Presents Action Methods in Addiction Treatment: An Introduction to Psychodrama, Sociometry  Group Psychotherapy   Addict

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Presents Action Methods in Addiction Treatment: An Introduction to Psychodrama, Sociometry Group Psychotherapy Addict

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2. Bellwood Health Services Founded in 1984 by Dr. Gordon Bell and Linda Bell 60 bed facility located in Toronto Treatment available on residential, day, or out-patient basis Accredited by the Canadian Council on Health Services Accreditation

3. Treatment Programs

4. Who Is Eligible? Males and females 19 years of age and over from across Canada

5. Treatment Philosophy Abstinence based program of education, therapy and physical healing. Holistic approach to treatment: Physical Mental Social Spiritual

6. Staff Interdisciplinary team has extensive medical, counselling and therapy experience in addiction and lifestyle enrichment.

7. Psychodrama at Bellwood An integral part of weekly Group Therapy program … the 4th group Clients in the residential program meet for 2-hour drama sessions ... maximum 12 clients per group Staffing: 2/3 Team members - psychodrama director and supporting team members

9. Definition of Psychodrama J.L. Moreno, the creator of Psychodrama, defines it as “the science which explores the truth by dramatic methods”.

10. What is Psychodrama? A method of learning through the spontaneous enacting of life-situations May be from past, present or future May be real or hypothetical Uses guided dramatic action to examine problems or issues raised in groups or individual sessions

11. How? A group member (the protagonist) acts out significant life scenes Other group members play the supporting characters (auxiliaries) of the story The director, a trained psychodramatist, guides participants in the action as the drama develops

12. Use of Psychodrama Can be used in individual and group treatment Involves action methods as well as verbal methods It is a powerful action method of group psychotherapy

13. Mind-Body Connection “The mind in action draws insight from the body’s knowing; the spirit encountered calms the troubled heart.” - Liz White, The Action Manual

14. Psychodrama Interpersonal Intrapsychic Role Training

15. Where and For Whom Broad range of mental health, educational and industrial environments throughout world Proven effective with low and high functioning populations Improves awareness, self-esteem, effectiveness in relationships

16. Treatment of Alcoholism Psychodrama has been used in the treatment of alcoholism since 1944 at the Psychodrama Institute in New York, founded by J. L. Moreno.

17. Value of Psychodrama Especially valuable in working with addicted population and family members Psychodrama -> one of 1st treatment methods to recognize an addicted person’s interpersonal/ intergroup relationships as essential elements of their problem

18. Psychodrama and Self-Help Programs Psychodrama is primarily a group action method Logical treatment extension of 12 Step programs

19. Supportive Environment Provide a trusting/ mutually supportive environment Encourage exploration, sharing of feelings and concerns with others Reduce feelings of isolation, fear, anger and loneliness Can be a temporary “Higher Power” until deeper spiritual role developed

20. Components of Treatment Both AA and Psychodrama foster mutual sharing and self-disclosure -> emotional connectedness Group members relate to the feelings and personal experiences of the psychodramatic enactment Each is a therapeutic agent for the other Mutual healing occurs Opportunity to “live twice”

21. Value of Psychodrama in Therapy Can be used in conjunction with other therapies Immediate emotional involvement: Helpful in working with addicts who can be withdrawn, reticent, isolated and in need of social reconnection Ideal vehicle for reversing passivity and denial

22. Confronting Denial Encounter the drug Find new solutions

23. Witnessing Recovering person may:

24. Goals in Early Recovery Groups Confront the drug/ addictive behaviour Recognize and express feelings Develop and rehearse new solutions to situations and problems Increase self-esteem, empathy and spontaneity Examine attitudes, relationships and roles related to addiction Increase group interaction and cohesion

