Eliciting and Amplifying Strengths DRY

These questions from Solution-Focused Therapy and Motivational Interviewing could be used to find out more about Augusten's strengths and resources and how these could be used to tackle his substance abuse.


1. How were you able to have such a successful career, despite dropping out of school so young and only having a GED? What qualities did you draw upon to reach your level of employment? How did you convince your employer that you were able to do this kind of work? How have you been able to be a success?
2. How were you able to survive the kind of childhood you had and rise above it?
3. The pain of this problem can affect many areas of your life. What aspects of your life are still intact despite the problem, such as relationships, hobbies, interests, employment, academics?
4. When have you been able to give up drinking or drugs, or cut down your use? How were you able to do that?
5. How have you been able to attract the friendships you have? What about you would they say you have going for you? How are you able to rely on them for support?
6. Motivational interviewing- What do you get out of drinking/What do you like about it? What are the not so good things?
7. What will your life look like when you are past this? What will you be doing/What will you be saying?/How will other people react to you?


1. How were you able to have such a successful career, despite dropping out of school so young and only having a GED? What qualities did you draw upon to reach your level of employment? How did you convince your employer that you were able to do this kind of work? How have you been able to be a success?
2. How were you able to survive the kind of childhood you had and rise above it?
3. The pain of this problem can affect many areas of your life. What aspects of your life are still intact despite the problem, such as relationships, hobbies, interests, employment, academics?
4. When have you been able to give up drinking or drugs, or cut down your use? How were you able to do that?
5. How have you been able to attract the friendships you have? What about you would they say you have going for you? How are you able to rely on them for support?
6. Motivational interviewing- What do you get out of drinking/What do you like about it? What are the not so good things?
7. What will your life look like when you are past this? What will you be doing/What will you be saying?/How will other people react to you?

BIOPSYCHOSOCIAL RISK AND RESILIENCE ASSESSMENT FOR DRY

Onset of the Disorder
Biological
RISK
• Family history of substance abuse (father)
• Family history of mental disorder (mother)
• Male
PROTECTIVE
Good Physical health

Psychological
PROTECTIVE
Lack of co-occurring disorder

Social
RISK
Physical abuse from father
Ongoing sexual abuse starting at 13
Maternal abandonment
Gay

PROTECTIVE
Was able to obtain his GED and have a high paying job

Course of the Disorder

Biological
PROTECTIVE
Good physical health

Social
RISK
Lack of family support
Gay

PROTECTIVE
Boss and co-worker are supportive of intervention
Has close relationships with friends
Continues to hold a well-paying job
Access to specialized treatment for people who are gay

Finding Strengths

The following types of techniques from solution-focused therapy show how we can discover more strengths and resources that Lauren may have:

1) Ask about the resilient qualities that have allowed Lauren to get to this point despite the pain she endured as a child and adolescent. What qualities does Lauren see in herself that allowed her to complete her education?
2) Ask coping questions such as: “You have really been through a lot. How were you able to cope when you were living with your family?” “How did you cope if things got rough in college?”
3) Ask about previous accomplishments: “What do you consider your greatest accomplishments?” “What allowed you to (accomplish X) when you were dealing with depression at the same time?”
4) Exception finding questions: Try to find a time when things were better. “What was different then?” “Were there times you have felt better than you feel now?” “What was different then?” “Were you doing anything different then to manage your situation?”
5) Externalizing: Make a linguistic difference between the person and the disorder. “What is different about the times you have been able to control the compulsions?”
6) Help envision the future: “Lauren, what will your life look like when you are feeling better?” “What will you be doing and saying?” “What will other people be saying to you?”

Risk and Resilience

Assessing a person from a risk and resilience framework helps see both the risk and the strengths and offers a more balanced appraisal. PROZAC DIARY does not emphasize strengths and resources; it is written in language symbolic of Lauren’s depression. Indeed, Lauren states that her creative writing is inspired by her depression; therefore, it is weighted to this account. Despite this slant, Lauren presents with many protective factors, as well as risk.

Risk and Resilience Assessment for the Onset of Depression

RISK

*Biological Factors
Female gender
Family history of mental illness

*Social Factors
Emotional abuse by Lauren’s mother (harsh and critical)
Parental divorce (not clear when this occurred relative to depression but assumed it was before depression started)

PROTECTIVE

*Psychological Factors
Leadership as a class president and leader of the school band (before age 12)

*Social Factors
Financial well-being
Participation in extra-curricular activities (music, dance, ice-skating, horseback riding)

Risk and Resilience Assessment for the Course (Adjustment or Recovery) of the Depression

RISK

*Biological Factors
Early onset

*Psychological Factors
Multiple episodes (and hospitalizations)
Residual symptoms
Co-morbid disorders (history of anorexia and cutting; current presence of obsessive-compulsive disorder)

*Social Factors
Lack of social support network
Poor employment history

PROTECTIVE

*Biological Factors
Intelligence

*Psychological Factors
Insight
Creativity (writing)

*Social Factors
Educated (bachelor’s degree from prestigious university
Financial support from family (this is assumed)