Title: Action Methods in Addiction Treatment:
1Presents Action Methods in Addiction
Treatment An Introduction to Psychodrama,
Sociometry Group Psychotherapy Addictions
Ontario June 3rd, 2008
Fiona G. Roche, B.Sc., CQSW, RSW, CGPA(dip),
TEP Therapist, Trainer Educator and Practitioner
of Psychodrama
www.bellwood.ca
2Bellwood 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
3Treatment Programs
Alcohol Drugs Gambling Sexual Addiction Eating
Disorders
4Who Is Eligible?
- Males and females 19 years of age and over from
across Canada
5Treatment Philosophy
- Abstinence based program of education, therapy
and physical healing. - Holistic approach to treatment
- Physical
- Mental
- Social
- Spiritual
6Staff
- Interdisciplinary team has extensive medical,
counselling and therapy experience in addiction
and lifestyle enrichment.
- Physicians
- Psychiatrists
- Clinical psychologists
- Registered nurses
- Psychotherapists
- Addiction counsellors
- Drama therapists
- Nutritionists
- Physiotherapists
- Fitness coaches
- Massage therapists
- Spiritual health counsellors
- Social workers
- Life skills coaches
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
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9Definition of Psychodrama
- J.L. Moreno, the creator of Psychodrama, defines
it as the science which explores the truth by
dramatic methods.
10What 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
11How?
- 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
12Use 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
13Mind-Body Connection
- The mind in action draws insight from the bodys
knowing the spirit encountered calms the
troubled heart. - Liz White, The Action Manual
14Psychodrama
Sessions are either
- Interpersonal
- Intrapsychic
- Role Training
15Where 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
16Treatment 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.
17Value of Psychodrama
- Especially valuable in working with addicted
population and family members - Psychodrama -gt one of 1st treatment methods to
recognize an addicted persons interpersonal/
intergroup relationships as essential elements of
their problem
18Psychodrama and Self-Help Programs
- Psychodrama is primarily a group action method
- Logical treatment extension of 12 Step programs
19Supportive Environment
Both
- 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
20Components of Treatment
- Both AA and Psychodrama foster mutual sharing and
self-disclosure -gt 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
21Value 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
22Confronting Denial
Using Empty Chair Technique
- Encounter the drug
- Find new solutions
23Witnessing
- Tell story of addiction and of life
- Have story witnessed by others
- Without interruption.
- Without it being fixed.
24Goals 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
25Participation
- May be significant accomplishment for some
individuals - Work with a sense of humour!
26Development of Addiction
Use
Misuse
Abuse
Dependency
Compulsive Use/ Addiction
27Addictions
- Behaviours
- Gambling
- Work
- Shopping
- Food
- Exercise
- Sex
- Computer
- Substances
- Alcohol
- Drugs
- Tobacco
28What 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
29Group Building
Sociometry exercises and methods enhance
- Belonging
- Cooperation
- Cohesion
- Openness
- Access to roles
30J.L.Morenos Concept of Mental Health
NEW CULTURAL CONSERVE
An adequate response to a new situation or a new
response to an old situation. - J.L. Moreno
31The Five Elements of Psychodrama
- The Director
- The Protagonist
- The Auxiliary Ego
- The Stage
- The Audience
32Psychodrama Evolves in Three Stages
STAGE 1 THE WARM UP
- To self
- To others
- To theme
- Suggested by the Director usually through an
exercise - A protagonist emerges
33Psychodrama Evolves in Three Stages (Contd)
STAGE 2 THE ENACTMENT
- A star or protagonist comes forward to act out
their dilemma - Generally related to a group theme
- Dramatizes the protagonists dilemma
- Director initiates interactions between
protagonist and group members
34Psychodrama Evolves in Three Stages (Contd)
STAGE 2 (Contd)
- Group members, selected by protagonist, play
significant roles - Continues until protagonist achieves a shift in
perception and tests a new approach
35Psychodrama Evolves in Three Stages (Contd)
STAGE 3 SHARING
- 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
36The Hollander Curve
Catharsis of Abreaction
Catharsis of Integration
Scene 2
Surplus Reality
Integration Closure
Scene 1
.
.
.
.
.
.
.
.
.
.
PSYCHODRAMATIC ENACTMENT
SHARING DIALOGUE
WARM UP
37The 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
participants social circle
38Morenos Social Atom
Male
Female
x
39Social Atom-Collectives
Relatives
NOTATIONAL SYSTEM
School
a.Attraction b. Rejection c.Indifference
Friends
Church
Me
Work
Social Groups
Family
40Applications in Addiction Treatment
- Atoms can measure an addicts relationships with
people, places or things - For example
- Work
- Cocaine
- Food
- Sex
- Exercise
- Family
- Friends
41Application 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
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43Sobriety/Magic Shop
Description
- Sobriety Shop variation of classic Magic Shop
- Structured exercise where unwanted, dysfunctional
qualities magically transform into
desired/beneficial qualities
44Sobriety/Magic Shop (Contd)
Style/Setting
- Mutually agreed fantasy/surplus reality
- Language of metaphor
- Bargaining process
45Sobriety/Magic Shop (Contd)
Qualities
- 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.
46Sobriety/Magic Shop (Contd)
Process
- Problem to the Solution
- Solution 60 of action time
- Willfulness and Willingness Motivation
47Sobriety/Magic Shop (Contd)
Players/Characters
- Shopkeeper -gt Action Director
- Customers seeking exchange qualities -gt
Protagonists - Assistants in action -gt Auxiliaries
- Audience -gt Commentators/Greek Chorus
48Sobriety/Magic ShopAction 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.
49Sobriety/Magic ShopAction Steps (Contd)
- Action exploration of qualities. Methods are the
following - Interviewing
- role-reversals
- Doubling
- Mirroring
- Sculpting
- role-training
- Bargaining quantity of quality
50Sobriety/Magic ShopAction Steps (Contd)
- Customer receives new quality
- Anchoring -gt in body
- Psychodrama photo
- Concretize in object
- Contract for use
- Report to 12-Step Meeting/Sponsor
- Sharing
51Sobriety/Magic ShopConclusion
- Metaphor for death
- Re-birth
- No gain without loss
- Group therapeutic agent
- Creativity through spontaneity/ play
- Optimistic view of human potential
Source Sobriety Shop - A Variation on Magic Shop
for Addiction Treatment Patients. Terry A. Rustin
and Peter A. Olsson. Volume 46/1. Psychodrama and
Sociometry. Spring 1993.
52Resources
- The Action Manual (Elizabeth White)
- Available by contacting actioninfo_at_rogers.com
- The Living Stage (Tian Dayton)
- Trauma and Addiction (Tian Dayton)
- Drama Games (Tian Dayton)
53Presents Action Methods in Addiction
Treatment An Introduction to Psychodrama,
Sociometry Group Psychotherapy Addictions
Ontario June 3rd, 2008
Fiona G. Roche, B.Sc., CQSW, RSW, CGPA(dip),
TEP Therapist, Trainer Educator and Practitioner
of Psychodrama
www.bellwood.ca