How did I get this problem?: S

This Social Responsibility Therapy workbook was designed to help individuals who are struggling with harmful behaviors such as problem eating, drinking, drugs and physical or sexual aggression. The focus is on understanding, "How did I get this problem?" and beginning to do something about it. No one plans to develop a problem. No one got up one morning and said, “It's raining outside, I think I'll stay inside and start developing a harmful behavior problem”. In reality, a chain of risk factors made it easy to start.

This workbook is structured to help each client discover the individual risk factors that enabled their unhealthy, harmful behavior. Individual Historical Risk Factors can involve toxic parenting, abuse, neglect or other past stressful events. Social-Emotional Risk Factors involve various individual problems with social and/or emotional maturity. Situational Risk Factors involve situations that are high-risk for unhealthy, harmful behaviors for a given individual. Cognitive Risk Factors involve individual types of irresponsible thinking that enables unhealthy, harmful behavior. When individual risk factors are combined, being in a high-risk situation for unhealthy, harmful behavior with a life stress history, social-emotional maturity problems and irresponsible thinking enables engaging in unhealthy, harmful behavior. Healthy Behavior Success Skills involving relapse prevention, emotional regulation, decisional balance and social problem solving are taught to help clients address the Risk Factor Chain that set the occasion for their unhealthy, harmful behavior.

Since the focus of this workbook is on individual risk factors that enabled the client to acquire their unhealthy, harmful behavior, it is ideal for those who are not aware of a behavior pattern, believe that it just started or they “only did it once" and thus have not developed a repeating behavior cycle. The increased workbook structure includes step-by-step self-discovery directions that addresses the self-awareness problems exhibited by many individuals with unhealthy, harmful behavior. It is also helpful for those with strong autonomy needs who value their independence, like to work on their own, take charge of their lives and help themselves deal with their own situations. It is ideal in limited resource public service or institutional settings that require group treatment by clients who must actively contribute and document progress towards their treatment plans and support of each other’s goals. Although developed for use with therapist input to help those in treatment become more active participants, it can also provide self-awareness and motivation for those considering therapy.

Social Responsibility Therapy utilizes Structured Discovery in a Client-Focused Case Conceptualization of unhealthy, harmful behavior. Three workbooks on understanding harmful behavior are structured to help clients work with their therapists to discover how they acquired their unhealthy, harmful behavior (this workbook), what maintained it (workbook 2) and how it generalized to other problem areas (workbook 3). When therapists process these workbooks with their clients, it elicits the client’s understanding of their condition, negotiates a common client and therapist conceptualization of the problem behavior and helps develop a therapeutic alliance.

Practical case examples, theory, research support and treatment exercises with adolescents and adults referred for unhealthy, harmful eating, substance use and sexual behavior are provided in “The Clinician's Guide to Social Responsibility Therapy: Practical Applications, Theory and Research Support for Unhealthy, Harmful Behavior Treatment” and “Social Responsibility Therapy for Adolescents & Young Adults: A Multicultural Treatment Manual for Harmful Behavior” available on Amazon.com. Further information is provided at www.srtonline.org.

James M. Yokley, Ph.D., is the Clinical Director of MetroHealth Recovery Services at MetroHealth Medical Center in Cleveland, Ohio. He is on the medical staff in the Department of Psychiatry and is an Assistant Professor at Case Western Reserve University School of Medicine. Dr. Yokley has expertise in the cognitive-behavioral treatment of multiple forms of unhealthy, harmful behavior, has authored over 50 research publications, book chapters, and professional presentations and has been a regular conference speaker on Social Responsibility Therapy for harmful, behavior.