All written and/or printed materials included.

Patent pending; filed 2015 USPTO, Washington, D.C. for software technology/avatar based substance abuse program.

All rights reserved. No original part of this manual may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system without permission in writing from Gloria K Manley, MD.

Interactive Avatar Substance Abuse Program

ACKNOWLEDGEMENTS

Interactive Avatar Substance Abuse Program

We would like to express appreciation for the professional contributions and dedicated services of all those who served and still serve on the IASAP team. For without their help this project could not have been achieved.

IASAP TEAM

Concept/Development Gloria Manley, MD, Pres, Interactive Health

Concepts, Inc

Scottsdale, AZ 85255 www.Media-Medicine.com

Technical/Program Development Charles A Keemer, Owner, Keemer Says

Upper Marlborough, MD www.KeemerSays.com

Clinical Program Consultant Catherine A. Roberts, MS,LCAS, LPC, CCS

Greenville, NC 27834 CABroberts@gmail.com

Clinical Program Consultant Latasha R. Green, MS,LCAS.LPC,CCS

Greenville, NC 27834 Latashargreen@gmail.com

ACKNOWLEDGEMENTS

Interactive Avatar Substance Abuse Program

IASAP TEAM

Software Development BlastAsia, Inc, Pasig City, Metro Manila

www.BlastAsia.com

Business Planning Larry Edmonson, CPA, Los Angeles, CA 1-310-722-8362.

Technical Assistant James McGill, Phoenix, AZ email@jmacgill.com

Research & Slide Development Devin M. Manley, Tillery, NC

devinmanley@gmail.com

Marketing/Networking Arline Woodbury, MD, Atlanta, Ga

drarline@gmail.com

Artist Stephen McIntyre. Greensboro, NC

Interactive Avatar Substance Abuse Program

I INTRODUCTION

Interactive Avatar Substance Abuse Program

WELCOME to interactive world of IHC - Interactive Health Concepts, Inc.

and Our new AVATAR program, IASAP – Interactive Avatar Substance

Abuse Program. IASAP is a software tool, designed for remote outreach

and to assist those who are struggling with alcohol and substance use

disorders. It provides anonymity between clients and real time

interactions via mobile devices such as cellular phones and tablets. It is

web based, cloud hosted, data encrypted, meets HIPPA standards and can

be implemented on both android and ios devices.

I INTRODUCTION

Interactive Avatar Substance Abuse Program

IASAP should be used by trained, licensed, substance abuse counselors

who are already familiar with standard best practice 12 week intensive

outpatient substance abuse (SA) programs. Although a basic clinical

template is included in this App, it is still necessary for the therapist to

explain the concepts, assign homework, implement practice exercises, set

the agenda and regulate the time structure. This Program will work best

when accompanied by treatment manuals with written practice exercises

and checklists.

I INTRODUCTION

Interactive Avatar Substance Abuse Program

IASAP is designed primarily for use on mobile devices such as cell phones

and tablets. For this reason, we suggest modifying the standard two (2) 90

minute sessions per week to three (3) one hour sessions. The App has a

built in scheduler that will allow the controller (therapist) to assign clients

to one hour appointment slots on MWF (Monday, Wednesday, Friday) or

TThS (Tuesday, Thursday, Saturday). An intake and screening process is

still necessary to determine if the client is appropriate for services. For

your convenience the commonly used screening tools, the AUDIT and DAST

10 are included in the Appendix. This App can be customized. For

additional fees other screening, testing instruments may be added

I INTRODUCTION

Interactive Avatar Substance Abuse Program

OPERATING this software: The therapist is not only the group leader but also the controller of this software. We allow only one controller per license.
For both technical and clinical reasons, we recommend limiting your remote group size to a total of eight (8) members, i.e. one (1) therapist and seven (7) clients per session..
The controller is free to move about to any slide or any avatar scene at any time. This allows an avatar practice exercise to be utilized several times in any session to ensure that all clients get to engage and play in all roles.
In this 1st version the 3d avatars are limited to scenes.

I INTRODUCTION

Interactive Avatar Substance Abuse Program

Avatar Scenes: For additional fees both the avatars and the scenes may be customized to meet your needs. This may include changing their style of dress, racial features, sex and the surroundings.
We strongly recommend preparing your clients prior to using the avatars in learning relaxation exercises, using the SUDS (Subjective Units of Distress Scale) and managing their triggers.
We have spent many hours preparing this App and feel that not only can it better engage and hold the attention of your clients but will also allow more qualified therapists to reach those in rural, remote and greatly underserved areas.

What To Expect From This Program

Interactive Avatar Substance Abuse Program

To learn skills to obtain abstinennce from drugs and/or

alcohol

Self Discovery

II ORIENTATION

Questions you might have:

Interactive Avatar Substance Abuse Program

Who leads the group?
What are the topics for each discussion?
How long is the meeting?

II ORIENTATION

THE GROUP EXPERIENCE

Questions you might have:

Interactive Avatar Substance Abuse Program

How do I know when I can speak?
Who else is in this group?
Do any special rules apply?

