Pendekatan Kaunseling Dalam Rawatan & Pemulihan Penagihan Dadah

PENDEKATAN KAUNSELING
DALAM RAWATAN & PEMULIHAN

PENAGIHAN DADAH
OLEH DR. MOHAMAD ISA BIN AMAT
UNIVERSITI SAINS ISLAM MALAYSIA
PENGENALAN
• Pensyarah Kanan bidang kaunseling
• Lulusan PhD dari UniWyo (USA), Master (UPM), Degree
(USIM)
• Bidang tumpuan: Kaunseling Ketagihan, Penyeliaan
Kaunselor, Rawatan & Pemulihan Dadah & Bahan
• SME AADK, EXCO Malaysian Substance Abuse Council,
Global Trainer Colombo Plan
3
Substance abuse counseling
• Substance abuse counseling is a combination of treatment and support to
help people break free from drug or alcohol addiction. This specific type of
therapy is often a key part of rehabilitation programs so clients can
overcome substance dependence mentally and emotionally. Clients will
work with a licensed addiction counselor or substance abuse counselor
(titles vary among states, but the therapeutic goals remain the same) in a
clinical setting to address issues like mental health, behavior patterns and
treatment options.
Substance abuse counseling may involve:
• Talk therapy sessions

• Discussing the causes of addiction
• Positive coping strategies
• Developing treatment goals and plans
• Practicing skills and behaviors necessary for recovery
• Recommendations for 12-step programs or groups
ADDICTION
COUNSELING
COMPETENCIES
MODEL
TRANSDISCIPLINARY FOUNDATION I: UNDERSTANDING
ADDICTION
•COMPETENCY 1:
•Understand a variety of models and theories of addiction and other
problems related to substance use.
•COMPETENCY 2:
•Recognize the social, political, economic, and cultural context within
which addiction and substance abuse exist, including risk and resiliency
factors that characterize individuals and groups and their living
environments.
•COMPETENCY 3:
•Describe the behavioral, psychological, physical health, and social
effects of psychoactive substances on the person using and significant
others.
•COMPETENCY 4:
•Recognize the potential for substance use disorders to mimic a variety
of medical and mental health conditions and the potential for medical
TRANSDISCIPLINARY FOUNDATION II: TREATMENT
KNOWLEDGE
COMPETENCY 5:
• Describe the philosophies, practices, policies, and outcomes of the most
generally accepted and scientifically supported models of treatment, recovery,
relapse prevention, and continuing care for addiction and other substance-
related problems.
• COMPETENCY 6:
• Recognize the importance of family, social networks, and community systems in
the treatment and recovery process.
• COMPETENCY 7:
• Understand the importance of research and outcome data and their application
in clinical practice.
• COMPETENCY 8:
• Understand the value of an interdisciplinary approach to addiction treatment.
TRANSDISCIPLINARY FOUNDATION III: APPLICATION TO
PRACTICE
• COMPETENCY 9:
• Understand the established diagnostic criteria for substance use
disorders, and describe treatment modalities and placement criteria
within the continuum of care.
COMPETENCY 10:
• Describe a variety of helping strategies for reducing the negative
effects of substance use, abuse, and dependence.
• COMPETENCY 11:
• Tailor helping strategies and treatment modalities to the client’s stage
of dependence, change, or recovery.
COMPETENCY 12:
• Provide treatment services appropriate to the personal and cultural
identity and language of the client.
TRANSDISCIPLINARY FOUNDATION IV: PROFESSIONAL
READINESS

• COMPETENCY 18:
• Understand diverse cultures, and incorporate the relevant needs of
culturally diverse groups, as well as people with disabilities, into clinical
practice.

