A Master’s MP 2015.pdf · Figure 2. Brain Functions Adlerian Approaches Ansbacher and Ansbacher (1956) stated that Individual Psychology points out that all behaviors of a human

Running head: COD AND TREATMENTS 1

Master's Project

Co-occurring Disorders and Treatments

A Master’s Project

Presented to

The Faculty of the Adler Graduate School

__________________

In Partial Fulfillment of the Requirements for

the Degree of Master of Arts in

Adlerian Counseling and Psychotherapy

__________________

By:

Starla Moore

October, 2015

COD AND TREATMENTS 2

Table of Contents

Introduction ................................................................................. Error! Bookmark not defined.

The COD Manual the Results ........................................................................................................... 3

Literature Review ..................................................................................................................................... 6

Stress and the Brain ............................................................................................................................ 6

Adlerian Approaches .......................................................................................................................... 8

Art Therapy ......................................................................................................................................... 11

Methods ..................................................................................................................................................... 13

Integrated Dual Disorder Treatment ........................................................................................ 13

Brain function ..................................................................................................................................... 15

Adler Therapeutic Approach to Addictions ............................................................................ 16

Cognitive Behavioral Therapy ..................................................................................................... 18

Dialectical Behavior Therapy ....................................................................................................... 19

Discussion ................................................................................................................................................. 20


Co-occurring Disorders and Treatments

Counselors have dialogues with clients and apply different concepts of behavioral

change, but do not assess the stages of change a client is presently in. Oftentimes

counselors dialogue with client(s) is for goal setting but have difficulty finding tools to

support their ideas. Clients often depart from a talk therapy session and forget relevant

information that was discussed in the session soon after leaving the session. The Co-

occurring Disorder Manual (COD) is a tool that can assist counselors with practical

application, evidence-based practices, and best practices when addressing the goals of the

client. Learning how to create an action plan and having a tool or tools to use for

preparation of the action plan for the next session is critical to the therapeutic process.

The COD manual can assist the client in the application of new skills in real world

situations after talking in session.

The COD Manual the Results

Learning different approaches, techniques, styles, and attributes of change can help

the counselor to teach the client how to develop resilience and appropriate coping skills.

The goals that are set in session to address client’s mental or chemical imbalance are

practical nevertheless, the COD manual gives applications for the client to apply. Each

client the counselor encounters has a different story to tell and the way that story is told is

different. For example: humans may live in the same habitat yet the way they understand

the world and develop is different. A counselor’s role is to adjust his or her approach to fit

the need of the individual client. The COD manual is designed to help the therapeutic

process and give the counselor tools to use to assist their client in their stages of change.


Assigning the COD manual can be helpful in giving the client new ways to learn

how to use all parts of their brain. Worksheets in the COD manual will walk a person

through different stages in life. The cognitive behavioral therapy (CBT) section of the

COD manual’s focus is on minimizing stress, stress triggers, stress management, and

assessing the stress in a person’s life. Each worksheet helps the client to begin to retrain

their brain which gives balance to the decision making process. Moreover, A person

under stress does not have the ability to make rational decisions; therefore, the COD

manual’s CBT section can aide in that process. CBT’s focus is on the cognition and

thought process. The COD manual helps a person to think more rationally and use the

logical, creative, intuitive, and emotional parts of the brain. There are a variety of clients

that do not understand how effective using all parts of their brain can be; because the

potential has been masked by their mental or chemical health disorder. By use of the

COD manual the counselor could teach many clients how to begin to use their brain

functions to its fullest ability.

The COD manual incorporates CBT, Dialectical Behavior therapy, Integrated Dual

Disorder Treatment, and Adlerian Therapy in the formation of the worksheets to train the

brain to be utilized entirely. In this literature review a discussion on: stress, its effect on

brain functioning, and different treatments used to address mental and chemical health

issues will be observed.


