What is Sobriety?
Historically, “sobriety” has been the measurement for determining success within Addiction Disorder (AD) treatment. This antiquated model does not take into account the complex nature of the disease or society’s influence in treating it. “Strength Based Practices” was introduced some 20 or so years ago with the advent of needle exchange, methadone houses and condom giveaways—and these methods, however controversial, was a step in the right direction. But these measures did not succeed in reducing the real harms of drug and alcohol abuse… they only slowed it down a bit. Previous paths to establish reduced harm—such as 12-Steps, rehabs, addiction counselors, and “Just Say NO” campaigns—have proven grossly ineffective. Today, Strength Based Practices has matured into a new protocol for actual treatment, and is now viewed and evidenced to be far more valuable in our fight against AD and the spread of diseases associated with AD then many of the alternatives, such as prior Harm Reduction methods like “Just Say No” campaign and needle exchanges.
From business to youth development, to neurobiology and the new field of Positive Psychology, a “strength based approach” to change, is demonstrating that reward, rather than punishment is more powerful, effective and sustainable. CHI Recovery utilizes this model in all aspects of client coaching and therapy.
We find that The Institute for Research and Innovation in Social Services offers the most comprehensive definition of strength-based practice:
“Modern Strength Based Practices require:
- motivational interviewing, engaging the patient’s own goals in the treatment plan;
- measuring risk categories in multiple areas and responding aggressively to all needs;
- accurate measurement through global assessments, which demonstrate improvements and failures within the strategies;
- goals which seek a decrease in the disease itself, (vs. to make the patient more socially acceptable through maintenance,) accomplished through comprehensive treatments and holistic healthcare.
“Strengths-based practice is a collaborative process between the person supported by services and those supporting them, allowing them to work together to determine an outcome that draws on the person’s strengths and assets. It concerns itself principally with the quality of the relationship that develops between those providing and being supported, as well as the elements that the person seeking support brings to the process. Working in a collaborative way promotes the opportunity for individuals to be co-producers of services and support rather than solely consumers of those services.
“Rapp, Saleebey and Sullivan (2008) offer six standards for judging what constitutes a strengths-based approach. The standards include:
- Goal orientation: Strengths-based practice is goal oriented. The central and most crucial element of any approach is the extent to which people themselves set goals they would like to achieve in their lives.
- Strengths assessment: The primary focus is not on problems or deficits, and the individual is supported to recognize the inherent resources they have at their disposal which they can use to counteract any difficulty or condition.
- Resources from the environment: Strengths proponents believe that in every environment there are individuals, associations, groups and institutions who have something to give, that others may find useful, and that it may be the practitioner’s role to enable links to these resources.
- Explicit methods are used for identifying client and environmental strengths for goal attainment: These methods will be different for each of the strengths-based approaches. For example, in solution-focused therapy clients will be assisted to set goals before the identification of strengths, whilst in strengths-based case management, individuals will go through a specific ‘strengths assessment’.
- The relationship is hope-inducing: A strengths-based approach aims to increase the hopefulness of the client. Further, hope can be realized through strengthened relationships with people, communities and culture.
- Meaningful choice: Strengths proponents highlight a collaborative stance where people are experts in their own lives and the practitioner’s role is to increase and explain choices and encourage people to make their own decisions and informed choices.”
Ideal interventions in the spread of AD and sexually transmitted diseases, such as HIV and HEP B and C, begin with pre-teens, adolescents and young adults, introducing a Strength Based Practices Model for Safety, which asserts early comprehensive education and “myth busting”; motivational interviewing and patient investment; risk assessment; social and community support; and psychological intervention. Honest and sustainable “recovery” involves comprehensive health screening and healthcare, sexual and health education detailing the spread of both diseases, physical improvements through diet, nutrition and exercise, education for all members of the family system, and community engagement and reinforcement. Most important of all, recovery requires that the patients themselves “opt in”, wanting health and believing they can have a better life. Getting patients to this state of consciousness can be a feat in itself, requiring high levels of clinical and motivational skills, usually found in highly qualified and seasoned therapists and caregivers.