methods in rehabilitation of addicts.

there are four approaches to rehabilitative work with addicti. The rehabilitation approach is the metamodel of the rehabilitation process, reflecting the positions of a specialist and the patient, and the nature of interaction between them, which can be implemented using different technologies and different style specialists.

Rehabilitation approach "Taming".

the Experts working within this approach, takes the position of the carrier the "right" knowledge. Patients are put on here a specialist in the position of the objects. The task of the patients strictly follow the instructions of the staff of the rehabilitation center. The main tool of recovery addicts is a system of rewards and punishments, organized system reinforcements needed ("correct") behavior in patients. Followers of this approach believe that a properly organized system of reinforcements, it is possible to form the optimal behavior pattern, securing it by repetition.

Main equipment used in this rehabilitation approach:

• Daily collection of the commune of rehabilitants for whom the day is summed up and understand the problems of the hostel and conflict situations;
• Occupational therapy;
• System of punishments and rewards. As a rule, in the form of individual monitors, which recorded the number of penalties and incentives.

Advantages of this approach:

1. a Relatively small input in the attraction of different specialists (psychologists, psychotherapists, social workers, family psychologists, art therapists, etc.);
2. fast Enough (compared to other approaches) "visible" result of the desired behavior of the patients of the center. For example, the use of labor "outfits" for the correction of incorrect behavior in patients – punishment for talking about drugs, swear words, failure of any assignments, etc.

the Disadvantages of this approach:

1. instability of the behavioral patterns generated in the framework of this approach. That is, once the external control over the behavior of the patient is removed (reduced), the probability of a return to old behavioral patterns increases.
2. Creation of the "visibility" of changes in patients.
3. Low professional level of training of the staff of the center.
4. Adverse therapeutic environment for rehabilitation.
5. Focus on the end result – "adressierung" patient specific skills.

one Can notice the obvious similarities of approach training with the behaviorist approach in psychology.

This approach to rehabilitation are best used in combination with other rehabilitation approaches.

Rehabilitation approach "Tutoring".

the Main objective of recovery under this approach is to give addict the necessary information about addiction, ways to overcome it and explain how to use it effectively. Specialists working in the framework of tutoring, based on the fact that learning the skills of a sober and healthy lifestyle is the result of purposeful transfer of information from one person to another (addiction counselor, social worker) due to the formation of more realistic ideas about their addiction and how to cope with it.

Main equipment used in this rehabilitation approach:

• keeping a journal of feelings and events of the day;
• Training;
• Lecture materials;
• Video;
• Classes for the spiritual education;
• Occupational therapy;
• Validation of knowledge;
• Completion of training – certificate of completion.

Advantages of this approach:

1. the Similarity of tutoring programs with pre-University and University education, which reduces anxiety and discomfort in patients.
2. a higher level of employee interaction center with patients.
3. Getting information about addiction and ways of its overcoming, which do not disappear in the absence of reinforcement system

the Greatest similarity, this approach has cognitive psychology.

the Disadvantages of this approach:

1. dependency Information is often not enough to change belief systems and beliefs that have been patient before joining a rehabilitation program.
2. the Lack of practical solutions for the revision of its system of values of the patient.
3. Not take into account the individual characteristics of patients, their life situations.
4. the Lack of a multidisciplinary team of professionals (psychotherapists, psychologists, etc.)

Rehabilitation approach of "Mentoring".

In this approach, you should engage a team of specialists with a serious level of training and effective interaction with each other on all levels. Specialist in the framework of this approach is the "conductor" of the patient, a senior partner in turn patients – the Junior partners of the expert of the center.

the task of the entire multidisciplinary team is to create the conditions in which the patient would be able to discover your own activity to seek and find the most acceptable ways of behaving. Specialist in this case, as a rule, is only responsible for creating the necessary conditions for learning and change, and the responsibility for the outcome rests with the patient. Under this approach, the specialists of the center do not impose on the patient their beliefs, and offers practical solutions to the patient have tested them myself and chose the most appropriate.

Main equipment used in this rehabilitation approach:

• keeping a journal of feelings and events of the day;
• Training;
• Lecture materials;
• individual and Group psychotherapy;
• Individual analytical tasks;
• Art therapy;
• Family therapy;
• Occupational therapy;
• Video;
• Classes for the spiritual education;
• Validation of knowledge;
• Completion of training – certificate of completion.

Advantages of this approach:

1. High level of training of specialists of the center.
2. Humanistic approach to the recovery of a person with addiction, where the person is seen as unique, holistic, constantly evolving system.
3. More versatile, able to seamlessly accommodate three previous approach.
4. Sustainability of external and internal changes of the patient.

the Disadvantages of this approach:

1. a Fairly long period of interaction with the patient.
2. a higher level of expenditure (professional, financial, social).

Rehabilitation approach "Ecological".

the Main purpose of rehabilitation in the framework of this approach becomes not the formation of a certain system of ideas, attitudes and skills of the patient (as in the other three paradigms). In this approach, the emphasis is on the value of the process: not so important, what are the current successes in this patient on the way to building your environmental world, most importantly – what are the dynamics of this process. This approach relies on model of ecological systems , proposed by the American psychologist URI Bronfenbrenner. According to this model, human development is a dynamic process that goes in two directions. On the one hand, the man himself restructurize their living environment, and on the other – is feeling the effects from the elements of this environment.

This approach is applied in later stages of recovery and development of the patient and require a fundamental change in the position of a specialist (psychologist, therapist, consultant). Here it is impossible not only the position of the Almighty media "absolute knowledge", but even the position of a wise shepherd herding "the foolish sheep." The task of the expert here is not to instruct the patient on the "right path" in one form or another, and the patient was able to open his own path, was the subject, "lying in the basis of" own life. So the main thing you need to do a specialist - to build a patient qualitatively different, subject-subject mode of interaction. And this requires some preparation by the staff of the rehabilitation centre, ongoing work on the revision of the existing stereotypes, change positions (sometimes radically) in the relations with the participants of the rehabilitation process.

Equipment used in this rehabilitation approach is applied based on the query each patient in his desire to build your ecological world. It can be also:

• Group therapy;
• Training;
• self-examination in the framework of the ecological systems;
• Techniques for controlling the flow of personal energy;
• Analysis of family scenarios;
• Sessions on genealogy;
• Training individual relaxation techniques and concentration;
• drawing up personal development plan;
• Therapy creative expression
• Hobby-therapy and more...

Advantages of this approach:

1. there is No focus on the result, the finished product;
2. subject-Subject relations allow the simultaneous development of both specialist and patient.

the Disadvantages of this approach:

1. higher requirements to the development staff;
2. Difficulty in finding a patient his own way without relying on "mentoring" and "tutoring".