Figure 1. The Whole Brain


Literature Review

Stress and the Brain

Understanding the different origins of stress could assist the individual in

managing distress. Managing stressors and identifying how they affect life could help

individuals to cope with situations better. Phelps 2004 study, talked about the

hippocampal complex forming episodic representations of the emotional significance and

interpretation of events, which can influence the amygdala response when emotionally

stimulated. Individuals that are able to identify their stressors aids in the relief of

emotional dismay, which helps them balance and cope with distress better. Stress is the

body’s response to distressing situations in life (NIMH, 2015). When using drugs or

alcohol the ability to think relationally is hindered. In addition, when suffering from a

mental disorder the ability to rationalize thoughts are suppressed by the disorder. For

Example: According to Rooney, (2015) Adler saw that the feelings of inferiority instilled

or absorbed in childhood could have a lasting negative effect on the adult individual.

Mosak and Maniacci, (1999, p. 79) felt that “stress is the nonspecific response of

the body to any demand made upon it . . . it is immaterial whether the agent or situation

we face is pleasant or unpleasant; all that counts is the intensity of the demand for

readjustment or adaptation. Decision- making is also affected by the body’s reaction to

distress. According to Bechara et al., (2011), advantageous decision-making requires the

contribution of multiple cognitive systems involved in at least two separate but related

processes. Individuals that are under distress have a hard time making rational decisions

perhaps it is because of the emotional instability. “Decision-making is believed to be


involved in areas of the brain which is part of emotions and memory” (Bechara, Gupta,

Koscik, & Tranel, 2011, p. 1).

In addition, by being proactive with stressors in a persons life; the individual have

to be able to address and identify those stressors and make appropriate decisions based on

rational thoughts.

The creative and intelligent brain is the higher brain, which separates us from the

primitive species. It is called the CEO or executive center. It sits over the

primitive brain exerting executive control. It is responsible for higher human

function: judgment, planning, moral reasoning, and control of the attention. In

addition, when were under stress, the prefrontal cortex shuts down? Moreover,

when under chronic stress, it shuts down chronically and it fails to develop

properly. (Hagelin, 2014)


Figure 2. Brain Functions

Adlerian Approaches

Ansbacher and Ansbacher (1956) stated that Individual Psychology points out that

all behaviors of a human being fits into a unit and is an expression of the individual’s life

style. For example: Identifying a person’s perception on life to help them think

relationally helps in finding a balance between reality and fiction. Adler stated, that in a

person’s lifetime they develop a sense of what life should and should not be (Dinkmeyer

& Sperry, 2000). Based on this theory, an individual forms a fictional final goal, which is

based off their perception of life. Adler also believed that individuals base their style of


life on a private logic, which is the way one perceives the world to be based on the

different relationship engaged. A relationship guides a person behavioral view in a good

or possibly bad way of what life is to be. An individual’s private logic of different

relational or irrational interaction in life, directly affects, the way one responds or reacts to

those situations. After those relationships fall apart, it brings on stress, which gears one in

an unconscious goal driven direction. It is hard to manage a life style that one perceives

as positive (Mosak & Maniacci, 1999). For example:

Each person develops in early childhood a fictional image of what she or he needs

to be like, safe, superior, feeling belonging, and so forth. The actualization of the

fictional image becomes the central goal of the lifestyle and, therefore, the

individual is limited in their ability to interact with others. (Dinkmeyer, Dinkmeyer

& Sperry, 1987) ajor depression is an episode of sadness or apathy along with ot

Ansbacher and Ansbacher (1956), stated that the child builds up his whole life,

which we have called the concrete style of life, at a time when he or she has neither an

adequate language nor adequate concepts. Those inadequate beliefs steer one's life in an

inadequate lifestyle that cause dilemmas as one develop into adulthood. Striving for

superiority (private logic) leads to the impossible and one ends up stressed, depressed, and

loses hope in what life should be. As the child grows and develops, the sense of life is

formed, and without a clear interpretation of how life should be, then one ends up

confused and unsure. Adler believed that one seeks to find social significance throughout

their life; depending on the interactions, a perception of what life should be is created.

