Completing an urge diary over the past week will have given the client insight into the trigger situations that lead them towards experience of a craving. They will have practised identifying the elements of the trigger situation itself, along with their responding thoughts, feelings and behaviours. Now it is time to put those observations to use in helping them to better manage their craving situations. By learning techniques to cope with each aspect of the client's experience of a craving, they can be more confident of 'surviving' that situation without acting on their urge to use speed.
Exercise 1: Describing a craving/urge8
- Ask the person to explain what their experience is of a craving/ urge for amphetamines.
"Tell me a bit more about your cravings – what are they like?"
- You may like to refer back to their urge diary, which they completed for homework following Session 1, for additional information.
- On a spare piece of paper, write down the headings: Behaviours, Physical Feelings, Thoughts.
- Write down each of the feelings/thoughts/physical responses that the person uses to describe their urge. Group together those responses that are behavioural (e.g. fidgety, pace the floor), thoughts (e.g. "I must have a hit"), and physical (e.g. heart races, feeling sick) in nature and write them under each column as appropriate.
Behaviours + Physical + Thoughts = Craving
In better coping with craving situations, explain to your client that it is important to use coping techniques that address each of these elements.
An important first step in this process is to educate the client about the nature of withdrawal from speed, and particularly that cravings are a key aspect of withdrawal and are to be expected. Top of page
8 Adapted from Monti, Abram, Kadden & Cooney, 1989