Transcript Salvando a mi hijo de las Adicciones

Building “Addiction-Free
Families”
Step 1
Basic Information
What is a drug?
What is a drug?
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It is a substance that alters the structure and
function of the body.
marihuana?
tobacco?
alcohol?
tea?
aspirine?
Classifications
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Legal – Illegal
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For Health – for Recreation
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Stimulants – Depressors – Hallucinogens
Abuse potential and medical value
The addiction process
Movie:
What is an addiction?
- Body
- Relationships
- Emotions - Life meaning
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Incurable, progressive, and mortal disease.
The addiction process
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Use
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Misuse
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Abuse
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Dependency/ Addiction
Pasos de la adicción
The Co-dependency process within
the family
Addict
Family
Use
Good Control
The process of independency could be
altered.
Misuse
Moderate Control
The ocasional behaviours are seeing as
normal (part of life/ part of growing)
Abuse
Moderate lack of control
The behaviour is enabled
They protect the addict from having
consequences
The topic is not argued
The negation process starts as a defense
mechanism
Internal cohesion sorrounds the famuly
member
Hiperrresponsability
Complete lack of control
Family secret
Feelings arise: feeling hurt, assamed,
unadequate, guilty, worried.
The own needs are replaced for the addict
needs
Dependency
Deaths in the U.S.
(Please note that
death is not the only
consequence or even
the worst, of abusing
drugs)
Building “Addiction-Free
Families”
Step 2
Risk and Protection factors
Activity
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¿What are the main reasons to take a drug?
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¿What are the main reasons for not taking it?
Why people use drugs?
Why people use drugs?
Why people use drugs?
Why people don’t use drugs?
Why people don’t use drugs?
Risk Factors: A class (2 points)
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Having parents, uncles or brothers with an addiction problem.
Been diagnosed with a behavioural problem which includes loss of
self control.
Trying legal drugs before permitted age or illegal drugs before 20.
Non or bad ADHD treatment.
Having anxiety or depression.
Been exposed to a trauma like sexual or physical abuse.
Experimenting a strong transition (loose job, friends, couple)
Been in a constant conflict with the family and/or couple.
Been exposed to drugs and alcohol within the community.
Other risk factors among teenagers
(12-17 años)
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They go two times more to parties, especially when there
are not parents available.
They belong to a school where is easy to get drugs
inside.
Between 13 and 14 years old the increase in first time
users is considerable.
Having low grades.
Having separate parents (even more risky than having
divorced parents)
They don’t attend religious offices.
They barely eat or have dinner with their family.
They sleep less than 8 hours a day.
Protection factors
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Developing self esteem; assertiveness, and
good communication of emotions.
School attachment, good social skills, and
resiliency.
Good family communication.
Good family relations
Constant and adequate discipline.
Having, and giving good and accurate
information about alcohol/drugs since they
were kids.
How to reinforce the protection
factors?
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Be an example: not only about the way you
consume, but also the way you relate to
others and live your life.
Teach your kid to say “No” even with you and
others.
Value the people who is different in opinions
and look.
Let your kid have different kinds of friends: it
strengths their criteria.
Value the effort, not only the success.
How to reinforce the protection
factors?
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Help your kid to have realistic goals, but don’t
cut their aspirations.
Give your kids responsibilities for themselves
and for home.
Let your kids learn to choose and to defend
their point of view. Help them by exploring
pros and cons in a decision. Help them reflect
after the decision and the consequences are
done.
Show your emotions to them.
How to reinforce the protection
factors?
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Teach your kids about how to talk about their
feelings in both positive and negative
situations.
Don’t be indifferent. Value ethically the
actions but not the persons. (but don’t judge
your son or others)
Let your kids learn the tolerance to
frustration. The imporance of waiting.
Building “Addiction-Free
Families”
Step 3
Communication: talking about alcohol /
drugs
Between 2-5 years
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Pre-schoolers
Need to understand beneficial drugs/substances
vs. misused drugs/substances vs. harmful drugs
substances
Pointing harmful substances at home that the
child may not touch
Keeping poisonous products out of reach
Explaining how medicines work. How to use them
and the medical supervision needed
Between 5 – 9 years
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Literal inquisitive and open to new information
and experiences. Concrete and immediate world.
