Marc Baisden

It has been some time since my last blog. I do apologize. Due to an unexpected illness and lengthy recovery I am back. During this time my RECOVERY was challenged, even with my 31st anniversary of recovery only 35 days from today. September 1, 2011.  There were times when I was not as motivated to maintain my recovery. This was due to the amount and type of prescription's they were providing in as large of quantities as the law would allow. The doctors seemed deaf to my pleas and statements about RECOVERY. One doctor told me that alternative methods of healing are fairy tales.


It took me getting upset and gaining their attention before  the doctors  began to truly listen to me. I also made calls to my recovery supporters to hold me accountable but also come and help be my voice about Recovery and the impact of medical treatments can have on maintaining  one's motivation to remain in Recovery.


Here are some tips:

1)    Let those who are your Recovery support know what is happening.

2)    If needed take one of them with you to your appointments.

3)    If in the hospital maintain contact with your supporters.

4)    Be honest with you physicians about your concerns related to medications and types.

5)    Ask about alternative treatments or substances.

6)    Br ready to talk and provide education about recovery and your needs. Many in the health profession do not have a clue about what RECOVERY really is.


Be open and honest about your RECOVERY with all and become a community educator, you will find it will increase to own motivation and self-accountability when the triggers occur. And as you know they do occur.

Thanks for reading.

Marc Baisden 

Its important to promote accountability within your family system and instill values into your children from an early age. This is the checklist I encourage parents to review:

1. Set Rules/Boundaries:  Let your teen know what is acceptable and unacceptable and that these rules are set to keep your child safe. Set limits with clear consequences and loss of privileges for violating  them.  Once set they can be  modified, yet need to be maintained so that they hold credibility with your child.

2. Praise and Reward good behavior for compliance and enforce consequences for non-compliance.

3. Limit and Monitor the amount of cash your child carries.  Consider having your child use a prepaid credit/debit card to pay for daily expenses.

4. Check on your Teenager. Occasionally check in to see that your kids are where and with whom they say they're going to be. And Help them to be engaged in activities  (Not video games or movies)  especially between 4 p.m. to 8 p.m. and the evening hours.

5. Establish a "Core Values Statement" for your family. Consider developing a family mission statement that reflects your family's core values.

6. Spend time together as a Family regularly and be involved in your kid's lives, including when they have friends over. This builds up credit with your child so that when you have to set limits or enforce consequences, it's less stressful.

7. Learn the Facts about drug use and underage drinking with your teen and talk about its harmful health, social, learning, and mental effects on young users.

8. Stay in Touch with all adult supervisors (teachers, coaches, etc.) of your child and ask them to inform you of any changes in your teen's behavior.

9. Get to know the Parents of your child's friends. Exchange phone numbers and addresses. Agree to forbid each others children from consuming alcohol and drugs in their homes, and pledge that you will inform each other if one of you becomes aware of a child who violates this pact. Call the parents whose home is to be used for a party. Make sure they can assure you that no alcoholic beverages or drugs will be dispensed and that they will be present.

10. Make it easy for your child to leave a place where substances are being used. Discuss with your child in advance how to contact you or another designated adult in order to get a ride home. Set a code word that they can text you to get them out of a situation.

11. Set Curfews and Enforce them. Discuss the intent of curfews, establish formal curfews, and enforce penalties for violations.

12. Encourage Open Dialogue with your children about their experiences. Tell your child, "I love you and trust you, but I don't trust the world around you, and I need to know what's going on in your life so I can be a good parent to you." At times that you are together, casually ask your teen how things are going at school, about friends, what plans are for the weekend.

Monitoring your children can promote accountability. Learn More.

Good Morning,
This the third and final section of this latest series. I continue to pray that it has brought some information that has help you and your family. I am aware as a parent myself that these are difficult and scaring times for all. We are facing issues that no one could have conceived of even 20 to 25 years ago. Thank you for letting me share with you insights and writing that may help. Next series is on parenting-and relationships with one or more people in your life that are using.  Thank you for the comments that you have sent me. I appreciate them.

