1 drug abuse recovery tools: maps, games, and mind play don dansereau psychology department texas...

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DRUG ABUSE RECOVERY TOOLS: Maps, Games, and Mind Play

Don DansereauPsychology Department

Texas Christian University

December, 2002University of Texas

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DONProfessor of Psychology

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Enjoys:• Master’s Track & Field• Golf• Fishing/Hiking• Photography• Grandchildren

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Born in Long Beach, CA

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Focusedon

cognitive psychology

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Co

M.S.&

Ph.D.

Co

High school & B.S. in industrial

engineering

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Grade SchoolCo

Teaches:• Statistics• Cognition• Learning strategies

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PrincipalInvestigator,NIDA Grant

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Rhode Island

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Buffalo, NY

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Carnegie Mellon UniversityPittsburgh, PA

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Texas Christian University

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?N

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Cognitive Enhancement Funding History

Drug Abuse Treatment And Research (DATAR I,D. Dwayne Simpson – PrincipleInvestigator)

Cognitive Enhancements forthe Treatment of Probationers(CETOP I, Don Dansereau –Principle Investigator)

DATAR II

CETOP II

DATAR III

1989-1995

1994-2000

1995-2002

2000-present

1999-present

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SufficientRetention

Early Engagement

Early Recovery

Posttreatment

Drug Use

Crime

SocialRelations

ProgramParticipation

TherapeuticRelationship

BehavioralChange

Psycho-SocialChange

ClientAttributesat Intake

Motive

CognitiveStrategies

BehavioralStrategies

Social SkillsTraining

Family &Friends

SupportiveNetworks

ReadinessTraining

Personal Health Services

Social Support Services

ProgramCharacteristics

StaffAttributes& Skills

TCU DRUG ABUSE RECOVERY TOOLS (DART)

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Enhanced Readiness Enhanced Counseling Special Topics  Will Core(Motivation) Skill (Personal Resources) Session Support Counseling  ● Downward Cognitive Awareness and Control ● Micro Modules ● Free Maps ● 12 Step Manual Spiral ○ Sudden Strengths ● Guide Maps ● Parenting

- Logical Thinking -Self Awareness/ ○ Rafting/Mind Play ● Information ● Time Out for me ● Map Magic Self Control ○ Flash Mapping Maps ● Time Out for men ● Skills booklets ● Under Construction ● Straight Ahead #2,5, and 8 ● Skills Booklet #7

-Creativity -Social Awareness/ ● Thought Communication

Team ● Viewpoint game ● Skills booklet #6

-Memory ● Skills Booklets -Emotional Control #3 and 4 ● Inward Bound

● Skills Booklet #9 

Figure 3 TCU DRUG ABUSE RECOVERY TOOLS

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Organizational DynamicsOrganizational Dynamics

Institutional & Institutional & Personal ReadinessPersonal Readiness

Stages of TransferStages of Transfer

ProgramProgramImprove-Improve-

mentment

1-1-ExposureExposure ((TrainingTraining))

• LectureLecture• Self StudySelf Study• WorkshopWorkshop• ConsultantConsultant

ProgramProgramChangeChange

InstitutionalInstitutionalSupportsSupports

2-2-AdoptionAdoption(Leadership decision)(Leadership decision)

4-4-PracticePractice(Routine use)(Routine use)

3-3-ImplementationImplementation(Exploratory use)(Exploratory use)

ResourcesResourcesMotivationMotivation

ClimateClimatefor Changefor Change

StaffStaffAttributesAttributes

ReceptionReception& Utility& Utility

Time & Time & PlacePlace

StaffStaff

Characteristics of the TCUDrug Abuse RecoveryTools

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Theory Based Evidence Based Pragmatically Based

Flexible EngagingEasy To Learnand Use

• Comprehensive content based on Simpson’s process model

• Design characteristics based on Simpson’s technology transfer model

• Demonstrated effectiveness in a variety of settings

• Numerous published reports of effectiveness

• Modular, all components can be used independently

• Open to counselor development & tailoring

• Can be used in a variety of settings (e.g., large & small groups, CJ, and community programs

• Can be used independently by clients (e.g., homework)

• Heavy use of games & “hands on” activities • Humor & popular culture integrated into many components

• Involving, counter- intuitive demonstrations used to initiate & maintain interest

