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Accredited Counseling & Intervention Services, Inc.

sailboat When Enough is Enough!

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  • Counseling
  • Individual
  • Couple
  • Family
  • Group
  • Case Management
  • Approach
  • Q & A

 

ACIS provides counseling services for those who are affected by substance abuse or the more frightening specter of dependence or addiction.

Sailboat on the bayACIS offers professional counseling: Individual, couples, family, and group counseling, and case management. Our counseling can add insight, support, and education as well as provide effective strategies for managing triggers and other factors influencing the continued harmful use of alcohol and other drugs. We provide counseling for process addictions and co-occurring disorders as well.

Problems of addiction are heart breaking, frustrating and mystifying for most individuals and families who are affected by them. Substance abuse and dependence all too often lead to loss of health, job, income and self-respect, as well as to divorce and alienation from family and friends, indescribable pain and sometimes death.

Sadly, anyone can become addicted to one or more substances that can lead to a life of loneliness and despair. Unless a problem of addiction receives responsible attention, it will continue to plague the addicted person and their family mercilessly.

Our services include individual, couple, and family counseling as well as structured groups that combine both educational and group support. We also utilize community self-help groups as an adjunct to treatment. At ACIS, we consider effective treatment for substance abuse to be a balance of hope and encouragement provided by our staff along with clear expectations for personal responsibility and accountability. These values are exemplified in all that we do.

ACIS's approach to substance abuse counseling integrates psychotherapeutic and coping skills-training techniques with abstinence-based addiction counseling. The primary goals of treatment are to enhance and sustain client and family motivation for change, establish and maintain client's abstinence from all psychoactive drugs, and foster development of (nonchemical) coping and problem solving skills to thwart and ultimately eliminate impulses to "self-medicate" with psychoactive drugs. The approach combines cognitive-behavioral, motivational, and insight-oriented techniques according to each client's individual needs. Our therapeutic style is empathic, client centered, and flexible. Strong emphasis is placed on developing a good working alliance with the client to prevent premature dropout and as a vehicle for promoting therapeutic change. The counselor attempts to work with and through rather than against a client's resistance to change. Aggressive confrontation of denial, the hallmark of traditional addiction counseling, is seen as counterproductive and antithetical to our approach. Individual, couple, family, and group counseling are delivered within the context of a structured yet flexible multistage treatment program that also includes psychoeducation for both the primary client and his or her family; supervised urine testing to encourage and verify abstinence; and, where indicated by a psychiatrist, pharmacotherapy for coexisting psychiatric disorders. Client participation in self-help is encouraged but not mandated, and accepting the identity of addict or alcoholic is not required.

Please see the other tabs for full descriptions of Individual, Couple, Family, Group, and Case Management counseling services.

Confidentiality

Maintaining confidentiality is very important in a counseling relationship as this leads to the development of trust. The counselor will not reveal the client's identity, personal details, and such information to other people without the client's permission.

  • Substance Abuse
  • Eating Disorder and Addiction
  • Gambling Addiction
  • Sex Addiction

 

ACIS counselors help people suffering from addiction navigate life's challenges. Counseling is a collaboration between the counselor and the client. Our addiction counselors help clients identify goals and potential solutions to problems which cause emotional turmoil; seek to improve communication and coping skills; strengthen self-esteem; and promote behavioral change and sobriety.

The goals for the individual sessions are the following:

  1. Provide a client who is suffering from addiction an opportunity to share his/her struggle and establish an individualized connection with the counselor.
  2. Provide a setting where a client can work out crises, air issues, and determine the course of treatment with the counselor as a guide.
  3. Allow the client to discuss their addiction openly in a nonjudgmental context with the full attention of the counselor.
  4. Include significant family member(s) in the treatment process.
  5. Provide the client with reinforcement and encouragement for positive changes.
  6. Make the client feel that the counselor is a combined teacher, coach, and concerned human being.

Common Session Implementation:

