by Thaddeus Camlin, Psy.D. Depression and substance use often co-exist.  Substance use is a common method of coping with depression.  Thus, abruptly stopping the use of substances can result in the intensification of underlying depression.  It is important to have a specific understanding of what your personal experience of depression is in order to overcome it. Depression is often understood to be a result of a chemical imbalance in the brain.  While this understanding is certainly true, it is only part of the story.  The problem with understanding depression solely as a chemical imbalance in the brain is that it reinforces feelings of helplessness – a cornerstone of depression.  The truth is, the antidote to depression is indeed something that we have a tremendous amount of pers...

by Thaddeus Camlin, Psy.D. Much is being said about changing the nomenclature in the treatment of problematic substance use.  The latest diagnostic manual (DSM-5) no longer uses the term ‘addiction.’  Anne Fletcher wrote about the value of cleaning up the language of addiction using powerful comparisons to other avenues of treatment.  She astutely pointed out that no therapist would tell people trying to lose weight that no progress would be made until they labeled themselves in a pejorative way.  Can you imagine a therapist telling someone who is overweight that before work can begin she or he must identify as a fat pig?  To do so would be unconscionable.  Yet, it is all but universal in the treatment of problematic substance use that an individual is told that no progress will be m...

by Tom Horvath, Ph.D., ABPP Practical Recovery’s IIOP The Individualized Intensive Outpatient Program To be clear: An Individualized Intensive Outpatient Program (IIOP) is not an Intensive Outpatient Program (IOP). An IOP is a group that typically meets three hours per day, three days per week. In addition, there may be one individual session per week. The IOP is the backbone of many outpatient addiction treatment approaches, and indeed, Practical Recovery offers one (which includes one individual session per week). One of the advantages of an IOP is that insurance companies are familiar with it, and tend to reimburse this service at a reasonable level. Nearly 20 years ago Practical Recovery introduced the concept of the Individualized Intensive Outpatient Program. This year we ar...

by Thaddeus Camlin, Psy.D. We all deal with people who bug us every day. Sometimes the people who annoy us are our neighbors, our co-workers, or our family members. Improving our ways of dealing with difficult people can help us enrich our own lives and decrease urges to use substances to cope with uncomfortable feelings. A common precursor to substance use is emotional discomfort. A common source of emotional discomfort is conflict in relationships. Many people go to great lengths to avoid conflict in relationships. However, it is often much more useful to focus our energy on managing conflict in relationships rather than avoiding conflict altogether. When conflict arises in a relationship it is important to discuss the conflict when emotions are manageable and not extreme. Below...

Linda Lewis shares her story. by Linda Lewis, Recovery Maintenance Counselor for Practical Recovery I’ve been preparing for my role as an addiction counselor all my life. From the time I was born, I was surrounded by people with addiction problems… life and death problems. Our family has a white sheep, one, my aunt Lois. She was the only stable person in my life for years. Not surprisingly, she is also the last of a large family who is alive and well. When I was 12, my step father , the good one, died drinking and driving. As for my biological parents, after sad chaotic lives, they both died in their forties because of their alcohol dependence. My father died of liver cirrhosis at 47. He spent years in and out of hospitals and mental institutions. Our relationship was strange and...

by Thaddeus Camlin, Psy.D. Many lively debates arise in discussions on the relationship between freedom and responsibility. Many individuals think that with increased responsibility comes decreased freedom. Challenging this notion can be a pivotal turning point in recovery from problematic substance use. It is a natural human phenomenon to re-establish a sense of freedom when we feel our autonomy restricted. It follows then, that if we feel responsibilities are imposing upon our freedom, it is natural to rebel against those responsibilities. Substances are an excellent way to rebel. It is not an uncommon scenario for an individual to think, “I’m stressed out, I’m sick of all these work demands, whatever, I’m going to Vegas this weekend and I’m not going to think about any of it...

By Reya Kost, Psy.D. According to Fonthill Counseling, “Insurance companies count on your ignorance, laziness and distractibility to avoid paying for services they are legally obligated to cover.”  Any person who has been responsible for getting treatment authorized, or utilization review, will tell you it is like going to battle.  The treatment staff is armed with what they believe is undeniable evidence of their client meeting “medical necessity.”  The insurance caremanager is tasked with finding anyway possible to justify a lower level of care, hence a lower payout, for the insurance providers.  For any veteran of the rehab industry, this is a tale as old as time.  “It’s not enough time.” “How can they expect someone to make it after only a week?”  “They have barely finished detox...

Rebuilding Your Life after Recovery, Pt. 2: Time Management Last week, we covered work ethic in terms of rebuilding your life after recovery. This week, we cover how to better manage your professional and personal life with time management skills. We all have busy lives managing several parts of our professional and personal life.  Do you have that friend that seems to always have extra time on their hands and seems to be able to get everything done in a day?  Do you also have that friend who seems to always be rushing, late to events or appears to be challenged with multi tasks? Managing our time effectively is a skill we can all improve upon. It is easy to get distracted or lose focus with so much going on in our lives, even though the concept itself is quite easy to understand. I...

Does the recovery community inadvertently contribute to the stigma of addiction? by Tom Horvath, Ph.D., ABPP Although the recovery community opposes stigmatizing individuals with addiction, the widespread use of the labels “addict” and “alcoholic,” and the view that addiction is a disease, actually contribute to the stigma of addiction. Alternative language, suggested here, could work against stigma rather than contribute to it. What is stigma? The Oxford English Dictionary defines stigma as 1) “a mark made upon the skin by burning with a hot iron (rarely, by cutting or pricking) as a token of infamy or subjection,” 2) “a mark of disgrace or infamy; a sign of severe censure or condemnation, regarded as impressed on a person or thing; a ‘brand,’” (this meaning is introduced as...

It can be challenging to stay sober when you're coping with tragedy. This last year has been full of grief, tragedy, and challenge. We continue to grieve together and are finding that many people are experiencing anger, sadness, confusion, grief and anxiety.  With a surge of emotions that arise in response to tragic events, it is understandable that some of us may experience temptations to return to our addictive behaviors in order to cope with stress and loss.  It is important to understand that this is a normal reaction and a part of recovery. It is also important to know that while the urge may be there, we do not need to give in. Now is the time to call on those new coping tools we've been working on! Some common reactions to tragic events: Increased fear, anxiety and worry i...