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Developmental Recovery – A
Habilitation Model of CareRobert L. Neri, LMHC, CAP
November 29, 2017
Thomas Durham, PhD
Director of Training
NAADAC, the Association for Addiction Professionals
www.naadac.org
Produced ByNAADAC, the Association for Addiction
Professionalswww.naadac.org/webinars
www.naadac.org/webinars
www.naadac.org/SUD-habilitation-treatment-webinar
Cost to
Watch:Free
CE Hours
Available:
1 CEs
CE Certificate
for NAADAC
Members:
Free
CE Certificate
for Non-
members:
$15
To obtain a CE Certificate for the time you spent watching this
webinar:
1. Watch and listen to this entire webinar.
2. Pass the online CE quiz, which is posted at
www.naadac.org/SUD-habilitation-treatment-webinar
3. If applicable, submit payment for CE certificate or join
NAADAC.
4. A CE certificate will be emailed to you within 21 days of
submitting the quiz.
CE Certificate
Using GoToWebinar – (Live Participants Only)
Control Panel
Asking Questions
Audio (phone preferred)
Polling Questions
Webinar Learning Objectives
LO #1: Participants will
learn the knowledge,
skills and attitude
model.
LO #2: Participants will
be able to apply a
hopefulness approach
to problem solving.
1 2
Participants will be able to define and identify multiple factors that complicate recovery for
these clients in a developmental recovery process.
LO #3: Practice
framework that
addresses the many
aspects of “arrested
development,”
LO #4: Identify a list of
core clinical issues and
how to address these
issues.
3 4
“A Habilitation Model of Care”
Developmental Recovery
Which modality best describes where you work?
Polling Question:
1. Administration
2. Outpatient or Iop
3. Shorter term residential (under 30 days, including detox)
4. Residential (over 30 days)
5. Other service modality
A blueprint for building, creating and tailoring
specialized treatment for those clients with early onset
and multiple chronic conditions.
Developmental Recovery
• Duration and intensity
• Creative focus
• Foundational approach
• Drill down on KSA’s
Developmental Recovery Requires:
• Parental conflicts
• Childhood stressors
• Peers unable to help each other
• Rigid
• Consequences not thought through
• Well defended
• Arrested and under-functioning
Client Characteristics
• It is a process, not an event
• Treatment is cumulative (dose matters)
• Developmental Psychology means: “The Psychology of
Maturation”
Developmental Recovery Principles
• Arrested development
• Learning styles
• KSA’s
• Knowledge, skills and attitude
Developmental Recovery Key Points
• Recognize control strategies
• Establish a sobriety based value system
Facilitate Movement Along the Continuum:
Submission
Compliance
Acceptance
Surrender
• Grieve the loss of drugs
Stages & Developmental Tasks – Pre/Early
• Build affiliation/belonging
• Resolve addict self/Sober self dynamic
• Spiritual framework
• Purpose/meaning
• Attachment, trust, affiliation
• Learned helplessness/hopefulness
• Social support
• Trauma impact
Stages & Developmental Tasks – Pre/Early
• Test personal control
• Stabilization skills:
• Internalize structure
• Self comfort/soothing skills
Relapse Risk
• Relationship mending
• Practice new behaviors
• Drill down and resolve emotional pain
• Manage the pace of change
• Transitional points
• Social skill development
Middle Stage Recovery Tasks
• Power and control
• Deeper level of acceptance
• Excitement, drama, crisis
• Relationship stages
• Attachment, nurturing, separation
• Victim stance reversal
• Un-mourned grief
• Quieting one’s own critical inner voice/self sabotage
Middle Stage – Focus on Core Issues
Stress of real life problems, especially relationships
Relapse Risk
• Avoid self sabotage
• Make peace with family of origin issues
• Expand identity
• Practice service to keep fresh memories
• Refresh memories
• Continue personal growth
• Resist complacency
Late/Maintenance Stage Tasks
• Becoming complacent
• Transition points
• Medical and pain challenges
• Family of origin issues
Relapse Risk
The best model for knowledge and skill acquisition
is immersion.
Learning by doing:
• Role play
• KSA testing
• Internalization vs. adaptation clinical work
Innovative ways to immerse clients in the
process:
• Embrace mistakes and failures as a wonderful
opportunity to learn
• Commit to an incentive based model
Programs that Embrace Developmental
Recovery
• Resetting the table
• Iterations and personal growth
Mistakes and Failures are time for:
Hopefulness must increase before pain does
High Hope High Pain
Low Hope Low Pain
Let’s take one
problem and practice
• Attachment and trust
“Ability to form close, personal
connections to others”
Relationship Core Issue
• Allows a self care/soothing/comfort - can be learned
• Allows for leaning on others
• Allows for comforting others
• Teaches empathy skills
Internalize that you can accept people
who care
• “I can only trust myself”
• “Everyone leaves”
• “People are users”
• “I have a bad picker”
Listen for (the opposite)
• Relationship values
• Receive, accept and express love and connection
• What you learned and where you learned it
• Inter-dependence
Knowledge
• Walls and gates
• Walls for protections
• Gates for connection
• Boundaries for new relationships
Continued Knowledge
• Making contact with others
• Expressing emotions
• Active listening
• Asking for what you want
• Giving others in need
• Handling and receiving feedback
• Establishing and defining boundaries
• Providing feedback
• Handling arguments/fight fair
• Etc.
Skills
• Willingness to grown and change personally
• Willingness to establish rapport to learn more regarding
relationships
• Appreciation of importance of empathy in building
relationships
Attitudes
• Planning
• Doing
• Experimenting
• Emulation
• Adjusting
“You never stop learning”
Some clinical sessions focus on
practicing this teaching model:
• Orientation
• Primary treatment
• Re-entry/integration
This teaching model is built into program
phases:
A therapeutic community structure works well as the
environment/community is the teacher.
Residential
• Self and mutual help
• Earned privilege system
• Social learning opportunity
• Role modeling
• Community expectations
• Belonging and individuality
Therapeutic Community Concepts
• Separation
• Boundaries
• Intimacy
• Power
• Etc.
Other relationship KSA work involves:
• Each clinical issue creates a learning opportunity
• Some of this can be peer facilitated
• Some can be done using technology
Competency Based Approaches
An exciting methodology to increase
dose, duration and intensity.
Developmental Recovery
• Alan Godwin – Helping Adult Clients Grow Up
• Terry Gorski – CENAPS corporation
• William White – Chestnut corporation
• Dr. Gabor Mat e – In the Realm of Hungry Ghosts
• Janet Woititz and Alan Garner – Lifeskills for Adult Children
• Elizabeth Kolbert – Why Facts Don’t Change Our Minds
References – Great Thought Leaders
www.naadac.org/SUD-habilitation-treatment-webinar
Cost to
Watch:Free
CE Hours
Available:
1 CEs
CE Certificate
for NAADAC
Members:
Free
CE Certificate
for Non-
members:
$15
To obtain a CE Certificate for the time you spent watching this
webinar:
1. Watch and listen to this entire webinar.
2. Pass the online CE quiz, which is posted at
www.naadac.org/SUD-habilitation-treatment-webinar
3. If applicable, submit payment for CE certificate or join
NAADAC.
4. A CE certificate will be emailed to you within 21 days of
submitting the quiz.
CE Certificate
December 20, 2017
December 6, 2017 January 10, 2017
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