  1. Orientation to treatment --- is designed to ensure that the client (and family member(s) when possible) has the proper orientation to treatment. The client and family member meet the counselor, hear about the program, and learn some basics about addiction and the brain. The self-destructive patterns of addictive use can be mystifying for both the user and family. This session helps explain the conditioned cravings that persist despite the user's intentions to stop, necessitating real behavior change. This topic underlies many later program topics such as scheduling, triggers, and thought-stopping.
  2. The first family contract --- engage family member in the treatment process, review the expected course of treatment, and start the client and family member(s) working together in the recovery process.
  3. Opening the door --- open the door on a sensitive and important topic: Alcohol, and other drugs.
  4. Making changes --- review Recovery Checklist, the changes that have been made during the initial stages of treatment. Review progress and be reminded of areas that may require attention. Focus on the important elements of the sobriety plan and encourage additional positive changes.
  5. About dreams --- they occur at different times during recovery with varying degrees of significance. Dreams are normal neurochemical processes that result in very vivid dreams. These should not cause alarm, but the dreams require attention. Later in recovery, dreams can be signals of relapse and require application of relapse prevention skills in response.
  6. Relapse Prevention --- client status review, addresses many of the issues of relapse prevention, such as leisure, exercise, relationships, and cravings. This requires a periodic review of these areas throughout recovery.
  7. A difficult period --- Clients who are beginning to have Wall-type symptoms may fail to recognize they are in the Wall stage of recovery. Review The Wall Checklist, which helps clients understand the emotional, cognitive, and behavioral manifestations of the Wall so that they can more easily accept this stage and take measures to navigate through it.
  8. The second family contract --- during this session, there needs to be recognition that healthy intimacy will eventually be a goal, but the first step towards that goal is the development of healthy individuals. The focus now will be on each person's individual issues. This session is designed to encourage and allow that focus to happen.
  9. Heartfelt matters --- review thoughts, emotions, and behavior. Help client identify their own feelings, and how they've dealt with them. Discuss how powerful emotions are factors in relapse. How to accept that they can't always control feelings, but they can control their behavior. Review past history, and skills to better handle feelings in the future.
  10. Setting goals --- the evaluation of the client's treatment begins with a review of the areas in which significant behavioral changes have occurred. The status of each of these eight areas above is then contrasted with where the client would like to be in that area of his or her life. This process of looking at the discrepancy between the present situation and clearly defining the client's goals in each of the same areas often generates motivation for the client to formulate steps to reach desired goals. The counselor encourages the client to make these goals realistic and help him or her to set realistic timetables for achieving them.
  11. (If Needed) Relapse Analysis Chart --- this session can be interjected whenever it is appropriate in place of another topic. It is to be used when substance use occurs after a period of abstinence, as a way to interrupt continued use. Relapse does NOT occur suddenly or unpredictably, although it often feels that way to client. The counselor works with the client to understand the context of the relapse to reframe the event. Many people who successfully complete inpatient and/or outpatient treatment experience a relapse at some point in the process. The critical issue is whether the process continues following the relapse. A relapse does not indicate failure; it should be viewed as an indication that the treatment plan needs adjusting.

Individual counseling is an opportunity to receive support and experience growth during challenging times. Individual counseling can help with many personal topics in life that contribute to substance abuse, such as anger, depression, anxiety, process addictions (gambling, sex addiction, eating disorder), relationship challenges, family issues, lack of direction and motivation, school difficulties, career/job challenges, and much more.

 

ACIS offers individualized one-on-one counseling for eating disorders, including Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, Body image issues, and weight management. Our approach to working with eating disorders is based on empirically validated treatments. We provide Cognitive Behavioral Therapy for adults and older adolescents with eating disorders, and involve the family as well when client is ready.

 

ACIS offers individualized one-on-one problem gambling counseling from 1 to 3 times weekly with a certified and licensed counselor. Counselors and clients will collaborate on the amount and intensity of treatment services based on a thorough assessment.

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), gambling addiction is categorized alongside substance-related disorders. This is due to the way gambling similarly impacts the reward centers of the brain. Some of the DSM-5 diagnostic criteria for gambling disorder include failed attempts to decrease or stop gambling, lying to conceal the extent of gambling activities, and negative effects on relationships or career as a result of gambling.

Gamblers Anonymous calls problem gambling “compulsive gambling” and views it as a progressive illness that can be managed but not cured. It is described as a sickness that one must overcome through acceptance, abstinence, and recovery.

Although the DSM-5 and Gamblers Anonymous view problem gambling from slightly different perspectives, both agree that the condition involves an urge to gamble despite damaging effects on one's life.

If you’ve noticed these symptoms in yourself or someone close to you, you should recognize it isn’t too late to seek help.

 

ACIS offers individualized one-on-one problem sex counseling from 1 to 2 times weekly with a certified and licensed counselor. Counselors and clients will collaborate on the amount and intensity of treatment services based on a thorough assessment.

Although sex is considered a natural part of life, as is the case with anything else, when it’s taken to an extreme, it can produce negative consequences. Sex addiction treatment program options are available, but it’s important to understand what’s involved in this addiction and how it develops. While psychologists have struggled to arrive at a precise definition for sex addiction, it’s largely believed to include an inability to control or manage one’s sexual behavior.

