hot. We used to put our water bottles in wet socks and hang them right outside the window just so the water would cool off of a bit, and maybe then you could drink it.
Man, it was cramped in there. You’d be drenched, nowhere to breathe. It’s like riding around in an oven. And you’d have your helmet on you, 100 pounds of gear and ammo. I swear, sometimes I feel like it’s still on me, like it’s all still strapped on me.
FEMALE SPEAKER: How many tours did you do in Iraq?
JAKE LEVY: Three. After that last recon, I just– There were 26 of us. Five marines in the Humvee I was in. I remember I was wearing my night vision goggles. We passed through a village and everything was green, like I was in a dream or under water.
And then there was a flash, bright light just blinded me. There was this explosion.
I can’t– I can’t- –
FEMALE SPEAKER: It’s OK, Jake. Take it easy. I understand this is difficult. There’s something I;d like to try with you. It’s called exposure therapy, and it’s a treatment that’s used a lot with war veterans, especially those struggling with anxiety and PTSD.
JAKE LEVY: Exposure therapy?
FEMALE SPEAKER: Yes. It’s to help someone like yourself to confront your feelings and anxieties about a traumatic situation that you’ve experienced. It’s a– It’s meant to help you get more control of your thoughts, to make sense of what’s happened, and to not be so afraid of your memories.
JAKE LEVY: Put that in a bottle and I’ll buy 10 cases of it.
FEMALE SPEAKER: Well, one part of it is learning to control your breathing. And when you practice that, you can learn to manage your anxiety, to get more control of it, not let it control you, to protect yourself. Do you want to try it?
JAKE LEVY: Right now?
FEMALE SPEAKER: Sure.
JAKE LEVY: Why not?
FEMALE SPEAKER: OK. Well, I know this sounds crazy, but a lot of people don’t breathe properly. And it really comes from bad habits. When they inhale and exhale, all the effort is here in their chest and shoulders. And the problem with that is you get a really short, shallow breath. And that really increases the stress and anxiety in your body. Assessing Clients with Addictive Disorders
Instead, a more natural breath should always involve your diaphragm, right here in your abdomen. When you breath in, your belly should expand. And when you breath out, your belly should fall. OK?
JAKE LEVY: OK.
FEMALE SPEAKER: So, let’s practice. Close your eyes. Now, I want you put one hand on your abdomen and the other across your chest. Good. Good. Now, I just want you to take a few breaths, just like normal. What are you feeling? Assessing Clients with Addictive Disorders
JAKE LEVY: I feel my chest moving up and down. But my belly, nothing.
FEMALE SPEAKER: OK. So that’s what I was just talking about. That’s OK. Let’s try this. I want you take a breath. And this time, I only want you to allow your abdomen to expend when you breathe in and to fall when you breathe out.
OK, let’s try it. Breathe in. Breathe out. Breathe in. Breathe out.
You feeling better? More relaxed?
JAKE LEVY: Yes.
FEMALE SPEAKER: And the more you practice it the easier it will become. So when you find that stress and anxiety coming on, just do your breathing. You can keep yourself from getting swept by all those bad thoughts. OK? Assessing Clients with Addictive Disorders
JAKE LEVY: Yes. Thank you.
FEMALE SPEAKER: So, do you want to try to go back to what you were telling me about before?
JAKE LEVY: I can try. It was night. We were out on recon. It was my third tour in Iraq.
Levy Family: Episode 3
Additional Content Attribution
MUSIC:
Music by Clean Cuts
Original Art and Photography Provided By:
Brian Kline and Nico Danks
© 2016 Laureate Education, Inc. 1
© 2016 Laureate Education, Inc. 1
© 2016 Laureate Education, Inc. 3
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EPISODE5.docx
Laureate Education (Producer). (2013c). Levy family: Episodes 5 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
Levy Family: Episode 5
Levy Family: Episode 5 Program Transcript
FEMALE SPEAKER: It was such an intense story. I just kept seeing things the way he did, you know. The weird green of his night-vision goggles, his sergeant screaming for Jake to kill him. I just keep seeing it all in my head. Assessing Clients with Addictive Disorders
[MUSIC PLAYING]
MALE SPEAKER: Why, do you think?
