SMART Recovery’s First Systematic Scientific Review by Tom Horvath, Ph.D., ABPP The first systematic scientific review of SMART Recovery was published earlier this year. What is a systematic review? It reports the process of “identifying, summarizing and evaluating the quality of evidence for SMART Recovery” (Beck, Forbes, Baker, Kelly, et al, 2017, p. 2). Prior reviews had become outdated, and they were “narrative in nature and tend[ed] to focus on the origins, development and principles of SMART Recovery….since Horvath & Yeterian’s narrative review (Horvath & Yeterian, 2012), the evidence base has doubled—an additional four studies, including the first randomized controlled trial (RCT), have been published” (p. 2). Although I regret that our 2012 review is no longer the...

Gauging Success in Recovery by Thaddeus Camlin, Psy.D. Success in recovery is about much more than abstinence. In fact, for about half of the people who recover moderation is the outcome. Basing success on abstinence sets people up for the abstinence violation effect, which can be a major factor in pushing a minor slip into an all-out relapse. So when someone is not measuring success by counting days of abstinence, what factors are useful in gauging success? Three factors have been shown to predict successful recovery. The first is a change in attitude towards substances. How people first felt about substance use compared to how they feel now often differs. People who once idealized substance use may now find it to be a nuisance or an impediment to more important things in life. I...

Why Do People Use Drugs? The Relationship Between Emotions and Addiction, pt. 6: Happiness by Thaddeus Camlin, Psy.D. The final topic of our in-depth exploration of each core emotion is happiness.  Happiness is the most pleasurable, desired, pursued, elusive, mercurial emotion of all.  If happiness is so pleasurable and desired then it can’t be a reason people use drugs, right?  Wrong.  People often use drugs to both achieve and sustain happiness and the drugs work, sort of.  As Tolstoy astutely observed, there appear to be many more ways not to be happy than there are ways to be happy.  Drugs are one method people employ to feel happy.  Therefore, understanding happiness is vital to understanding addiction. Did you miss part 5 of this series? Learn about the relationship betwee...

Why Do People Use Drugs? The Relationship Between Sadness and Addiction by Thaddeus Camlin, Psy.D. This week sadness is the topic that continues our in-depth exploration of each core emotion.  If you ever wonder, ‘why do people use drugs?’ sadness is often an answer.  Many of the most painful emotions (e.g. grief, bereavement, mourning) and debilitating disorders (e.g. major depression) are rooted in sadness.  Humans often put forth valiant efforts to avoid and ward off sadness and its related emotions.  However, sadness is not inherently negative and efforts to avoid it are often destructive because sadness is crucial to the human experience. Did you miss part 2 of this series? Explore the relationship between anger and addiction here. Sadness generally features an appraisal...

Why Do People Use Drugs? The Relationship Between Emotions and Addiction, pt. 2: Anger by Thaddeus Camlin, Psy.D. For the first in-depth look at each core emotion we begin with anger.  Few would object that anger is one answer to the question, ‘why do people use drugs?’  Anger tends to conjure potent associations like violence, hatred, and destruction, but anger is not all bad.  Sometimes substance use helps suppress and manage anger, other times substance use helps facilitate the release of anger.  Anger and substance use certainly have a storied history (stereotypes of ‘angry drunks’ are abundant).  This article investigates the nature of anger and its relationship to substance use. Missed last week's article? Learn more about the relationship between substance use and emotion...

High Sobriety: Cannabis Inclusive Treatment Opens in Los Angeles An Interview with Joe Schrank, by Tom Horvath, Ph.D., ABPP In an effort to offer another pathway to recovery, High Sobriety in Los Angeles opened last month a residential treatment facility that includes the option of prescribed cannabis. The home page states: “For generations we have been told marijuana is a gateway drug; this has been debunked by science and common sense. At High Sobriety, we believe marijuana can be an exit drug.” Reinforcing the notion of an exit transition process, the facility’s tagline is “lethal > non-lethal > life.” I have great admiration for the courage demonstrated by the founder of this facility, Joe Schrank. Several years ago I contemplated offering a similar option, but finally ...

How to Pick a Good Therapist by Thaddeus Camlin, Psy.D. One of my favorite professors often espoused that, “when it comes to therapists, the competition is at the level of mediocrity.”  Finding the right therapist can be quite an undertaking.  In the world of therapists there are countless therapeutic modalities, certifications, qualifications, and credentials.  This article hopes to help one navigate the multitudinous therapeutic acronyms, degrees, and services out there to find the right fit for you. Read on for information on how to pick a good therapist. The world of addiction and recovery presents some unique challenges to finding a good therapist.  Three primary types of providers make up the options for therapists when it comes to addiction: certified drug and alcohol coun...

Alcohol, Drugs, and Health: Highlights from The Surgeon General's Report Tom Horvath, Ph.D., and Thaddeus Camlin, Psy.D. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health, released in November, has received considerable attention. The massive effort involved in creating this document is in itself worthy of respect. The opening pages list seven science editors, three managing editors, five contributing editors, 21 contributing authors, one science writer, 117 reviewers, and 10 other contributors (these individuals apparently being mostly involved in production). The professionals involved include many of the most important individuals in the fields of addiction and recovery. You may have heard the expression that a camel is a horse that was des...

Self-Care in Recovery H.A.L.T. At The Crossroads by Thaddeus Camlin, Psy.D. I recently received a request from a reader to examine H.A.L.T. in light of current research. H.A.L.T. is a commonly used acronym by 12-Step circles in discussions of triggers and relapse prevention, and it stands for hungry, angry, lonely, and tired. It is based largely on the content of four chapters from the Alcoholics Anonymous publication Living Sober. This article will explore each of the four topics referenced in the H.A.L.T. acronym with empirical and self-empowering inclusions. Hungry The Living Sober book suggests that eating or drinking something, particularly something sweet, is an effective method of dampening the desire to drink. SMART Recovery would call the technique of eating ice cream in...

by Thaddeus Camlin, Psy.D. Turn New Year's Resolutions into Lasting Change Achieving lasting change can be elusive.  Whether you make resolutions at the dawn of the New Year or at other times in your life, we all make promises to ourselves to change.  However, many times the firm commitments we make to ourselves fade like a sigh within weeks or months.  Those who exercise year-round will attest to the inevitability of their fitness centers becoming more crowded in January than during the other 11 months of the year.  So what gets in the way of adhering to our new year's resolutions and the promises we make to ourselves?  We do. Significant and lasting behavior change is rarely achieved without also looking inward.  Whether you call them your demons, your hang-ups, your vices, your ...