The program curriculum at Diamond IOP is focused on relapse prevention, primarily integrating 12-Step recovery and the relapse prevention model developed by Terence T. Gorski, an internationally recognized expert on substance abuse and mental health.
The IOP curriculum includes the following educational topics:
Anger and Resentment
Anger can be a devastating relapse trigger. Patients need to learn to recognize the warning signs of oncoming anger and how to use calming techniques to deal with those situations in a positive manner.
Many people with addiction suffer from a lack of self-esteem. Assertiveness is closely related to self-esteem. When addicted people choose the path of recovery, they often need to rebuild self-esteem and that includes relying on their own assertiveness.
Addiction is a biopsychosocial disease. To achieve a lasting recovery, all aspects of the disease need to be addressed.
Codependency occurs when individuals who are not themselves addicted to drugs and alcohol are controlled by the addicted person’s behavior. Codependency is a kind of addiction around a relationship and typically involves enabling behaviors by the codependent that are promoting sickness, both in themselves and the addicted person.
Developmental Model of Recovery
Terence Gorski’s Developmental Model of Recovery (DMR) consists of six progressive stages—transition, stabilization, early recovery, middle recovery, late recovery, and maintenance. Each DMR stage has a primary focus. Having a primary focus for each stage doesn’t mean that other issues are ignored. It means that emerging problems are dealt with in the context of the current stage of recovery.
Family Systems in Addiction
“Addiction is a family disease that stresses the family to the breaking point, impacts the stability of the home, the family's unity, mental health, physical health, finances, and overall family dynamics.” – National Council on Alcoholism and Drug Dependence.
As patients start taking care of their emotional needs again in sobriety, emotions they may have been dulling for years tend to reemerge. Emotions often trigger physical responses linked to the reward circuit in your brain. Learning what feelings people experience when they are triggered may help. Mindfulness practices like yoga, meditation, and breathing exercises can put patients more in touch with their body, helping them recognize triggers when they become active.
Guilt and Shame
In the early stages of recovery, many addicts are tormented by feelings of guilt and shame. As people enter treatment and remain sober, they finally realize the hurt they caused themselves and their loved ones. This tends to cause negative feelings unhelpful for recovery. The key to overcoming feelings of guilt and shame is to learn coping skills that enable patients to work through these feelings and use this process to strengthen their recovery.
Studies show that women who abuse drugs are less likely than men to seek help. They are often the main caregiver in their family, taking care of children and sick relatives. Using drugs and alcohol to get relief from painful emotional states when they are expected to take care of the family carries a strong stigma. Often, trauma caused by domestic violence and/or sexual abuse is the driver behind the addictive behavior.
Men have gender-specific issues, too. Males start using drugs at an earlier age. Men abuse drugs more often and in larger amounts. Males are more likely to abuse alcohol and tobacco. Men are more likely to engage in binge drinking. Many men have been brought up to assume they have to be strong in all situations and always have it together. This may interfere with their ability to be open and honest in addiction treatment.
Phases and Warning Signs of Relapse
Relapse warning signs are progressive. Once initiated, they can cascade like a row of falling dominos. They include denial, avoidance, confusion, depression, and behavioral loss of control. If recognized early enough and countered relapse can be avoided.
Post-Acute Withdrawal Symptoms
After the initial acute withdrawal symptoms during detox, patients often experience what’s known as post-acute withdrawal syndrome (PAWS). During this second stage of withdrawal, patients typically have fewer physical but more emotional and psychological withdrawal symptoms, including resurgent cravings. The most common PAWS symptoms are mood swings, anxiety, irritability, fatigue, low energy, difficulty concentrating, and disturbed sleep.
Defenses Against Relapse
In order to avoid a relapse, people in recovery need to learn and strengthen coping skills. They enable people in recovery to utilize specific tactics to counter relapse triggers before they escalate. Coping skills allow people to recognize and respond correctly to relapse warning signs.
Spirituality in Recovery
For many, spirituality seems far removed from science-based psychology and psychiatry, but many addiction professionals regard addiction as a biological, psychological, social and spiritual disorder. Recovery can also be seen as an opportunity to reexamine core beliefs and start living life in a more meaningful way.
Developing Sober Support Systems
Only you can do it but you cannot do it alone. People in recovery need a support system, a network of helpers they can rely on when things get tough. In 12-Step facilitation, the central role in that system will be the sponsor. But it could also include meetings, religious communities, family members, and therapists.
Common Fears in Early Recovery
Recovery requires courage and determination. The are lots of fears to conquer: the fear of feeling unwell without drugs or alcohol, the fear of change—even if it is a change for the better, the fear of feeling again after years of suppressing unwanted negative feelings with substances. There is also the fear of failing at recovery as well after many perceived failures in the past.
Grief and Loss
The life of an addict is completely dominated by substance use or behavioral addiction. Radically changing that situation can be experienced as a loss even though a dangerously unhealthy behavior is abandoned. This loss may be processed in a grief-like manner. The grief process and recovery share important similarities. Both start with denial and are only resolved in the acceptance stage.