II ORIENTATION

THE GROUP EXPERIENCE

II ORIENTATION

THE GROUP EXPERIENCE

II ORIENTATION

THE GROUP EXPERIENCE

Rules and guidelines for groups

Interactive Avatar Substance Abuse Program

Confidentiality- This is important because sensitive/private information is shared. Never divulge names or personal information to anyone outside the group.
Express Empathy- Open your mind to accept others ideas and be open to feedback.
Begin your sentences with the word, “I,” it makes the experience personal to you.

II ORIENTATION

THE GROUP EXPERIENCE

Rules and guidelines for groups

Interactive Avatar Substance Abuse Program

Be respectful- Treat others the way you would like to be treated. Respect should be shown both by you and the leaders of the group.
Be honest- Honesty is the best policy and the only way to achieve good results.

II ORIENTATION

THE GROUP EXPERIENCE

Rules and guidelines for groups

Interactive Avatar Substance Abuse Program

One at a time –Be polite. Allow the speaking person to complete their question or comment.
Conversations not pertaining to the main topic shouldn’t be happening.
Since the group does have a time limit, the leader may occasionally have to interrupt if one person is taking too long.

II ORIENTATION

THE GROUP EXPERIENCE

Interactive Avatar Substance Abuse Program

III UNDERSTANDING SA AND ADDICTION

In the beginning there was light

Interactive Avatar Substance Abuse Program

Motivation is a key factor if change is going to occur
Why have you decided to change?

DECIDING TO CHANGE

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

The most common response to this question will be the reason you were referred to this Program
The Matrix Institute surveys showed these responses to include:
- I was arrested, and it was either this or jail
- My wife says if I don’t stop, we are finished

DECIDING TO CHANGE

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Last time I used I thought I was going to die
They are going to take the children from us unless we stop
I’ve been using for years, I want to change
I can’t return to work until I complete this program

DECIDING TO CHANGE

The Matrix Institute surveys showed these responses included

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Reasons for deciding to change could be anything from personal goals you wish to accomplish, improving your health, mending relationships, pursing a new career/activity, etc.

DECIDING TO CHANGE

Matrix Institute Survey Responses

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

It is important to keep these goals in mind as you begin your new path
Know that change is not always easy but it is surely possible

DECIDING TO CHANGE

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Financial – Loss of funds and an inability to meet your financial obligations or being able to support your family
Legal – This Program or jail? This surely is the better choice
Keep your goals nearby, review them daily, never forget what you wish to achieve and most importantly –

DECIDING TO CHANGE

Other factors that may have motivated your desire for change could include:

Never Give Up

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Avoid people who use drugs/alcohol
Change your phone number
Avoid bars/clubs
Refrain from alcoholic beverages

CHANGING

The new path you have chosen requires commitment and dedication.
Below is a list of helpful recommendations to aid your success:

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Get rid of and Stop using all illegal drugs and/or alcohol.

CHANGING

Avoid using all narcotics or regulated drugs. Discuss your substance abuse issue with your physician and request to use nonnarcotic medication when possible.

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Destroy all drug paraphernalia and associated items
Identify your addictive behaviors and triggers
Avoid triggers when possible (See Section IV: Triggers)
Learn and use thought stopping techniques for cravings (See Section IV: Preparation For Change)

CHANGING

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Exercise daily
Learn and use natural relaxation techniques (See Section IV Preparation For Change: Relaxation and Visualization)
Schedule your daily activities and follow through
Budget monies and pay financial obligations promptly

CHANGING

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Have your money deposited directly into bank accounts
Attend all program groups
Honestly reveal your thoughts, feelings and behaviors in all sessions
Try new activities that are drug free (local library, churches, community centers, etc.)

CHANGING

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

What do they do to the body
Different kinds of drugs and how they effect a person
Behaviors exemplified when on drugs
Possible consequences of these behaviors

THE EFFECTS OF DRUGS AND ALCOHOL

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Street Names: Hard liquor, Beer, Wine, Boot leg, Grain Alcohol
Possible Health Effects: Reduce social anxiety, reduce pain, Sense of well being
Negative Effects: Poor judgement, liver damage, heart damage, permanent brain damage, confusion, impaired memory, slurred speech, loss of balance, impaired concentration, birth defects, seizures, poor impulse control, More likely to be involved in vehicular accidents, alcohol poisoning and death

Alcohol

EFFECTS OF DRUGS AND ALCOHOL

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

Downers, Reds, Phennies, Yellows, Red birds
Possible Health Effects: Stops seizures , improves sleep, lowers anxiety, sedation, Slower pulse and blood pressure
Negative Effects: Confusion, lack of concentration, unusual fatigue, lack of good judgement, blackouts, withdrawals, death by overdosing

Barbiturates

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street names: Weed, Smoke, Pot, Grass, Mid, Loud, Gas, Blunt, Tree, Ganja, Dank
Possible Health Effects: Decreased anxiety, decreased pain sensation
Negative Effects: Coughing, Slow thinking, loss of motivation, poor coordination, fast heart rate, altered perceptions (especially in time), hallucinations, disinhibition and poor judgement

Marijuana

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street names: Liquid ecstasy, Georgia home boy
Possible Health Effects: Sense of well being, decreased anxiety, increased sex drive
Negatives Effects: Poor memory, nausea, poor judgement, dizziness, confusion, severe drowsiness, seizures, coma, death from overdose

