1	FAMILIES IN RECOVERY MATRIX INSTITUTE ON ADDICTIONS MATRIX/UCLA INTEGRATED SUBSTANCE ABUSE PROGRAMS
2	Development of Craving Response
3	DEVELOPMENT OF CRAVING RESPONSE Cognitive Process During Addiction Conditioning Process During Addiction Development of Obsessive Thinking
4	Cognitive Process During Addiction INTRODUCTORY PHASE
5	Conditioning Process During Addiction INTRODUCTORY PHASE STRENGTH OF CONDITIONED CONNECTION
6	Development Of Obsessive Thinking INTRODUCTORY PHASE
7	Family Response to Increasing Addiction Non-recognition Confusion regarding occasional atypical behaviors Admiration for abnormal accomplishments achieved through drug/alcohol use
8	Cognitive Process During Addiction MAINTENANCE PHASE
9	Conditioning Process During Addiction MAINTENANCE PHASE STRENGTH OF CONDITIONED CONNECTION
10	Development Of Obsessive Thinking MAINTENANCE PHASE
11	Family Response to Increasing Addiction Experimentation with solutions Extreme responses “Enabling”
12	Cognitive Process During Addiction DISENCHANTMENT PHASE
13	Conditioning Process During Addiction DISENCHANTMENT PHASE STRENGTH OF CONDITIONED CONNECTION
14	Development Of Obsessive Thinking DISENCHANTMENT PHASE
15	Family Response to Increasing Addiction Avoidance of problem Blaming the addicted Blaming selves Guilt and shame
16	Cognitive Process During Addiction DISASTER PHASE
17	Conditioning Process During Addiction DISASTER PHASE STRENGTH OF CONDITIONED CONNECTION
18	Development Of Obsessive Thinking DISASTER PHASE
19	Family Response to Increasing Addiction DISASTER PHASE Separation Internalization of bad feelings Resignation and hopelessness Establishment of unhealthy family rules
20	Development Of Craving Response INTRODUCTORY PHASE
21	Development Of Craving Response MAINTENANCE PHASE
22	Development of Craving Response DISENCHANTMENT PHASE
23	Development of Craving Response DISASTER PHASE
24	BENEFITS OF FAMILY INVOLVEMENT Family involvement is associated with better treatment compliance and outcome. Family members have clearer understanding of the roadmap for recovery. Patients and family members understand their respective goals and roles in recovery. Family members and patients get support in the recovery process.
25	STAGES OF RECOVERY
26	SEQUENCED GOALS FOR PATIENTS BEGINNING STAGE (1-6 Weeks) Discontinue use of drugs and alcohol Become educated about psychoactive chemicals Improve physical health and/or manage psychiatric condition Evaluate severity of the addiction and agree to interventions for change
27	SEQUENCED GOALS FOR FAMILY MEMBER(S) BEGINNING STAGE (1-6 Weeks) Make commitment to treatment Recognize addiction as a medical condition Support discontinuation of drug and alcohol use Learn to recognize and discontinue triggering interactions
28	SEQUENCED GOALS FOR PATIENTS MIDDLE STAGE (6-20 Weeks) Improve significant relationships Maintain stable abstinence from all psychoactive chemicals Develop a recovery support system outside the treatment center Learn to recognize and cope with emotions
29	SEQUENCED GOALS FOR FAMILY MEMBER(S) MIDDLE STAGE (6-20 Weeks) Decide whether to recommit to the relationship (leave or trust) Learn to be supportive instead of co-addicted Begin finding ways to enrich own life Practice healthy communication skills
30	SEQUENCED GOALS FOR PATIENTS ADVANCED STAGE (20+ Weeks) Identify and monitor necessary components of successful recovery Recognize relapse indicators and identify appropriate responses Clarify new roles and boundaries in sober relationships Set goals for continuing new lifestyle after program
31	SEQUENCED GOALS FOR FAMILY MEMBER(S) ADVANCED STAGE (20+ Weeks) Learn to accept the limitations of living with an addiction Develop an individual, healthy, balanced lifestyle Monitor self for relapses Be patient with the process of recovery
32	KEY RELAPSE ISSUES FOR DRUG/ALCOHOL USERS 1. Drug/alcohol use 2. Drug using friends 3. Environmental cues associated with drug/alcohol use 4. Severe craving 5. Protracted abstinence - “The Wall” 6. Stimulant - sex connection 7. Boredom
33	KEY RELAPSE ISSUES FOR FAMILY MEMBER(S) 1. Emotionally triggered by situations perceived as patient relapse 2. Fear of being alone 3. Lack of individual goals and interests 4. Unable to release responsibility for other