“Once the goal of the superiority of life has been made concrete, there are no mistakes

made in the style of life” (Ansbacher & Ansbacher, 1956, p. 188).


Adlerian Therapy tends to move individuals towards their driven goal once the

interpretation of one's direction is formed to normalcy. For example: “Every problem

child, every neurotic, every drunkard, criminal, or sexual pervert is making the proper

movements to achieve what he takes to be the position of superiority” (Ansbacher &

Ansbacher, 1956, p. 188). When people do not do what situations calls for they are

operating from their private logic (Dinkmeyer et al., 1987). These situations determine

the way we make rational decisions. In this theory, Adler believed that plans; goals, and

experiences affect the way we act in a certain situation. Our behaviors stem from our

thought processes, and if they are not operating correctly, then our thoughts are irrational

(Dinkmery & Sperry, 2000).

A person’s perception could lead to a misconception of a sense of reality. Adler

believed that individuals would conform their behavior and thoughts in ways that are

congruent to their goals, anything that is most comfortable for them. Adler felt that all

individuals experienced pluses and minuses in life. The counselor’s aim is to provoke the

clients thought process to engage them in positive movement towards a self-selected goal.

The ability to become resilient is the goal thus pluses in life aides in positive movement.

A minus in life is what cause the individual to adapt into a fictional life style that aids to

the mental or chemical disorder. Individuals suffering from a mental or chemical disorder

where positive movement is not allowed until that person wakes up out of a neurosis.

Neurosis is the failures, lack of support, discouragement, and no sense of belonging

(Dinkmeryer & Sperry, 2000). When a person is in a neurotic state of being their ability

to think relationally is altered by the anxiety and the constant state of worry. A

counselor’s obligation in a neurotic situation is to build a positive therapeutic relationship


to help the individual move toward their pluses in life. Neurosis affects a person’s

personality and causes mental, chemical, or physical disruptions.

Furthermore , in the neurotic state, counseling is an opportunity to teach coping

skills to the client for address mental or chemical inappropriate behaviors. Adler believed

that all individuals strive to belong to something throughout the lifespan. By belonging,

one foundation is formed no matter the consequence. According to Dinkmeyer et al.

(1987), a counselor’s knows that a person’s ability to learn, yet not able to move forward,

is still a factor in influencing the lifestyle of that individual.

More often than not, a individual purpose in life is to connect with others, not

being accepted changes the idea of self, which depletes ones perception and life is

unfulfilled. The desire to be a part of or accepted into the significant group or groups is

critical and fulfilling. The lack of connection or acceptance in the significant group or

groups forces one to end up in a neurotic state that leads to maladaptive coping

mechanisms, to deal with unwanted feelings. Moreover, Adler stated that all human

beings behaviors have a social meaning; but argued that behavior is apart of a desire to be

socially competent. Dinkmeyer and Sperry, (2000), stated that human are dependent on

each other for survival; those interactions helps our behaviors, and when we do not engage

in social activities, our worth is affected. In other words, being around others helps our

social competencies, which nurture our development in life (Rooney, 2015).

Art Therapy

Paints, fabrics, lumps of clay, pencils and more have the ability to convey what

sometimes cannot be spoken. The pain of parental betrayal, the shame of sexual

violation, the humiliation of spousal abuse, and the indignity of trading sex for


drugs. The uncomfortable thoughts and emotions are ultimately transferred into

artwork. For hurting or wounded individuals with Co-occurring Disorders, the

tool used in Art Therapy replaces words not spoken. (Lawna, 2014, p. 5)

The unspoken pain is a build-up of stressors that cause a person to be irrational in

their responses to situations. Art therapy as an expression is used to help a individual to

relieve and communicate stress experienced; whom suffers from a mental or chemical

disorder.

