Substance Abuse and Abuse Q 25
The client has been hospitalized and is participating in a substance abuse therapy group sessions. On discharge, the client has consented to participate in AA community groups. The nurse is monitoring the client’s response to the substance abuse sessions. Which statement by the client best indicates that the client has developed effective coping response styles and has processed information effectively for self use?
A. “I know I’m ready to be discharged. I feel I can say ‘no’ and leave a group of friends if they are drinking… ‘No Problem.’”
B. “This group has really helped a lot. I know it will be different when I go home. But I’m sure that my family and friends will all help me like the people in this group have… They’ll all help me… I know they will… They won’t let me go back to my old ways.”
C. “I’m looking forward to leaving here. I know that I will miss all of you. So, I’m happy and I’m sad, I’m excited and I’m scared. I know that I have to work hard to be strong and that everyone isn’t going to be as helpful as you people.”
D. “I’ll keep all my appointments; go to all my AA groups; I’ll do everything I’m supposed to… Nothing will go wrong that way.”
Correct Answer: C. “I’m looking forward to leaving here. I know that I will miss all of you. So, I’m happy and I’m sad, I’m excited and I’m scared. I know that I have to work hard to be strong and that everyone isn’t going to be as helpful as you people.”
The client is expressing real concern and ambivalence about discharge from the hospital. The client also demonstrates reality in that statement. In support groups, there’s a collective strength — a collaboration of like-minded individuals all pursuing recovery and willing to help others who desire a sober life as well. Here you’ll share experiences as well as provide encouragement and support to fellow group members.
Option A: In the defense mechanism of denial the person denies reality. The basis for 12-step programs is a guideline which, if followed step by step, leads one through a series of practices. These practices are intended to gather knowledge of self, become open to accept help, consciously work to change thoughts and behaviors, and maintain through ongoing efforts. AA calls this “recovery.” Their belief is that one is never really “cured” of alcoholism. Rather, they believe that the alcohol-dependent instead needs to perpetually maintain an effort to remain sober, and progress via awareness of their susceptibility to alcohol abuse.
Option B: The client is relying heavily on others, and the client’s focus of control is external. AA is a faith-based program and they stress giving over oneself to a “higher power” or God. This does not, however, preclude one from benefiting from the program if they are not particularly inclined toward religion. There are ways to still practice the steps so one can “take what they need” from the program and “leave the rest,” as sometimes advised by those familiar with the program. One piece of advice frequently offered is that your “higher power” can be anything, even be sobriety itself.
Option D: The client is concrete and procedure-oriented; again the client identifies that “Nothing will go wrong that way” if the client follows all the directions. Meetings provide a secure, readily available, and consistent environment to continue to work on your recovery. In particular, these groups provide a support system that can offer stories of hope and reminders of the importance of working a recovery program. After all, in the context of recovery from addiction, support groups have a specific purpose: to allow recovering addicts to work on their recovery and help others do the same. It’s a place where hope and a sense of purpose can begin to grow and then flourish.