By Tom Horvath, Ph.D., ABPP Wondering whether you should moderate or abstain? You're not the only one. Read on for some things to consider as you determine which approach is best for you. Practical Recovery's policy is not to give advice about whether to moderate or abstain. Unfortunately, this approach has sometimes been interpreted to mean that we “advocate” moderation. We neither advocate nor oppose any specific level of addictive activity, including cutting back (to something short of moderation) or focusing on safety without reducing quantity and/or frequency (e.g., “I won’t cut back my drinking, but I’ll stop drinking and driving”). Harm Reduction The term for this broad position, which follows the client’s lead on what changes to make, is harm reduction. Harm reduct...

“Procrastination makes easy things hard, hard things harder.” -- Mason Cooley Procrastination is a common problem. It’s all too tempting to put off an unpleasant task until some later time. However, procrastination can resemble addictive behavior and can be extremely problematic. The more we procrastinate, the more stress we typically create for ourselves. Here are some tips to help you avoid procrastinating: Start small—Just commit to taking one small step. Usually, you will find that it is not as bad as you expected, and it will be relatively easy to keep going. If you are procrastinating because the task feels overwhelming, breaking it down into smaller, easier steps makes it feel much more manageable. Confront negative beliefs—If you are telling yourself things such as, “...

By Dan Galant, PhD "The Abstinence Violation Approach" - This ominous sounding term from the relapse prevention literature is perhaps one of the most useful concepts to understand in addiction treatment. I often have clients tell me years after our last therapy session that this was the singular most helpful idea to keep them on track! So what’s it all about – and how can it help you? The Abstinence Violation Effect (AVE – think the abbreviation for avenue to help you remember it) is what happens when an individual deviates from his/her plan – and then continues to remain off that path due to frustration, shame, guilt, etc. Think of the problem drinker who has chosen to abstain from alcohol. When that person takes even one drink (”violating” their abstinence), the tendency is to t...

Focusing on the past can lead to feelings of regret and guilt. Similarly, thinking about the future can create anxiety and worry. Sometimes, the best thing to do is to stay in the present moment—to be mindful. To be mindful means to be aware of your thoughts, emotions, and physical sensations without judging or criticizing yourself or your experience. Mindfulness is a great tool for managing cravings, anxiety, and other emotions/experiences that are difficult to handle. Here is a simple mindful breathing exercise to get you started: Sit or stand in a comfortable position. Slowly inhale through your nose, counting to five. Exhale from your mouth, counting to eight. Repeat several times. The key to mindfulness is to be present and maintain focus on the moment. Thoughts will come; si...

My role as the Chief Operating Officer is to oversee the operations to maximize the client's experience at Practical Recovery. The goal is to ensure consistent quality of service by developing and enforcing good automated systems; validating processes; overseeing operational documentation; managing branding in each facility (core values/mission), and ensuring standardization and execution of policies and procedures at all sites. My team completes these operational objectives by completing daily audits such as: medication procedures, food/beverage service, therapeutic activities, satisfaction surveys, hospitality procedures, safety compliance, room searches/inventories, intake, admission and discharge procedure audits, monitoring drug testing, supervising client schedules and operational...

Debunking the bad science behind 12-step programs and the rehab industry Book Review by Tom Horvath, PhD., ABPP Text: 160 pages; Preface: 1 page; Notes: 9 pages The subtitle of this book guaranteed that it would be unpopular with many in the 12-step and rehab communities. However, titles are often a compromise between publisher and author. The publisher wants to sell books. The authors do also, but do not want to diminish the credibility of the work. A controversial title may be acceptable to authors if it can be nuanced in the work itself. This writing team is a psychiatrist and addiction expert father, and his son, a free-lance writer with a BA from Yale and an MFA from USC. What exactly do they say about 12-step groups and the rehab industry? Chapter 3 is entitled “Does A...

“There were many terrible things in my life and most of them never happened.” – Michel de Montaigne Worrying can be useful since it can motivate us to be prepared. However, too much worry can be problematic and can lead to sleep problems, irritability, poor concentration, and overwhelming feelings of anxiety and stress. Worrying can also be a waste of time and energy. Often, the things that we worry about are beyond our control and no amount of worrying will guarantee a positive outcome. Here are some quick tips for managing worry: 1. Challenge your thoughts – when we worry, we tend to overestimate the likelihood of a negative outcome. So ask yourself how likely that worst case scenario really is and consider other options that may be more realistic and easier to handle. 2. Use...

Run with Dr. Horvath! August 9th, 2014 7am And join us as we support efforts to raise awareness addiction! Dr. Horvath will be running the 10k, then speaking afterward. Run. Support. Have Fun.                                                     REGISTER! Valley of the RUN Facebook Page                

For many people, summer is the best time of the year. Warm weather, days at the beach, vacations… What’s not to love? But when you’re in recovery, especially early recovery, the pool parties and vacations of summer can be major relapse triggers. Here are some tips for enjoying summer without getting off track. 1. Plan ahead—If you know that you will be attending a party, barbecue, or other event that may be triggering, have an exit plan in place. Drive your own car so that you won’t get stuck there longer than you want to, or bring a sober friend along for support. If you are going on vacation, consider researching some self-help meetings that are available in the area, or use the online meetings that SMART Recovery offers to keep your focus on recovery. 2. Get outside—Summer ...