FEMALE SPEAKER: Why what?
MALE SPEAKER: Why do you think you keep thinking about this story, this particular case?
FEMALE SPEAKER: I don’t know, maybe because it’s so vivid. You know, I went home last night, turned on the TV to try to get my mind off it. And a commercial for the Marines came on, and there was all over again– the explosion, the screams, the man dying. Such a nightmare to live with, and he’s got a baby on they way.
MALE SPEAKER: Could that be it, the baby?
FEMALE SPEAKER: Maybe. That’s interesting you say that. I mean, the other vets I work with are older, and they have grown kids. But Jake is different. Assessing Clients with Addictive Disorders
I just keep picturing him with a newborn. And I guess it scares me. I wonder if he’ll be able to deal with it.
Levy Family: Episode 5 Additional Content Attribution
MUSIC:
Music by Clean Cuts
Original Art and Photography Provided By:
Brian Kline and Nico Danks
© 2016 Laureate Education, Inc. 1
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EPISODE1.docx
Required Media
Laureate Education (Producer). (2013c). Levy family: Episodes 1 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
Levy Family: Episode 1
Levy Family: Episode 1 Program Transcript
[MUSIC PLAYING]
FEMALE SPEAKER: You’re not dressed? You’re going to be late for work.
MALE SPEAKER: I’m not going to work. I’m sick.
FEMALE SPEAKER: Of course you’re sick. You’re hungover. I don’t want the boys to see you like this. Go back to bed.
MALE SPEAKER: See me like what? I told you, I’m sick.
FEMALE SPEAKER: Well, what do you call it when someone is sick almost every morning, because they drink every night while they sit in the dark watching
TV?
MALE SPEAKER: You calling me a drunk?
FEMALE SPEAKER: What do you call it?
MALE SPEAKER: I call it, leave me the hell alone.
FEMALE SPEAKER: Baby, you need to stop this. It’s tearing us up. The drinking, the anger– you’re depressed.
MALE SPEAKER: You said, for better or worse.
FEMALE SPEAKER: My vows don’t cover this. You were never like this before.
You’ve changed. I want us back, the way we used to be.
MALE SPEAKER: That way is dead. It died when I went to Iraq.
Levy Family: Episode 1 Additional Content Attribution
MUSIC:
Music by Clean Cuts
Original Art and Photography Provided By:
Brian Kline and Nico Danks
© 2016 Laureate Education, Inc. 1
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EPISODE6.docx
In Their Own Words
In Their Own Words
In Their Own Words
Laureate Education (Producer). (2012c). In their own words [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 23 minutes.
In Their Own Words
Program Transcript
NICOLE: My name is Nicole. And May 30, I will have five years in recovery.
RICKY: My name is Ricky. I’ve been in recovery for 10 years.
GRETCHEN: My name is Gretchen. And I’ve been in recovery for about three years.
JASON: My name’s Jason, and I’ve been in recovery for five months.
ODESSA: My name is Odessa, and I have been in recovery for six years.
SHANE: My name is Shane, and I have 11 years clean.
FEMALE SPEAKER: Six addicts, six remarkable stories of addiction, treatment, and recovery in their own words.
GRETCHEN: My addictions are prescription pain pills and alcohol. I’m a survivor of childhood sexual trauma, so that’s– and my parents are addicts. And my parents always used around me. Their friends always used around me.
I grew up thinking that was normal. I grew up thinking chaos was normal and negative type behaviors. My mother had breast cancer, and my mother has other health issues. And she’s addicted to her pain pills.
I would try and reach out to her for help, and she would just say, you know, go get me a bottle or go get me a beer or go get this. And she would take those pain pills with that alcohol. When you sit there and you watch your mother do that and not help you and not support you and not listen to you, and the whole time I was there I was telling her I needed to get help.
I needed help. I needed counseling. I needed treatment. I needed something.
