by Tom Horvath, Ph.D., ABPP When I began specializing in addiction treatment in 1985 I affiliated with the New Horizons outpatient network of providers. To my knowledge none of the original providers (nearly two dozen at one point) are still in practice. However, one newer practitioner works in Hawaii. Mark Turansky became involved some years after I left (to focus on the development of Practical Recovery). Mark and I met in 2014. I still appreciate many aspects of the New Horizons approach. In this article I focus on that approach and Mark’s activities. To place any recovery approach in context, nothing works for everyone, and almost any approach will work for someone. The challenge to providers is matching services, approaches and options with individuals who might benefit from ...

Addiction Treatment: Understanding and Integrating Motivational Enhancement Therapy Guest Post by Jonathan Liss, Ph.D. Of course you have heard about Motivational Interviewing, and maybe Motivational Enhancement Therapy. However, if you are not involved with MI or MET regularly, the following summary would be good way to refresh your memory, and provide a springboard for including MI more regularly in your work. Thanks Dr. Liss for this article! Motivational Enhancement Therapy (MET) is a brief therapy, derived from Motivational Interviewing, designed to produce rapid, internally driven change for individuals in early stages of contemplation about the role of substance use in their life. Though non-directive, this brief (approximately four sessions) therapy aims to harness an ind...

The SEATA site is poised to become the leading resource for finding harm reduction and self-empowering US addiction treatment and recovery services. “Self-empowerment” is used to contrast the approach with powerlessness-based services. As Step 1 of Alcoholics Anonymous states, “We admitted we were powerless.” A SEATA provider will work to enhance the client’s capacity for self-regulation, with the ultimate goal (even if never realized) of having sufficient self-regulation to prevent problematic addictive behavior, rather than viewing oneself as indefinitely powerless. The site offers only free listings. These listings should encourage participation by all appropriate providers. The site also allows for reviews (as Amazon, Yelp and many other sites do). Free listings should also el...

By Tom Horvath, PhD, ABPP All species aim to survive. They do so by seeking out some experiences and avoiding or escaping others. The behaviors associated with addiction and recovery can be understood in this larger context of survival, approach and avoidance. The implications of an evolutionary perspective for addiction include new definitions for commonly used addiction terms, and a revised approach to addiction treatment and recovery. Addictive Behavior: Primary addictive behavior is pleasurable survival behavior. All species engage with the environment in order to survive. Depending on the level of consciousness of the species, the repetitive involvement with these essentials is experienced as pleasurable. Survival essentials include food, sex, and in some mammals attachmen...

by Devon Berkheiser Recovery: A Lifelong Process? In the traditional 12 step approach to addiction treatment, members identify themselves as “alcoholics” or “addicts.” They are commonly told that addiction is a chronic disease, one that will never fully go away regardless of how long they maintain abstinence. This approach can work for many people. Some find it useful to identify themselves with such labels as “alcoholic” because it is a way for them to stay humble and to use that label in a safe setting, minimizing feelings of shame. Also, the idea that recovery is a lifelong process can help people stay vigilant and avoid the pitfalls of complacency. However, for other people, this approach can feel hopeless and shaming. The idea of saying that one can never really be free from a...

by Tom Horvath, Ph.D., ABPP "Rarely have we seen a person fail who has thoroughly followed our path. Those who do not recover are people who cannot or will not completely give themselves to this simple program." - AA's Big Book, Chap 5, "How It Works," opening lines Is AA effective? It is my understanding that, at present, the studies that would be required to answer that question have not been conducted. If they were conducted, I suspect AA would be found helpful for some individuals (which is the most powerful statement you can make about any approach to recovery). The recent arguments in the media about AA's effectiveness (Glaser, Singal; and many prior) are important but a secondary issue in the day-to-day work of encouraging addiction recovery, which is about finding wh...

By Devon Berkheiser In early recovery, many people face a choice: whether to continue friendships with people who may still be using or to end those friendships in order to protect their own sobriety. This is not always an easy decision to make. Some using buddies may actually be long-term friends, and it can be hard to handle another important loss when you’re already dealing with so many changes in your life. Additionally, you may not have sober friends, which leaves you with the option of going back to old friendships or essentially starting over, which can feel overwhelming. If you do decide to maintain friendships with friends who are not sober, here are tips to help you manage the situation: 1. Evaluate the risk Some using buddies may be supportive of your new sobriety while ...

By Devon Berkheiser, Psy.D. Just as there are many different ways to recover, there are many different resources available to help in recovery. One great resource is books, and there are practically an unlimited number of options! From self-help books to autobiographical accounts, here are our picks for interesting and inspiring recovery-oriented books: 1. "Buddha’s Brain: The Practical Neuroscience of Happiness, Love, and Wisdom," by Rick Hanson This book focuses on more than just addiction, exploring how readers can work toward greater overall well-being. It provides information about the core functions of the brain (regulating, learning, valuing), along with practical applications of neuroscience to everyday life. 2. "Her Best Kept Secret," by Gabrielle Glaser In this info...

By Devon Berkheiser, Psy.D. Recovery is a major change that affects your entire lifestyle. When your energy is not spent on obtaining or using a desired substance, you might wonder what to do with your time or how to exist in “normal” life. Additionally, it’s common for people in early recovery to experience something of a slump after the first few weeks of sobriety. Perhaps you were expecting everything to be magically better once you got sober, but instead feel disappointed with the somewhat mundane nature of life in recovery. Although it can be a big transition, there are some things that you can do in order to make the adjustment to regular life easier. Here are 5 tips for getting used to normal life: 1. Learn to tolerate boredom and discomfort While we all want to experien...

Looking for some additional recovery support? While 12-step support networks such as AA and NA are the most widely-known, it’s important to know that, just as with addiction treatment, you have choices when it comes to recovery support. That’s why we’ve compiled a list of self-empowering organizations that offer resources for mutual- and self-help support. The Best Approach to Recovery We strongly believe that the best approach to recovery is the one that works for you. You may find one of these organizations to be just what you need. Or, you may find the support you need through 12-step oriented groups. Maybe you’ll even decide to combine different approaches and customize your recovery support to fit your needs. Whatever you decide, remember it’s your journey – choose the path that’...