Tag Archives: substance abuse

Introducing the Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook at the Houston Chapter of TAAP Spectrum 2011 Annual Conference

The Thirty-Eighth Annual Houston Chapter TAAP Conference on Addiction Studies
September 22 – 24, 2011

TAAP (Texas Association of Addiction Professionals)

Doubletree Hotel at Bush International Airport
15747 JFK Boulevard – Houston, Texas  77032

DBT-CBT for Co-Occurring Disorders and Destructive Coping Behaviors: A Workbook-Based Group Therapy Program Combining DBT, CBT, and AA Recovery Principles

This 1.5 CEU workshop will be presented by Melanie Gordon Sheets, Ph.D.

from 10:30 – 12:00 pm on Friday, Sept 23th, 2011.

This workshop will provide an introduction to the workbook based DBT-CBT recovery program, a modified DBT program for individuals with affective disorders, personality disorders, and destructive coping behaviors, such as substance abuse, self-injury, suicidal threats, verbal/physical aggression, eating disorders, overshopping, etc. Some key recovery concepts, skills, techniques, and understandings will be discussed and several program worksheets will be reviewed.

Training Objectives:

  • Participants will gain information about the structure of the DBT-CBT program, target populations, problems addressed, and utility in various treatment settings and by various providers including peer support specialists.    
  • Participants will understand the basic dynamics of Emotional Mind which drive emotional dyscontrol, relief-seeking destructive coping behaviors, and the Cycle of Suffering.
  • Participants will gain familiarity with the use of the Wise Mind Worksheet to work through destructive emotional states, thoughts, and impulses to facilitate constructive problem-solving and life-enhancing coping responses.
  • Participants will gain familiarity with the structure and use of a “Game Plan” (a client developed individualized recovery plan) including the use of Rational Mind and Wise Mind to challenge recovery sabotaging Emotional Mind “excuses” and Rational Mind “obstacles.”

Dr. Sheets is the Chief Psychologist at Big Spring State Hospital, the Co-Director of the Lone Star Psychology Residency Consortium internship program, a Clinical Assistant Professor at Texas Tech University School of Medicine, Department of Psychiatry, and the author of the DBT-CBT “Out-of-Control” recovery workbook. She began her career as a mental health technician at Richardson Medical Center in 1985 helping individuals with agoraphobia, substance abuse, depression, Bipolar Disorder, and Borderline Personality Disorder. She earned a doctorate in clinical psychology in 1992 from Texas A&M University where her training emphasized psychoanalytic and Jungian psychotherapy methods. She completed her pre-doctoral internship at the Dallas VA Medical Center in the PTSD Clinic, the Substance Abuse Unit, and Inpatient Psychiatry units. She has conducted the DBT-CBT Group since 2004 for forensic, VA, and general psychiatric inpatients.

The full title of the therapy workbook is “Out-of-Control: A Dialectical Behavior Therapy (DBT) – Cognitive-Behavioral Therapy (CBT) Workbook For Getting Control of Our Emotions and Emotion-Driven Behavior (targeting drug / alcohol abuse, bipolar disorder, borderline personality disorder, depression, anger, cutting, and codependency recovery)”published by Recovery Works Publications (2009).

Dr. Sheets will be presenting on the DBT-CBT Workbook program at the North Texas State Hospital Forensic Conference in October, 2011.  Details will follow.  

(click here to visit the Houston Chapter website)

TAAP is a state affiliate of the national organization, “The Association for Addiction Professionals” (NAADAC), formerly known as the National Association for Alcoholism and Drug Abuse Counselors.   The name change reflects the increasing variety of addiction services professionals: counselors, administrators, social workers and others, who are active in counseling, prevention, intervention, treatment, education and research.

For more information about TAAP, visit their website at:  http://www.taap.org

For more information about NAADAC, visit their website at:
http://www.naadac.org


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Why We Relapse: Desperate for Peace in a World of Emotional Turmoil

I responded today to a LinkedIn discussion started by Elisabeth Davies, MC of Bright Alternatives, Inc.  and the author of “Good Things, Emotional Healing Journal: Addiction.”  The discussion topic was, “Is relapsing with unhealthy substances an attempt to get more peace of mind? Being so passionate about this recovery topic, here’s my long-winded response!