Unlike spoken words, which possess no longevity, the art is tangible. A

painting, drawing, or clay sculpture becomes a concrete representation

of emotion. The sorrow, guilt, shame or pain (discussed in The COD

Manual) a patient has felt for years, perhaps decades, is now literally on

the table. Being creative allows the individual a sense of freedom from

that bondage and is immensely powerful. Art therapy is expressive and

beneficial for everyone, regardless of disorder(s), addiction, or degree of

trauma experienced throughout a lifetime. (Lawna, 2014, p. 5)

The body’s natural response to stress is to forget the problems or issues that have

caused the interruptions in the brains functioning (Mosak & Maniacci, 1999). The use of

“Art therapy can be beneficial to people of all ages, including adults who have emotional,

cognitive, and/or physical disabilities” (AATA, 2010, Art Therapy Posttraumatic stress

disorder, veterans section, About Art therapy, para. #1).

According to American Art Therapy Association (2015), a therapist uses a wide

variety of art-based techniques in the assessment and treatment of adults with emotional

dismay for the expression of a persons’ feeling. Art therapy helps an individual to


communicate the unspoken feeling, hurts, pain, stressors, or disappointments of life that a

person bears. Using art as a way to express a persons feeling can help release the weight

of stress or distress in life. Unspoken words, nonverbal, or verbal communication is a

healthy way to release unwanted stress or distresses from a person’s life through the

expression of art.

Method

Integrated Dual Disorder Treatment

National Institute on Alcohol Abuse and Alcoholism (2007) stated that people who

suffer from mental illness, most often always deal with substance abuse issues at some

point in their lives. Alcohol is a substance that affects a person’s ability to cope or

manage stress. Individuals who have co-occurring disorders have a difficult time

managing difficult situations in their lives. These situations caused stress, and the lack of

coping skills tend to lead to negative consequences. Combining treatment can assist the

person in depth and ultimately improve all mental and chemical health symptoms because

the substance slows down the brain's function ability.

In order to combine treatment, a counselor first has to build a relationship to

identify what a person is suffering from in order to help in the recovery process

(Dinkmeyer & Dinkmeyer, 1987).

Back and Brady, (2008) study stated that comorbidity was found to be a

National Epidemiological condition related to Drug, Alcohol, and criteria for

Anxiety along with other mental disorders. For example: When dually

diagnosed the substance takes over the mental ability to function in a normal

capacity, thus drugs and alcohol have their own unique affects. Individuals


suffering from comorbidity not only have to find a way to manage one illness

but two at the same time. “Drugs are a pleasure producing chemical that activate

or imitate chemical pathways of the brain which is associated with feelings of

well-being, pleasure, and euphoria” (Stalcup, 2006, p. 3). “A major depressive

disorder is an illness which have significant neurobiological consequences that

involves structural, functional, and molecular alterations in several areas of the

brain” (Maletic et al., 2008, p. 1).

Using different tools, approaches, and treatments that are geared toward both

disorders, such as the COD Manual, will help battle both disorders at the same time.

Besides, both disorders affect a person’s ability function when it is intermingled therefore;

prevention is a way to assist the function ability of that individual.

Neuroadaptation. Is damage caused by neurotransmitter insensitivity

that leads the user to feel, when sober, the opposite of feeling high. Under

unstimulated conditions, there is profound interference with the ability to

experience pleasure. Exclusive of drugs or alcohol, the process by which

receptors in the reward and pleasure centers of the brain adapts to high

concentrations of neurotransmitters is changed; thus, “user feels as if s/he is

experiencing an unmet instinctive drive: dysphoria anxiety, anger, frustration,

and craving” (Stalcup, 2006, p. 4).

Dual diagnosis is a term used to describe people with mental illness who also

have problems with drugs or alcohol. The relationship between the two is

complex, and the treatment of a person with co-occurring substance abuse (or

dependence) and mental illness is more complicated than the processing of either


condition alone. Unfortunately a common situation—many individuals with

mental illness have ongoing substance abuse problems, and many people who

abuse drugs and alcohol experience mental illness. (NAMI, 2014)

The COD Manual is one part of a preventive plan that can assist an individual

though the recovery process. In other words, treatments that address both disorders are

relapse preventive plans and relapse prevention programs. There are many different

models of treatment plans and prevention that aid in the individual’s recovery. Most

treatment models also measure up to the psychological and neuroimaging technology to

provide compelling neurobiological evidence for the nature of addiction and relapse as a

process for recovery (McGovern et al., 2005, p. 10). “Relapse prevention models have

evolved from purely cognitive-behavioral that are linear towards a dynamic interplay

among dispositions, contexts, and past or current behaviors” (McGovern, Wrisley, &

Drake, 2005, p. 10).