• 2 hour workshops are sufficient for most components • Can be easily integrated into most settings • Descriptions & instruction are presented in a “user friendly” style

CHARACTERISTICS OF THETCU DRUG ABUSE RECOVERY TOOLS

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Enhanced Readiness Enhanced Counseling Special Topics  Will Core(Motivation) Skill (Personal Resources) Session Support Counseling  ● Downward Cognitive Awareness and Control ● Micro Modules ● Free Maps ● 12 Step Manual Spiral ○ Sudden Strengths ● Guide Maps ● Parenting

- Logical Thinking -Self Awareness/ ○ Rafting/Mind Play ● Information ● Time Out for me ● Map Magic Self Control ○ Flash Mapping Maps ● Time Out for men ● Skills booklets ● Under Construction ● Straight Ahead #2,5, and 8 ● Skills Booklet #7

-Creativity -Social Awareness/ ● Thought Communication

Team ● Viewpoint game ● Skills booklet #6

-Memory ● Skills Booklets -Emotional Control #3 and 4 ● Inward Bound

● Skills Booklet #9 

TCU DRUG ABUSE RECOVERY TOOLS

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Research Approach

We systematically create, introduce, and evaluate new induction techniques for drug abuse treatment within the criminal justice system

Evaluation

Development of New Induction

Techniques

• Collaboration with treatment providers (e.g., counselors, administrators)

• Examination of the treatment literature

Modification of techniques based on evaluation

• Psychometrically sound evaluation system

• Random assignment to treatment or standard groups

• Sufficiently large data bases

• Powerful statistical methods to examine our manipulations

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Confidence

Knowledge

Resources

If I getinvolved in treatment, can I stick with it?

And will it work?

Confidence

Knowledge

Resources

If I makethe change will I be able to handle it? And will it

be good?

Steps to ReadinessEnhancing Steps to Readiness: 2 Examples

Yes! Yes!

Thinking About Whether or not to Change

Deep Readiness for Change

Thinking About the Process of Change (Treatment)DOWNWARD

SPIRAL

UNDERCONSTRUCTION

UNDER CONSTRUCTION

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• Under Construction is a strengths and quotes selection activity in which clients apply these to problem situations

Under Construction

• It has been shown to calibrate appropriate levels of self-esteem, to improve mood, and maintain arousal

(Sia, Czuchry, & Dansereau, 1999)

DownwardSpiral

• Downward Spiral is sole-survivor type of game in which clients see how continued drug use affects their life

• Backed by research that supports its effectiveness

(Czuchry & Dansereau, 2000; Sia, Dansereau, & Czuchry, 2000; Czuchry, Sia, & Dansereau, 1999)

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• Downward Spiral is a board game like Monopoly

• Players roll the dice and land on a square (each has its own symbol/color)• Cards (with matching symbol/color) are read to players

• Players mark points lost on score sheet

Playing downward

spiral

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Your kids are caught using drugs at school and they say they got the drugs from you.

Lose 5 Family pts.

Serious involvement with drugs is related to whether other family members are also drug users.

Fact

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Downward Spiral Personal Assets Score Sheet

Jail

Health

Thinking/ Judgment

Physical

Emotions/ Sanity

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Self-concept

Self-Confidence

Personal Accomplishment

Personal Satisfaction

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Social Support

Friends

Family

Significant Other

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Personal Assets worth

car

computer

TV/VCR

stereo

Compact disks

camera

jewelry

$5,000

$1,000

$200

$200

$200

$60

$150

Keep trackof score

on personalassets score

sheet

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Social Support

SignificantOther

Family

Friends

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Your kids are caught using drugs at school and they say they got the drugs from you.

Fact

Serious involvement with drugs is related to whether other family members are also drug users.

Lose 5 Family pts.

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Downward Spiral Personal Assets Score Sheet

Jail

Health

Thinking/ Judgment

Physical

Emotions/ Sanity

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Self-concept

Self-Confidence

Personal Accomplishment

Personal Satisfaction

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Social Support

Friends

Family

Significant Other

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15

Personal Assets worth

car

computer

TV/VCR

stereo

Compact disks

camera

jewelry

$5,000

$1,000

$200

$200

$200

$60

$150

Health

SocialSupport

SelfConcept

Financial

Legal

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Downward Spiral Squares

Health Recovery

Social Support

Self-Concept

Financial/LegalChance Square

Death

Safe Squares

Transports You

Opportunity

Money

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downwardspiral

Game summary

• Start the game with $200• Each Roll a die to see who rolls first

• Roll 3 dice and move the total number of spaces indicated• Select the card that matches the square and read it to the group