An individual who’s suffering from sexual addiction might also have made multiple attempts to control their behavior without success. Sex addicts might also spend an extensive amount of time attempting to obtain sex. This behavior can interfere with work, recreational and social activities. In some instances, the person might experience sexual rage disorder and become anxious, distressed or violent if they aren’t able to engage in sexual activity.

If you’ve noticed these symptoms in yourself or someone close to you, you should recognize it isn’t too late to seek help.

 

Counseling for couples can help resolve conflicts and heal wounds. As a couple grows in recovery, they often experience ups and downs in their levels of closeness and harmony. This can range from basic concerns of stagnation to serious aggressive behavior. Overall, counseling can help couples slow down their downward spiral and reestablish realistic expectations and goals.

General Session Content and Procedures

During initial sessions, ACIS counselors work to decrease the couple’s negative feelings and interactions about past and possible future drinking or drug use, and encourage positive behavioral exchanges between partners. Later sessions move to engage the partners in communication skills training, problem solving strategies, and negotiation of behavior change agreements.

At the outset of therapy, the counselor and the couple together develop a recovery contract. As part of the contract, the partners agree to engage in a daily abstinence trust discussion (or sobriety trust discussion). In this brief exchange, the substance-abusing partner typically says something like, “I have not used drugs in the last 24 hours and I intend to remain abstinent for the next 24 hours.” In turn, the non-substance-abusing partner expresses support by responding, for example, “Thank you for not drinking or using drugs during the last day. I want to provide you the support you need to meet your goal of remaining abstinent today.”

For addicts taking medications such as Naltrexone or Disulfiram (Antabuse) to facilitate abstinence, ingestion of each day’s dose can be a component of the abstinence trust discussion, with the non-substance-abusing partner witnessing and providing verbal reinforcement. The non-substance-abusing partner makes a record of the abstinence trust discussion and other activities in the recovery contract (for example, attendance at self-help support groups) on a calendar. The calendar is an ongoing record of progress that the counselor can praise in sessions, as well as a visual and temporal record of problems with adherence. During each session, the partners perform behaviors stipulated in their recovery contract, such as their abstinence trust interaction, which highlights the behaviors’ importance and allows the counselor to observe and provide affirming or corrective feedback.

Sessions tend to be moderately to highly structured, with the counselor setting a specific agenda at the start of each meeting. Typically, the counselor begins by asking about urges to use since the last session and whether any drinking or drug use has occurred. The counselor and the partners review compliance with agreed-upon activities since the last session and discuss any difficulties the couple may have experienced.

The session then moves to a detailed review of homework and the partners’ successes and problems in completing their assignments. The partners report any relationship or other problems that may have arisen during the last week, with the goal of resolving them or designing a plan to resolve them. The counselor then introduces new material, such as instruction in and rehearsal of skills to be practiced at home during the ensuing week. Toward the end of the session, partners receive new homework assignments to complete before the next session.

When Progress in Therapy Is Insufficient: How the Counselor Responds.
Problem Criterion Counselor’s Response
Relationship distress Either partner, 3 weeks in a row, reports clinically significant relationship distress. Focus on relationship enhancement and communications skills training.
Continued or renewed substance use The substance-abusing partner reports substance use 2 weeks in a row or urges to use 3 weeks in a row. Place greater emphasis on substance use issues. Encourage attendance at self-help meetings and more frequent contact with the individual counselor. Identify and reduce the stressors under-lying or contributing to cravings.
Noncompliance with homework The couple fails to complete homework 2 weeks in a row. Isolate and eliminate factors interfering with completion. Reduce the amount of homework to a level manageable by both partners.
Arguments about past substance abuse Either partner reports such arguments 2 weeks in a row. This violates one of the major tenets of the intervention, which focuses on the future, not the past. Encourage the non-substance-abusing partner to discuss these issues in Al-Anon/Nar-Anon meetings or with an individual counselor.
Angry contact There have been episodes of mild physical aggression between partners. Reiterate the couple’s commitment not to resolve conflict with physical aggression of any kind; emphasize conflict resolution skills.
Severe violence (e.g., behavior causing injury or fear) is another matter. Refer partner to domestic violence treatment and cease therapy.

Therapy also employs a set of behavioral assignments designed to increase positive feelings, shared activities, and constructive communication, all of which are viewed as conducive to abstinence.