(along with nutrition, exercise, safety, hygiene,
body parts, illness prevention, family life, selfworth, interpersonal communication taught by
school and parents)
Experiential material
What drugs and medicines are. How foods,
poisons, and illegal drugs differ.
5-9
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Why taking the wrong substance (or too much of
it) can hurt you
What the rules are at home and at school
regarding alcohol, tobacco, and other drugs
Refusal skills. Drug Safety Rules
Which adults to trust for questions in an
emergency
Reject unknown candies, pills, especially from
strangers
How to listen and talk about emotions without
offending
Between 9 - 12
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Enjoy learning and take pride in knowing lots of
facts (the more bizarre the better). Some begin
experimentation with alcohol, tobacco or other
drugs.
They need credible information and strong no use
messages.
Differences between use, abuse, and addiction
(biological and psychological)
Short and Long Term effects and consequences
of alcohol and other drug use.
Between 9 - 12
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Why people use and or abuse drugs
Value choosing not to use.
Connection between non-use and self-steem,
positive values, and achievement.
Media and peer pressures. Refusal Skills.
Passive smoking and health.
Value of sports, art, etc.
Relaxation exercises.
Healthy social skills
Between 13 - 16
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7th-9thSome students begin to experiment, and a
few graduate to regular use or abuse. They need
encouraging for stopping.
For those who still not use, reinforcement in
values and skills is really helpful. They are able to
think abstractly and consider their own identity
and future.
They compare themselves and their families with
others. Belonging is very important for them.
They need family and emotional support,
dialogues and clear rules and expectations,
positive role models, opportunities for social
bonding, and healthy alternative highs.
Between 13 - 16
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Risk Factors for abuse and addiction (family history,
age of first use, environment).Progression of chemical
dependency from use to addiction.
Effects of drug use on social, emotional, intellectual
and physical development. Specific drugs and how
they affect the physiology and psychology of the body
and human development.
Media and cultural influences. Intervention skills.
When, where, and how to seek help.
Effects of alcohol and other drugs on driving,
pregnancy, sexual responsibility.
Between 13-16
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Ramifications of drug use for family
relationships, personal values, identity
development.
Refusal skills.
Misperceptions surrounding use by their
peers and adults.
Having clear rules about alcohol and drugs
Decision making
Between 6 - 19
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They have more experience, their own that of
others. They are more challenging, and will
question what they hear.
Some students are looking for reasons to use.
Others are looking for reasons to continue to not
to use.
They appreciate a honest and sincere approach,
and the message will be lost if not.
Between 16 - 19
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Risk Factors for abuse and addiction (family
history, age of first use, environment).
Progression of chemical dependency from use to
addiction.
Effects of drug use on social, emotional,
intellectual and physical development.
Specific drugs and how they affect the physiology
and psychology of the body and human
development.
Media and cultural influences. Intervention skills.
Between 16 - 19
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Same topics but in a deeper way:When, where,
and how to seek help.
Effects of alcohol and other drugs on driving,
pregnancy, sexual responsibility.
Ramifications of drug use for family relationships,
personal values, identity development.
Refusal skills.
Misperceptions surrounding use by their peers
and adults.
Basic Skills for Communication…
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Skill 1:
Reframe: put in your own words what the kids say.
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Skill 2:
When you are speaking with the kids, watch their faces and body
language.
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Skill 3:
Bring support and non verbal feedback.
Basic Skills for Communication…
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Skill 4: Use the proper tone of voice for the
response you are giving.
Skill 5: Use stimulating phrases that may
show your interest and can keep alive the
conversation.
Others: Choose the right moment. Speak
directly about what worries you. Take
advantage of the occasions when it comes
easy to the conversation (after a movie, a
song, an experience, etc.)
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ABOUT THE OWN CONSUMPTION...
The “this is what I did… this is what I regret
… because of…”
Never!
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Feel ashamed about speaking about drugs. It
is a health problem (check how comfortable
you are on this).
Lie or exaggerate the consecuences: the fear
last a few, and adolescents try everything by
themselves.
