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Introduction

Social skills training is proven to significantly decrease the relapse rate for alcoholics and drug addicts. One common trait of many individuals with substance abuse disorder is problems interacting with others in social situations. This is known as a lack of social skills. Sometimes this difficulty is what leads a client into addiction in the first place. Often, some clients have been addicted to substances for such a long time that it has affected their social development.

Social skills training for individuals with substance abuse disorder consists of:

• How to interact with friends, family members, and coworkers
• How to interact in social situations, especially when drugs and alcohol will be present
• Drug and alcohol refusal skills

Theory

Skills training is an approach to drug and alcohol treatment based on the Skills Acquisitional frame of reference. This frame of reference is based on learning theories and is aimed at skill acquisition to improve overall function for optimal performance in an environment. This theory often uses behavioral principles in teaching, such as repetitive practice and rewards.

Evidence

Social networks have an impact on an individual’s overall well-being. A classroom-based model, Moving Ahead Program (MAP), showed an improvement in self-esteem and self-efficacy (Nelson, 2012). These positive changes encouraged participants with previous substance abuse to build new social networks. Gray, Shaffer, and Nelson (2016), found that life skills programs, such as MAP, influenced positive changes over time for participants with substance use.

Case Study

Edie is a 35-year-old woman aspiring to become an actress. She has suffered with alcohol abuse for about a decade, and is now socially isolating herself from all social situations. She has begun attending the local 12-Step AA meetings, and has been getting to know some of the members who also attend the meetings. However, she will not attend any social gatherings apart from these meetings for fear that she will not be able to refuse temptation if alcohol were present. She was referred by her sponsor to see an occupational therapist in order to help her reach her goals.

Intervention Plan

Problem Statement:

Edie’s social isolation is secondary to her fear of exposure to alcohol in all social situations, hindering her social participation.

Short-Term Goals:

1. Edie will initiate conversation with one member of her AA group to improve social participation in 2 weeks.
2. Edie will invite one AA member to join her for a yoga session to improve social participation in 2 weeks.
3. Edie will identify at least one motivational statement she will use when presented with a social situation involving alcohol within 1 week to improve self-efficacy.

Long-Term Goals:

1. Edie will demonstrate an increase in assertiveness by saying no to at least 3 temptations when in high-risk situations involving alcohol by discharge.
2. Edie will demonstrate an increase in self-efficacy by voicing 3 motivational statements when presented with a social situation involving alcohol by discharge.

Intervention Format:

Group

Setting:

Edie will meet with the occupational therapist in an outpatient setting for 1 hour 2x per week for 1 month.

Supplies:

None

Agenda:

• Group members are introduced (5 min)
• Ice breaker activity (10 min)
• Therapist presents the session’s outline and discusses the session’s messages (5 min)
• The therapist lists and briefly discusses the skills to be introduced and practiced in the session (10 min)
  • ■ Assertiveness skills training
  • ■ Refusing drugs and resisting cravings
  • ■ Managing leisure time
• A group exercise is used to practice the social skills (25 min)
  • ■ Role play
• Provide a summary of the discussion (5 min)

Documentation

S: “ I want to have more positive and healthy social experiences and boost my confidence!” Edie states she fears she will fall into temptation when presented with a social situation involving alcohol. =

O: Edie participated in practicing social skills with other members. Edie engaged in an icebreaker activity focusing on social participation.

A: Client presents low self-efficacy when faced with high-risk situations. Edie demonstrated positive social skills during the group session by interacting with the therapist and other clients.

P: Edie will continue social skills training in order to decrease her social isolation. Evaluate improvement in client’s social participation; continue to enhance and improve when necessary. Client is to see OT 2x per week for 1 month.

References 

Social Skills Training for the Alcoholic & Drug Addict. (2008). Retrieved from http://alcoholrehab.com/alcohol-rehab/social-skills-training-for-alcoholic-drug-addict

Gray, H., Shaffer, P., Nelson, S., & Shaffer, H. (2016). Changing Social Networks Among Homeless Individuals: A Prospective Evaluation of a Job- and Life-Skills Training Program. Community Mental Health Journal, 52(7), 799-808. doi:10.1007/s10597-014-9817-5

Nelson, S. E., Gray, H. M., Maurice, I. R., & Shaffer, H. J. (2012). Moving ahead: Evaluation of a work-skills training program for homeless adults. Community Mental Health Journal, 48(6), 711–722.