Originally posted on the Reunion San Diego blog on June 2, 2013 For a long time, addiction treatment programs have used the word “relapse” to describe a return to drinking or drug use following a period of voluntary abstinence by people with drug and alcohol problems. Often the words “lapse” or “slip” are used to distinguish a brief period of “using again” from a return to more extended and long-term use. At Practical Recovery, we’re joining hands with a number of experts in the field who want to do away with the use of the word “relapse” because we think it has negative connotations. As addiction scholar William White, M.A., author of Slaying the Dragon: The History of Addiction Treatment and Recovery in America, points out, the terms lapse and relapse actually have their ...

Barry Hazle recently received media attention, and a nearly $2 million dollar settlement, after he challenged the legality of a mandate to a 12-step substance abuse treatment program. Hazle was convicted of possession of methamphetamine in California and sentenced to a 90-day treatment program. Because he was an atheist, Hazle had difficulty engaging in the treatment, which was 12-step in its approach and required a belief in God. When he was sent to prison for failure to participate, Hazle fought back, alleging that his First Amendment rights were being violated. He sued the parole officer that sent him to prison, California corrections officials, and Westcare Corporation (a company which contracts with the state to provide treatment facilities for parolees). The U.S. district court ag...

by Tom Horvath, Ph.D., ABPP There are multiple ways to experience any well-developed approach to addiction recovery, whether that approach is, for instance, SMART Recovery, a 12-step group or Stanton Peele’s PERFECT Program. In this article I present my observations about experiences in SMART Recovery. I acknowledge the foundation established for this article by The Varieties of Religious Experience: A Study in Human Nature by William James, and The Varieties of Recovery Experience: A Primer for Addiction Treatment Professionals and Recovery Advocates, by William White and Ernest Kurtz. This article is written to help celebrate SMART Recovery’s 20th anniversary, and the annual conference last month in Washington, DC, celebrating that anniversary. The highlights of that conference,...

If you were a woman with breast cancer, you’d probably want to know that there were several treatment options you had: radical mastectomy, lumpectomy, radiation, chemotherapy, holistic services, nutritional approaches, some combination of these options, do nothing, or wait until the next new treatment emerges.  You might be inclined to let your physician decide what to do.  However, most individuals would want to make a decision of this magnitude for themselves.  So, you would want to know how successful each approach is, what it costs, the recovery period involved, the side effects, and the likely complications.  You would want to talk to individuals who had used each approach.  You would search the internet.  You would get input from multiple sources.  Your final decision would probab...

Previous research suggests four to eight percent of women under the age of 44 are alcohol dependent. Further, up to 65 percent of alcohol dependent women have a co-occurring psychiatric disorder, and women are typically less likely to seek alcohol treatment as compared to men. Research also shows that many alcohol dependent women have high levels of stress in their marriage. Barbara McCrady of the University of new Mexico Center on Alcoholism, Substance Abuse and Addictions and Elizabeth Epstein of Rutgers University led a study which found that couples therapy for alcohol dependent women may work well for women with supportive spouses. Couples Therapy vs. Individual Therapy The researchers compared alcohol behavioral couples therapy to alcohol behavioral individual therapy in a rando...

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...

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...

Ashley Adams, MFTI does much of the couple and family work at Reunion and below, she discusses the practice of Emotionally Focused Therapy. At Practical Recovery, our goal is to give clients the necessary tools that empower them to make healthy choices. One such choice is the option to participate in couples therapy and family therapy. Although this work is highly recommended (in most cases), clients have the option to decline. We may also offer their loved one individual therapy with another provider who is not working with the resident, as a way to provide additional support in conjunction with the couples/family therapy. Before the first session occurs, the family or partner will fill out a number of brief questionnaires and have some basic understanding of what emotionally focuse...

by Kevin Murphy, Psy.D. Exposure Therapy emerged in the 1950s as an intervention to treat panic-phobic disorders. Owing to the abundance of empirical support behind the intervention, Exposure Therapy (ET) has become a staple in the treatment of anxiety disorders. Building on that long track record, Cue Exposure Therapy (CET) borrows heavily from the format used in ET, but is specifically designed to treat the cravings that perpetuate substance use disorders. CET acts to de-sensitize the effect of triggers (the feel of a cold bottle, the sight of a sandwich baggie, etc.) that tend to prompt cravings. Research into CET is not nearly as robust as the literature that supports the efficacy of ET. Eventually, it’s predicted, CET will become as mainstream a practice in the field of chemical...

by Tom Horvath, Ph.D., ABPP Motivational Interviewing and Harm Reduction compared: In this article I compare these two important contemporary recovery concepts. From my perspective they are mostly similar, but have dramatically different rates of acceptance in the addiction treatment industry. You might also be interested in: Addiction Treatment: Motivational Enhancement Therapy Motivational Interviewing (MI) Motivational interviewing (MI) is a psychotherapeutic approach for promoting any healthy behavior change. MI was created for work with addiction, then extended to any behavior change about which someone is ambivalent. Ambivalence is a crucial aspect of MI. The person who is completely committed to change is actually changing, and not sitting in front of you discussing the pos...