Brain Function

The human brain is the body’s engine, and it is very complex. The three pounds of

mass that sits at the center of the brain controls the human activity. The human activities

are controlling a car, eating, feeling pleasure, breathing, imagination, or any active thing

the body does. In contrast, a person’s brain controls their body’s function ability. The

brain helps an individual to translate and react to all experiences. In addition, the brain

controls feelings, thoughts, conduct, and emotions, which is the body’s engine. The U.S

department of Health and Human Services (2009), reported that substance use is a

problem in teenagers and tends to coexist with other psychiatric conditions, and


approximately 75% of adolescents with current substance abuse issues also meet criteria

for mood, anxiety, or conduct disorders (Boger et al., 2014, p. 109).

Addiction is a disease of the pleasure-producing chemistry of the brain;

neuroadaptation is the mechanism of the disease. Over-stimulation of pleasure

pathways causes them to neuroadaption, interfering with the normal experience

of pleasure. Transition to addiction from substance abuse arises from the

development of tolerance and withdrawal. Once neuroadaptation occurs,

cessation of drug use leads to ‘inversion of the high’; sobriety becomes pleasure

less. (Stalcup, 2006, p. 5)

Adler Therapeutic Approach to Addictions

Social interest. “In Adler’s, mature theory, social interest is not a second dynamic

force counterbalancing a striving for superiority; social interest denotes the innate aptitude

through which the individual becomes responsive to reality, which is primarily the social

situation” (Ansbacher & Ansbacher, 1957, p. 133). Adler believed that humans all strive

to belong to a group of importance. As counselors using this theory, the objective is to

investigate and identify the motive behind a behavior because, as Adler would say, (there

is a purpose behind all behaviors). How a person behaves under the influence of drugs or

alcohol is important to the recovery process. For example, Adler’s social interest

perspective theory, suggests that; individuals can move toward making some gains from

disadvantages in life. Those disadvantages of life can take a toll on a person thus gaining

a new perspective through treatment could benefit both counselor and client in recovery.

In the recovery process, a counselor obligation is gaining an understanding of the client

state of being to help the client understand of self. The knowledge of self will help the


recovery process. Furthermore, it helps the client to be more aware of the pluses and

minuses of life that is endured. Counselors and clients that builds a therapeutic

relationship, helps in the growth and movement into the individuals driven goal.

Relationship. Counselors in this stage are more prone to reducing the superiority

energy; that allows the client to feel at ease and comfortable with the therapeutic process.

In addition, in addiction counseling, it is important to make the client to feel sense of

sincerity which aides in the relationship process of development and decision-making.

“Adlerian counselors, while actively using their knowledge and experience to help others,

also maintain respect for individual’s capabilities and power to make independent

choices” (Sweeney, 1989, pg. 242).

Interpretation. “Having listened to the individual discuss concerns, possibly

explore family constellation and/or early recollections, and having observed

behavior in counseling and/or elsewhere, the counselor tentatively will offer

observations that are descriptive of the individual and may have implications for

meeting the individual’s life tasks” (Sweeney, 1989, p. 246).

At this point, the counselor is gaining a better understanding of the client’s

lifestyle, which is centered on the individual’s knowledge of self. Now that a picture has

been painted for the counselor, the expression of how the client’s lifestyle is played out

through their private logic is reviewed. Therefore, the counselor is able to interpret the

client’s point of view and help the client to make rational decision, which was once

influenced by substance abuse or mental illness. In other words, the interpretation process

of interaction is for a clinician to develop a relationship and get an understanding of the

client(s) through their lens.