GHB (Gamma-hydroxyl butyrate)

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street names: Smack, H-train, Boy, horse, H, Dogfood, Heron, Black tar
Possible Health Effects: Pain relief, sense of well being, sedation, improved sleep
Negative Effects: Hepatitis risk, HIV risk, confusion, slowed heart rate, swelling of the gums, skin and brain abscesses, leaky heart valves, enlarged heart, death from overdose

Heroin

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street names: Blow, Snow, Coke, White, Whitegirl, Powder, Sniff, Yayo, Nose Candy, Line, Bump
Possible Health Effects: Sense of brighter mood and increased energy
Negative Effects: Mania, anger, violent/aggressive behaviors, paranoia, increased heart rate, heart arrhythmias, increased blood pressure, heart attack, stroke, coma, increased erratic behavior, nasal congestion, melting and sores in the nasal walls, runny nose, death from overdose

Cocaine

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street names: Rock, Base, Ball, Jellybean, Nuggets, Candy, Raw, Hard, Product
Possible Health Effects: none
Negative Effects: Respiratory problems, seizures, sexual dysfunction, infertility, malnutrition, tooth decay and loss of teeth, heart failure, increased blood pressure, liver failure, melting and sores in the nasal walls, constant runny nose, depression, hallucinations, paranoia, aggressive and violent behaviors, death from overdose

Crack

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street names: Meth, Glass, Crank, Crystal, Ice
There are no health benefits of methylated amphetamines. It is often confused with dextro-amphetamines, such as the medication Adderall. Adderall and others similar are used to treat ADHD and extreme cases of obesity
Negative Effects: Permanent disturbing hallucinations, increased blood pressure and heart rate, loss of appetite, unpredictable and violent behaviors, vomiting, tremors, clenching of the jaws, seizures, obsessive skin picking resulting in sores and ulcers, depression, heart attacks, death

Methamphetamine

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street names: Ecstasy, Peace, X, E, Molly, Beans
Possible Health Effects: Feeling of empathy and well being, increased sexual desires, increased pleasure from touch
Negative Effects: Heart damage, poor memory, kidney failure, liver damage, increased blood pressure, hot or cold flashes, dangerous changes in body temperature, tightness in jaw, death by heatstroke, overdose, hyponatremia (low salt from drinking too much water)

MDMA

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street Names: Special K, Super acid, Jet, K , Cat Valium
Possible Health Effects: Decreased anxiety, improved mood, mind altering changes
Negative Effects: Increased heart rate, numbness, increased blood pressure, “near death experiences”, amnesia, hallucinations, death from respiratory complications

Ketamine

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street names: Acid, Cubes, Blotter
Possible Health Effects: Changes in perception
Negative Effects: Hallucinations, permanent psychosis, fast heart rate, increased temperature, nausea, flashbacks, tremors, sleeplessness, death

LSD

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

Street Names: Angel dust, Boat, Love boat, Wets, Purple tear drops
Possible Health Effects: Numbness, perception changes
Negative effects: Fast heart rate, high blood pressure, hallucinations, delusions, permanent psychosis, violent outbursts, death from overdose

PCP

III UNDERSTANDING SA AND ADDICTION

EFFECTS OF DRUGS AND ALCOHOL

Interactive Avatar Substance Abuse Program

What substances have you abused?

What did these substances do to you?

HELPING TOOLS: SELF CHECK IN

Workbook Exercise:

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

What lingering health problems have you had because of drugs or alcohol?

What problems concern you about discontinuing your use?

HELPING TOOLS: SELF CHECK IN

Workbook Exercise:

III UNDERSTANDING SA AND ADDICTION

Interactive Avatar Substance Abuse Program

It may be a common belief that we already know our own selves well

IV EARLY INTERVENTION

UNDERSTANDING YOURSELF

"Hello Me"

Interactive Avatar Substance Abuse Program

Still, Let's be sure. Let's not forget that the mind has that subconscious or hidden side

IV EARLY INTERVENTION

UNDERSTANDING YOURSELF

Interactive Avatar Substance Abuse Program

We must learn to recognize how we feel and the beliefs that contribute to these feelings – Our
Our is how any situation or circumstance is viewed
Our determines our opinions and actions

IV EARLY INTERVENTION

"Hello Me"

Point Of View

UNDERSTANDING MYSELF

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Fact , fiction.....excuses?

Self control is a learned skill

(I'm helpless, really?)

I can't control my emotions
Learn to self assess and when to take a relaxation break
I can't control my behavior
Create schedule and allot something productive for every hour of the day

UNDERSTANDING MYSELF

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Fact , fiction.....excuses?

“I don’t care about my life nor if my addiction kills me”
“I’m in control and I can stop whenever I want”
“Without drugs or alcohol, I can’t manage my problems effectively”

UNDERSTANDING MYSELF

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Fact , fiction.....excuses?

"I'm nothing like (another addict) they definitely need help I don't"
"My addiction affects me only and no one else"
"Life without drugs or alcohol is boring"

UNDERSTANDING MYSELF

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Fact , fiction.....excuses?

(I'm Powerful)

I know when to stop

UNDERSTANDING MYSELF

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Fact , fiction.....excuses?