ROLE OF THE COUNSELOR/PARENT
As described above, there are many factors which impact on the state of mind and level of motivation of substance users. Counselors are often faced with clients who are unsure of themselves, and unsure of their ability to cope with life without drinking or taking drugs. In simplistic terms, the counselor's role is to help the client work through their ambivalence, and motivate him or her towards gaining control of their substance use.

Aspects of the role:
(1) Assessment: To assess the extent of the person's "problem" - how bad is it?
(2) Mental health issues: To assess whether there is an underlying mental health problem; a referral may need to be made for further assessment.
(3) Identify triggers: Help identify the situations, thoughts and feelings that trigger the client's drinking or drug taking.
(4) Life style changes: Help the client make appropriate life style changes - paying particular attention to the people they mix or socialize with who may draw them into substance use.
(5) Self-soothing activities: Help the client find distractions or self-soothing processes to cope with cravings.
(6) Suggest treatment options: Make referrals to residential treatment programs when this is appropriate. Those with substance dependence problems will usually require more intensive "treatment" than those with substance abuse problems
(7) Provide support: Help support and motivate those that want to change, but are finding it hard.

THE CYCLE OF CHANGE
Given that so many alcohol and drug users are in fact ambivalent about wanting to stop, may be lacking in trust, or may just be in denial, the support of a professional counselor becomes essential. Helping someone in this situation can sometimes be a difficult task. However there are a number of tools at the practioner's disposal.
The following is a model or theory of change developed by two social scientists (Prochaska & Diclemente), and may be used to explain the different decision-making stages that we tend to go through when trying to make a significant lifestyle change. Whether the desired change is to give up alcohol & drug use, or perhaps to get fit and lose weight, the process is basically the same.

The diagram below demonstrates the decision-making process of someone wanting to take control of their substance use.

It begins here (moving your mouse over each part of the diagram will activate different messages):

UNAWARE

(of consequences)

STAGE

(pre-contemplation)

AWARE STAGE

(awareness of consequences)

PREPARATION STAGE

(looking at options)

ACTION STAGE

(putting your plan into action)

RELAPSE PREVENTION STAGE
 
SLIP or
RELAPSE
RECOVERY

A fuller explanation of this model is provided below.

THE STAGES OF CHANGE
Pre-Contemplation Stage: A state of unawareness where the user has no concerns about the consequences of their alcohol or drug use. Teenagers are generally in this stage and some people may be stuck here for years.

"Denial" might describe this stage for people who have a long history of alcohol or drug use but insist they can handle it.

Contemplation Stage: The stage where the person has become aware that there are problems associated with their substance use, has begun to think about the issue, but is not yet ready to deal with it.

The consequences are not yet so bad that they feel the need to take action; or the consequences are serious, but the person feels that getting control of the situation is just too hard.

Preparation Stage: The stage where the client is beginning to try things such as going to AA, looking at the options, and making a plan to stop or cut down.

The preparation stage is perhaps the most important in the process. If you move too quickly and stop using without a proper plan or without putting the necessary support in place, the chances of long term success are not great. Finding the right support is the key to success in any significant personal change.

Action Stage: The stage where the person is actively attending counseling or AA/NA or both, and has committed to an attempt to cut back or stop using (preferably on a certain date.)

Maintenance Stage: The stage where the person uses 'relapse prevention' strategies to ensure new behaviors are maintained. Strategies in this stage might include:
•    On-going counseling
•    Attending a support group such as AA , NA , Ala-Non
•    Telling friends and family of their plan
•    Avoiding friends they used to "use" with
•    Self-esteem building processes
•    Finding replacement activities
 
Relapse: The process of learning to cope with a "slip" to prevent it turning into a full-blown relapse. Few people are able to get on top of substance abuse or dependence without a "slip", where they start using again. However some of the best learning comes from having a slip which is brought under control before the user relapses completely. In the process of stopping quickly, new skills are learnt which then become  part of the user's relapse prevention repertoire.