In the worst stage of my addiction, I just kind of went off the deep end with it all. I just realized that I couldn’t handle it anymore and I didn’t know how to fix it. So I just self-medicated and drank, and drank, and drank, and took pills and drank. And some things happened that just caused me to realize that I was going to die if I didn’t reach for help.
JASON: I snuck into a Casino with a fake ID at 14 and won $1,000 playing Blackjack, and then it was like my whole life went this way. It was like college, that all can wait, because there’s no way I can make this much money. So it was just off to the races from then.
I can remember one time I cashed out my 401k, took out like $30,000, went straight to the casino. Doubled that and didn’t leave. And then lost $40,000.
I think I got the same feeling losing or winning. It was as long as I was gambling. It didn’t matter. It’s the same. It’s the rush.
I would go to the casino. And, of course, they’d give me a room for a week or two weeks, whatever I wanted. I would stay there literally. I just wouldn’t go to work. And of course, no employer’s going to put up with that.
I pretty much just lost everything. And I knew it was time to do something.
RICKY: My daddy, when I finished high school, he passed away. So that just, that left me, the oldest son, on the farm. So I had to drop everything. There was a lot of pressure. There was a lot of disappointment, and the only way I could cover that up was by drinking. Assessing Clients with Addictive Disorders
NICOLE: My addiction began when I was a child. I was ADHD, always bouncing off the walls. And that’s when I first got my first experience with pills.
And I remember that chemical feeling of feeling relaxed, and I liked it. And throughout my adolescence I experimented with marijuana, pills, alcohol, whatever.
I had a schedule where I would drink at noon, and then I would drink at 2:00. You know I had this whole schedule of– it was really silly. It’s funny how you have this whole mindset and you can trick yourself. And you’re thinking in addiction is absolutely crazy.
My addiction got really bad. I was in an abusive marriage. I had a heart attack during that time. And anyway, it was just really, really bad. And basically, I just wanted to numb the bad feelings.
ODESSA: Addiction started for me at an early age, probably around eight-yearsold, nine-years-old. My grandparents made homemade wine, and I would like taste it. So that’s where I think it actually started for me.
It started with alcohol, marijuana, and cocaine, and then later crack cocaine. For most of my 20s and 30s, I was an active addict. I could stop for many years and then start back. But every time I would start back, the addiction would get worse and worse.
Once I got to a point in my life where things were falling totally apart. Foreclosure on homes, repo of vehicles, family dynamic totally destroyed, living on the streets, prostituting, doing whatever I had to do to get drugs. That’s when I realized I needed help.
SHANE: I found my drug of choice right out of high school, which was methamphetamine. When I found my drug of choice, nothing else really mattered to me. It was just the getting and using and finding ways and means to get more.
Through that period of life I got married a couple times, but one thing was clear, I stayed married to methamphetamine. I didn’t have the ability to get away from it. It became a normal part of life for me.
And I called myself being a functioning addict, because I had the ability to go to work. I had the ability to be an energetic father, and all these lies I kept telling myself, because I was able to function in everyday society. That addiction cost me two marriages. It almost cost me my family. And it pretty much destroyed my relationship with my kids.
First treatment center I went to they brought a guy by me in a straight jacket, and I left out after about three hours, because I knew that if I talked to somebody that they were going to know I was crazy. Because I knew the things that were happening in my head were not supposed to be in my head. So I ran. Told them I needed to get a bag out of the car, and I was gone.
I guess some of the first events that happened to me that allowed me to begin to open my eyes was, first of all, was a suicide attempt. I had a pistol in the truck, and I couldn’t pull the trigger. I had it to the roof my mouth, and I had that blink of something’s wrong and I need help. I can’t do this on my own. And I want to die. I just couldn’t do it.
Second glimmer was I had hit– I had gotten arrested. And I can remember laying there in that jail cell, and looking up at that ceiling, being on suicide watch in a paper suit, not really thinking the substance was a problem, but thinking that something was a problem.
I am not meant to be in this cell. Something’s wrong, and I need to get some help. That time, they released me straight out of jail into treatment. All those things came flooding back up, and I just wanted to live right back in that denial again and blame it on everybody else but myself. But that was the start.