It’s (all the negatives) not going to happen to me
Using results in a chaotic lifestyle with many loses and failures
Using often results in alienation of love ones and sometimes homelessness

UNDERSTANDING MYSELF

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Following your schedule prohibits impulsive behaviors and gives you a sense of accomplishment and satisfaction

UNDERSTANDING MYSELF

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

UNDERSTANDING MYSELF

Fact , fiction.....excuses?

How thoughts and emotions are connected...

"For as he thinks in his heart, so is he..." Proverbs 23:7

Thought "It's a dreary day outside"
Emotion - I feel sad and depressed
Question - Must you feel sad because the day is cloudy?
Perhaps this a day to build up energy vs using energy as we often do on
bright sunny days

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Fact , fiction.....excuses?

Drugs help me:

Get to sleep
Deal w/ stress
To relax, socialize, have fun
Feel better or feel normal

MYTHS, JUSTIFICATION, NEEDS VS. DESIRE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Fact , fiction.....excuses?

FACT: Real outcomes of drug and/or alcohol use

Increase the chance of accidents
Hurt or injured myself and/or another person
To do something I'm ashamed of

MYTHS, JUSTIFICATION, NEEDS VS. DESIRE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

MYTHS, JUSTIFICATION, NEEDS VS. DESIRE

Fact , fiction.....excuses?

FACT: Real outcomes of drug and/or alcohol use

Damaged my reputation personal and/or professional
Loss control-forgot what I did
Loss self control or control of my anger
Found my problems were still there after I cleaned or sobered up

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

EFFECTS OF USING

Fact , fiction.....excuses?

FACT: Real outcomes of drug and/or alcohol use

You may experience on or more of the following problems:

Remembering faces or names becomes difficult
Forgetting simple things
Trouble with directions or getting lost in familiar places
Feeling fatigued when you shouldn't be

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

EFFECTS OF USING

Fact , fiction.....excuses?

FACT: Real outcomes of drug and/or alcohol use

Trouble problem solving or making mind up about certain things
Being disorganized or leaving tasks unfinished
There may be others that are not listed here but do apply to you.
Workbook Task: Identify which of the above outcomes apply to you

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

HELPFUL IDEAS

Addressing issues one by one vs trying to tackle them all

together is the best way to solve the problem.

Problem Fixers:

Inability to think clearly or stay focused

Work out - Exercise is very essential in increasing blood flow to the brain. This increased blood flow helps to improve your memory.
Get rid of distractions - Turn off the TV, radio and place your cell phone on silent. Find a quiet place, try to focus on a single task.

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

HELPFUL IDEAS

Be Organized - Keep your notebook, pen, glasses, keys and important items in the same place. Get rid of the clutter, create a calendar (can make your own) and write down your appointments and planned activities

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

HELPFUL IDEAS

Write notes and reminders to yourself
Repeat instructions or important information
Healthy Eating - Eat foods rich in antioxidants (red/black/blue berries, tomatoes, green vegetables) and Omega 3 &6 also helps increase blood flow to the brain

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Stay Busy; Stop Using

Schedules should be created to prevent idle or too much free time
Schedules should be written down and not exclusively in ones’ head to avoid repeatedly changing them
It’s key to schedule substance free activities with substance fee people
Play virtual games including “Second Life”

HELPFUL IDEAS

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Stay Busy; Stop Using

Consider if it’s best for you to engage in old hobbies/activities; or if getting involved with new activities keeps you more interested Examples may include learning new sports, visiting a new museum, etc.)

HELPFUL IDEAS

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Stay Busy; Stop Using

Call friends or family member who does not use drugs or alcohol
Get Plenty of Rest – It is hard to focus when you are tired. Counteract this by getting the recommended 7 to 8 hours of sleep every night
Take breaks when you need them, have a glass of water, stretch/move around, say hello to your pet

HELPFUL IDEAS

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

In social interactions: Difficulty Remembering Names/Faces:

Use the repetition technique - Repeat the names of people you just met then use it several times in the conversation.
Find a connection – Look for hints in the person’s face or name or perhaps you may find something memorable about the encounter.
Pay attention to the face- Its important to simply pay attention and not focus on what’s coming next. Keep the focus on what is important which at the time would be the person’s face or name

HELPFUL IDEAS

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Workbook Exercise:

Which of these situations or problems do you feel most apply to you?
What solutions to these problems will you implement?
How can the counselors be of help?

PUT IT TO USE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Self Esteem: Purpose

Understanding self esteem and why it is important
Tactics used for increasing self esteem
Understanding that is your responsibility to improve your self esteem

SELF ESTEEM

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Self Esteem

Understanding how low self esteem can negatively impact your
Success tends to go hand in hand with people who generally feel good about themselves. In recovery, improving self esteem is very important. There are methods that may increase self esteem and those that may cause harm.

SELF ESTEEM

Point Of View

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Self Esteem

Everyone wants to feels better about themselves, although some may hide behind a mask, saying, “I feel fine.”

SELF ESTEEM

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Which of the following ways do you use to build self esteem?

