Principles of Self-Empowering Addiction Treatment
By Tom Horvath, PhD
Most US addiction treatment does not use a self-empowering approach and instead relies on some version of the 12-step powerlessness approach. If you are looking for an alternative to the 12 steps, this blog describes Practical Recovery’s implementation of the self-empowering approach.
Self-empowerment: Rather than listening to others about what to do, ultimately you listen to yourself (after considering knowledgeable suggestions from others).
At Practical Recovery we endeavor to make treatment as positive and self-empowering as possible, to help you lead a satisfying, connected, meaningful, and purposeful life based on your values and goals. The following ideas are central to our work:
Treatment Goals: We accept your goals if they lead to addictive harm being reduced. We work to promote your wellbeing. You may choose to abstain, moderate, or reduce engagement with any substance or activity. We also recognize that you may be slow to engage with us or prefer to engage intermittently. You set the pace.
The Whole Person: For many of our clients, most of our session time is focused on related problems, not the addictive problem itself. For instance, you may be dealing with depression, anxiety, trauma, bipolar disorder, or other disorders. We focus on them as much as needed.
Scientific Foundation: We maintain knowledge about current scientific research on addiction and recovery.
Informed Consent: We help you make informed choices about treatment, mutual help groups, other services, and goals, primarily by providing well-established information and asking questions about your preferences. You are given unbiased information about the full range of options available.
Client Responsibility: We understand treatment and support services as adjuncts to the natural process of change, a process for which you are primarily responsible, working in collaboration with us (and anyone else you wish to consult). We will refer out a client whose model of recovery is incompatible with our approach.
Treatment Matching: If treatment is not achieving the desired outcomes, we consider it a mismatch between the treatment and the client, rather than blaming the client. We refer out if needed.
Family Involvement: We recommend having concerned significant others (CSO’s) involved in the treatment process, to the extent the adult client is willing and CSO’s are beneficial to the change process. Family involvement, where helpful, is a high priority for teenage clients. A self-empowering approach is also used with the CSO’s.
Choice of Providers: Within the limits of available staff, you may choose the providers you work with. We typically suggest your initial schedule. After that, you decide with whom, when, and how often you have sessions. Because no facility can provide all services, we often work with your existing providers and new outside providers, to provide you with the support for change that you need. If significant coordination of care is needed, one psychologist fills that role.
“Success rate:” Many facilities present their “success rate.” Unless this statistic has been established by independent research and published in a peer-reviewed scientific journal, it is most likely a made-up number. We consider Practical Recovery to be like a well-equipped gym. All the equipment you might need is here, but you are the one working out. Another analogy is a mountain climbing guide. We can show you what needs to be done and a fair amount about how to do it, but you are the one climbing the mountain.
Licensed Psychologists as Providers: With the exception of the meditation instructor (whose services are optional, and quite popular), all staff are licensed psychologists.
Financial transparency: We do not pay any referral fees (“kickbacks”) to anyone. Our marketing expenses are minimal. In some facilities most of the fees you pay are paid out as commissions, referral fees, kickbacks, and marketing expenses. Because disclosure of these payments is typically not required by law, you may never learn about them.
Refund for unused services: If you provide 48-hour notice of departure, we refund any additional money you have already paid. Work with us as long as it is helpful, and then move on to the next activities in your life.