Final Comment: This is a theoretical model. Everyone is unique with different skills and strengths, and few people go through the stages from start to finish in a systematic manner. People enter the cycle at different points and many people go through different stages of the cycle a number of times before they finally achieve the outcome they want.

As promised, Part two,  I am sure that the information has sparked some thinking and challenges of working with youth and our own children. Enjoy and continue to send feedback.  marcb@counselingandconsultingservices.com 

STAGES OF YOUTH IN THE CHANGE PROCESS
MARC BAISDEN, MA, CMHC, CIS

THE ROLE OF WILLPOWER

Even when someone is ready to stop or cut back their drinking or drug use, they may feel they have to get it under control by themselves by using will power. Most cigarette smokers do this when they decide to quit. However most cigarette smokers try and fail many times before they finally succeed in giving up. The situation is usually no different for those trying to cut back on alcohol or drug use. Most attempt to control their substance use by using will power alone - and usually fail.

Restructuring  the  environment: In fact, many 'users' struggle with their drug or alcohol problems for years trying to keep it under control, before they finally realize they can't do it by themselves. This is because when up against an addiction, will power is a very limited resource and will only take you so far. Learning to restructure your environment so that it supports an alcohol and drug free lifestyle is usually the key to recovery. Once a supportive lifestyle is in place, when temptation arises, some will power may be needed; in the right environment it then becomes much easier to exercise the necessary willpower to avoid further drug use.

The need for support: In order to change the drug user's environment, the support of a good alcohol and drug counselor, and/or the support of a group such as AA, is generally what makes the difference. Without such support, the average alcohol or drug user is left with nothing but their own limited resources to make what is usually a difficult journey. Add denial, low self-esteem and conflicting intentions to the mix and the odds may seem insurmountable.

The role of courage: Having the courage (or perhaps the desperation) to seek professional help is probably the biggest favor that someone in this position can do for themselves.

DENIAL

When someone has an alcohol or drug problem but is not yet ready to face up to it or do something about it, they are sometimes said to be "in denial". Denial is often a combination of a lack of awareness of the actual consequences of drug taking, combined with a lack of self-belief that the user could stop using even if they wanted to. Teenagers especially tend to deny their drinking or drug taking is a problem, but often do so because they have not yet been 'using' long enough to have experienced sufficient on-going negative consequences to be that concerned about it. On the other hand, those with long term drinking or drug problems may be very concerned about their drinking (or drug use), but feel powerless to stop or control it.

When this lack of awareness, insight or self-belief continues for many years, then it would not be unreasonable to call it "denial". In psychological terms, someone with such little insight into the impact of their substance use may be called pre-contemplative. Pre-contemplation is the first stage in a model (known as the Stages of Change model) that describes the stages people go through when making a significant change in their lives (see below). This model is a useful way of assessing the "user's" readiness to make changes regarding their drinking or drug use.

CHANGES IN MOTIVATION

Substances users may be in denial, they may be ambivalent about wanting to stop, or they may think they should be able to control their substance use by using will power alone. They may also have low self-esteem and lack trust in themselves and others.

The impact of these different psychological factors is that levels of motivation depend on the circumstances and vary over time. They also vary enormously from one individual to another. Often in the early stages of dealing with a drug or alcohol problem, the motivation or desire to deal with it may be low. As time goes by, drug use may escalate or the consequences may get worse, and so the need to address the problem may become clearer.
The impact of a crisis: Sometimes people only come to the realization that they need to address their drinking or drug use when there is a crisis - such as the breakup of a relationship or the possibility of imprisonment because of a legal offence such as a drink driving conviction. Those who are required to have an alcohol and drug assessment prior to sentencing in Court are often described as having high 'pre-sentence motivation'. Once the crisis is over, if the individual avoids going to prison, such motivation often does not last. The point is that motivation is not a fixed entity, which someone either has or doesn't have; it varies with the circumstances.

The impact of seeking help: An indication that someone's motivation may be on the increase is if or when they decide to seek help. They may attend an AA meeting or perhaps ring an alcohol and drug agency. Although this might be a hopeful sign, sometimes people will take this step just to appease a family member who may be expressing concern about the problem. However, the level of motivation involved in addressing alcohol and drug issues in order to please family members or friends is not likely to be sufficient in the long run.
 
