Strengths based Biopsychosocial Approach to Addressing Addiction
Dr. Dawn-Elise Snipes PhD, LPC-MHSP, LMHC
Executive Director, AllCEUs
Podcast Host: Counselor Toolbox and Happiness Isn’t Brain Surgery

Objectives
~ Identify relapse triggers
~ Identify the components of a strengths based approach
~ Explore the types of strengths to identify in each of the 9 life domain areas
~ Review some basic strengths-based questions
Relapse Triggers
~ Sense of powerlessness and hopelessness
~ Lack of self-confidence
~ Low self-esteem
~ Poor relationships / lack of social support
~ Ineffective interpersonal skills
~ Lack of sufficient resources
5 Components of a Strengths-Based Approach
~ Components
~ 1. Client responsibility for recovery
~ 2. Client-directed goal-setting
~ 3. Focus on client strengths and resources
~ 4. Collaboration and partnership
~ 5. Community-based services and resources
~ Function
~ Make the most of client and community strengths
~ Build the most effective therapeutic relationships with clients
~ Develop clients’ ability to believe in themselves and in the success of treatment

9 Life Domains for Strengths and Goals
~ 1. Life Skills
~ 2. Finance
~ 3. Leisure
~ 4. Relationships
~ 5. Living Arrangements
~ 6. Occupation/Education
~ 7. Health
~ 8. Internal Resources
~ 9. Recovery

Client Responsibility for Recovery
~ When people take responsibility for their own recovery, they feel a greater sense of investment in the outcome.
~ An urge to go back to self-destructive behavior looks less like rebellion or resistance, and more like a threat to their own interests.
~ As the ability to take responsibility is exercised and strengthened, a sense of confidence and self-esteem grows.
~ The focus on the client’s own strengths and resources helps people become empowered and feel confident in their ability to succeed in recovery
~ The strong sense of collaboration and partnership in the treatment process creates a more active partnership role

Benefits
~ Finding resources within the family, culture, and community helps develop supportive relationships and provides a broad base of ongoing resources that the client can use beyond the treatment setting.
~ Clients learn more about themselves and their goals as they try out their plans in real life and reflect on their results in treatment sessions
~ Clients learn and practice goal-setting and solution-building skills that they can use throughout their lives.
~ Each revision of their goals and plans carries clients farther in the recovery process

Client Directed Goal Setting
~ Strength-based providers become teachers, coaches, and resources to their clients, as clients learn to:
~ Set their own goals, including treatment goals
~ Make plans to meet their goals, using the strengths that they continue to identify
~ Try out their goals and plans and report on the results
~ Revise their goals and plans as they gain more information and experience
Client Directed Goal Setting
~ As the goals are defined, providers also help people identify:
~ Small, manageable steps toward those goals
~ Concrete actions they can take
~ Resources they can call on to complete these tasks
~ Strengths within themselves that will help them reach their goals
~ Paradigm shift from
~ Pointing out the problems to eliminate
~ Developing treatment goals for their clients, or directing clients in the goal-setting process
~ Focusing on complete abstinence as the only legitimate treatment goal

Focus on Client Strengths and Resources
~ A number of techniques help in the strength-finding process, including:
~ First learning about their clients from the people's own words, rather than from case histories or primarily negative intake or assessment forms
~ Encouraging people to tell their stories and talk about their experiences in their own words
~ Listening for evidence of people's values, skills, inner strengths, cultural strengths, family and community resources, etc.
~ Watching people's behavior for signs of strength
~ Pointing out all these strengths and resources
~ Asking clients about times and situations in which they have been at their best or things have gone well for them, and helping them identify strengths through those experiences

Focus on Client Strengths and Resources
~ A number of techniques help in the strength-finding process, including:
~ Balancing out people's negative statements about themselves with questions designed to probe for strengths and resources
~ Reframing people's negative statements about themselves, where reframing is appropriate
~ Helping people learn to think and speak in terms of challenges and counterproductive choices rather than problems and negative character traits
~ Teaching people the use of clinical tools that will take inventory of their strengths and resources
~ Remembering that no one can empower another human being, but that we can help people learn to empower themselves

