Rehab

Social skills training within the context of Rehab centers around instilling an advanced level of education among addicts on how best to form and maintain interpersonal relationships which can be successful in both the short term and the long term. Social skills training focuses on both interpersonal and intrapersonal personal management skills. Interpersonal skills gained in Rehab may include being able to give and take criticism, providing positive feedback, the skills of listening and conversation, the ability to express feelings and assertiveness and the ability to refuse an offer of an alcoholic beverage and/or a recreational narcotic drug.

The process of improving and ameliorating the various intrapersonal capabilities of the patient in a Rehab setting deal with managing thoughts about drinking excessive amounts of alcohol and/or consuming recreational narcotic drugs, mood management, coping with the inevitable cravings, dealing with negative, self-destructive and anti-social thoughts, coping with urges to drink alcohol and take narcotic drugs, and decision making. These types of approaches have been used effectively within a wide range of disorders which overlap between substance abuse and psychiatric problems and have proven of exceptional applicative value in the cases of patients who consume excessive amounts of alcohol.

Community reinforcement is the therapeutic strategy which links various methods to focus on the functioning of the patient within society. It was originally only implemented for people who have problems with their consumption of alcohol, however, recent research has proven that this can also be a very valid application when applied to other addictions such as narcotics in a professional Rehab setting.

This Rehab approach's goal is to modify the addict’s milieu in order to make abstinence an activity which is more rewarding than the consumption of excessive amounts of alcohol or the use of recreational narcotics. Community reinforcement involves the utilization of recreational, social, familial and other reinforcing factors and catalysts to assist patients in the complicated process of recovery within Rehab.

Community reinforcement centers around the application by Rehab professionals of a functional analysis which are useful in a clinical setting in order to determine antecedents and consequences of the consumption of excessive amounts of alcohol, setting targets for sobriety, providing the access to being able to prescribe disulfiram, as well as the creation of a treatment plan which will incorporate various basal skillsets in interpersonal communication, problem solving, and refusing alcoholic beverages or offers of narcotic substances.

Various medical clinical researches has been conducted on community reinforcement and in a number of the Rehab studies, patients could also attend a club to assist them locating gainful employment, be the subject of marital therapy, social and recreational counseling, and relapse prevention training. The underlying effectiveness of this approach can be explained by the strategy of combining a number of effective therapies into a single strategically integrated program.

An important and integral component of the Rehab strategy of community reinforcement is to assist the patient with locating and securing gainful employment, preferably on a full time basis. In a major medical clinical study involving criminal offenders with a history of violent and antisocial behaviour linked with their alcohol problems demonstrated that the levels of employment were considerably improved as compared to the time of the patient's intake. The clinical study centered on the mobilization of a number of social and community resources to ameliorate the offenders’ skills in locating gainful and preferably full time employment.

Cue exposure is a relatively new concept in therapeutic management of addiction and few controlled studies analyzing this method are available at this time. The Cue exposure approach is centered on the concept that craving and withdrawal are two pre-conditioned responses that can be eliminated by creating a situation whereby alcoholic drinkers and recreational narcotics users can be exposed to the various alcoholic drinking or narcotics use cues while at the same time not exposing the patient at all to alcohol or narcotics.

The process of cue exposures includes a variety of stimuli. In the case of alcoholic patients it includes the provision of a range of the sights, smells and tastes of alcoholic beverages, as well as images of bars and social alcoholic consumption locations. In the case of narcotics patients it includes the provision of the spectrum of the sights, smells and tastes of recreational narcotics, as well as images of syringes, “lines,” and drug-taking environments.

There are various approaches to cue exposure which demonstrates its potential as a therapeutic intervention, and each one is tailored to the specific addiction and patient. In a variety of clinical trials, alcoholic drinkers have been allowed to ingest tiny doses of alcohol and then prohibited from any further consumption of alcohol. When cue exposure is applied to narcotics addicts, it appears that termination of drug-related cues is not stable and poses difficulties in the process of establishing and ascertaining its eventual efficacy.

In both cases of alcoholic and narcotics addictions, the community reinforcement strategy has constantly been demonstrated to be successful in Rehab settings, particularly in the case of patients having limited social support infrastructures and more severe problems with the excessive consumption of alcohol or abuse of recreational narcotic drugs.

The various therapeutic processes which focus on marital behavioral aspects seek to ameliorate interpersonal communication and problem solving abilities, and to hasten the exchange of positive reinforcement between the patient and their spouse or partner. The various components of marital therapy may incorporate education on the specific communication skills which are impacted most significantly by alcohol or narcotics consumption as well as establishing a sound basis of skillsets dealing with the various aspects that are confronted within the marital relationship.

Marital therapeutic interventions have been demonstrated to be effective in both brief and more extended Rehab implementations. The benefits of these forms of marital therapy may not display themselves immediately as the beneficial factors often take a certain amount of time to become effective, but they may become clear and overarching in the long term as the patient develops innovative skills which become an integral part of the relationship between the patient and their spouse or partner.