• COMPETENCY 19:
• Understand the importance of self-awareness in one’s personal,
professional, and cultural life.
• COMPETENCY 20:
• Understand the addiction professional’s obligations to adhere to
ethical and behavioral standards of conduct in the helping relationship.
Continuum of
Care
Defining Therapeutic Groups in Substance
Abuse Treatment
• All groups can be therapeutic. Anytime someone becomes
emotionally attached to other group members, a group leader, or the
group, the relationship has the potential to influence and change that
person. Identifying a group as “therapy” does not imply that other
groups are not therapeutic.
Modifying Group Therapy To Treat Substance
Abuse
• It requires specific training and education for therapists so that they fully understand therapeutic group work
and the special characteristics of clients with substance use disorders.
• The importance of understanding the curative process that occurs in groups cannot be underestimated.
• Individual therapy is NOT equivalent to group therapy. Some principles that work well with individuals are
inappropriate for group therapy. Using the wrong approach may lead to several undesirable results:-
* First, the rich potential of groups––self-understanding, psychological growth, emotional healing,
and true intimacy–– will be left unfulfilled.
* Second, group leaders who are unfamiliar with and insensitive to issues that manifest themselves in
group therapy may find themselves in a difficult situation.
* Third, therapists who think they are doing group therapy when they actually are not may observe
the poor results and conclude that group therapy is ineffective.
Modifying Group Therapy To Treat Substance
Abuse….cont’
• Group therapy also is not equivalent to 12-Step program practices. Many therapists who lack full
qualifications for group work have adapted practices from AA and other 12-Step programs for use in
therapeutic groups.
• AA and other 12-Step programs are not group therapy. Rather, they are complementary components to the
recovery process.
• 12-Steps programs can help keep the individual who abuses substances abstinent while group therapy
provides opportunities for these individuals to understand and explore the emotional and interpersonal
conflicts that can contribute to substance abuse.
• Progress toward optimal group therapy has also been hindered by the misconception that group therapy with
clients who have addictions does not require specially qualified leaders. This notion is false.
• “Why is group therapy so effective for people with addictions?” We already have part of the answer, and it
lies in the individual with addiction, a person whose character style often involves a defensive posture
commonly referred to as denial. Addiction is, in fact, frequently referred to as a disease of denial.
5 models of group therapy currently used in
substance abuse treatment
•Psychoeducational groups, which teach about substance abuse
•Skills development groups, which hone the skills necessary to break free of addictions.
•Cognitive–behavioral groups, which rearrange patterns of thinking and action that lead to addiction.
•Support groups, which comprise a forum where members can debunk each other’s excuses and
support constructive change.
•Interpersonal process group psychotherapy (referred to hereafter as “interpersonal process groups”

or “therapy groups”), which enable clients to recreate their pasts in the here-and-now of group and
rethink the relational and other life problems that they have previously fled by means of addictive
substances
Cognitive Behavioral Groups
• CBT groups are well established part in S.U.D treatment and are particularly
appropriate in early recovery (ER).
• Purpose: CBT group conceptualized dependency as a learned behavior that is
subject to modification through various intervention including identification of
stimuli associate with specific addictive behavior, avoidance of such stimuli,
development of enhanced contingency management (CM) strategies, and
response-desensitized
• CBT group works to change learned behavior by changing thinking patterns,
beliefs, & perception.
• CBT group also work to develop social network that support continued abstinence
so the person with dependency aware of behavior leads to relapse and develop
strategies to continue in recovery.
Cognitive Behavioral Groups..cont’
• Changing some errant (deviant) beliefs on inviduals entering
recovery:-
“ I am failure”
“I am different”
“ I am not strong enough to quit”
“I am unlovable”
• Changing such cognition and belief may lead a greater opportunities
to maintain sobriety and recovery.
Cognitive Behavioral Groups..cont’
• Principal characteristics:
• CBT group for S.U.D problem, the leader focus to provide structured
environment within which group member can examine the behaviors,
thoughts, & beliefs that lead their maladaptive behavior.
• Treatment manual provide specific protocols for intervention
techniques.
• Most CBT group emphasizes on structure, goals orientation, and
immediate problem
Example of CBT Group: Women with PTSD
and substance abuse problem; the design
• Educate clients about the 2 disorders
• Promote self-control skills to manage over-whelming emotions
• Teach functional behaviors that may have deteroriated as a result of
disorders
• Provide relapse prevention training
Example of CBT Group: Women with PTSD and substance
abuse problem; the characteristics of program-
• Uses a model design for 24 sessions, in which 3-10 members, meeting 2X each
week, for 3 months, in 90 minutes group meeting.
• Its ER oriented with strong focus on coping skills to gain control over symptoms.
• Has homogenous membership (all men @ women)
• Includes 6 session unit on relationships and themes; such as Safety and Self
Protection, & Reaching Out for Help.
• Uses educational devices to promote and rapid and sustained learning of
materials; visual aids, role preparation, memory improvement technique, written
summaries, review sessions, homework, audiotapes of each session
• Focus on both disorders with instruction on stage of recovery to motivate
members to achieve abstinence and control over PTSD and its symptoms.

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PENDEKATAN KAUNSELING

DALAM RAWATAN & PEMULIHAN

• Talk therapy sessions

•Interpersonal process group psychotherapy (referred to hereafter as “interpersonal process groups”

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