Judge your kid or or his friends: You’ll close
the communication.
Never!
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Be self virtuous o hipocrate.
Pretend to have all the answers; don’t
overwhelm with advises and tips
Criticize or make him feel ridiculous
Think that your kids problems are less
important than the adult problems.
Be incongruent between what you say and
what you are.
Speak in an accusative tone.
Activity
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Role Playing... Talking with a kid.
Look for a partner.
We’ll share at the end how we felt.
Building “Addiction-Free
Families”
Step 4
Discipline and rules around the use and
abuse of alcohol/drugs
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If I drink sometimes, can I ban my kid from
drinking? (the guilt)
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If his brother does it?
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If ‘everybody’ does it?
Key points
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Set your own position about drugs.
Set rules: few, clear, congruent.
Dialogue: what would happen if you…”
Don’t feel guilty about setting rules and
having consequences.
Dare to give consequences: choose
approppriate.
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Have warm discusions
Don’t allow everything
Supervise
Value honesty but at the same time demand
commmitment.
Clear rules, non changing, fair, not life
sentences.
Exercise: create rules for certain situations.
Giving the consequence
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Appropiate to the mistake
Don’t negotiate the consequence in the
moment.
Set it when you are calmed and not angry; try
to make it soon.
NEVER…
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Constantly spy
Pursue and pressure; change the rules
suddenly, even if you are suspicious.
Give to much freedom to the extent where
there is not structure.
Threat: they loose strength as a control tool
with time.
Activity
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Creating a rule list…
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The talk and negotiation of a rule list…
Building “Addiction-Free
Families”
Step 5
Assessing the risk and resources
available in my community
Is my son/daughter using drugs?
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There are signs like alcohol/drug smell, founding
drug paraphernalia like mirrors, rolling papers,
pipes, etc.
Change of priorities, change of friends
Having less interest in routinary activities; slowing
down in grades and/or attendance.
Sudden changes in the routine, sleeping less;
change in the appetite.
Isolation or euphoria; drastic mood changes.
The Pupil on Drugs
How to help somebody close to us
Informal Intervention
1. Learn All You Can About Chemical
Dependency
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Addiction is a primary illness
Addiction is a progressive illness
Addiction is a chronic illness
Addiction is is a fatal illness
2. Get Help for Yourself
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Don’t shoulder the entire burden yourself
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Seek out a support group
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Talk to your friend when he or she is sober
and clear-headed
3. Pick the Right Time and Place
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Talking to a person under the influence is a
waste of time.
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Choose a setting that is calm, private, and
free of distractions and interruptions.
4. Plan What You’re Going to Say
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Give some thought ahead of time to your
feelings about your friend.
What do you like and respect about her?
How has she helped or supported you in
the past?
What are the specific behaviors or stated
attitudes that fuel your concern? What
options exist for helping her?
5. Convey Your Affection and/or Respect
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Let the person know how much she means
to you, how important the relationship is to
you.
Talk about her fine qualities and all the
times she has helped and supported you.
This minimizes the possibility of anger or
defensiveness on her part.
6. Express Your Concern
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Be caring and non-judgmental:
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− “You’re my best friend and I’m really worried
about you.”
− “I’m afraid you’re going to hurt yourself.”
− “I worry that some of the things you’re doing
could have harmful and irreversible
consequences.”
7. Use Specific Examples
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Provide examples of the worrisome behaviors
you have observed.
Avoid hearsay, sweeping generalizations,
accusations, or blameful statements such as:
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− “You’re destroying your life.”
− “You have a really big problem with drugs.”
− “You’re hurting everyone around you.”
− “You’re an addict.”
Statements such as these trigger anger and argument
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7. Use Specific Examples (cont)
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Instead, describe the behaviors or incidents
you have personally witnessed:
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− “The last two times we went out you drank so
much I had to get home by myself.”
− “You said really mean things to Amy and she
left the party in tears.”
− “Last season you were the lead scorer, and this
year you’re warming the bench.”
7. Use Specific Examples (cont)
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Talk about how the person’s behavior is
affecting you and your relationship:
− “I miss spending time with you.”
