Recovery Is Life Worth Living — Family Recovery Support Community

Session Online Version

CHECK-IN SECTION – Maximum time 20 minutes

Mindful Minute -- take a break from what you have been doing, breathe deeply, relax and recharge.

Step 1: Find a comfortable seated position with both feet grounded on the floor. Put a hand on your stomach. Close your eyes.

Step 2: Take a deep breath in through your nose and out through your mouth. Notice your thoughts and feelings and any tensions in your body.

Step 3: As you inhale and exhale, breathe deeply so your belly fills and empties with air. The hand on your stomach helps you practice belly – not chest breathing.

Step 4: or the next minute make breathing in and out your only focus. Let your thoughts come and go without trying to control them. If you find an area of tension in your body, relax it and let the tension go.

Step 5: At the end the minute slowly open your eyes. Gently bring your presence back to your surroundings.

Our Purpose

CRAFT Connects’ Family Support groups are for parents, partners, families and other Concerned Significant Others (CSOs) who have a loved one that is struggling with a substance use or mental health disorder. We know from first-hand experience that loving someone with these challenges can be a difficult, lonely journey. To create a safe place for honest sharing of our lived experience we use appropriate language and behavior. We are empathetic, nonjudgmental, genuine, respectful, steer clear of confrontation and imposing our own solutions. We encourage hope and compassion for all. CRAFT Connect helps to reframe and energize connections between you, your loved one and behavioral health professionals into a “therapeutic alliance” that leads to progress and healing. There is a lot we can learn from one another.

Last week we studied the “FS14. Aftercare Planning” session:

A. Were you able to follow through on these commitments?

· Become familiar with my loved ones’ relapse plan. (Circle one) Yes, No

· Review the Recovery Maintenance ideas and Weekly Recovery Activity Checklist with your loved one. (Circle one) Yes, No

B. What experience did you have practicing or sharing last session’s principles and skills?

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C. What did you do to purposefully take care of yourself?

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LEARN SECTION – Maximum time 30 minutes

1. Recovery is a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential (SAMSHA, July 2019). Recovery is not about getting rid of our loved one’s mental health or substance use problems but seeing beyond them, recognizing and fostering their abilities, interests and dreams. Traditional concepts of behavioral health illness and social attitudes often impose limits on people experiencing mental health and substance use disorders. Health professionals can have reduced expectations, while family members can be overly protective or pessimistic about what their loved one will be able to do (Jacob, 2015). Recovery is about looking beyond these limits, real and imagined, and helping our loved one become their “best self”. (Something everyone wants.)

Discuss: How have you been thinking about your loved one’s recovery?

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2. Motivation, being willing, ready and able, is what propels our loved ones to make changes in their lives. This is not a static trait that our loved one either has or does not have. It exists along a continuum of readiness to change. Research shows that most people progress through six stages of change in a spiral, not necessarily a direct manner (Prochaska and Norcross, 2001). Look at the “Cycle of Change” Handout. This approach provokes less resistance and encourages our loved ones to progress at their own pace toward deciding about, planning, making, and sustaining positive behavioral change.

Discuss: Where do you think your loved one is in the Cycle of Change? What could happen if we try to push our loved ones at a faster pace than they are ready to take?

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3. It’s natural for people to continue to explore the pros and cons of any major life choice as part of their recovery. Our loved ones do the same thing about changing or not changing their behavior. We can help them work through this ambivalence by:

· Providing objective feedback about the consequences of behaviors,

· Validating changes in behaviors,

· Identifying obstacles to change,

· Reinforcing efforts to change, and

· Remembering that our loved one may need help making decisions and choices.

Discuss: Having both positive and negative feelings about something is a natural and very normal part of change. How does understanding that, help you and your loved one?

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4. The process of recovery is highly personal and occurs via many pathways. Choosing the right mix of treatments and supports that work for your loved one is an important step in the recovery process. Treatment choices for mental health and substance use conditions vary from person to person. Even people with the same diagnosis will have different experiences, needs, goals and objectives for treatment. There is no “one size fits all” treatment (NAMI, 2019) Recovery is also characterized by continual growth and improvement in health and wellness that may involve frequent setbacks. It is common for individuals with behavioral health disorders to go in and out of treatment programs a number of times before they begin to make lasting changes.

