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...

by Tom Horvath, Ph.D., ABPP San Diego is coping with another major set of fires. Our hearts go out to everyone affected by these events. Any disaster brings additional risk for individuals in addiction recovery. We hope the following guidelines are helpful. 1. Focus on the physical first. Attend to injuries, even minor ones. Get to the safest place you can. Get warm (or cool). Stay fed and hydrated. Rest as needed. 2. Expect to be more emotional. It’s OK to be numb at first. However your emotions show up, and in whatever time, accept them. Express yourself to others. Be careful not to mistreat others. 3. Include self-care as a component of your efforts to restore your life. It is not just possessions that need restoration. In time, if needed, seek professional help. 4. Ma...

by Tom Horvath, Ph.D. “Everyone is entitled to his own opinion, but not his own facts.” Ironically, I have not been able to confirm (the fact of) who first expressed this idea. It is widely attributed to Daniel Patrick Moynihan, four-time US Senator from Massachusetts (1927-2003). What are the primary “facts” or findings about addiction and recovery, of which any theory of them, and any approach to treatment and recovery, would need to take into account? I will propose a few facts (and opinions too). Of course, even our selection of “facts” can be biased. However, only by making the effort to understand the foundations of one’s own opinions can these opinions be improved. 1) Prohibition will be of limited effectiveness in preventing addiction. Alcohol prohibition in the US (...

How could believing addiction is a disease be bad? There are now several studies suggesting that individuals who believe their behavioral problems (either addiction or mental health) are a disease may have more trouble recovering from them. The most recent study found that individuals who believe obesity is a disease are less focused on weight loss. If someone views himself or herself as having an addictive disease, there seems little benefit in trying to change that view (and possibly much to lose). However, if someone does not view addiction as a disease, is attempting to instill that view worthwhile? Given that viewing addiction as a disease may be a high-risk belief, promoting that belief is inconsistent with promoting recovery. Unfortunately, many US addiction treatment faci...

In addition to the facts arising from the science of addiction treatment, there is another compelling and relevant aspect of addiction: Natural recovery. Most who recover from addictive behavior do so without attending treatment or a support group. Recovery is thus a broader concept than treatment.  In daily life natural recovery is easily visible in how people quit smoking.  Although for most quitting smoking involves multiple attempts and a major expenditure of effort, very few individuals attend treatment or a support group to quit.  Nevertheless, in the US millions of individuals have quit smoking, especially since the widespread recognition in the mid-20th century that smoking was seriously harmful. Large scale population studies have confirmed that even for the substances of ab...