• follow the instructions on the game card• Keep track of what occurs on your score sheet

You Lose if:• You Die by losing all of your health points• You die by landing on a death square• you go to jail 4 times

• you recover by landing on the recovery square• You outlast other players

• your opponents select you as the winner

You Win if:

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Three Major Components

1. Tower of StrengthsCalibrating self-esteem through a personal inventory of actual and desired strengths

2. Building Blocks Using Quotes for inspiration and motivation

3. Putting it all Together

Personal problem solving using strengths and quotes

Under Construction

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Then select 5 strengthsyou desire and writethem in these boxes

PARTS OF YOU

Write down how many strengths of each type you desire. S = T = H = 1 E = M = L =

Write down how many actual strengths of each type you have. S = T = H = E = M = L =

DESIRED STRENGTHS

FOUNDATION OF ACTUAL STRENGTHS

Select 10 strengthsyou currently have fromstrength cards, and write them in the boxes

Athletic H

Friendly S

Athletic H

Friendly S

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Mistakes are a fact of life.It is the response that counts.Nikki Giovanni (born 1943)

U.S. Poet

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Use Quotes as “Building Blocks” to help you achieve your Desired Strengths

BUILDING BLOCKS

Ideas For Achieving Desired Strengths

Do not bite at the bait ofpleasure,

till you know there is nohook beneath it.

Thomas Jefferson (1743-1826)U.S. President

The giving is the hardest part.What does it cost to add a smile?Jean De La Bruyere (1645-96)

French Writer

A journey of a thousand milesmust begin with a single step.

Lao Tzu (6th Century)

Friendly S

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PUTTING IT TOGETHER

Picture How

Picture How

Picture How

able to expressfeelings

PersistentDeterminedWilling to take a stand

Dealing with the stressfrom my Dad!!

The supreme happiness of lifeis the conviction we

are loved!!

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Rationale

Targeted Skills

Learning to switch perspectives is a difficult cognitiveskill

The Viewpoint Game makes learning cognitive skills interesting and approachable

Enhanced Communication

Perspective Taking/Shifting Skills

Enhanced Emotional Control

Improved Cooperation (practice giving and receiving helpful advice)

Playing the game requires communicating and cooperating effectively

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AdaptableQuotePerson

Strength

I wish I was more Spiritual

I wish I had more

confidencein myself1. Players select 2 problems from Problem Deck

I wish I had more

confidencein myself

I wish I was more Spiritual

2. Players select 5 New View cards

Martin Luther King, Jr.

PersonAdaptable

Strength

Picture

A journey of a thousand miles

must begin with a single step.

Lao Tzu (6th Century)

Quote

3. Players try to apply New View cards to any of the problems

Picture“I think a key could apply to your spirituality. Maybe by unlocking or opening yourself to new ideas, you will allow yourself to be more spiritual.”

4. Players receive one bead from each player who felt the advice was actually helpful

5. There are multiple winners

Most Beads Overall

Most Blue Beads(focused on own problems)

Most Green Beads(focused on other’s problems)

Most Clear Beads(Most Cooperative with others)

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Enhanced Readiness Enhanced Counseling Special Topics  Will Core(Motivation) Skill (Personal Resources) Session Support Counseling  ● Downward Cognitive Awareness and Control ● Micro Modules ● Free Maps ● 12 Step Manual Spiral ○ Sudden Strengths ● Guide Maps ● Parenting

- Logical Thinking -Self Awareness/ ○ Rafting/Mind Play ● Information ● Time Out for me ● Map Magic Self Control ○ Flash Mapping Maps ● Time Out for men ● Skills booklets ● Under Construction ● Straight Ahead #2,5, and 8 ● Skills Booklet #7

-Creativity -Social Awareness/ ● Thought Communication

Team ● Viewpoint game ● Skills booklet #6

-Memory ● Skills Booklets -Emotional Control #3 and 4 ● Inward Bound

● Skills Booklet #9 

 TCU DRUG ABUSE RECOVERY TOOLS

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• RAFTing is a Relaxation And Focusing technique

• Research suggests it reduces cravings, heightens mental clarity, reduces blood pressure, pain, and much more.