Reorientation. In this process, the counselor is leaving it all up to the client(s) to

make movement or not towards the individual’s driven goal. As a result, it helps the

counselor to gain an “Understanding and meaning of the clients’ behaviors and goals of

life, which he or she pursues, that frees, the individual to decide what other behaviors he

or she might wish to try” (Sweeney, 1989, pg. 256). As an Adlerian counselor, the client

is allowed the power to make a step towards change or not.

Cognitive Behavioral Therapy

Psychology Today (2015) defined Cognitive Behavioral Therapy (CBT) as a form

of psychotherapy that treats problems and boosts happiness by modifying dysfunctional

emotions, behaviors, and thought, and the focus is on solutions, encouraging clients to

challenge distorted cognitions, and change destructive patterns of behaviors. For example

the University of Wisconsin-Madison (2015), found that emotions could be elicited by

external stimuli, but that stimuli must have relevance or motivational significance in order

to guide appropriate and adaptive behaviors. CBT treatment helps an individual to guide

their emotions in the right direction; by exploring patterns of thinking that lead to self-

destructive actions. Improving a person ability to cope with their mental illness would

help them to understand self and make better choices. The beliefs that direct people

thoughts with mental illness can be modified through improvement of coping skills and

thinking (National Alliance on Mental Illness, 2014). Moreover, being mindful of one's

ability to process thoughts will give the counselor the knowledge needed to help one

improve their functioning. CBT treatment helps individuals learn how to make rational

decisions. It also tends to elaborate on one's ability to modify irrational feelings and

understand how to tolerate undesirable emotions as suitable. In addition, to the cognitive


emotion of an individual’s brain function, CBT helps the individual to navigate rationally

through all situations. Therefore, an emotional balance is needed, when making decisions.

Being cognitive of how a person’s process is through situations; will help the individual to

make better choices that will improve their ability to function.

Dialectical Behavior Therapy

The dialectical behavior therapy (DBT) is an approach that can answer the

question of what is a basic emotion and how do a person cope with those emotions when

they are unbalanced?

What are basic building blocks of emotional life --- a science of emotion should

focus on --- basic emotion is described as anger, sadness, fear, happiness, and

disgust, are the biological inherited that reflex modules that cause a distinct and

recognized behavioral and physiological patterns. (Barrett & Wager, 2006, p. 79)

When an individual is under the influence of a substance or emotionally

imbalance, DBT educates individuals on how to enhance their skills to regulate thoughts,

emotions, feelings, and behaviors. The dialectical method involves helping individuals to

increase their ability to regulate emotions and become more rational in their thought

process; through learning of triggers that lead to reactive responses. DBT also assist in the

individual learning how to resolve behavioral approaches that are not appropriate and

develop more resolutions that are appropriate. In addition to helping identify

inappropriate behavioral responses DBT help in learning how to utilize the skills

developed in the appropriate manner. Once a person understands how frustration can

disable them; the two components of DBT are there to assist in behavioral changes.


The DBT model has two components: behavioral, solution emphasis combined

with recognition that is focused on dialectical method.

DBT teaches individuals a better way of dealing with their mood imbalance. DBT

instructs one on how to regulate emotions rationally (Harvey 2012). The ability to manage

their emotions and behaviors such as judgments, aggression, self-awareness, character

building, and crisis stabilization increases through DBT training (Mathew 2012). Being

aware of moods and reactions to those mood changes teaches a person to be more

proactive in the management of mental illness or substance abuse. Moreover, mood

regulation will improve the ability to interact with others appropriately.

Alves, Fukusima, & Aznar-Casanova (2008), offered the insight that the prefrontal

cortex mediates the control of high-level of cognitive functions and is associated with the

regulation of many aspects of the affective system. The use of DBT will assist individuals

in learning how to regulate emotions. As a result, the person becomes emotionally

healthy. The affective system represents the goals, achievements, and working emotion-

bases of decision making in which process DBT aids. Managing emotions will also

benefit a person’s mental health. A person with substance abuse issues loses the ability to

control their thoughts; feeling, emotions, and caring for self tend to be difficult. Learning

how to manage stress could help maintain sobriety.