Nevertheless if the person actually engages in the counseling process, this does allow them to become clearer about their own intentions. When someone reaches the point that they wish to address the issue for themselves; when their own intention or goal becomes clear, the necessary motivation required will usually come from within.

Welcome to the new series addressing chemical dependency in youth. This will be a three part series.
Part 1: Conflicting Intensions, Lack of Trust and Low self-esteem
Part 2: Role of Willpower, Denial, and Changes in Motivation
Part 3: Role of the Counselor, Cycles of Change and Stages of Change.

Remember this is also not only about chemical dependent, yet also encapsulates other areas of our lives like relationships, emotions, and relapse that occur in recovery. I look forward to your questions and comments. Thanks for allowing  me to be a part of your recovery and support.

STAGES OF YOUTH IN THE CHANGE PROCESS
MARC BAISDEN, MA, CMHC, CIS

CONFLICTING INTENTIONS (AMBIVALENCE)
In the initial stages of addressing an addiction or emotional/relational issue, most people are ambivalent about wanting to gain control of it - they may have some wish to cut back or stop, but the temptation to continue may also be very strong. This is particularly so when someone is either psychologically or physically dependent on a particular drug. The consequences of their substance use may be serious, and they may want to stop, but their dependence makes it very hard to do so.
When a drug user is unclear about their intentions, this is the time when support from a professional counselor can be very helpful. Acknowledging the conflicting feelings that most people in this situation experience, a good alcohol & drug practitioner can assist the 'user' to clarify their intentions and move through their ambivalence. The point is that having conflicting feelings about wanting to stop is a normal part of the process.

LACK OF TRUST
So many adolescents experiment with alcohol, cannabis and other drugs and find their adolescent anxieties or insecurities are temporarily relieved in the process. If that "experimentation" continues unabated for too long, they may begin to develop more trust in the alcohol or the cannabis as a means of dealing with their problems, than they do in themselves or in other people. This is often one of the biggest difficulties that substance users have to overcome. They become so used to "trusting" their drug of choice to regulate their emotions, it becomes their best friend, and they find it hard to trust human beings.
So when someone is ready to deal with their drinking or drug use, one of the things they may need to learn is how to begin the process of trusting themselves. Part of this process involves learning to trust those people who are trying to provide support. For the 'user', this may begin with the slow development of belief (with the support and encouragement from a counselor), that they can in fact cope with life without resorting to drugs or alcohol.

LOW SELF-ESTEEM
Another very common underlying issue that many people with alcohol and drug problems have is low self-esteem. Self-esteem is not an easy concept to define, but in general if someone comes from a family background where their psychological and developmental needs were not adequately met as a child, there is a good chance that they will have grown up with feelings of anxiety or insecurity. Such feelings are not conducive to the development of psychological maturity and impact negatively on self-esteem.
When such feelings are combined with or derive from invalidating experiences such as psychological, physical or sexual abuse or extended emotional neglect, the consequences can be devastating. Childhood circumstances of this nature sometimes create such intense on-going emotional distress, that in our society, the use of alcohol and drugs to sooth such feelings is almost inevitable. Your counselor can help you explore whether or not low self-esteem contributes to your alcohol or drug use.

Seven-Step Path to

Better Decisions

1. STOP AND THINK
One of the most important steps to better decisions is the oldest advice in the world: think ahead. To do so it's necessary to first stop the momentum of events long enough to permit calm analysis. This may require discipline, but it is a powerful tonic against poor choices. The well-worn formula to count to 10 when angry and to a hundred when very angry is a simple technique designed to prevent foolish and impulsive behavior. But we are just as apt to make foolish decisions when we are under the strain of powerful desires or fatigue, when we are in a hurry or under pressure, and when we are ignorant of important facts. Stopping to think provides several benefits. It prevents rash decisions. It prepares us for more thoughtful discernment. And it can allow us to mobilize our discipline.