(Benson, 2000)

• Mind Play is an activity designed to heighten appreciation for mental imagery and to explore its application to life situations • We are just beginning to examine its effectiveness

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RAFTing

Why do it?What is it? How do you do it?

Rafting is a technique that uses relaxation and a mental focus to gain emotional control and to harness your mental capabilities.

RAFT stands for:Relax and Focus

Technique

“Because, Everyone Cool Does!!”

Actually, Olympic athletes, Tiger Woods, businessmen and women, and others all use the technique to improve their lives and their performance.

1. Find a quiet and comfortable location.

2. Allow your muscles to relax.

3. Focus on your breaths going in and out, or repeat a word, phrase, or focus on an object.

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Mind Play

Why do it?What is it? How do you do it?

Mind play is using “Mental Pictures” or imagery to unlock your creative and forward thinking potentials.

It lets you practice for important events in your mind.

EXAMPLES:

Improvement on skills such as free throws, dart throwing, and spiking in volleyball.

1. RAFT

2. Choose a topic for your Mind Play

3. Get a clear mental picture of what will happen

4. See yourself succeed.

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Rationale Behind Node-Link Mapping

• Counseling involves helping clients understand and manage their personal problems and issues.

• Cognitive psychologists have determined that the critical step is defining and representing the problem.• Visual representations are recommended (“A picture is worth a thousand words”).

• There is limited use of visuals in counseling (no general purpose system available).

• TCU node-link mapping system may be the answer.

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Main “Parts” of Node-Link Maps

• A node, which is just an idea captured in a box, circle, or other shape

For Example:

• Links (named or not) which show the relationship between nodes

For Example:EX

Blockbuster Movie

Blockbuster Movie

Titanic

“An Example of a Blockbuster Movie is Titanic”

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Node-LinkMapping

TT

Knowledge Maps Free Mapping Guide Maps

T

ExpertProduced Structured

ConveyInformation

Represent & ExplorePersonal Issues

Represent & ExplorePersonal Issues

JointlyProduced Spontaneous Structured/

Free

FrameworkProvided by

ExpertC

C C C CC C

CC

LegendT = TypeC = Characteristic

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NODE-LINKMAPS

Good Communication

Compatible with Human Memory Easy to Navigate

Easy to Illustrate CyclesLess Word Clutter

CC

CC

L

Knowledge Map

LegendC = Characteristic L = Leads To

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Dealing With Relapse

“Finally accept thefact that I may

need help.”

Hit rock bottom

Realize youmay be weak

DenialPut blameon others

Hurtingothers

Positive thoughts

Desire tobe clean

P

PP

P

L

L

Ex

P

Free Mapping

LegendP = PartL = Leads ToEX = Example

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Your Goal

1

Why do you wantto reach this goal?

What support doyou have to reachthis goal?

What steps should you take?

1.

2.

3.

4.

2 3

4

5 6

Problems you might encounter? Ways of dealing with the problems?

C

CC

CP

Find an AA sponsor

I want to be ableto stay cleanI want to be a goodparent

My higher powerMy parentsMy kids

Go to several localAA meetingsSelect the one Ifeel the most comfortable atTalk to some members

Just ask one!!

May be too nervous to askTransportation may be a problem

Remind myself how important this is to doI could take the bus, or walk

LegendP = PartC = Characteristic

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The Set of Link Types

Actions

Influences

Leads to

Next

Descriptions

Characteristic

Part

Type

IllustrationsAnalogy

Comment

Example

Name Symbol

I

L

N

C

P

T

A

Co

Ex

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USE OF MAPS IN A COUNSELING SESSION

• Focus attention on the topic at hand

• Easy reference to past discussions

• Way of getting off “dead center” – Link types provide ready-made questions to ask

• Provide a workspace for exploring possible changes and corrective actions

• Memory aid for client and counselor

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Counseling

Session

New Ideas

Memory

Communication

FocusC

C

C

C

Important Features of a Counseling Session That Mapping Improves

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Communication

PP

Helps Clients withDifferent Ethnic

Backgrounds

• Dansereau, Joe, Dees,& Simpson, 1996

• Blankenship, Dees, & Dansereau, 1997

(conference presentation)

