Advances in Addiction Treatment – 2012

I recently attended a training workshop presented by Gateway Foundation at the Adler School of Professional Psychology. The presenter, David Mee-Lee, M.D., was one of the editors of the criteria used by substance abuse counselors to guide placement into treatment. His “take-away” message was that treatment professionals need to become experts at meeting clients “where they are”… Aligning their treatment plan with the actual goals that motivate the client, rather than focusing on getting the client to accept the counselor’s idea of what is needed. This can be a little bit controversial, because the nature of addiction makes it hard for people to see their own situation clearly, even when they know they need to do something about the problems that alcohol or drugs are causing in their lives. Counselors have become used to having to work hard to break through layers of “denial,” as it’s popularly viewed.

Most people think of “rehab” when they hear of someone whose substance use has gotten out of control and is causing problems in their life. We hear of celebrities “going into rehab” – sometimes over and over again. The model program for this was a 28-day residential treatment setting, such as the type of residential treatment used at Hazelden and the Betty Ford Center. These programs evolved over the past 40 to 50 years, and are characterized by being rooted in the 12-step traditions of Alcoholics Anonymous and Narcotics Anonymous.

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SMART Recovery expands Chicagoland meetings

I have been talking this week to some individuals who are Facilitators and Advisors to SMART Recovery groups in Chicago, and have learned that more meetings are taking place than ever before. This is a positive development for people struggling with drug and alcohol dependence, and for the professionals who need self-help resources to provide referrals for their clients.Continue Reading SMART Recovery expands Chicagoland meetings

Choices in self-help for substance use disorders

(Author’s note: This post follows from the earlier post on new findings about addiction. I had originally added this as a comment to further discuss alternatives to AA and other 12-step approaches. I have moved that comment into this separate post.)

S.M.A.R.T. Recovery (Self-Management and Recovery Training) was started by a group of mental health professionals who were formerly part of Rational Recovery (RR), a non-12-step abstinence based support and self-help organization based upon Albert Ellis’s Rational-Emotive Behavior Therapy (REBT).

RR and SOS (Secular Organizations for Sobriety / Save Our Selves) were the first mutual help organizations to offer alternatives to the dominant AA/12-step approach, at a time when choice was needed. Both groups raised concerns about the legal and ethical issues involved in mandating people into a program that many felt to be religious in nature.Continue Reading Choices in self-help for substance use disorders

New research reports on addiction

The latest issue of the journal Neuron is devoted to research on addiction and how it operates in (and affects) the human brain. This is important research, and the publishers have made this entire issue accessible at no charge to the public. One of the main take-aways is the idea that addiction is not so much as disease as a “hijacking” of the brain systems that ordinarily serve to help us survive and be healthy. The substances themselves produce changes in the functioning of the brain at the cellular level, and those changes unfortunately create a vicious cycle of use, abuse, and withdrawal. They also impair the very processes that ordinarily help people avoid trouble and think their way out of danger. “Executive functioning” is the term loosely used to describe our ability to plan ahead and choose things that may be less pleasurable in the short term but ultimately better for us in the long run. Addictive substances (and perhaps even process addictions) may impair our very ability to think clearly and plan ahead. I’ve certainly never agreed with the old AA chestnut that says, “Your best thinking got you here.” Actually, I’ve always thought it was the opposite – not being able to use your best thinking is what can get you there. (Even in the case of Charlie Sheen!)Continue Reading New research reports on addiction