2. CLARIFY GOALS
Before you choose, clarify your short- and long-term aims. Determine which of your many wants and don't-wants affected by the decision are the most important. The big danger is that decisions that fulfill immediate wants and needs can prevent the achievement of our more important life goals.

3. DETERMINE FACTS
Be sure you have adequate information to support an intelligent choice. You can't make good decisions if you don't know the facts. To determine the facts, first resolve what you know and, then, what you need to know. Be prepared to get additional information and to verify assumptions and other uncertain information. Once we begin to be more careful about facts, we often find that there are different versions of them and disagreements about their meaning. In these situations part of making sound decisions involves making good judgments as to who and what to believe.

Here are some guidelines:
· Consider the reliability and credibility of the people providing the facts.
· Consider the basis of the supposed facts. If the person giving you the information says he or she             personally heard or saw something, evaluate that person in terms of honesty, accuracy and memory.
· Remember that assumptions, gossip and hearsay are not the same as facts.
· Consider all perspectives, but be careful to consider whether the source of the information has values   different than yours or has a personal interest that could affect perception of the facts.
· Where possible seek out the opinions of people whose judgment and character you respect, but be careful to distinguish the well-grounded opinions of well informed people from casual speculation, conjecture and guesswork.
· Finally, evaluate the information you have in terms of completeness and reliability so you have a sense of the certainty and fallibility of your decisions.



4. DEVELOP OPTIONS
Now that you know what you want to achieve and have made your best judgment as to the relevant facts, make a list of options, a set of actions you can take to accomplish your goals. If it's an especially important decision, talk to someone you trust so you can broaden your perspective and think of new choices. If you can think of only one or two choices, you're probably not thinking hard enough.

5. CONSIDER CONSEQUENCES

Two techniques help reveal the potential consequences· "Pillar-ize" your options. Filter your choices through each of the Six Pillars of Character: trustworthiness, respect, responsibility, fairness, caring and citizenship.
Will the action violate any of the core ethical principles? For instance, does it involve lying or breaking a promise; is it disrespectful to anyone; is it irresponsible, unfair or uncaring; does it involve breaking laws or rules?
Eliminate unethical options.
Identify the stakeholders and how the decision is likely to affect them.
Consider your choices from the point of view of the major stakeholders.
Identify whom the decision will help and hurt.

6. CHOOSE
It's time to make your decision. If the choice is not immediately clear, see if any of the following strategies help:
•    Talk to people whose judgment you respect. Seek out friends and mentors, but remember, once     you've gathered opinions and advice, the ultimate responsibility is still yours.
•    What would the most ethical person you know do? Think of the person you know or know of (in real life or fiction) who has the strongest character and best ethical judgment. Then ask yourself: what would that person do in your situation?
•    Think of that person as your decision-making role model and try to behave the way he or she would. Many Christians wear a small bracelet with the letters WWJD standing for the question "What would Jesus do?" Whether you are Christian or not, the idea of referencing a role model can be a useful one. You could translate the question into: "What would God want me to do?" "What would Buddha or Mother Teresa do?" "What would Gandhi do?" "What would the most virtuous person in the world do?"
•    What would you do if you were sure everyone would know? If everyone found out about your decision, would you be proud and comfortable? Choices that only look good if no one knows are always bad choices. Good choices make us worthy of admiration and build good reputations. It's been said that character is revealed by how we behave when we think no one is looking and strengthened when we act as if everyone is looking.
•    Golden Rule: do unto to others as you would have them do unto you. The Golden Rule is one of the oldest and best guides to ethical decision-making. If we treat people the way we want to be treated we are likely to live up to the Six Pillars of Character. We don't want to be lied to or have promises broken, so we should be honest and keep our promises to others. We want others to treat us with respect, so we should treat others respectfully.

7. MONITOR AND MODIFY
Since most hard decisions use imperfect information and "best effort" predictions, some of them will inevitably be wrong. Ethical decision-makers monitor the effects of their choices. If they are not producing the intended results or are causing additional unintended and undesirable results, they re-assess the situation and make new decisions.