5. Because setbacks are a natural part of life, resilience becomes a key component of recovery. Resilience is the quality that allows people to be knocked down by life and come back at least as strong as before. Rather than letting difficulties or failure overcome them and drain their resolve, they find a way to rise from the ashes. Resilience develops over time and gives us and our loved one the capacity not only to cope with life’s challenges but also to be better prepared for the next stressful situation. Optimism and the ability to remain hopeful are essential to resilience and the process of recovery.

Discuss: How has your resilience helped you and your loved one?

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Watch: “Bill Hanning interview” video.

6. Like other chronic diseases, substance use and mental health disorders can be managed successfully. Treatment has made wellness and recovery a reality for people living with these conditions. The chronic nature of these disorders means that relapsing to unwanted behaviors is not only possible but also likely, with symptom recurrence rates similar to those for other well-characterized chronic medical illnesses that also have both physiological and behavioral components (NIDA, July 2019). Supported scientific evidence shows that relapse rates for many mental health and substance use disorders “are comparable to those for chronic diseases, such as diabetes (20 to 50 percent), hypertension (50 to 70 percent), and asthma (50 to 70 percent)” (U.S. HHS, 2016, p. 4-15).

7. Setbacks -- relapses, lapses and slips -- are an expected part of any change process. Every time you and your loved one make a plan with goals and objectives and they go awry you each have the opportunity to learn something about yourselves. If your loved one stops taking their medication and starts abusing alcohol you may view this as a major relapse. You and your loved one can take the time to identify what preceded the lapse, for instance, were there specific problems that may have led them to stop their medication and start drinking heavily? Maybe a friend was out of town that they usually talk to when they have problems. Now, you can discuss how they would respond to a similar situation, maybe they could call you or a confidante.

Discuss: How does knowing that substance use and mental health disorders are chronic condtions like diabetes, hypertension and asthma provide a perspective on your loved one’s lapses?

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8. Whatever the coping strategy you and your loved one discuss, the important thing is that a setback is seen by you and them, not as a failure, but as a natural part of the process of learning how to better manage their disorder. Maintain your focus on the positive things that have happened, the good changes that have resulted. Relapses are a natural part of the recovery process and can actually make you and your loved one stronger, more resilient, as you use them to figure out what went right and what went wrong (Meyers and Wolfe, 2004).

9. Helping your loved one with a behavioral health disorder can be difficult, even if you try to do everything "right." As family and friends of a loved one with a mental health or substance use disorder we can also relapse back into our pre-CRAFT Connect behaviors. No book, therapist or website can tell you how to prepare for all the situations that may arise. You can make it easier to avoid an emotional overreaction to a loved ones’ lapse by anticipating and preparing for it. When they relapse be careful not to fall back into old patterns of behavior. Remember the changes you've made in the ways you respond to your loved ones’ unwanted behaviors.

10. Answering the questions in the “Relapse Awareness Worksheet” included with this session can help you individually think about situations which may be particularly difficult for you to stay with the new CRAFT Connect skills you are learning. When your loved one relapses, be careful to not fall back into old patterns of behavior. Remember the changes you’ve made in the ways you respond to your loved one’s unwanted behaviors.

Discuss: How does understanding when we might “relapse” help ourselves and our loved one?

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11. No matter how well you prepare some events will still catch you by surprise. That's okay. You cannot predict every experience with your loved one that may ‘trigger’ an emotional reaction, but you can use the unexpected to add to your arsenal. Think of your own experience with recovery as a learning process. As soon as the dust settles, sit down at the computer or grab your notebook and describe the whole situation from beginning to end as if you were a detective. Look at what you could have done differently, then describe how.

12. The recovery road is a constantly changing one. Sometimes it is smooth, other times it is ravaged by potholes. Staying on the road depends on your willingness to work around whatever obstacles occur. Everyone who learns CRAFT Connect skills and principles wins. Your loved one wins by working to become their best self, you win by satisfying yourself you did everything possible to help. Remember both you and your loved one have the right to a life worth living.

GROUP SHARING SECTION – Maximum time 30 minutes

13. We will now begin the sharing portion of the meeting. You are invited to share from 3 to 5 minutes about your experience as it relates to your loved one’s recovery, this week’s session or what you are currently working on. Please focus your sharing on potential solutions rather than the problems. We will conclude the sharing five minutes before the end of the meeting. Who would like to begin?

MY COMMITMENTS SECTION – Maximum time 10 minutes

14. Please remember that what has been shared here is confidential and that the opinions expressed are of the individuals who shared them. These are the group commitments. We will start the next CRAFT Connect session by reporting on our commitments. This week I will:

A. Do the in-between session assignments

· Complete the “Relapse Awareness Worksheet”.