  • In the “Catch Your Partner Doing Something Nice” exercise, each partner notices and acknowledges one pleasing behavior that the significant other performs each day.
  • In the “Caring Day” assignment, each partner plans ahead to surprise the other with a day when he or she does some special things to show caring.
  • Planning and engaging in mutually agreed-upon shared rewarding activities are important; many substance abusers’ families have lost the custom of doing things together for pleasure, and regaining it is associated with positive recovery outcomes.
  • Practicing communication skills - paraphrasing, empathizing, and validating - can help the substance-abusing patient and his or her partner better address stressors in their relationship and their lives. These skills are also believed to reduce the risk of relapse to substance abuse.

As a condition of the recovery contract, both partners agree not to discuss past drinking or drug abuse, or fears of future substance abuse, between scheduled therapy sessions. This agreement reduces the likelihood of substance-abuse-related conflicts occurring outside the therapy sessions, where they are more likely to trigger relapses. Partners are asked to reserve such discussions for the therapy sessions, where the counselor can monitor and facilitate the interaction.

Throughout therapy, the counselor monitors both partners’ relationship satisfaction. In each session, the partners complete two brief measures: the Marital Happiness Scale (Azrin, Naster, and Jones, 1973), which assesses relationship adjustment for the previous week, and the Response to Conflict Scale (Birchler and Fals-Stewart, 1994), which evaluates the partners’ use of maladaptive methods such as yelling, sulking, or hitting to handle relationship conflict during the last week.

If the partners are not making sufficient progress in any areas, the counselor gives greater attention to skills that address the specific problems. For example, if the addict is not abusing or reporting urges to abuse drugs or alcohol, but the partners report that their relationship conflict and distress are not abating, the therapist stresses relationship enhancement exercises and communication skills (see “When Progress in Behavioral Couples Therapy Is Insufficient: How the Therapist Responds”).

Coordination With Other Therapy Components

If, as typically happens, therapy is provided in conjunction with individual substance abuse counseling, the respective treatment providers share information about the addict’s progress. Such coordination is essential to maximize the effectiveness of both modalities, as addicts often disclose problems in one type of counseling that are best addressed in one or the other treatment format. For instance, a couple might discuss in a therapy session the addict’s need for vocational training to obtain a higher paying job, but the individual treatment provider is usually better positioned to coordinate such training as part of the addict’s overall treatment plan.

Planning for Continuing Recovery

Once the couple has attained stability in abstinence and relationship adjustment, the partners and the counselor begin discussing plans for maintaining therapy gains after formal therapy is completed. From a couples therapy perspective, relapses can take the form of a return to substance use or a recurrence of relationship difficulties. Consistent with Marlatt and Gordon’s (1985) seminal work on relapse prevention, the counselor discusses openly with both partners the fact that relapse is a common, though not inevitable, part of the recovery process. The counselor also emphasizes that relapse does not indicate that the treatment has failed and encourages the couple to make plans to handle such occurrences.

There is a strong tendency for the non-substance-abusing member of the couple to see any relapse to substance abuse by his or her partner as a betrayal of the relationship, a failure of the treatment, and an indication that their problems are never going to end. To counter this response, the discussion and planning for relapse include encouragement for both partners to view relapse, if it should occur, as a learning experience and not a reason to abandon hope and commitment.

In the final therapy sessions, the couple writes a continuing recovery plan. The plan provides an overview of the couple’s ongoing post-therapy activities to promote stable abstinence (for example, a continuing daily abstinence trust discussion and attendance at self-help support meetings), relapse contingency plans (such as re-contacting the counselor, re-engaging in self-help support meetings, contacting a sponsor), and activities to maintain the quality of their relationship (for example, by continuing to schedule shared rewarding activities).

The Appropriate Therapeutic Stance

The counselor’s ability to develop a strong collaborative therapeutic alliance with the partners is essential for successful therapy. Key therapeutic skills include empathizing, instilling a sense of hope, and working on mutually established goals. The most common clinical barrier to engaging and allying with couples in treatment is partners’ fears that sessions will become a forum for laying blame on each other. To allay such fears, the counselor will highlight skill-building goals and focus consistently on the present and future rather than on emotional reactions to past problems. Most partners who participate in therapy report that the highly structured sessions and activity-based homework exercises are a welcome change from their otherwise chaotic lifestyles.

Although most couples who participate in therapy comply with session exercises and between-session homework assignments, some do not. When partners have difficulty completing assignments as agreed, the counselor assesses possible barriers and solicits the couple’s ideas for enhancing compliance. In addition, the counselor can adjust assignments that may be too ambitious for some partners, for example, by reducing the weekly quota of self-help meetings. The counselor can also conduct brief telephone conferences with the partners between sessions to assess their progress on the week’s assignments and encourage completion of the homework.