Think about myself in a positive way
Admit my wrong doings and move on (You can not change yesterday but you can change today and tomorrow’s outcomes)
Don’t harshly criticize or judge myself or others (Learn to forgive)
Accept positive comments

SELF ESTEEM

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Take care of yourself emotionally and physically
Don’t feel that everything has to be “Perfect”( Just do the best you can)
Express kindness towards others (Everyone needs love)
Spend time with respectful people and also respect myself

SELF ESTEEM

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Have you been hurting your self esteem by:

Not believing in myself
Constant critical self talk and talking down to myself
Letting everyone run over me and not standing up for myself
Not letting go of negative habits or negative behaviors
Trying to do everything myself and not asking for help when needed

SELF ESTEEM

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

The following are methods may help to boost your self esteem:

Make a list of what I’m good at
Dress and present myself in a way that is appealing
Give a helping hand or give compliments to another person
Write down obtainable goals and strive to accomplish them
Can you think of Other techniques?

WORKING ON YOUR SELF ESTEEM

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

List at least 5 strengths that you have:

What healthy things make me feel good:

HELPING TOOL: BUILDING POSITIVE FEELINGS

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Methods for stopping craving thoughts:

It involves wearing a rubber band on your wrist and “popping” yourself each time you have a thought about using
It is important to say “no” to those negative thoughts and think about something positive
Your progress can be measured by decreasing the number of times you pop because you are decreasing the negative thoughts you have about using substances or drinking

PREPARATION FOR CHANGE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

PREPARATION FOR CHANGE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Relaxation - This technique can be used for

Use deep breathing
Slowly fill your lungs up completely with air
Hold your breathe for 5 secs then slowly exhale
Feel your whole body relax each time you exhale
Repeat this exercise 3 (three) times

PREPARATION FOR CHANGE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Visualization

Begin this exercise after you have relaxed with deep breathing
Choose your most peaceful setting:
Nearby a crystal clear mountain lake on a bright, cool day. You are surrounded by tall green trees, see the bright multicolored flowers, birds flying contented overhead across a bright blue sky with big white fluffy clouds. You can smell the fresh scent of alpine air. You have no worries, no concerns or problems

PREPARATION FOR CHANGE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Visualization

A tropical seaside – in your own private paradise on a bright warm day. The palm trees wave as a gentle tropical fragrant breeze blows by. You’re lying contently in a hammock, can see and hear the gentle sea waves break upon the shoreline
Make up you own – Discuss with the group
When not in group or time permits, enhance your relaxation experience by relaxing in a warm (not hot) bath and using soothing aromas such as sage lavender or eucalyptus

PREPARATION FOR CHANGE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

As part of your recovery, you must be aware that thought stopping is a you must make
There is a sequence that happens that is part of the thought stopping technique
Making the choice to use or not to use is illustrated by Thought-Stopping Technique demonstrated by this diagram from the Matrix Institute

PREPARATION FOR CHANGE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Trigger---Thought---Thought stopping techniques..is the way you want to go
Trigger---Thought---Continued Thoughts---Cravings---Use... This way you can go if you thought stopping techniques

CHALLENGES: Triggers

DON'T USE

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Triggers can be people, feelings, circumstances, objects and/or things that can cause cravings and a desire to use or drink.
Examples include: Money, being around people who use, being in a place or situation where using is common
Identify your triggers

CHALLENGES: Triggers

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

“Relapse Justification” is when you make a decision to stop using substances or drinking alcohol, but end up doing it anyway.
There are usually two thoughts inside your head: To remain abstinent or to give in to “relapse justification” and make excuses to start using again
(Review your fact, fiction or excuses and Myths and Justification)

CHALLENGES: Triggers

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

Just because you think about a craving or have an urge to use, you still can make a decision not to. If you allow yourself to continue, giving in to cravings and keep using, you are making a decision to relapse
Remember the sequence of Trigger---Thought---Craving--- Try to prevent your relapse by using the thought stopping techniques. When you first have a negative thought or craving, go straight into the thought stopping so that the craving doesn’t become too strong

CHALLENGES: Triggers

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

How thoughts and feelings can impact substance abuse:

Do thoughts and feelings about drugs and alcohol impact the decision to use
Which specific thoughts lead to abuse
Consider: In any given situation, what coping methods work best for me

CHALLENGES: Triggers

Interactive Avatar Substance Abuse Program

IV EARLY INTERVENTION

External Triggers

Parties or Celebrations
Being home alone
Concerts

CHALLENGES: Triggers

These include particular situations, settings, people, or activities that may influence you and when around them are more likely to cause you to use. The following are some examples. Which ones apply to you?

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External Triggers

After payday
After passing a particular street
Weekends
Before sexual activites

CHALLENGES: Triggers

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Internal Triggers

Angry
Bored
Afraid
Overwhelmed

CHALLENGES: Triggers

can be activated by certain emotions or feelings you may have that cause you
to want to use. Here are a few examples. Which ones apply to you?