Collaboration and Partnership
~ Recognize and remember that clients are the experts on their life
~ Seek to understand what clients are saying, rather than correct it
~ Work to understand what clients and families really want
~ Help people see the full range of choices available to them
~ Teach people skills that they can use in their own empowerment
~ Use language, imagery, and metaphors that the individual client will find personally relevant

Collaboration and Partnership
~ Stay calm and consistent in setting limits and responding to any challenges of those limits
~ Respect the boundaries that promote people ’s psychological safety and trust in the therapeutic relationship
~ See resistance as a sign that the provider may be pushing too hard, or in the wrong direction
~ Seek and honor people’s feedback about the relationship, and adjust their own words and actions to improve the relationship

Community Based Services
~ Clients’ lives, jobs, schools, families, support systems, recovery groups, and the businesses they use are centered in the community.
~ True test of services takes place in the community, where a host of triggers and stress factors await.
~ Families, communities, and cultures are home to many strengths and resources, but many people need help in identifying them:
~ They may not be aware of many of the resources.
~ They may be too foggy from the addictive process to recognize the resources, or to separate them from the dangers that exist there.
~ They may be so used to hearing negative things said about their families, communities, and cultures that they assume the resources don’t exist.
~ Connection with community based services helps clients build networks of resources that they can call on as they face the challenges of recovery.
~ Clients begin to see themselves as stronger and more resourceful as they recognize the strengths and resources in the families, communities, and cultures with which they identify.

Application
~ Five general guidelines for finding strengths:
~ Look everywhere
~ No strength is too small
~ No strength is too big
~ Look in the past, present, and future
~ Look under “flaws” to find more strengths

~ The Nine Domains:
~ Life Skills
~ Finance
~ Leisure
~ Relationships
~ Living Arrangements
~ Occupation/Education
~ Health
~ Internal Resources
~ Recovery

Life Skills
~ Concrete, everyday survival skills and strengths that keep people’s lives in order.
~ Household skills (budgeting, cleaning, organizing, planning, managing, cooking)
~ Interaction with the community (reading the news, using the computer)
~ Transportation (using public transportation, driving, finding places, getting where needed)

Finances
~ Managing money
~ Checking
~ Saving
~ Using cash or money orders
~ Re-establishing credit
~ Paying bills
~ Budgeting
~ Setting spending priorities
~ Setting and working toward financial goals
~ Having a consistent, legal income

Leisure
~ Excess stress can:
~ Activate symptoms of post-acute withdrawal syndrome (PAWS), including confusion, memory loss, mood swings, difficulty understanding feelings, and insomnia
~ Trigger a mood disorder
~ Trigger cravings and urges to drink or use
~ Serve as a justification for returning to alcohol and/or other drug use

Leisure
~ Helps women resolve the tension between the need for leisure and the fear of leisure time and rediscover what they enjoy.
~ These include:
~ The talents and skills (e.g., artistic, athletic, imagination, creativity)
~ The cooperation skills they learn in group or team activities, and the self-esteem they gain from identification with the group or team
~ Initiative & dedication developed by starting and completing projects
~ The strength and support they gain from shared leisure-time activities
~ Strength that comes from physical activity
~ The physical and emotional resilience that come from having enough rest
~ The spiritual and emotional healing that can come from spending time:
~ in quiet reflection
~ with nature
~ with people with whom one has a sense of spiritual or emotional connection

Relationships
~ Relationships are among the areas of life in which addiction does the most damage.
~ Relationships with providers, recovery group members, and members of their faith communities can be of paramount importance
~ Interpersonal Effectiveness
~ Communication and listening skills
~ Developing trust (with self and other)
~ Respect
~ Cooperation and flexibility
~ Conflict resolution
~ Interdependence and boundary setting
~ Skills for handling “difficult people”

Relationships
~ Relationships with friends
~ Family relationships
~ Involvement in community groups
~ Recovery or support-oriented relationships
~ Involvement in faith communities
~ Caregiving skills (Parenting/nurturing)
~ When is it easiest for you to be caring with others? With yourself?
~ When is it hardest for you to be caring?
~ What in you makes it hard for you to be caring at those times?
~ What might help you be more consistently caring?
~ Coping skills

Living Arrangements
~ Living in a place where children can live with them
~ A place with physical & emotional safety
~ Making a house a home
~ Independence
~ Housing assistance and resources
~ Example; a client who is feeling as if she’s failed because she’s staying in a recovery home might realize that she’s physically safe there, that people there support her recovery, and that she’s working on plans for independent living in the future.

