This document discusses invitational intervention and the ARISE model for engaging resistant substance abusers in treatment. It addresses several key points: - The ARISE model is a three-level continuum of intervention using the family/support system to motivate entry into treatment. Level I involves a first call, Level II adds a family meeting, and Level III is a formal intervention if needed. - Research on the ARISE model found over 80% of substance abusers entered treatment or self-help, often at Level I involving just one call. Involvement of more family/friends and parental involvement predicted better outcomes. - Real-world data from another treatment center replicating ARISE also found high rates of

1. Invitational Intervention:The ARISE ModelGetting Resistant Substance Abusers into TreatmentChar Scott MaloneyPassages Counseling Center, Inc. www.passagescounseling.netwww.ARISEInterventionNow.comOffice: 630.848.0445charlcswcadc@sbcglobal.net

2. Today’s AgendaScope of addiction and current challengesPsychosocial AspectsThe role of families and support systems in treatment engagementImpact of stressorsTreatment engagement, treatment and long-term recoveryHow families can bring about healing

3. DEFINITION OF ADDICTIONLOSS OF CONTROLPROBLEMS IN ONE OR MORE OF THE FOLLOWINGHEALTHHOMELEGALWORKFINANCIALEMOTIONALCONTINUED USE IN SPITE OF PROBLEMS

4. ADDICTION STEREOTYPES & MYTHSMyth 1: “You are powerless to help until the substance abuser is ready”Myth 2: “Putting pressure on the substance abuser will push him/her over the edge”Myth 3: Secrets are really secretMyth 4: “The substance abuser must ‘hit bottom’ before getting help”Myth 5: Substance Abusers are disconnected from their familiesMyth 6: “Tough consequences will chase the substance abuser away forever”

5. TREATMENT ENGAGEMENTA very small proportion of people with drug dependency or abuse are engaged in treatment or self-helpNATHAN (1990) ESTIMATED 5%FRANCES ET AL. (1989) ESTIMATED 10%KESSLER ET AL. (1994) ESTIMATED 8%

6. Psychosocial Aspects of Addiction

7. Loss and AddictionOnset of addiction is almost always connected to:death of a parent, grandparent, spouse or significant friend,

8. natural or human-made disaster, immigration/refugee experience, or warSubstance use:numbs the sadness, loss, anger, guilt and loneliness

9. distracts from grief in other members of the familyMore Vietnam veterans have died from addiction and/or suicide than were lost during the Vietnam conflictDeaths of Vietnam veterans: during Vietnam conflict: 58,000

10. since Vietnam conflict from addiction/suicide: 62,000Trauma and Addiction:Individual Trauma 60% of the women in AA report a history of sexual abuse

11. 30% of the men in AA report a history of sexual abuseDespite prevailing beliefs, Addicted Individuals do not need to hit bottom to receive help or be motivated to get treatment. Families can help.Substance abusers and others suffering from addiction are closely connected to their families

12. 70%64%60%51%50%40%30%20%9%10%0%Non-AddictsHeroinPolydrugPercentage of Subjects in Daily Telephone Contact With One or More ParentAddictsHeroinAddictsPolydrugNon-addictss(Purzel and Lamon, 79)

13. IS THERE A STRANGER LIVING IN YOUR HOME?Nature of calls that come in from family regarding getting a resistant loved one started in treatment

14. Prefrontal Cortex -- Functions(Executive Functions)judgment

15. impulse control

16. self-monitoringPrefrontal Cortex -- Functions(Coping Functions)attention span

17. organization

18. learning from experience

19. empathy

20. problem solvingPrefrontal Cortex – Malfunctionsinability to objectively assess oneself

21. poor judgment

22. inability to learn from experience

23. decreased attention span

24. becoming easily bored

25. argumentative

26. thin skinned

27. Self-centered

28. disorganizedPrefrontal Cortex related– Recovery SlogansThink, Think, Think

29. Easy Does It (But Do It)

30. Insanity: Doing the Same Thing Over and Over Again and Expecting a Different Outcome

31. I cannot control my first thought---but I am responsible for my second thought.TRANSITIONALFAMILY THERAPY

32. PHILOSOPHY OF TRANSITIONAL FAMILY THERAPYFamilies are intrinsically healthy and competent

33. People and environments are constantly in transition

34. Individuals, families and communities will find and utilize their competence

35. Competence is unavailable when individuals and families are cut off from their extended families and natural support systems

36. To access competence, mobilize and extend natural support system

37. Eliminate the we/they dichotomy and maintain connection to family and culture of originImpact of Stressors/Change on Family Functioningand Getting Off-Track