The steps that helped me the most from my addictions counselor’s standpoint is the ability to sit down and talk to me like a human being. I guess I had a definition of myself when I got to treatment the last time from being in jail and being called a convict that I was just trash and that I’d never amount to anything.
And then you hear all the rumors of when somebody’s an addict, they’re always an addict. And there’s no help for people like us. That addictions counselor actually treated me like a human being, and he asked me a point blank question. Assessing Clients with Addictive Disorders
What do I want to do with my life?
And here I was a 28-year-old man that didn’t have a clue what he wanted to do with his life. That was the starting point that hey, this guy wants me to do something. So maybe I should start thinking about my dreams again.
Everybody had dreams as a child. But I had lost mine somewhere. I had gotten into this monotonous life of getting high, going to work, that didn’t work anymore. What was I going to do with my life?
He built me up. He gave me confidence to walk into a 12-step meeting, to walk into a public place and actually talk.
ODESSA: I had to relapse several times to understand that I couldn’t do this by myself. I couldn’t beat this thing. The first step, I had to admit that I was an addict. For years, I didn’t want to accept that, because I had been so productive for so long.
And the second thing was for me to be able to surrender to something. It’s hard to surrender to something that you don’t know anything about. So to be able to trust someone in recovery was like foreign land to me.
RICKY: If I don’t do anything about this, I’m going to die. And I had to come out of this denial stage and realize that. I began to come open-minded to suggestions, because I wasn’t living. I was trying to survive. I wasn’t living.
JASON: The first 30 days, 35 days or so, it was like extensive group therapy every morning of the week, where you get in groups with a bunch of people, maybe 10, 15 people with my addiction. We talk about it, talk about what we’re going through, and what not, what’s on our mind, just whatever, and just be open.
And then you have these classes that you deal with about the addiction. And then, of course, the meetings at night, 12-step meetings. After the 35 days, another 60 days of the same thing, but a little bit more freedom, not so intense, but staying around people in recovery and not just going back out there to where I came from.
I’ve been in treatment four times. And I’ve always gone back. Gotten out and gone back to where I came from. It does help to kind of relocate and then be around people that are trying to do what you’re doing for sure.
Because every time I would go back to that old environment– of course, I’m with my old friends. They don’t have that problem, but they’re going to do it. And then here you are getting dragged back into it.
NICOLE: This lady who had been my cousin’s sponsor, her name popped into my head. And so I called her and I said, I don’t know what’s going on with me. I said, I tried to quit drinking.
But I feel like if I don’t get a drink, I’m going to die. And I know that that means something is wrong. And she was like, well, I’m going to chair a meeting tonight, a narcotics anonymous meeting. Why don’t you come?
And I was like, well, I don’t need a meeting. I’ve never done cocaine or shot needles in my arms. I don’t need a meeting. And so I got through the afternoon by the grace of my higher power somehow. And I was throwing up. I was so sick.
And I was like, no, I’m not going. Yes, I’m going to go. No, I’m not going to go. And finally, I went. And I’ll never forget that day.
And I walked in, and it was full of people. And I’m so scared. And when they did the readings at the meeting, I was like, it just got chills. And I knew I was home. Assessing Clients with Addictive Disorders
GRETCHEN: I would not suggest to anybody to do it the way I did. I would suggest someone maybe in my position to get medical detox, which I didn’t do. It could have killed me. But I detoxed at home.
I was very violently ill. And I just kept telling myself, God doesn’t want me to forget what this feels like. He doesn’t want me to forget this time.
And the people at my church and the people in my meetings, they helped me. They helped me through it. They helped me to understand that I was going to be all right and that even though it didn’t seem like that there was going to be a better day, there was.
And I just reached out to every resource I could find to get information on why I might be doing the things I was doing or feeling the way I was feeling and what to do about it. And I’m still doing that, and I’m not going to stop. Nothing stopped me when I was in my addition, and now, nothing’s going to stop me in my recovery.