 − “I don’t like it when you ask me to lie to protect you.”
 − “I’m embarrassed to invite you over to my house
now.”
It’s hard to predict your friend’s reaction. Common
reactions: tears, anger, deffensive, She might lash out
at you as “someone who should talk” considering all of
“your problems.” This can be very hurtful. Try to see it
as the illness talking, and not your friend.
Don’t argue or get angry. Your friend would rather
debate the issue than look at her own behavior.
Instead…
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8. Offer to Help
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Depending on the circumstances, offer to go
with her to the school counselor, her parents or
doctor, a 12-step meeting, and/or a local
resource for evaluating and treating people with
substance abuse problems. Tell her that
chemical dependency is not a problem she can
solve alone.
Your friend may make excuses for why she
doesn’t need to get help. She may promise to
“quit” or “cut back” on her own. Know in advance
how you will respond to this and any other
objections to seeking help she is likely to make.
9. Set Limits
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Don’t be a co-conspirator (enabler) in the
problem.
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Establish limits so that you will no longer be in
awkward or dangerous situations:
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− “I’m not going to let you copy my homework.”
− “I only want to spend time with you when you’re
sober.”
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− “I’m not going to lie for you anymore.”
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10. Don’t Expect Miracles
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Your intervention may not appear to have
“worked.” Don’t be discouraged. People
rarely change long-standing behaviors
based on one remark or conversation.
Each expression of concern, added to the
next, can lead to that point at which your
friend is no longer able to ignore the truth.
The Formal Intervention
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Same steps
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Is run by a proffesional
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Is usually group focused
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Requires commitment and changes from the
people around.
The CRAFT Model(Community
Reinforcement and Family Training)
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Your love has power. You are not alone
You attract and are more powerful with love words than critic words.
You can try several times by giving little steps. Setting goals might help.
Is also about learning how to take care of yourself.
It certainly not always works but it never hurts.
When you change the way you respond to your people, you can also
change your own feelings, even the most destructive ones.
Know how to ask for help; know how to accept help
Activity: Check list
Myths
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The addicts are bad, fool or crazy. They are bombs
and live in the streets.
It’s just a question of will power. (the reward system
is not conscious in the brain)
The addicts need punishments, not treatment.
If you are addicted to one drug, you are addicted to
the others. (although it’s proven there is a relation)
The addicts don’t need medication.
It’s only a behavioural problem, not physical.
To quit drugs you only need to stay in one place
and/or go to AA meetings.
The Intervention
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There are not signs that any teenager can
quit drugs by themselves. Although some
teenagers learn the resources to get out of
drugs after experimenting, this is not always
the case. Usually they need some kind of
help, sometimes moderate, sometimes
emergency help.
What to look if you need help?
A treatment is…
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Detoxifying
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Rehabilitation
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Continued treatment
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Other alternatives: Family therapu, individual
therapy, support groups, rehabilitation clinics,
medical and spiritual support.
Is it a good rehab centre?
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Is it designed for teenagers or there are teenagers in the centre?
Is there any kind of assessment in the admission process?
Does it last between 3-12 months?
Does it reminds more like a home?
Can he continue his studies inside?
The centre has good patient retention numbers?
Is there a support program for the family?
Is there professionals available 24hrs a day?
Are there any previsions to give continuity and support when the
teenager is out of the centre?
Do they have information about the effectiveness of the
program?
Relapses
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Between the 50% and the 80% of those who
get detoxification relapse.
30% relapses in the first year.
The best way to prevent a relapse is by
giving continuity to the treatment; looking for
help in crisis stages, and by looking for the
common signs in the patient before the
relapse.
Resources
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Choices and Consequences
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Hoffman, Froemke. Addiction : Why can’t
they just stop? HBO Ed. 2007
FCD Magazine/ prevention program.
National Survey of addiction and attitudes.
USA 2006.
Resources on the internet
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http://www.buenaestima.com/
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http://www.edex.es/10pasos/default.asp
Bibliography
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FCD Guidelines (Freedom from Chemical
Dependence)
Recursos Audiovisuales
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What the bleep do you know??