However, noncompliance with agreed-upon assignments is never excused or ignored in therapy. A pattern of avoidance and failure to follow through on commitments is common. However, allowing the partners to break commitments in therapy is likely to undermine the goals of the intervention by perpetuating and reinforcing behaviors that may underlie many of the couples’ problems.

ACIS Counseling can offer you the benefits of couples counseling for issues surrounding addiction. With this in mind, we keep our counseling direct and straightforward and set concrete goals for both of you. Couples counseling benefits the couple whether one or both of you get help. One partner can start counseling on their own until their partner is ready to join them. We will give you and your partner the tools and skills you need to work through common addiction problems in relationships. We have successfully worked with couples to help them move beyond active addiction and obtain the relationship they want; we are here to help you do the same.

 

Addiction, co-occurring mental health disorders, and family counseling with a certified and licensed counselor is available to help individuals and families stabilize mental health symptoms, learn new coping skills, and develop strategies for lifestyles that offer the most independence. We provide support for relationships with licensed professionals in order to assist in the recovery processes. Our clinicians address relationship problems, sex addiction, as well as other types of addiction.

Family counseling is recommended while a family member is receiving treatment, and for a period thereafter. Family systems are self-regulating and self-maintaining which is the reason for the inclusion of family members in treatment. The identified patient or addict would be unable to continue destructive behavior without a system (family or significant others) to support the behavior. This in no way implies that the system prefers the individual's continued use of drugs, rather that the system accommodates and adjusts itself to the individual's use. The family may be traumatized by the consequences of the abuse, but at the same time finds it essential that the individual continue using to maintain the system's homeostasis. Therefore, when the individual decides to stop destructive behavior, the family balance is disrupted. Without intervention, the family may seek to return to its previous homeostasis or balance, which in this case includes the addict's destructive behavior.

The value of including the family in assessment lies in the multiple perspectives that become available when family members are included. No longer does the counselor only have the individual abuser's information about substance use; he or she now has access to a variety of perspectives about the individual's patterns of behavior. Additionally, the counselor has information concerning the family's problem solving skills, daily routines, and rituals, or more specifically, how the family maintains itself in the face of the dilemma.

It is important for the counselor to address the differences in the family's behavior patterns when an addict is using and when he or she is not using (wet or dry conditions). Developing a clear understanding of these behavior patterns can be essential in assisting the family in change.

ACIS counselors share with many other practitioners in the field the belief that meaningful counseling can only begin after an addict stops using mind-altering drugs (alcohol is a drug). Therefore, detoxification is a fundamental step for beginning treatment. The family counseling approach to detoxification includes a contract with the entire family for detoxification which involves not only abstinence for the addict, but also a shift in the self-regulating patterns of behavior that have developed in the family around the use of drugs.

When an individual stops using alcohol or other drugs, this new situation creates a crisis within the family. Sometimes other problems increase: an adolescent will begin to act-out, a physical illness will become worse, or another family member's drug use will worsen. ACIS' counselors approach the system recognizing the family's attempt at returning to balance and addresses these issues from that perspective. Just as the family learned to organize itself around the substance use, it must now reorganize itself when there is no substance abuse in the family. This reordering will require the restructuring of family rituals, roles, and rules. For many families, daily routines will be significantly altered without the presence of alcohol or other drug use. In the common case of long-term substance abuse, families may have no concept of "ways of being" other than those that are centered around the abuser's behavioral shifts.

Counseling focuses on the stress negatively affecting one or all areas of family closeness, family structure (rules and roles) and communication style. This mode of counseling can take a variety of forms. Sometimes it is best to see an entire family together for several sessions. Other times it is best to see family members separately, and then later on all together. This is determined on a case by case basis in order to achieve the best outcome.

ACIS understands the toll that substance abuse has on the whole family. Our counselors understand the problems related to chronic long term substance abuse, and addiction. They are prepared to assist individuals and families in the healing process through counseling using techniques that are shown to be effective. ACIS is open to serving clients who choose medically assisted, religious, 12-step, and cognitive approaches to recovery. Our counselors are prepared to encourage and empower clients in whatever healing process they prefer.

 

Group Counseling reveals that we are not alone in our challenges surrounding addiction. To be involved in a group of peers who are in a similar place not only increases one's understanding of the struggles around the problem, but also the variety of possible solutions available. Members listen to each other and openly provide each other feedback. Typically, groups have up to eight participants, one or two group leaders, and revolve around common topics that support recovery, like: impulse control, management of triggers, relapse prevention, anger management, communication, self-esteem, self-confidence, stress management, and other substance abuse issues. The content of the group sessions is confidential; members agree not to identify other members or their concerns outside of group.