“For many, yes. Many use substances as a coping behavior to help bring their emotional level to a more tolerable or comfortable level. Also, returning to such a behavior reduces the extreme tension of wanting to do it and not allowing ourselves to…thus, the experience of immediate relief or peace in-the-moment. To help us to feel better about relapsing, we’ve probably come up with all types of reasons (emotion-driven lies) as to why it is okay to do and would help us…and how we can also quit again when life settles down, etc…unless of course, it is a major emotional reflex to an immediate stressor and we do it VERY impulsively…without giving it much thought.

Relapsing on substances is little different than wolfing down a big bag of cookies or scoops n’ scoops of ice cream, or starting to smoke again, a “forbidden” sexual encounter….whatever. I think these types of behaviors have to do with attempts to bring an “out-of-control” emotional mind into control…so that we feel better and more comfortable in the emotional moment. It is all about being desperate for relief and doing what brings us relief, often immediate relief. It’s a desperate way to experience a sense of emotional, psychological, and physical peace IN-THE-MOMENT…although we’ll have hell to pay when we come to (when the emotional moment passes and rational mind picks up strength).

When we come to and realize what just happened and are faced with the consequences of our behavior…and the unresolved problem…we feel bad again…and then we may continue destructive coping….chasing “peace in the moment”…When we use destructive coping behaviors to deal with our pain and problems, we enter the Cycle of Suffering. Our problems multiply and intensity and we go through a period of increased pain and suffering as a result.

I believe most people use destructive coping behaviors to some degree (e.g., overworking, oversleeping, physical aggression, yelling, throwing fits, being rude and ugly, ‘always speaking our mind”, lying, gambling, obsessive exercise, cheating, sleeping around, codependency, procrastination, smoking, prescription meds, alcohol, overeating or eating the desired “poison foods” for us, being hyperreligious, narcissistic….and the list goes on and on.) I actually tell my patients that it’s “normal” to be “abnormal” and entirely abnormal to be so perfectly normal and in control of ourselves. We all do some destructive coping behaviors and the healthier or more in recovery we are…the less we do these things…and the more we work VERY hard to stay in control of our emotions, behaviors, and our addictions of choice….and the more we choose life-enhancing coping behaviors instead.

I’m obviously very passionate about this…it’s one of those, “been there, done that, still doing that…having to fight for recovery at times to stay in control…and not to get too far out of control” type of things for me. I believe that when we are in recovery…we remain “works in progress.” Sometimes it’s a daily battle and sometimes, an occasional battle. We’re emotional critters and creatures of habit…and when we hurt or are feeling desperate and “out-of-control”…we tend to fall back into old patterns of relief-seeking behaviors…or to certainly think about doing them!

We’re emotional critters and creatures of habit…and when we hurt or are feeling desperate and “out-of-control”…we tend to fall back into old patterns of relief-seeking behavior…or to certainly think about doing them!”

And you know the more we think about doing them…the more likely we are to finally do them. That’s because the tension is building…we want…and we won’t allow ourselves to have…and we want…we tell ourselves “NO”…and we want…and we’re tired of the pain, problems, tension, and frustration…and we become desperate for relief and peace…that we finally do what we keep trying not to do…and we relapse. Have you “been there, done that?” Have you been through this struggle? It’s a battle of the minds, Emotional Mind vs. Rational Mind and Wise Mind. It’s a battle of wills…willingness vs. willfulness. Which recovery skills do you use to get through the “fixing to relapse” moment? Do you still have these moments?

I believe that one of our major recovery tasks is to learn ways to keep our Emotional Mind in control and to tame our Emotional Mind when it is getting out-of-control. That’s my biggest recovery task…and it’s always a battle of the mind states and a battle of will. Sometimes, I grow tired of the battle and dealing with my emotional, willful self. At those tired, weak moments, I remind myself….”Mel, what do you want…peace and stability or chaos and pain?” Isn’t it horrible that you have to parent yourself even when you’re a grown-up!?

Link to the LinkedIn discussion

Link to Elisabeth’s book:  “Good Things, Emotional Healing Journal: Addiction on Amazon

Link to Elisabeth’s blog