Occupation/Education
~ Occupation
~ Job-seeking skills
~ Work experience
~ Work-related training and transferrable skills
~ General employment skills
~ Collaborative skills
~ Work ethic
~ Satisfaction with work
~ Education

Occupation/Education
~ Types of Intelligence
~ Language
~ Logical & Common sense
~ Mathematical
~ Spatial
~ Musical
~ Emotional
~ Bodily (physical grace, touching, feeling)
~ Interpersonal
~ Wisdom

Occupation/Education
~ An assessment of strengths and skills in a variety of types of intelligence is important because:
~ Society and the media tend to define “smart” or “intelligent” in terms of book-learning, memory, academic achievement, job title, or income
~ Many intelligent women have been called “stupid,” “slow,” or “below average” because they don’t have stereotypical intelligence
~ Many women who have made counter productive choices in their lives tend to blame those decisions on a lack of intelligence, ignoring all the social and emotional forces that helped shape their decisions

Health
~ Many women have been conditioned to think of their own health as less important than that of others
~ Basic Habits
~ Sleep
~ Diet
~ Exercise
~ Stress management
~ Relaxation

Health
~ Medical
~ Regular check-ups
~ Taking prescribed medications (including psychiatric medications)
~ Following any other health measures necessary for any existing conditions (including psychiatric conditions or physical conditions such as HIV, diabetes, cancer, high blood pressure, or high cholesterol)

Internal Resources
~ Hopes and dreams
~ Passions
~ Goal setting skills
~ Decision making
~ Compassion
~ Confidence
~ Sense of humor
~ Responsibility
~ Reliability
~ Courage
~ Honesty
~ Humility
~ Faith
~ Willingness
~ Generosity

Recovery
~ A strength-based approach looks at and appreciates even seemingly small successes in all areas of life, including recovery.
~ Provide stage-appropriate interventions to help people move to the next stage at their own pace.
~ Show appreciation for a partial change
~ Through experiments with cutting down and controlling use that people discover the limits of their ability to use addictive substances in a controlled way. You can help them organize and analyze the information gained from these experiments.
~ Any drug (including alcohol) that is avoided, even for a day, means at least a small reduction in damage
Recovery
~ Awareness of effects of addictions
~ Willingness to accept personal responsibility
~ Belief that they can and deserve to recover
~ Engagement in recovery support activities
~ Active participation in treatment activities
~ Development of supportive recovery relationships
~ Progress in recovery

General Strengths Questions
~ What do you think is your greatest strength?
~ What do you like most about yourself?
~ What do other people like most about you?
~ What do other people find most exciting about you?
~ What values are most important to you?
~ What are your best sources of help or support?
~ What are your closest or easiest sources of help or support?
~ What are some other sources of help or support you might try?
~ How have you survived so far?
~ Describe a time in your life when you didn’t have the difficulties you’re telling me about. What was different about that time?
~ Are there any times now when you don’t have these difficulties? What’s different at those times?

General Strengths Questions
~ What do you want?
~ What do you need?
~ What are your hopes and dreams?
~ How do you think you might get these things?
~ What are some possible ways you’d like this situation to turn out?
~ If you woke up tomorrow and everything was great, how would it look and feel? What would a typical day be like? What would you be like?

Summary
~ A strengths based approach helps people build on what is working for them, what has worked in the past or what they think might work in the future
~ It emphasizes client choice and self-direction in goal setting to increase empowerment, investment and self-efficacy

CEUs
If you haven’t already signed up, please remember that Addiction and Mental Health Counseling and Social Work continuing education credits are available for this presentation and are accepted in most US states, Canadian provinces, Great Britain, Australia and South Africa.

Go to https://www.allceus.com/counselortoolbox and click on the link “Counselor Toolbox CEU Spreadsheet” to easily locate the course based on this presentation