Discussion

According to Ansbacher and Ansbacher (1956) Adlerian counseling is about

engaging continuously in the eyesight of the client through their lens. For example: The

identification of one's interpretation through their interactions with the world around them

helps counselors understand life from the client’s viewpoint. Adler’s focus is on how one


perceives life and how those interactions with others are interpreted. Our perception

affects our thoughts, which ultimately hinders the way they are processed through one's

understanding. In Adlerian therapy, to understand one's perception, a counselor has to

investigate the inner subjective person being counseled (Ansbacher & Ansbacher, 1956).

For example: A distressed individual is in a disruptive frame of mind. The mind is

not thinking in a manner that will allow it to function properly. Being dispirited makes an

individual feel inferior to the world around them and in turn cause inappropriate

behaviors. Gaining a relationship with the therapist helps in that process of understanding

the individual; which ultimately helps the recovery process.

Adlerian therapist's purpose is to build a therapeutic relationship to help the client

identify and define their private logic. Helping, clients identify their perceived

perceptions will aid with the development of goals that are congruent with rational

thinking. When a person does not feel that they received positive feedback, they engage

in behaviors that are provoking to others. Moreover, the therapeutic emphasis is placed on

building a relationship to prevent provoking behaviors and to develop healthy

relationships and skills to manage those healthy relationships as a part of the therapeutic

process (Ansbacher & Ansbacher, 1956).

The COD Manual would help individuals to learn new ways to manage unpleasant

situations to recover and gain mental stability. Learning how to process through problems

gives a person a healthier balance in difficult situations in life. The inability to manage

life’s stressors could lead to the use of maladaptive coping strategies (Dinkmeyer &

Sperry, 2000).


To cope and interact appropriately in a problematic relationship is to define it,

tackle it, and arrange life through the situation. It is important to identify who, what, and

where individuals in one's life stand. Taking a moment to look at how a person views

others that relates to oneself will help in regulating relationships. Sometimes it is

impossible to do anything about how a person views others, and the use of substances

hinders their ability to rationalize these relationships. Individuals with mental health

issues suffer because they are not looking through a clear lens. On the other hand, just

properly placing those relationships will help manage the symptoms better. The Help

Guide (2014) discussed the issue of alcohol and drug abuse, which increased mental

health complications as well as the substance abuse problems individuals face.

The use of DBT, IDDT, CBT, and Adlerian treatment approaches will assist in the

treatment goals of regulating emotions and maintaining sobriety. Along with the evidence

based practices of DBT, IDDT CBT, and Adlerian therapy the cod manual promises to

address mental and chemical health disorders issues. The attached example illustrates

coping strategies when someone is under stress (Appendix, A, B).


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Appendix


Appendix A

Minimizing Stress

Below some coping strategies you can use when under stress. They might not

take the stress away but can give you some ease of mind, while dealing with the

stressful situation. Put an (X) by the strategies tried and an (O) by the strategies

you would like to try now or in the future.

____ go on a date

____ go get a movie from the movie box

____ cook for your loved ones

____ read something

____ play music

____ sit in the rain

____ let up the windows in the house or apartment

____ scream

____ work-out

____ eat healthy foods

____ go on a walk

____ turn on the radio

____ watch your favorite show

____ take a walk in a mall

____ visit people you haven’t seen in a while

____ go to the coffee shop


____ go to the library

____ go dancing

____ go get manicure

____ go get your hair done

____ go get pedicure

Now, can you think of something else you have not done in a while that you could

do? Write your answer below.

© 2015 Starla Moore


Appendix B

Stress Triggers

What is something that made you upset?

What was your reaction? How could you handle it differently?

So, what is the biggest issue you’re having today? How will you handle it?

© 2015 Starla Moore

Documents

A Master’s MP 2015.pdf · Figure 2. Brain Functions Adlerian Approaches Ansbacher and Ansbacher (1956) stated that Individual Psychology points out that all behaviors of a human