Therapeutic Interventions

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1. Using an AA First Step exercise, help the client to see the power-lessness and unmanageability that resulted from using addiction to deal with negative feelings associated with childhood trauma.

2. Explore the painful experiences endured in the client's family of origin, and help identify the unhealthy emotional and behavioral patterns that evolved from those experiences.

3. Administer to the client psychological instruments designed to objectively assess childhood trauma (e.g., Childhood Trauma Questionnaire [CTQ], Davidson Trauma Scale [DTS], Beck Depression Inventory-II [BDI-II], Beck Anxiety Inventory [BAI]); give the client feedback regarding the results of the assessment.

4. Identify the unhealthy rules and roles learned in the family of origin. (2, 4)

5. Verbalize an understanding of how childhood abandonment, neglect, or abuse led to emotional and social problems. (5)

6. Identify a pattern of abusing substances as a means of escape from psychological pain associated with childhood traumas, and verbalize more constructive means of coping. (6, 7)

7. Verbalize a plan as to how to fulfill the unmet needs of childhood now that adulthood has been reached. (8, 9)

2. Explore the painful experiences endured in the client's family of origin, and help identify the unhealthy emotional and behavioral patterns that evolved from those experiences.

4. Teach the client about the unhealthy rules and roles that develop in dysfunctional families, and help identify what role he/she played in the family dynamics.

5. Help the client to understand the relationship between childhood trauma and current problems with trust, anger, self-esteem, or depression.

6. Explore the client's behavior of addiction as a means of coping with emotional pain, and assist him or her in identifying the self-defeating, negative consequences of this behavior.

7. Teach the client healthier and more constructive means of coping with emotional pain (e.g., sharing pain with others, attending AA meetings, confronting and then forgiving perpetrator, turning issues over to a higher power).

8. Assist the client in identifying, understanding, and verbalizing unresolved needs, wishes, and wants from the childhood years; then help him/her develop a written plan to meet each unmet need, wish, or want.

9. Have the client read Healing the Shame that Binds You by Bradshaw and Outgrowing the Pain by Gil; then help him/her identify unresolved feelings, wishes, and wants.

List and replace the dysfunctional thoughts, feelings, and behaviors learned during the childhood trauma and/or neglect. (10, 11)

9. Attend group therapy sessions to share thoughts and feelings related to childhood traumas, and how addiction has been used to avoid negative feelings. (6, 12)

10. Implement healthy problemsolving and communication skills. (13, 14)

11. List five ways a higher power can assist in recovery from childhood trauma and addiction. (15)

12. Verbalize an understanding of the power of forgiving perpetrators. (15, 16, 17, 18)

10. Probe the client's childhood trauma and/or neglect and help him/her to relate these events to current feelings, thoughts, and behaviors.

11. Teach the client realistic, positive self-talk, to replace the distorted messages that were learned from childhood experiences.

6. Explore the client's behavior of addiction as a means of coping with emotional pain, and assist him/her in identifying the self-defeating, negative consequences of this behavior.

12. Direct group therapy sessions in which the client is encouraged to share his/her story of childhood trauma, allowing for feedback of empathy, acceptance, and affirmation from group members.

13. Explore the client's family-of-origin maladaptive style of conflict resolution and communication patterns; relate these patterns to the client's current interpersonal skill deficits.

14. Use modeling, role-playing, and behavior rehearsal to teach the client healthy problem-solving and communication skills to use in recovery (e.g., active listening, using "I" messages, cooperation, compromise, and mutual respect).

15. Teach the client about the AA/NA concept of a higher power, and how the higher power can assist him/her in forgiving others and reestablishing self-esteem.

15. Teach the client about the AA/NA concept of a higher power, and how the higher power can assist

13. Write a letter to the perpetrator, detailing the childhood abuse and its effect on one's thoughts, feelings, and behavior. (19, 20)

14. Write a letter to each primary caregiver describing the childhood abuse and current feelings, wishes, and wants. (21)

15. Learn and demonstrate honesty, openness, and assertive-ness in communicating with others. (14, 22, 23, 24)

him/her in forgiving others and reestablishing self-esteem.

16. Help the client to understand that often perpetrators were wounded children also, and need to be forgiven and turned over to a higher power in order to not harbor rage at them.

17. Recommend the client read books on the topic of forgiveness (e.g., Forgive and Forget by Smedes, When Bad Things Happen to Good People by Kushner).

18. Teach the client the benefits (e.g., release of hurt and anger, putting the issue in the past, opens door for trust of others) of beginning a process of forgiveness (not necessarily forgetting or fraternizing with) of abusive adults.

19. Assign the client to write a letter to his or her perpetrator detailing the emotional trauma that resulted from the abuse.

20. Assign the client to write a forgiveness letter to the perpetrator of the abuse; process the letter.

21. Assist the client in writing a letter to each parent or primary care-giver, detailing his/her childhood abuse and sharing what the client wants from each person in recovery.

14. Use modeling, role-playing, and behavior rehearsal to teach the client healthy problem-solving and communication skills to use in recovery (e.g., active listening, using "I" messages, cooperation, compromise, and mutual respect).

16. Identify any patterns of repeating abandonment, neglect, or abuse experienced as a child. (25)

17. Verbalize an understanding of how the home group in AA/NA can provide a substitute for the healthy home the client never experienced. (26)

18. Develop and agree to participate in an aftercare program to continue to recover from childhood abuse and addiction. (27)

19. Share with the family the pain of childhood trauma and commit to working with the family in continuing care. (28)

20. List three things each family member can do to assist in recovery. (29)

22. Assign the client to read Taking Charge of Your Social Life by Gambrill and Richey to enhance social communication skills; process concepts in session.

23. Teach the client the healthy communication skills of being honest, asking for wants, and sharing feelings.

24. Using modeling, role-playing, and behavior rehearsal, teach the client healthy assertive skills; then practice these skills in several current problem situations.

25. Explore the tendency to repeat a pattern of abuse and neglect toward the client's own children when it has been experienced on a regular basis in childhood.

26. Help the client to see how the new home AA/NA group can help to substitute for a healthy home that he/she never had.

27. Help the client to develop an aftercare program that includes regular attendance at recovery group meetings and the continued therapy necessary to recover from childhood trauma and addiction.

28. Hold a family therapy session in which the client is supported in sharing the pain of childhood trauma with family members; connect the pain of the past with his/her current addictive behavior.

29. Help the client make a list of three things each family member can do to assist him/her in recovery.

21. Complete a re-administration of objective tests of childhood trauma effects as a means of assessing treatment outcome. (30)

22. Complete a survey to assess the degree of satisfaction with treatment. (31)

30. Assess the outcome of treatment by re-administering to the client objective tests of childhood trauma; evaluate the results and provide feedback to the client.

31. Administer a survey to assess the client's degree of satisfaction with treatment.

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Exploring EFT

Exploring EFT

EFT stands for Emotional Freedom Technique. It works to free the user of both physical and emotional pain and relieve chronic conditions by healing the physical responses our bodies make after we've been hurt or experienced pain. While some people do not carry the effects of these experiences, others have bodies that hold onto these memories, which affect the way the body works. Because it is a free and fast technique, even if you are not one hundred percent committed to whether it works or not, it is still worth giving it a shot and seeing if there is any improvement.

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