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Arguments and turmoil in the home and seeking an escape maybe a trigger

CHALLENGES: Triggers

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Internal Triggers

Nervous
Hungry
Happy
Insecure

CHALLENGES: Triggers

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After you have identified your triggers and what leads you to want to drink or use, now you can begin to plan to not use

If you are bored, remember to find important things to do with your time.
If you feel like you are alone, remember to find people who are supportive of you. The point of this is to not get into situations where you may use again

TOOLS TO MANAGE TRIGGERS

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PLAN AHEAD

Plan Ahead: Create scripts of responses you can use in difficult situations
Example – Say, “No thank you” to an offer for an alcoholic party drink and request a soft drink or other beverage
Activity: Say no to drug using friends who want to hangout or visit. Create scripts using avatars

TOOLS TO MANAGE TRIGGERS

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TOOLS TO MANAGE TRIGGERS

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Which of these skills would you prefer to get you on a better trak?

Learn how to deal with anger or stress
Working out and exercising more
Developing a better diet and eating healthier

TOOLS TO MANAGE TRIGGERS

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Finding a mentor
Learning better time management techniques

TOOLS TO MANAGE TRIGGERS

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Sleep better
Learn how to manage money or finances better

TOOLS TO MANAGE TRIGGERS

Now with the help of your counselor, choose an item that you can work on and try to set goals to continue with your recovery

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Sometimes the cravings can be weak and thinking about something else is easy
Sometimes the cravings are so severe all you can think about is using

Cravings happen when you think about wanting to drink alcohol or use substances

CHALLENGES: CRAVINGS

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Almost everyone who stops drinking or using substances will have cravings and want to start back

The good news is that cravings are not the end of the world. Just because you are having cravings doesn’t mean that you have to start using. If you think about the positives as to why NOT use substances, .

cravings will eventually go away

CHALLENGES: CRAVINGS

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There are positive thoughts you can use to get over your cravings, such as:

I can do this
Cravings will not hurt me
The longer I go without substances or alcohol, the more the cravings will go away
I have worked hard to remain substance free, I do not want to mess it up now

CHALLENGES: CRAVINGS

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Do any of the following common triggers of substance abuse apply to you:

Physical:

Fatigue
Feeling sick
Pain or discomfort

SELF CHECK IN

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Relationship problems:

With husband or wife
With mom or dad
With sister or brother
With friends

SELF CHECK IN

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Social Occasions or Having a good time may create a very challenging situation:

Hanging out with friends
Special occasions, like weddings, birthday parties, special holidays
Rewarding yourself for success

SELF CHECK IN

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Emotional Issues:

Bored
Angry
Sad
Frustrated

SELF CHECK IN

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Since Beginning This Program I Have:

Destroyed all drug paraphernalia
Avoided people who use drugs and alcohol
Avoided bars, clubs and old hangouts
Stopped using all drugs and/or alcohol

SELF CHECK IN

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Since Beginning This Program I Have:

Begun daily exercise and drinking at least 8 oz of water upon arising
Avoided my triggers (when possible)
Used Stop Thought Techniques for cravings
Paid my bills regularly

SELF CHECK IN

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Since Beginning This Program I Have:

Honestly discussed my thoughts, feelings and behaviors
Seen my physician for a physical exam
Scheduled daily activities

SELF CHECK IN

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Coping Skills

There are many everyday situations that may challenge your ability to stay abstinent or sober.
Some of these challenges may include becoming bored; getting angry with a family member, boss or coworker; increased stress or feeling overwhelmed by too many bills, having insufficient time to meet all obligations or feeling guilty that all responsibilities were not completed.

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What is it?
What are Associated risks?
What to do

BOREDOM

Boredom is lack of interest or the feeling to want to do something different than what you're currently doing

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The associated risks of boredom could be using drugs/alcohol more frequently, being in a depressed mood, eating more than usual, etc.
When bored, there are plenty of things you can do to be productive. Simple things such as exercising, cooking, and reading a book or playing a virtual game like Solitaire can help. If you want to get more advanced, travel somewhere you’ve never been, learn a new language, volunteer to work with animals or create a website.

BOREDOM

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BOREDOM - TRY READING

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Feeling bad about something you’ve done or failed to do
Having done something that doesn’t fit your morals or beliefs

GUILT AND SHAME

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Workbook Exercise:

What are somethings you feel guilty about?

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Techniques to Release These Feelings:

Apologize; Request forgiveness
Know that you can't change the past but can change yourself
Lingering on the past is not going to help anyone

GUILT AND SHAME

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Demanding Job Employment

Recovery must be your first priority even when you have a job that requires long hours, difficult tasks, or a changing schedule.

IN THE WORKPLACE

There can be challenging situations within the work place that sometimes cause difficulty in the treatment and recovery process. A few examples are listed below:

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Job Situation is making Recovery difficult:

You make work at a job where people drink or use other drugs on breaks or at lunch. Remember that recovery is your first priority. Avoid these challenges by scheduling your breaks or lunchtime at a different time or go to a different location. Stay away from these type of situations.