B. Share what I am learning with my family, friends and community.

C. Show kindness for myself by having self-compassion and taking care of myself.

As you listen to this “Song about Connection” take a few minutes to quietly think about what you learned in this session. Write your thoughts and personal commitments below.

Watch “Only Child, Jackson Browne - lyrics” video

What are the most important things I learned?

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What will I do differently because of what I learned?

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Cycle of Change Handout

For over 35 years researchers have found that individuals move through a series of six stages (precontemplation, contemplation, preparation, action, maintenance, relapse) in the adoption of healthy behaviors or cessation of unhealthy ones. Research on a variety of different problem behaviors has also shown that there are certain predictors of progression through the stages of change (e.g., Prochaska & DiClemente, 1983), including decisional balance (Prochaska, 1994); self-efficacy (e.g., DiClemente, Prochaska, & Gibertini, 1985); and the processes of change (Prochaska & DiClemente, 1983).

Where do you think your loved one is at in the Cycle of Change, and why?

Precontemplation, not yet acknowledging that there is a problem behavior that needs to be changed. The stage in which an individual has no intent to change behavior in the near future, usually measured as the next 6 months. PR contemplators are often characterized as resistant or unmotivated and tend to avoid information, discussion, or thought with regard to the targeted health behavior (Prochaska et al., 1992).

Contemplation, acknowledging that there is a problem but not yet ready or sure of wanting to make a change. Individuals in this stage openly state their intent to change within the next 6 months. They are more aware of the benefits of changing, but remain keenly aware of the costs (Prochaska, Redding, & Evers, 1997). Contemplators are often seen as ambivalent to change or as procrastinators (Prochaska & DiClemente, 1984).

Preparation, getting ready to change. The stage in which individuals intend to take steps to change, usually within the next month (DiClemente et al., 1991). Preparation is viewed as a transition rather than stable stage, with individuals intending progress to Action in the next 30 days (Grimley, Prochaska, Velicer, Blais, & DiClemente, 1994).

Action, changing behavior. An individual has made overt, perceptible lifestyle modifications for fewer than 6 months (Prochaska et al., 1997).

Maintenance, maintaining the behavior change. These are working to prevent relapse and consolidate gains secured during Action (Prochaska et al., 1992). Maintainers are distinguishable from those in the Action stage in that they report the highest levels of self- efficacy and are less frequently tempted to relapse (Prochaska & DiClemente, 1984).

Relapse. Returning to older behaviors and abandoning the new changes.

This Transtheoretical Model (TTM) of change in health psychology explains or predicts a person's success or failure in achieving a proposed behavior change, such as developing different habits. It attempts to answer why the change "stuck" or alternatively why the change was not made. TTM — currently, the most popular stage model in health psychology (Horwath, 1999) — has proven successful with a wide variety of simple and complex health behaviors, including smoking cessation, weight control, sunscreen use, reduction of dietary fat, exercise acquisition, quitting cocaine, mammography screening, and condom use (Prochaska, et al., 1994).

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Relapse Awareness Worksheet

The following questions can help you individually think about situations which may be particularly difficult for you to stay with the new CRAFT Connect skills you are learning. The “loved one” referred to in this worksheet could be supporting someone with a substance use or mental health disorder or could be suffering with the disorder themself.

In what mood or moods are you most likely to relapse into old behavior patterns?

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At what time of day are you least confident of maintaining new behavior patterns? ————————————————————————————————————————————————————————————————————————————————————————————————————————————————

What places make it particularly difficult for you? ————————————————————————————————————————————————————————————————————————————————————————————————————————————————

Are there any people whose presence makes it tough to stay with new patterns? ————————————————————————————————————————————————————————————————————————————————————————————————————————————————

Are there days of the week or weekend that are particularly difficult? ————————————————————————————————————————————————————————————————————————————————————————————————————————————————

What situations are most likely to make you lose control and go back to old patterns? ———————————————————————————————————————————————————————————————————————————————————————————————————————————————

What moods of your loved one make it especially hard for you to stay in control? ———————————————————————————————————————————————————————————————————————————————————————————————————————————————

What statements or tones of voice of your loved one push your buttons in old ways? ————————————————————————————————————————————————————————————————————————————————————————————————————————————————

What behaviors of your loved one set you off?

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