Why does group therapy work?

When people learn to interact freely with other group members, they tend to recreate the same patterns of interactions that have proved troublesome to them outside of the group. The group therapy environment provides a safe confine to experiment with alternative ways of treating yourself and others that may be more satisfying. Many people feel they are somehow weird or strange because of their problems or the way they feel; it is encouraging to hear that other people have similar difficulties, and can move past them.

What do I talk about in group therapy?

Talk about what brought you to ACIS in the first place. Tell the group members what is most concerning you. If you need understanding, let the group know. If you think you need pointed feedback about something you say or do that seems to have a negative impact, let them know that also. It's important to tell people what you expect of them. Unexpressed feelings are a major reason people experience difficulties in recovery. Revealing feelings by self-disclosing is an important part of group and affects how much you will gain from the group experience. The most useful disclosures are those that relate directly to your present concerns. How much you talk about yourself is your decision; it will depend in part on your own comfort level and how much you are committed to change in a given area. If you have questions about what might or might not be helpful, you can always ask the group.

What is the nature of group therapy?

  1. Participation in the group
    • You control, and are ultimately responsible for, what, how much, and when you tell the group about yourself. The more you become involved, the more you are likely to benefit.
    • Most people find that when they feel safe enough to share personal issues, therapy groups can be very affirming and enriching.
    • Many people are helped by listening to others and thinking about how what others are saying might apply to themselves.

  2. Advantages of group therapy
  3. Ways that group therapy may be more enriching for some than individual therapy:

    • You can benefit from the group even during sessions when you say little but listen attentively to others. Most people find that they have important things in common with other group members, and as others work on concerns, you can learn much about yourself. In the group environment, others serve as mirrors that reflect aspects of yourself that you can recognize and explicitly choose if you want to modify or change.
    • Group members may bring up issues that strike a chord with you, which you might not have been aware of or known how to bring up yourself.
    • A natural process of enhanced acceptance of self and others occurs as one learns to relate more honestly and directly with others in the group.
    • The group provides an opportunity for personal experimentation, and it is a safe place to risk enough to learn more about yourself.

  4. Group atmosphere
    • The first group task is to establish an atmosphere of safety and respect; group leaders are trained to help the group develop an environment conducive to doing the work of personal growth.
    • An important benefit of group therapy is the opportunity to receive feedback from others in a supportive environment. It is rare to find friends who will gently point out how you might be behaving in ways that hurt you or others; this is a unique benefit of the group. The leaders will help members give feedback in a direct, yet respectful way so that you can understand and utilize your new awareness and experiences.

  5. Group therapy vs. individual therapy
    • A common myth is that groups are somehow second rate treatment. Group therapy is recommended when your counselor believes that it is the best way to address your concerns.
    • Your counselor can discuss the advantages or disadvantages of a group for your particular concerns and needs.

  6. Fears about beginning
    • It is common for people to experience some discomfort over the prospect of talking in group initially; this initial anxiety is quite normal as most people have never been exposed to a group therapy environment and don't know what to expect. Almost without exception, within a few sessions people get comfortable enough to interact in the group.

ACIS's counselors use fun exercises in groups, including role playing to give clients the practice they need to develop the coping skills and tools they can apply in the world. This increases their ability to choose positive action in a situation. Examples of role playing exercises are: Triggers and Planning for Sobriety, Trust and Addiction, Irrational Beliefs, Making Amends and Forgiveness, Guilt and Forgiveness , Expressing Anger, Anger and Communication, Relationships and Feelings, Stress and Supportive Relationships, Early Recovery and the Sexual Pull, Sex and Drugs, and many more exercises.

Why are role-play exercises used in treatment?

Clients can develop healthy behaviors by imitating counselors and recovering clients. They can also develop healthy behaviors and think through problems by acting out or role-playing the contrast between healthy and unhealthy actions.

Modeling, imitating others, and identifying with other people are complex behaviors that engage both the emotional "lower brain," or limbic system, and the intelligent "higher brain," or cerebral cortex. This "whole brain" engagement makes modeling and role play powerful tools for changing behavior.

Role-play exercises also offer people participating in a group a "safe haven" where members can practice and improve skills prior to trying them out in the real world.