IN THE WORKPLACE

It seems your job is becoming overwhelming while trying to recover:

Talk with your manager or boss and see if you can work out a solution

Try adjusting your schedule or availability if this is an option

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Job Situation is making Recovery difficult:

Perhaps your job requires handling large amounts of cash and that may tempt you to do something you shouldn’t. Again, remember that recovery comes first, giving in to these temptations could not only lead to a relapse, but also possible jail time for theft.
If the pressures of these type situations prove to be overpowering or too much for you, a change in jobs may be best for you

IN THE WORKPLACE

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Unemployed:

Being out of work, may change your priorities; treatment may not be the first thing on your mind, getting a job is foremost.
While unemployed, you have more time on your hands, meaning there is a chance you may go to using to kill time

IN THE WORKPLACE

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Unemployment makes treatment difficult for a number of reasons

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Unemployed:

There are also limited resources when you don’t have a job, meaning the excuses you have to use substances will be plentiful. Remember treatment is only successful if you choose to put it first. There are no easy fixes, just dedication and commitment on your part.
What interventions can you use to keep busy? (See previous slides,
)

IN THE WORKPLACE

IV Early Intervention: Helpful Ideas: Stay Busy; Stop Using

V COPING IN EVERYDAY LIFE

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Stopping the use of alcohol can be very challenging because:

Everywhere you go it seems as if people are drinking. How can you be in a social setting and refrain from drinking?
It seems as if you feel better if you drink alcohol. What feelings or situations make you want to drink?

AROUND ALCOHOL

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Combined with other drugs, alcohol may not seem like a problem (but in reality it has added to your problem list).
What problems have you encountered when trying to stop drinking?
When drinking alcohol, thinking becomes cloudy.
Describe how it is when you are sober and see people drink.

AROUND ALCOHOL

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Holidays such as New years, parties, anniversaries, etc. mark days where alcohol is used to celebrate. What events or which holidays apply to you?
Sometimes alcohol is used to relieve stress or feel comfortable in a situation. What situations or events occur in your life? (Enter in your workbook)
Sometimes alcohol is used as a sort of initiation or to feel apart of a group.

AROUND ALCOHOL

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If you have nothing to do, using substances becomes an option and thinking about past use becomes a trigger. Has free time ever been a trigger for you to use?
If having free time has led to you using again, how can you prevent this in the future?
Did you ever want to be alone and use substances?

STAYING BUSY

It is important to be sure to schedule positive activities and things to do in your spare time. It is important to remain busy everyday for a number of reasons.

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STAYING BUSY

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How did being alone affect your substance abuse?
In recovery, does being alone remind you of past experiences when you were by yourself and decided to use?
For Interventions refer to previous slides from

STAYING BUSY

IV Early Intervention: Helpful Ideas: Stay Busy; Stop Using

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Being honest is a very important part of your recovery process

Describe some ways you were not truthful when using substances
Has being honest been difficult in your recovery process?

BEING HONEST

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As you use, more and more, your usual everyday tasks become less important. When this happens, you may do or say anything to get more of the addictive substance. In most cases this includes not being honest.

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Telling The Truth

Told people what you think they want to hear
Tell people what you wish was the truth
Tell less than the whole truth

BEING HONEST

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Some may think that not telling the whole truth or being partly honest is the same as being honest. It is not.

Have you ever done any of the following?

Not being honest will make recovery from substance abuse very difficult

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It is important to have healthy supportive relationships as well as healthy boundaries in these relationships
Boundaries are defined by the amount of privacy shared between people or the amount of sharing that goes on between them
Learning to not intrude on personal boundaries is just as important as having supportive relationships

POSITIVE RELATIONSHIPS

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Personal Space is the amount of physical contact that is comfortable for each person and the amount of physical space needed for comfort
Some people greet family with hugs and kisses while others prefer nothing more than a hand shake or perhaps air kisses

POSITIVE RELATIONSHIPS

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Healthy boundaries clearly state, “ We care but we are separate ; each with our own needs
Blurred boundaries are uncertain and beg the question, “Who am I and who are you?”
Rigid boundaries questions, “Do I know you?”

POSITIVE RELATIONSHIPS

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I let someone hurt my feelings
I try to please other people before myself
I open to people I just met too easily
I allow outsiders to tell me how to think or feel

POSITIVE RELATIONSHIPS

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Self Check In

Do you display any signs of poor boundaries such as:

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I never ask for help when I need it
I don't allow people to become close to me
I don't open up about my feelings with anyone
I feel that if the only person trustworthy is myself

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Do you show any signs of rigid boundaries:

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Always show self respect
I don’t tolerate being abused or used
I can respectfully decline an opinion if I don’t agree
I treat others the way I would like to be treated

POSITIVE RELATIONSHIPS

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Display healthy boundaries:

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Why are boundaries important in my relationships with my family?
Why are boundaries important in my relationships with my friends?
Why are boundaries important in my relationship with my husband or wife?

POSITIVE RELATIONSHIPS

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Helping Tool:

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What changes do I need to make in my relationships to aid in my recovery?
How has my substance abuse changed my relationships?
What must I do to make improvements in my relationships?

POSITIVE RELATIONSHIPS

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Helping Tool:

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Thoughts, can be controlled but it is first necessary to become aware of your thinking (or to become conscious of them). They must be moved from your subconscious mind to your conscious mind.

THINKING, FEELING, BEHAVING

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Its no secret that constant substance abuse can affect your behavior, thoughts, and feelings. There are different ways that this can affect the process of recovering.