JASON: The best program out there for me is the 12-step program. I meet a lot of people that are coming into the program, and they think once they go to church and get saved, and all this kind of stuff, they’ll be fine. Which if it works for them, good. But for me it didn’t, because I wasn’t around those people with the same problems that I had. So the 12-step program has definitely been the most beneficial to me.
SHANE: I think the most successful treatment that helped me would be cognitive behavior. It allowed me to see that the problem wasn’t the problem. It was the thought about the problem. I would think it, and then all of sudden, it became a problem, because it would be rethought, and rethought, and rethought before it becomes this monstrous mountain I can’t get through.
So I was beginning to see that if I just dealt with my problems as they came along, they didn’t become these monsters. They were just life. And then of course, the motivational interviewing, the being able to sit down right where I am, and meet me there, and then walk from me there was just amazing to me.
Of course, the 12-steps played a monstrous role. And I continue working the 12 steps today. It is part of the maintenance program that I utilize day in and day out. Those three things are probably the most powerful things that happened in my life and some of the things that I’m the biggest proponent of today.
RICKY: Connecting with God, spirituality. When that clicked in, it was on. All of it began to make sense, all of it. I made that connection. And I don’t think I would have made that connection without the 12 steps. I wouldn’t be sitting here to be honest with you. It saved my life. Literally, it did. I made that connection with God.
ODESSA: 12 steps was the most helpful for me. It gave me an outlet. And not only with people that are just like me, but people that were totally opposite. People that you could say that you wouldn’t think would be there were there, the support. They understood. Assessing Clients with Addictive Disorders
NICOLE: 12 step was really the only I’ve– I mean it worked. We started a women’s only group, which has been great, a couple years ago. And that’s my home group. And so I go to a couple a week. I’m always working on step work, and I will be the rest of my life.
GRETCHEN: I just kind of winged it myself. But that’s dangerous. I realize that now. I mean I knew I was sick when I was withdrawing. I knew, but I didn’t know what physically could have happened to me really. I’m here now.
RICKY: The most successful thing that I learned that guarded me against relapse was seeing the people coming to treatment and realizing that it’s still out there, bigger than ever, badder than ever. And all I had to do is take that one slip and that’s it.
JASON: The most successful things I’ve learned to guard myself against relapse would be like triggers. Certain kinds of music is a trigger for me, as weird as it sounds. Or definitely talking about it, entertaining glory stories of, man, one time I went, and I won this amount of money.
Entertaining that thought, and then my blood is flowing, and that becomes my obsession in my head. So just realizing the fact that I’ll never be able to gamble again, not keeping that reservation in the back of my mind that, well, maybe one day if I’ll be able to manage it.
ODESSA: Cravings still come, thoughts of using. Just driving past a place that you’re familiar with. To be able to pick up the telephone and call someone and tell them about the things that you’re thinking. That was a hard, hard thing for me to do.
And to ask for help from others, it is was just almost unheard of. But that was the main thing that helped me to start my road to recovery. Assessing Clients with Addictive Disorders
SHANE: Some of the things that I learned in treatment that allowed me to begin to see what some barriers would be or what would be some walls that I could put up to stop me from relapsing, of course, was the ability to talk to people. When I was able to share those sick thoughts, then they dissipated. They would leave me.
I can remember the very first time I did that with an individual, the first person I called, my sponsor. And I reached out and I said, here’s the craziness that I’m thinking, that I could go out and use just one time, that I could be successful with it this time, or just use on the weekends.
And he said, man, do you know how crazy that sounds. And it hit me. He did. He knew how crazy that sounds because he had thought the same thing. That connection was the beginning of being able to trust people again. And that there were people just like me.
NICOLE: To make a cake you have to have all the ingredients. And if you leave out one of those ingredients, the cake’s not going to turn out. So to prevent relapse, you have to have all the ingredients, which is have a sponsor go to meetings and learn the steps with your sponsor.
GRETCHEN: I’ve watched other people die. I’ve watched other people relapse. And I came to a place inside of my addiction, where I could have really died. I knew I was going to. I knew I was. if I didn’t stop it.
