Conditions & Symptoms - Level 1
Goal: Partner with the individual to find out what they understand about addiction, including common criteria for substance dependence or abuse.
Possible Action Steps
- Find out if the individual is interested in talking about addiction in general terms, or their addiction(s) more specifically. If not, find out what the individual wants to talk about today and talk about that instead.
- Find out whether individual will identify and speak honestly about their addiction(s). What is his/her substance use status right now? Relapse or recovery?
- Talk about common criteria for substance dependence and have individual identify the ones that they think are true for them.
- Need for more
- Withdrawal symptoms
- Substance taken in large amounts over long period of time
- Desire or unsuccessful efforts to cut down/control use
- Much time and effort spent to obtain the substance
- Other activities are eliminated or reduced due to use
- Use continues even knowing it causes physical/psychological problems
- Ask individual to discuss one or two most troubling physical/psychological/social problems related to their addiction.
- Find out if the individual has had thoughts of suicide and/or death. If yes, talk about the need to call 9-1-1 or a doctor.
- Provide individual with praise for participating in today's health coaching session today and provide a supporting resource of interest.
Goal: Promote awareness of the language of addiction.
Possible Action Steps
- Find out if the individual would like to talk about their understanding of addiction. If not, learn what he/she would like to talk about today and talk about that instead.
- Find out if the individual has heard words and phrases used in the discussion of addiction that they don't fully understand.
- Together, review key addiction terms and words - e.g. relapse prevention, 12-step program, cycle of addiction, detoxification, co-morbid condition, "wet brain," dual diagnosis, relapse trigger, etc.
- Find out if the individual has any unanswered questions about addiction - try to respond to each question.
- Provide individual with praise for participating in today's health coaching session today and provide an interesting supporting resource.
Goal: Build awareness of the substances that are commonly abused - frequently, more than one at a time.
Possible Action Steps
- Find out if the individual is interested in talking about the problem of poly-substance abuse. If not, find out what the individual wants to talk about today and talk about that instead.
- Talk about commonly abused substances and have individual identify the ones that they use or have used. (HINT: alcohol; amphetamines; caffeine; cannabis; cocaine; hallucinogens; inhalants; nicotine/tobacco; opioids; phencyclidine; sedatives, hypnotics, anxiolytics, etc.)
- Find out what substance or substances are of greatest concern to individual. Learn if they are in relapse or remission for each substance.
- Together, figure out the monetary cost of all non-food substances consumed by individual. What percent of each day revolves around all non-food substances consumed?
- Learn why the individual believes they have to depend on or abuse substances to get through the day. Why do they need to change the way they feel? Do they want to make any changes?
- Provide individual with praise for participating in today's health coaching session today and provide an interesting supporting resource.
Goal: Encourage individual to engage in a regular pleasurable activity that does not involve any addictive substances on most days.
Possible Action Steps
- Find out if the individual would like to talk about engaging in a pleasurable activity of their choosing that does not involve any addictive substances. If not, find out what he/she would like to talk about today and talk about that instead.
- Together, make a short list of activities the individual has done in the past that they enjoyed. Are they still interested in these activities?
- Find out if there are any activities the individual has never tried that are of interest to them right now. What would need to happen to get started on a fun activity?
- Talk about how substance use usually starts as a way to positively change the way a person feels. Discuss how mood is elevated when engaging in a pleasurable activity. Ask individual to roughly figure the percentage of each day spent in pleasurable activities. Could this percentage be increased? Could mood be elevated without addictive chemicals?
- Ask individual to commit to increasing the amount of time each day spent in pleasurable activity and notice any impact on mood.
- Provide individual with praise for participating in today's health coaching session today and provide an interesting supporting resource.
Goal: Build awareness that long-term addictions can result in multiple physical and mental health problems.
Possible Action Steps
- Find out if the individual would like to talk about physical and mental health problems caused by chemical addictions. If not, find out what he/she would like to talk about today and talk about that instead.
- Talk about common mental health issues that are made worse by substance abuse - depression, anxiety, suicide, stress and coping problems, memory loss, and dementia.
- Talk about common physical health issues that are made worse by substance abuse - constipation/diarrhea, gastrointestinal diseases, nutritional deficiencies, anemia, neurologic diseases, diabetes, high blood pressure, cirrhosis, seizures, shortened life, osteoporosis, weight loss, dehydration, etc.
- Find out if the individual can identify their mental and physical health consequences of their addiction(s). What additional drugs do they need to treat these problems?
- Find out if the individual believes they need help to deal with an addiction problem. If so, encourage ongoing participation in a recovery group/program like AA or NA.
- Provide individual with praise for participating in today's health coaching session today and provide an interesting supporting resource.
Goal: Help individual identify what is a priority for them with regard to how they feel and function.
Possible Action Steps
- Ask individual if they would like to talk about their accomplishments and life priorities. If not, find out what he/she would like to discuss today and talk about that instead.
- Discuss with individual how their life priorities conflict with how they feel and function. How does cost of addiction and time spent on addiction impact individual's stated life priorities?
- Together, identify a small action step to work toward what is important to the individual. If individual is in either relapse or recovery, would they be open to ongoing participation in a recovery group?
- If individual is unable to identify a small action step, make some suggestions: take a short walk each day, do one fun thing each day, join AA /NA recovery group, resume a meaningful hobby, etc.
- Ask individual to commit to take a small action step to feel and function better.
- Provide individual with praise for participating in today's health coaching session today and provide an interesting supporting resource.
Goal: Work with the individual to ensure that they understand that addicts can recover even if they have failed in the past.
Possible Action Steps
- Find out if the individual would like to discuss their past efforts to recover and live in recovery. If not, find out what he/she would like to talk about today and talk about that instead.
- Find out which solutions to addiction the individual has been given in the past - solutions from friends, family, healthcare providers, etc. What has worked, even if for a short time?
- Talk about the individual's level of interest in kicking their addiction(s) and living in recovery.
- Ask individual to look into the future and describe their life on a recovery path vs. a recidivism path. What has more appeal? What would it take to get on and stay on the path of choice?
- Provide individual with praise for participating in today's health coaching session today and provide an interesting supporting resource.
Goal: Help the individual get more help and support out of interactions with healthcare providers, family, and friends.
Possible Action Steps
- Find out if the individual would like to talk about key members of their healthcare and recovery team - AA / NA sponsor, primary care doctor, psychiatrist/psychoanalyst, pharmacist, spouse, partner, family member, friend, neighbor, etc. If not, find out what he/she would like to talk about today and talk about that instead.
- Find out if the individual believes they have supportive-others in their life. Have they had supportive experiences with peers in recovery groups like AA and NA?
- Find out if individual believes they have ongoing positive contact with people outside his/her family. If not, where does individual think that they could get involved with supportive people and groups?
- Together, role-play to help individual feel comfortable asking questions to a sponsor or healthcare provider.
- Ensure that all necessary healthcare appointments and recovery group meetings are scheduled and the individual has transportation to get to all meetings and appointments.
- Provide individual with praise for participating in today's health coaching session today and provide an interesting supporting resource.