Helps Clients withLess Education

• Pitre, Dansereau, & Joe,1996

Client Perceptions of Communication

Ability

• Newbern, Dansereau,& Pitre, 1999

P

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Focus

Helps ClientsWith Attentional

Problems

EnhancesGroup Counseling/

On Task Performance

• Czuchry, Dansereau, Dees,& Simpson, 1995

• Dansereau, Joe, & Simpson,1995

• Joe, Dansereau, & Simpson,1994

• Dansereau, Dees, Greener,& Simpson, 1995

• Dansereau, Joe, & Simpson,1993

• Knight, D., Dansereau, Joe,& Simpson, 1994

PP

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Idea Producing

Greater Breadth

Greater Depth

•Collier, Czuchry,Dansereau, & Pitre,

2001•Dansereau, Dees,Greener, & Simpson,1995

•Newbern, Dansereau,& Dees, 1997

Insights

Identify Gaps

Uncover Psychological

Issues

PP

PP

LL

• Czuchry & Dansereau,1999

• Dansereau, Joe, &Simpson, 1993

• Dansereau, Joe, &Simpson, 1993

• Pitre, Dansereau,& Simpson, 1997

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MoreMemorable

Educational Settings Treatment Settings

P P

N

• Holley & Dansereau, 1984

• Rewey, Dansereau, Skaggs,Hall, & Pitre, 1989

• Rewey, Dansereau, &Peel, 1991

• Knight, Boatler, & Simpson,1991

• Knight, K., Simpson, &Dansereau, 1994

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Therapeutic Alliance

Increased ClientRapport

• Dansereau, Joe, & Simpson, 1993

• Dansereau, Joe, & Simpson, 1996

• Dansereau, Joe, Dees, & Simpson, 1996

Stronger Alliance

• Simpson, Joe, Rowan-Szal, &Greener, 1997

PP

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During TreatmentSelf Assessments

• Pitre, Dees, Dansereau,& Simpson, 1997

• Dansereau, Joe, & Simpson, 1993• Dansereau, Joe, & Simpson, 1995• Dansereau, Joe, Dees, & Simpson, 1996• Joe, Dansereau, Simpson, 1994

Pitre, Dansereau, Newbern,& Simpson, 1997Newbern, Dansereau, &Pitre, 1999

Blankenship, Dees, & Dansereau, 1997Newbern, Dansereau, &Pitre, 1999

Czuchry, Dansereau, Dees,& Simpson, 1995Knight, D., Dansereau, Joe,& Simpson, 1994Pitre, Dansereau, Newbern,& Simpson, 1997

Self Confidence Self Efficacy

Therapeutic Progress

ProblemSolving

Positive AffectiveResponses

P P

PP

P

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During TreatmentBehavioral Indicators

Czuchry, Dansereau, Dees,& Simpson, 1995

Dansereau, Joe, Dees, & Simpson, 1996

Dansereau, Joe, & Simpson, 1993

Joe, Dansereau, & Simpson, 1994

Miss FewerSessions

Less Urines Positivefor Opiates or Cocaine

Czuchry, Dansereau, Dees,& Simpson, 1995

Dansereau, Joe, & Simpson, 1995

Dees, Dansereau, Simpson, 1997

P P

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Post TreatmentBehavioral Indicators

Less Opiate Use Less Needle Use Less Criminal Activity

PP

P

• Pitre, Dansereau, & Joe, 1996

• Joe, Dansereau, &Simpson, 1997

• Pitre, Dansereau, & Joe, 1996

• Joe, Dansereau, &Simpson, 1997

• Pitre, Dansereau, & Joe, 1996

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Enhanced Readiness Enhanced Counseling Special Topics  Will Core(Motivation) Skill (Personal Resources) Session Support Counseling  ● Downward Cognitive Awareness and Control ● Micro Modules ● Free Maps ● 12 Step Manual Spiral ○ Sudden Strengths ● Guide Maps ● Parenting

- Logical Thinking -Self Awareness/ ○ Rafting/Mind Play ● Information ● Time Out for me ● Map Magic Self Control ○ Flash Mapping Maps ● Time Out for men ● Skills booklets ● Under Construction ● Straight Ahead #2,5, and 8 ● Skills Booklet #7

-Creativity -Social Awareness/ ● Thought Communication

Team ● Viewpoint game ● Skills booklet #6

-Memory ● Skills Booklets -Emotional Control #3 and 4 ● Inward Bound

● Skills Booklet #9 

 TCU DRUG ABUSE RECOVERY TOOLS