Modeling The cornerstone of modeling is role-playing. Stephanie may very well be intimidated by modeling. Her distaste for acting out circumstances and preference for solitary work or working with her therapist in a one-on-one setting may mean that encouraging modeling may be detrimental to Stephanie’s treatment plan. Conditioning Conditioning relies on the use of positive reinforcement to encourage particular behaviors. Stephanie has a history of shyness and lack of confidence. She may benefit from the support and encouragement that are central to conditioning. Systematic Desensitization Systematic desensitization may or may not be a useful treatment choice for Stephanie. Central to the practice of systematic desensitization is the ability of the adolescent to imagine a frightening situation while the therapist employs techniques to help with relaxation and the attainment of coping skills. Since this is a solitary intervention that relies on interaction with the therapist, Stephanie may be willing to attempt to use this type of therapy. However, if she has difficulty using imagery and imagination as part of the therapeutic process, systematic desensitization will probably not be effective for her. In summary, cognitive behavioral therapy consists of multiple strategies. The therapist and patient must work together to determine which of these strategies are most likely to facilitate achievement of desired outcomes. Regular evaluation of the effectiveness of the treatment plan is critical, since methods thought to be effective might not be, and methods that were originally rejected may ultimately prove to be effective. management, school interventions, drug counseling, and media. Multisystemic therapy also addresses the subsystems of the client’s peers, schools, juvenile courts, and neighborhoods. Guiding principles for using multisystemic therapy include the following (SAMHSA, 2021b; Wilkens & Kosanke, 2015). ● Assess to find a “fit” between the problem and the systemic context ● Therapeutically emphasize a strengths perspective, focusing on the positive, not just the problem ● Stress that interventions must promote responsible behavior among family members ● Be present-focused and action-oriented, targeting specific, well-defined issues ● Target sequences of behavior within and between multiple systems ● Be developmentally appropriate and fit the needs of the youth ● Require daily or at least weekly effort on the part of the family ● Evaluate the efficacy of the interventions from multiple perspectives ● Promote treatment generalization and long-term maintenance of therapeutic change way that maintains ongoing recovery, 12-step programs offer a haven, a community, and a culture that encourages abstinence, sober or clean living, and mutual support. In this respect, many adolescents use AA, Narcotics Anonymous (NA), Cocaine Anonymous (CA), and similar programs as their relapse prevention mechanisms.
A variety of techniques are associated with cognitive- behavioral therapy. These techniques have been successful treatment strategies for a variety of conditions, including SUD. However, some may be better than others, depending on the individual patient. Stephanie has informed her therapist that she dislikes group settings and prefers individualized therapy. A review of some cognitive- behavioral therapies helps to identify which ones may be most appropriate for Stephanie. Behavioral Homework Assignments Stephanie has a deep desire to be an academic success. She prefers to work alone or in one-on-one settings with her therapist. Behavioral homework assignments are a good fit for Stephanie. She is likely to complete assignments and use the assigned homework to determine what responses she could make in situations that trigger her alcohol use. Cognitive Rehearsal Cognitive rehearsal is not the best option for Stephanie. She has expressed a dislike of group work and what she calls “play acting.” Acting out (role-playing or rehearsing) various difficult situations may not be therapeutic for Stephanie. It is possible that Stephanie may try cognitive rehearsal in a one-on-one setting with her therapist, but it is unlikely to be of the most help to her. Journaling Journaling may significantly help Stephanie. Using the written word to express feelings, concerns, and thoughts may appeal to Stephanie’s academic orientation and preference for working alone. Journaling can help Stephanie to gain insight into her thoughts and feelings about social environments and the impact of her alcohol use. Family Therapy Family therapy presupposes that an adolescent is rarely self-referred and that the parents (if available) try to assert control over the adolescent’s behavior as much as possible. This treatment considers the youth’s behavior to be an indication of the entire family’s symptoms. The approach involves setting boundaries, addressing problem relationships, and focusing on emotional concerns. Family contracts, parenting strategies, and communication skills are taught. It is important to recognize that sometimes the problem’s precipitants lie within the family. In fact, therapists note that the “identified patient” (often the adolescent) may be the strongest family member, acting as the “red flag” for the family to get the help it needs. Divorce, neglect, drug addiction, and other parental factors can adversely affect the young client and occasionally require referral to a family therapist. For this reason, family therapy is commonly indicated. Among the evidence-based approaches to drug abuse treatment recommended for adolescents by the National Institute on Drug Abuse (NIDA) is multisystemic therapy, with outpatient or partial hospitalization variations called multidimensional family therapy (SAMHSA, 2021b; Wilkens & Kosanke, 2015). This therapy combines family intervention and community-based treatment approaches, such as case 12-Step Models Adolescents’ tendency to strive for peer approval helps to make group meetings that include fellowship an effective treatment. While treatment centers have “aftercare” for those who have successfully completed their course of treatment, adolescent substance users are most vulnerable to relapse after they “graduate” from such programs. For those seeking to integrate back into everyday life in a
EliteLearning.com/Social-Work
Book Code: SWUS1525
Page 104
Powered by FlippingBook