And now I’m seeing it happen to other people, and everybody thinks it’s not going to happened to me. Yes, it happens. It can happen to you. And it scares me. I’m scared.
But my last relapse, just all the events that took place, really reality hit. And I became very afraid, and my fear of it seems to keep me, it seems to drive me towards recovery, more and more every day. Assessing Clients with Addictive Disorders
SHANE: I still go to 12-step meetings. I still have a sponsor. I still talk to my sponsor if not every day, but every other day, because those sick thoughts will come back. And that beast is waiting on me.
JASON: Man, how am I going to enjoy football or sports without betting on them.
I even told myself for a little while that maybe I’ll do it again one day, but just not today. I’m going to, just today, I’m not going to think about gambling. I’m not going to gamble. I’m not going– I’m just going to be.
GRETCHEN: It’s kind of like you’re in a boat with a pale, and you’re throwing the water out of the boat, and you don’t want to give your pale to anybody, because you know you’ll sink. But at the same time, you know you are trying to help others as well.
I have to remember that I’m still in recovery, and I have to take care of me first. Or I’ll be a disaster, and I won’t be able to take care of anybody else.
RICKY: What I do now, I’m an alcohol and drug counselor. It feel good to know you’re helping others in the same predicament that you were once in. And I’m going to continue doing that, because I know what it’s like.
SHANE: One of the counselors had a mirror in his office, and he said, go look in that mirror. And I walked into that mirror. And he said, now, look straight in the eyes of the person that’s looking at you in that mirror and say, if that’s not the problem, there is no solution, because I can’t change anything else but that.
And that scared me. It scared me, because I was the one destroying everybody around me, including myself. It’s like I was OK with dying. I was afraid of living. And boy, it impacted so much in my life. It’s one of the things that still draws me to recovery today.
And I want tear up thinking about it right now, because it’s one of the powerful things that keeps me going. And that addictions counselor doesn’t know how much he’s helped me.
NICOLE: An addiction counselor helped me and pushed me to go back to school and back to college. And I graduated with honors, and I would have never even tried it if it weren’t for him. And we got married. And he’s my husband today.
ODESSA: For so many years, I only believed in me and what I was incapable of doing. But no man is an island. And I’ve learned that. And reaching out to others and working in a 12-step program and being held accountable has made my life successful. Matter of fact, all the years that I thought I was productive, I wasn’t at peace. Today, I’m at peace. Assessing Clients with Addictive Disorders
© 2016 Laureate Education, Inc. 1
© 2016 Laureate Education, Inc. 1
© 2016 Laureate Education, Inc. 9
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EPISODE5.docx
Laureate Education (Producer). (2013c). Levy family: Episodes 5 [Video file]. Baltimore, MD: Author.
Note: The approximate length of this media piece is 2 minutes.
Levy Family: Episode 5
Levy Family: Episode 5 Program Transcript
FEMALE SPEAKER: It was such an intense story. I just kept seeing things the way he did, you know. The weird green of his night-vision goggles, his sergeant screaming for Jake to kill him. I just keep seeing it all in my head. Assessing Clients with Addictive Disorders
[MUSIC PLAYING]
MALE SPEAKER: Why, do you think?
FEMALE SPEAKER: Why what?
MALE SPEAKER: Why do you think you keep thinking about this story, this particular case?
FEMALE SPEAKER: I don’t know, maybe because it’s so vivid. You know, I went home last night, turned on the TV to try to get my mind off it. And a commercial for the Marines came on, and there was all over again– the explosion, the screams, the man dying. Such a nightmare to live with, and he’s got a baby on they way.
MALE SPEAKER: Could that be it, the baby?
FEMALE SPEAKER: Maybe. That’s interesting you say that. I mean, the other vets I work with are older, and they have grown kids. But Jake is different.
I just keep picturing him with a newborn. And I guess it scares me. I wonder if he’ll be able to deal with it.
Levy Family: Episode 5 Additional Content Attribution
MUSIC:
Music by Clean Cuts
Original Art and Photography Provided By:
Brian Kline and Nico Danks
© 2016 Laureate Education, Inc. 1