The Task Planner

An Intervention Resource for Human Service Professionals

William J. Reid

• Publisher: Columbia University Press
• Year: 2000
• eBook ISBN: 9780231506199
• Topic: Social Sciences
• Subtopic: Social Science Research & Methodology
• Index: Social Sciences

A comprehensive, A-to-Z set of task planners for more than one hundred psychosocial problems from alcoholism and anxiety to domestic violence and sexual abuse. Each entry includes a menu of actions the client can undertake to affect resolution, a guide to the practitioner's role in facilitating these actions, and a reference list. An accompanying disk allows social workers to update the task planners they are working with and enables keyword searches for specific topics.

Task Planners

Alcoholism /Addiction

Adult /Adolescent Relapse Prevention

Substance abuse may be defined by continued use of alcohol or other drugs despite adverse consequences. These consequences for adults or adolescents may include one or more of the following: family or work disruption, health problems, engaging in high-risk behaviors, such as driving while intoxicated, and poor school performance or failure (Barker 1995; American Psychiatric Association 1994). The leading causes of death among youths are accidents and suicides, both of which are highly correlated with substance abuse. Research has suggested that substance abuse now begins at an earlier age than in previous generations, and that in youths, substance abuse progresses into polysubstance abuse more quickly than in adults (Nowinski 1990).

Although it may be helpful in work with substance-abusing clients generally, this task planner is oriented toward those who have made progress in treatment but face risk of relapse. Relapse is defined as the resumption of drug use after a period of abstinence. Generally relapse is accepted as a frequent part of the substance abuse/recovery process (National Institute on Drug Abuse 1994). In one large-scale study the only predictor of relapse was severity of drug and alcohol use at admission (McLellan, Alterman, & Metzer 1997).

Literature: Catalano et al. (1991, 1999); Collier & Marlatt (1995); Curtis (1989); Fiorentine (1999); Fischer (1992); Kaminer (1994); Marlatt & Gordon (1985); Marlatt & VandenBos (1997); McLellan, Alterman, & Metzer (1997); National Institute on Drug Abuse (1994); Nowinski (1990); Smyth (1998); Vaughn & Long (1999).

Task Menu Person with substance abuse problem

1. Construct a “relapse plan” that includes actions you will take to prevent relapse if one is imminent (Curtis 1989) and actions you will take if a relapse occurs (e.g., inpatient treatment, increasing relapse prevention efforts, or extended residential placement).

Practitioner’s Role: Provide information on inpatient and other appropriate treatment programs. Assist the client in identifying appropriate actions to take to prevent relapse or to deal with relapse should it occur. For instance, a distinction between a “lapse” and a “relapse” can be made. A lapse is a single incident of drug use and may or may not result in relapse (i.e., returning to previous levels of substance abuse [NIDA 1994]). Therefore, a lapse may be appropriately addressed by increasing relapse prevention efforts, while relapse may require admission to inpatient treatment.

2. Participate in drug-free recreation activities (e.g., sports, clubs, creative pursuits, hobbies).

Practitioner’s Role: Provide the client with information about drug-free programs and activities in the community. Assist client in identifying interests and suggest possible related activities he or she may pursue.

3. Develop a recovery support system, comprised of people who understand your problem and support your abstinence.

Elaboration: Identify supportive relationships and maintain regular contact with your support system via phone calls and shared activities (Nowinski 1990).

Practitioner’s Role: Assist the client in identifying supportive people in their family, peer group, school, and community. If needed, assist client in finding additional members for the support system by suggesting social opportunities for making friends.

4. Learn and practice refusal skills.

Practitioner’s Role: Obtain materials on refusal skills and provide training to the client using such techniques as role playing.

5. Identify triggers as well as risky situations that might cause a relapse.

Practitioner’s Role: Assist the client in identifying high-risk situations that may lead to substance use, as well as relapse triggers he or she may not be aware of (e.g., feelings such as anger, loneliness, fatigue, anxiety; places or activities that remind client of substance use).

6. Identify strategies and alternatives to using alcohol or drugs should relapse triggers occur (Curtis 1989).

Practitioner’s Role: Provide the client with helpful strategies, as needed. For example, have client notice how he or she is feeling, rather than using substances. If a client is anxious, recommend slow diaphragmatic breathing or applied relaxation.

7. Identify cognitions that have led to relapse in the past and develop alternative cognitions that help you remain free of alcohol and other substances.

Practitioner’s Role: Through use of cognitive restructuring, help client assess which cognitions led to the relapse, then work to develop alternative cognitions that assist him or her in remaining free of alcohol and other substances. For example, a client might say, “If I go past our old hangout, I might as well go in and talk to my old friends.” Work with client to develop alternative cognitions, e.g., “Although I go by the old hangout daily, I know I shouldn’t go inside. If passing by it continues to tempt me, I should go another way until I have the ability to resist going in. I should also hang out with my new friends who are cool and avoid substance use.”

8. If relapse occurs, identify precipitating events, feelings, and triggers and record this information in a journal.

Elaboration: Keeping a journal increases awareness and helps prevent future relapses.

Practitioner’s Role: Read client’s journal and utilize information to help the client prevent a relapse triggered by similar circumstances at a future time. For instance, if client has certain patterns, such as being able to go to a former place or type of party and abstain from substances four or five times, but then relapses after the fifth or sixth visit, then that place or type of party is not safe even though the initial successful visits seem to suggest that it is. The journal showing such a pattern suggests the course of action needed to prevent relapse.