25. Participation May be significant accomplishment for some individuals Work with a sense of humour!

26. Development of Addiction

27. Addictions Behaviours Gambling Work Shopping Food Exercise Sex Computer Substances Alcohol Drugs Tobacco

28. What is Sociometry? Definition: A science which studies the formation and construction of groups Uses methods to describe and account for interpersonal relations within groups Makes the covert, overt Reveals underlying connections Used for group building

29. Group Building Belonging Cooperation Cohesion Openness Access to roles

30. J.L.Moreno’s Concept of Mental Health Spontaneity Creativity

31. The Five Elements of Psychodrama The Director The Protagonist The Auxiliary Ego The Stage The Audience

32. Psychodrama Evolves in Three Stages To self To others To theme Suggested by the Director usually through an exercise A protagonist emerges

33. Psychodrama Evolves in Three Stages (Cont’d) A “star” or protagonist comes forward to act out their dilemma Generally related to a group theme Dramatizes the protagonist’s dilemma Director initiates interactions between protagonist and group members

34. Psychodrama Evolves in Three Stages (Cont’d) Group members, selected by protagonist, play significant roles Continues until protagonist achieves a shift in perception and tests a new approach

35. Psychodrama Evolves in Three Stages (Cont’d) Group members share their emotions and associations evoked by the enactment Auxiliaries share the feelings experienced in the roles played Often these remarks have deep significance for the protagonist Reduces feelings of exposure for protagonist

36. The Hollander Curve

37. The Social Atom A sociometric exercise The participant explores on paper and in action the nucleus of persons to whom he/ she is connected It observes and measures the nearness and distance which exists in the relationships It accounts for inclusion or exclusion from participant’s social circle

38. Moreno’s Social Atom

39. Social Atom-Collectives

40. Applications in Addiction Treatment Atoms can measure an addict’s relationships with people, places or things For example Work Cocaine Food Sex Exercise Family Friends

41. Application in Recovery Recovering persons can explore support and recovery resources For example Sponsor 12 step programs Therapy Journaling skills Family Friends The two atoms can be compared in action

43. Sobriety/Magic Shop Sobriety Shop: variation of classic Magic Shop Structured exercise where unwanted, dysfunctional qualities magically transform into desired/beneficial qualities

44. Sobriety/Magic Shop (Cont’d) Mutually agreed fantasy/surplus reality Language of metaphor Bargaining process

45. Sobriety/Magic Shop (Cont’d) Lying, stealing, grandiosity, people-pleasing is highly valued in addiction. This is dysfunctional in recovery. Honesty, self-esteem, serenity, self-care. These are helpful new qualities in recovery.

46. Sobriety/Magic Shop (Cont’d) Problem to the Solution Solution = 60% of action time Willfulness and Willingness = Motivation

47. Sobriety/Magic Shop (Cont’d) Shopkeeper -> Action Director Customers seeking exchange qualities -> Protagonists Assistants in action -> Auxiliaries Audience -> Commentators/Greek Chorus

48. Sobriety/Magic Shop Action Steps Scene Setting Qualities/ behaviours stocked in shop In/ Available signs Barter system In: Brainstorm qualities contributing to addiction/ dysfunctional in recovery. Available: Brainstorm qualities helpful in recovery.

49. Sobriety/Magic Shop Action Steps (Cont’d) Action exploration of qualities. Methods are the following: Interviewing role-reversals Doubling Mirroring Sculpting role-training Bargaining quantity of quality

50. Sobriety/Magic Shop Action Steps (Cont’d) Customer receives new quality: Anchoring -> in body Psychodrama photo Concretize in object Contract for use Report to 12-Step Meeting/Sponsor Sharing

51. Sobriety/Magic Shop Conclusion Metaphor for death Re-birth No gain without loss Group = therapeutic agent Creativity through spontaneity/ play Optimistic view of human potential

52. Resources The Action Manual (Elizabeth White) Available by contacting [email protected] The Living Stage (Tian  Dayton) Trauma and Addiction (Tian  Dayton) Drama Games (Tian  Dayton)

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