Deciding which type of substance abuse counseling will work are highly personal decisions and should be based upon needs and circumstances. What worked for your neighbor, or even your twin sister, might not work out for you. The benefits of group therapy for substance abuse are many. First, group therapy sessions are a markedly cheaper option than individual sessions. There’s also the fact that meeting with other people who are facing the same struggles that you are can offer a “big picture” view that broadens your perception and puts your own problems into a different perspective. Furthermore, listening to other people talk about their addiction can help you come to terms with the fact that there is more than one way to deal with an issue. If the way you’ve been doing things in the past has failed, there are other options to try in the future. Finally, group sessions add the benefit not only of encouragement, but accountability. Not only will you build new relationships with others who are in the same challenging position as you, the participants can keep an eye out on one another and provide strength and support when needed.

 

Case management is an appropriate intervention for substance abusers because they generally have trouble with several aspects of their lives. This is especially true for those clients whose problems or issues can be overwhelming even for people not struggling with addiction. Among these special treatment needs are poverty, homelessness, responsibility for parenting young children, social and developmental problems associated with adolescence and advanced age, involvement with illegal activities, and more.

Case Management is a coordination of care with other professionals and is an essential part of treatment. Case Management consists of services that help clients receive needed medical, social, educational, and other services. This includes direct assistance with obtaining access to services, coordination of care, oversight of the entire case, and linkage to appropriate services. Case Managements includes: (1) assessment of the client to determine service needs; (2) development of an individualized integrated care plan; (3) referral and related activities to help the client obtain needed services; (4) monitoring and follow-up; and (5) evaluation.

Coordination of care with other professionals may include a psychologist, psychiatrist, primary care physician, dietician, lawyers, and/or other specialists. This all depends on the needs of each individual. In addition, case management may include finding a job, resume writing, help filling out an application, GED, college, volunteer work, sober housing, government assistance, treatment status reports and letters for court, and whatever is needed for an individual to be productive.

ACIS counselors use their expertise to identify options for the client, but the client's right of self-determination is emphasized. Once the client chooses from the options identified, the counselor's expertise comes into play again in helping the client access the chosen services. Case management is grounded in an understanding of clients' experiences and the world they inhabit --- the nature of addiction and the problems it causes, and other problems with which clients struggle (such as HIV infection, mental illness, or legal case). This understanding forms the context for the counselor's case management work, which focuses on identifying psychosocial issues and anticipating and helping the client obtain resources. The aim of case management is to provide the most flexible level of care necessary so that the client's life is disrupted as little as possible.

 

Counseling & Psychotherapy Theories

The study of counseling and psychotherapy theories encompasses a wide array of theoretical approaches, each with its own history, focus, strategies, and techniques. At ACIS, we believe at the core of each orientation are fundamental beliefs about the meaning of life and the ways people change. The approaches that may look similar to one another in practice originate from a different perspective on what drives therapy. We primarily work with clients from an Integrative Therapy approach. Our counselors combine elements from different theories to meet the unique needs of a client.

Counseling & Psychotherapy Theories drawn from, include:

Adlerian therapy

Its humanistic and goal oriented. It emphasizes the individual's strivings for success, connectedness with others, and contributions to society.

Behavior therapy

The counselor provides psychoeducation to understand how changing behavior can lead to changes in how a client is feeling.

Cognitive therapy

The focus is on thoughts to promote change.

Cognitive behavioral therapy

Comprises a variety of procedures, such as cognitive restructuring, stress inoculation training, problem solving, skills training, relaxation training, and others.

Constructivist approaches

The client is viewed as the agent of change, the therapist facilitates change, guided by faith in human resiliency and capacity for self-reorganization.

Dialectical behavior therapy

This approach works towards helping clients increase their emotional and cognitive regulation by learning about the triggers that lead to reactive states and helping to assess which coping skills to apply in the sequence of events, thoughts, feelings, and behaviors to help avoid undesired reactions.

Existential therapy

Focuses on what is meaningful to a client, development of self-awareness.

Family (systems) therapy

Addresses the structure and behavior of the broader family relationship system that forms the character of the individuals. That the change in behavior of one family member would necessarily influence the way that the family functions over time. The Family Systems approach looks at structural roles and rules, strategic functions, such as communication and problem solving patterns, and intergenerational -- acknowledges generational influence on family and individual behavior.

Feminist therapy: A multicultural approach

Both men and women have the opportunity to have their strengths valued, and build on inner resources toward higher self-esteem and personal empowerment.

Gestalt therapy

An experiential focus on the here-and-now, and understanding a client within their environment. Bring feelings to the surface and resolve existing conflicts.

Integrative therapies

The integrative approach refers to the infusion of a client's personality and needs - integrating the affective, behavioral, cognitive, and physiological systems within one person, as well as addressing social and spiritual aspects. Essentially, integrative counselors are not only concerned with what works, but why it works - tailoring therapy to their clients and not the client to the therapy.