9. [if adolescent] Identify school- and career-related goals and take action to prepare for the world of work (Kaminer 1994).

Elaboration: Do any or all of the following: meet with an academic advisor to discuss academic plans, problems, and future goals; learn more about career aspirations by talking to a career counselor; seek out a mentor; obtain a part-time volunteer position; work at a paid career-related job to gain experience to apply toward career goals; look into vocational training; learn how to network.

Practitioner’s Role: Provide referrals to mentoring, vocational training, and job/volunteer programs, as well as career counselors in the community. Teach the client networking skills.

10. Learn and practice communication and problem-solving skills.

Elaboration: Work on communication and problem-solving skills with family members and in other relationships. Participate in family or group meetings and social situations to practice using listening skills and “I messages” (Gordon 1976).

Practitioner’s Role: Train client in communication and problem-solving skills through role plays and family work. Provide written materials to facilitate understanding.

11. Identify stress reduction activities that work for you and utilize them when under stress (e.g., exercise, progressive relaxation, meditation).

Practitioner’s Role: Books, such as Reaching New Highs: Alternative Therapies for Drug Addicts (Heggenhougen 1997) and Life After Psychotherapy (Davison 1997) contain information on meditation as well as other topics to help maintain recovery through the reduction of stress.

12. Participate in self-help groups, such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or Alateen.

Elaboration: Attend meetings, obtain and work with a sponsor, learn about and utilize coping and relapse prevention strategies suggested by fellow members.

The following information on self-help groups may be useful: (for adults)

Alcoholics Anonymous, P.O. Box 459, Grand Central Station, New York, NY 10163; (212) 870–3400. Online directory by states enables one to locate an AA group in any given community: http://www.alcoholics-anonymous.org/econtent.html

Rational Recovery Systems, P.O. Box 800, Lotus, CA 95651; (916) 621– 4374 or (800) 303–2873. http://rational.org/recovery/

Narcotics Anonymous World Services, Inc., P.O. Box 9999, Van Nuys, CA 91409; (818) 773–9999; FAX: [phone]. http://www.na.org or mailto: [email protected]

SMART Recovery, Self-Help Network (Self-Management and Recovery Training). SMART is an abstinence program based on cognitive-behavioral principles, especially those of rational-emotive-behavior therapy. SMART, 24000 Mercantile Rd., Suite 11, Beachwood, OH 44122; (216) 292–0220 (day) or (216) 951–0515; FAX: [phone]. mailto: [email protected] or http://www.smartrecovery.org/ (for adolescents)

Alateen International, c/o Al-Anon Family Group Headquarters Inc., 1600 Corporate Landing Parkway, Virginia Beach, VA 23454 –56127; (757) 563–1600 or (800) 344 –2666. http://www.al-anon.org or http://www.alateen.org

Practitioner’s Role: Provide meeting lists, but be aware that some clients are uncomfortable with twelve-step programs for various reasons. If client is an adolescent, he or she may be unable to relate to perceived differences in personal experiences or perspectives when group members are older. Some communities have young people’s groups, which would be preferable for an adolescent client under these circumstances. See Alateen above.

13. Discuss with your partner ways he or she can help you stay sober.

Practitioner’s Role: Meet with client and partner to develop a plan that the partner can use.

14. Imagine positive aspects of not using and negative aspects of using.

Task Menu Parents or caregivers [if client is an adolescent]

1. Learn about adolescent substance abuse, relapse, and relapse prevention strategies and read articles and books about substance abuse recovery, adolescents, and parenting.

Practitioner’s Role: Educate parents about adolescent substance abuse, relapse, and relapse prevention strategies. Provide reading materials and suggest relevant books (Nowinski 1990; Hawkins & Catalano 1992) on adolescent substance abuse.

2. Participate in Al-Anon or Families Anonymous program.

Elaboration: Attend meetings and obtain and work with a sponsor. Practice the coping skills suggested and ask for support from other members.

The following information may be useful in locating a group:

Al-Anon: Al-Anon Family Group Headquarters Inc., 1600 Corporate Landing Parkway, Virginia Beach, VA 23454 –5612; (757) 563 –1600 or (800) 344–2666. http://www.al-anon.org

Families Anonymous: National: Families Anonymous, P.O. Box 3475, Culver City, CA 90231–3475; (800) 736–9805 or (310) 313– 5800. email: http://www.familiesanonymous.org

Practitioner’s Role: Provide meeting lists. Suggest the book Alcohol Problems Among Adolescents (Boyd, Howard, & Zucker, 1995).

3. Work with adolescent to identify risky behaviors and together plan reasonable consequences for behaviors.

4. Provide appropriate supervision.

Practitioner’s Role: Educate and provide parents or caregivers with information and strategies for appropriate supervision of an adolescent with a substance abuse problem. The Handbook of Parenting, Volume 4: Applied and Practical Parenting (Bornstein 1995) should prove useful in this task.

5. Whenever possible, keep household drug/alcohol free.

6. Provide transportation to drug-free activities and tw...

Table of contents

• Cover 
• Half title
• Title
• Copyright
• Dedication
• Contents 
• Acknowledgments
• List of Task Planners
• Simplified Guidelines
• Task Planners: Overview and Applications
• Task Planners
• Common Procedures
• Appendix: Task Schedule
• References
• Index