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After you become aware of your thoughts you can then block out those negative ones about using

THINKING, FEELING, BEHAVING

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Feelings; are the emotions associated with thoughts. If, however, you are not conscious of your thought, then it may feel that the emotion came from nowhere – out of the blue
You can control what you do with your feelings and not using substances has to be a top priority
(See previous slides #58 and #52
)

THINKING, FEELING, BEHAVING

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IV Early Intervention: Helpful Ideas: Stay Busy; Stop Using

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Behavior; is simply what you decide to do. Going to play sports, work, even going to substance treatment are all behaviors
Recovery occurs when you push your thoughts and emotions away from substance use
The object is learn how to control your thoughts and feelings so that your behavior results in improving your life

THINKING, FEELING, BEHAVING

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Addictive behaviors are those shown to sustain your substance use and to maintain control
The longer you have been using substances, the harder it is to have control over your life.
Sometimes these behaviors only occur when people are using. The earlier you recognize these behaviors starting to occur, the better you will fare in the recovery process
Which are addictive behaviors for you? (See the following list)

THINKING, FEELING, BEHAVING

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Addictive Behaviors

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Stealing
Lying
Isolating

THINKING, FEELING, BEHAVING

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Addictive Behaviors

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Being irresponsible or unreliable
Missing or tardiness for treatment/work/picking up children, etc
Losing Interest in matters such as hygiene, appearance, other people, etc

THINKING, FEELING, BEHAVING

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Addictive Behaviors

may include:

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Drugs can alter the brain’s ability to perform important functions that are necessary for life. (Autonomic functions - heartrate, breathing, senses, etc)
Drugs affect the brain by interrupting the communication systems and changing how information is sent, received, and processed (Executive function)
Drugs target the brains reward system by flooding it with dopamine, a neurotransmitter that also controls movement, motivation, emotions and feelings of pleasure

THE BRAIN

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The brain and its Role in Recovery

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By flooding the brain with dopamine, drugs produce a euphoric effect and the user must use more and more to try to get that feeling again. This is called Tolerance and addiction
Trying to recover from a substance use disorder is a process that takes time and effort.
The brain has been affected by the use. (The brain is a very delicate organ which is why it is heavily shielded by the skull. It is easily damaged by drugs and chemicals.) It now requires healing.

THE BRAIN

The brain and its Role in Recovery

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Use your rescue remedies
Do a fun activity
Contact your counselor or someone that has been supportive to help get your mind off using

Symptoms such as difficulties with feelings and thoughts are common during this phase.
Lack of enthusiasm, depression, not being able to concentrate are other symptoms that are experienced
Cravings become more pronounced and relapse risk is high if the client does not remain focused on recovery
During this period, exercise is highly recommended

RECOVERY: THE PHASES

The Wall Phase:

The roller coaster ride when using has ended

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COMMON RECOVERY OBSTACLES

Although everyone is different, there are some difficult situations that can’t be easily avoided and could place you right back in the using mode. Some of these situations and possible solutions:

You stay in a home where there are other drug users:

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Ask the others to refrain from using around you

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COMMON RECOVERY OBSTACLES

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If there are loose drugs or paraphernalia or alcohol laying around, dispose of it
If these things don’t work, explore the possibility of moving in with a family member or friend or somewhere else that is drug free. (Ask your counselor or others for help in locating a halfway or recovery residence.)

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VI RECOVERY

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COMMON RECOVERY OBSTACLES

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Do you...

Have feelings of self pity ( Alcoholics Anonymous : Poor me, poor me, pour me a drink)
Expect a lot out of other people
Feel frustrated at times
Become overconfident

Say "NO" to Relapse Triggers

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HALT

4 of the most common triggers known to those in the 12 Step Program can be described by the acronym HALT: Hunger, Anger, Loneliness, Tiredness:

Hunger – When using people often do not eat regularly and can even become malnourished. The body requires proper nutrition to obtain both physical and emotional stability.

Anger –The anger emotion is often both the cause and consequence of using. An irritable mood can occur after using most drugs. It is important to learn how to relax and to release anger.

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HALT

Lonely – While using relationships with many friends and/or family may be irreparably damaged resulting in your being either alienated or alone. It also may become necessary to give up associations with those who are still using. Be prepared to create new friendships.

Tiredness – Irregular sleep patterns are often a result of using drugs. A lack of sleep can result is feelings of tiredness, fatigue and exhaustion. The sleep cycle will most likely return to normal over time. Discuss this problem with your primary care physician. Be sure to make him or her aware that you are in a recovery program.

Always remember, Relapse is a choice

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VI RECOVERY

12 STEPS ALCOHOLICS ANONYMOUS

We admitted we were powerless over alcohol - that our lives had become unmanageable.
Came to believe that a Power greater than ourselves could restore us to sanity.
Made a decision to turn our will and our lives over to the care of God as we understood Him.
Made a searching and fearless moral inventory of ourselves.
Admitted to God, to ourselves and to another human being the exact nature of our wrongs.
Were entirely ready to have God remove all these defects of character.

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12 STEPS ALCOHOLICS ANONYMOUS

Humbly asked Him to remove our shortcomings.
Made a list of all persons we had harmed, and became willing to make amends to them all.
Made direct amends to such people wherever possible, except when to do so would injure them or others.
Continued to take personal inventory and when we were wrong promptly admitted it.
Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

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