Mindfulness-based cognitive therapy

Use of mindfulness meditation is effective at reducing cravings for substances that clients are addicted to. Addiction is known to involve the weakening of the prefrontal cortex that ordinarily allows for delaying of immediate gratification. The practice of mindfulness meditation has been shown to increase activity in the prefrontal cortex, a sign of greater self-control.

Motivational Interviewing

Is a method that works on facilitating and engaging intrinsic motivation within the client in order to change behavior. MI is a goal-oriented, client-centered counseling style for eliciting behavior change by helping clients to explore and resolve ambivalence.

Person-Centered therapy: Rogerian therapy

Talk therapy where the counselor's focus is on attitudes of empathy, congruence, and unconditional positive regard.

Positive therapy

In essence this approach doesn't just focus on the reduction of negative symptoms, but attempts to help clients realize their potential.

Rational emotive behavior therapy

It focuses on resolving emotional and behavioral problems and disturbances and enabling people to lead happier and more fulfilling lives.

Reality therapy: Choice theory

Counselor is nonjudgmental and encourages client to ask themselves whether specific behaviors are moving them towards their goals.

Relational therapy

Involves clients in a group process to examine bonding and boundaries.

Solution-Focused therapy

The counselor listens and responds to clients using their words, carefully tracking how they talk about their problems, and mirroring back the strengths and skills they already possess.

 

What Is the Counselor's Role?

The counselor serves a multifaceted role as collaborator, teacher, adviser, and change-facilitator.

Who Talks More?

In general, the client talks more. However, the counselor does not hesitate to offer education, advice, and guidance where appropriate.

How Directive Is the Counselor?

The counselor takes an active role, offering specific advice and direction, particularly during the early phases of treatment where immediate behavioral changes are required to establish and maintain abstinence.

How long will the counseling take?

Ideally, counseling is terminated when the problem that you pursued counseling for is resolved.

Will I need to take medications?

Being seen by a counselor for therapy does not necessarily mean you will need to take medications. Many addiction and psychological problems can be successfully treated without the use of medications. If you and your counselor decide that medications should be considered as a adjunct to counseling, your counselor will discuss referral options with you. You will need to see a physician (such as a psychiatrist) to be prescribed any medications. It is important to let your counselor know about any medications you have already been prescribed and whether you are taking them as indicated.

Do my parents have to know what we talk about during counseling?

No. Federal and state law prohibits us from acknowledging that you are a client or disclosing any information to your parents without your specific written permission. An exception to this rule is for minors under age 18. Although these individuals are generally afforded the same confidentiality protection as an adult, there are some limitations that a counselor will be happy to discuss with you. We do require that persons under age 18 have written parental (or guardian) consent to receive our services.

It often happens, however, that our clients find it very helpful for their counselors to speak with a parent or guardian. Furthermore, it is usually the parent or guardian, and not the client, who requests our services. However, it is up to you and your counselor to discuss what would work best in your particular situation. If you have any questions or concerns about confidentiality, feel free to bring them up with a counselor.

If I am in group therapy, how much personal information do I have to share?

You control what, how much, and when you share with the group. No one will force you to reveal your deepest, most personal thoughts. Most people gradually feel safe enough to share what is troubling them, and a group can be very helpful and affirming. However, you can also be helped by just listening to others and thinking about how what they are saying might apply to you.

If I think my friend (or a family member) needs help, how do I get him/her to come see or call you?

It can be very difficult when someone you care about is in pain. You might find yourself feeling helpless, frightened, frustrated or angry. It is very hard to make a person seek help if they don't want to or don't feel they need it, and counseling with an unwilling client is usually not very effective. Here are some things you might offer as a friend:

  • Let your friend know that you are concerned. Suggest that he or she make an appointment with a counselor to see if we can be of help. Try to phrase the communication using "I" language, rather than "You" language. For example, "I care about you and I am sad to see you are hurting" rather than "You are in trouble and need help."
  • Offer to sit with your friend while he/she makes an appointment.
  • Offer to accompany your friend to their first appointment, and either wait in the waiting area or go to the appointment with him/her.
  • Call ACIS yourself, and talk with a counselor about your worries about your friend. You will not need to tell the counselor your friend's name, and you do not necessarily even need to let your friend know you called. The counselor may be able to offer you suggestions about how to interact more effectively with this friend, as well as to manage your own feelings about the situation.
  • Search the web for information about your friend's problem(s), and pass it along to your friend. Invite him/her to compare the information, or talk about the information with a counselor.