A psychotherapy team involves multiple therapists who meet successively with the same client for individual therapy. Leading edge psychotherapy teams have begun to emerge, in varying degrees, in a few state-of-the-art addiction treatment facilities. Their emergence may have occurred somewhat serendipitously but as Pasteur remarked “chance favors the prepared mind.” To my mind, the experience with the leading edge psychotherapy team format highlights the illusion of believing that a client exists as such and that the client’s problems or difficulties exist as such. By “as such” I am referring to the idea that the client and his or her difficulties can be apprehended or discovered as they “really” are, objectively, in pretty much the same way that a physician (with the help of lab test...

There are many effective alternatives to the 12-step addiction recovery approach.  This article will describe the major treatments and support groups that one might choose if interested in and answer the question: are non-12-step recovery approaches effective?  These alternatives need to be widely known because individuals who might never attend an AA (Alcoholics Anonymous) meeting might attend treatment or a support group with a different approach.  What might not be possible for them in AA might be possible elsewhere.  It would benefit everyone if the alternative approaches were as widely known and as easily available as AA and other 12-step groups.  Even AA would benefit from the individuals who chose to go elsewhere.  Those remaining in AA would know that they were attending because...

Should individuals who need help have choices when it comes to treatment and recovery from addiction?   Imagine talking to your child or partner, who is obviously drinking or drugging too much. “Why don’t you get it?  It’s SO obvious!  You are becoming addicted!  Look at the damage you are causing, to yourself, to me, and to everyone who cares about you.  YOU NEED TO STOP!  I’m arranging to send you to treatment.” And imagine an angry response, perhaps something like “This is my life, I’ll live it the way I want…You just don’t respect my lifestyle…You are blowing this way out of proportion…Just because you are a prohibitionist doesn’t mean I have to be one…You can take your treatment program and…” Looking in from the outside, we could say that this drinking/drugging indi...

The primary myth about AA is that “it is the only thing that works.” Of course, like other myths, there is some truth in this one. Many people assert that AA saved them or others they know well from alcohol problems. They may be correct. However, no one knows. From a scientific perspective, the effectiveness of AA is unknown. Furthermore, what is known to be effective alcohol treatment, from a scientific perspective, is not very similar to AA. Therefore, what should be said about AA is that “it might work—many people claim based on personal experience that it does—but other approaches are known to work, and they are rather different than AA.” An introduction to the complex scientific literature on AA can be found here: http://en.wikipedia.org/wiki/Effectiveness_of_Alcoholics_An...

Although Alcoholics Anonymous (AA) and other 12-step groups are far more widely known, there are other addiction support groups worth knowing about.  They are listed here in approximate order of size and influence.  All of the self-empowering recovery groups support abstinence, with Moderation Management supporting both abstinence and moderation with alcohol. SMART Recovery:  Self-Management And Recovery Training (SMART) is a global community of mutual-support groups. At meetings, participants help one another resolve problems with any addiction (to drugs or alcohol or to activities such as gambling or over-eating). Participants find and develop the power within themselves to change and lead fulfilling and balanced lives guided by our science-based and sensible 4-Point Program®. http...

Science has revealed that addiction is far more complex than we formerly thought. As a result, professionals and individuals in recovery have changed their language about addiction and recovery. Addiction is now described as a complex problem, and recovery is described as having biological, psychological, social, and spiritual aspects.  This "biopsychosocial" model of recovery groups model includes physiology and genetics; behavior, beliefs and emotions; family, community and culture; and values, morality, and ultimate beliefs. If we accept that addiction and recovery are bio-psycho-social-spiritual, which addiction support groups support this broad and complex approach? Which groups include all four aspects in their program (based on a review of the primary publications)? Fortunately,...

A well-functioning family, community or society needs to have a balance between self-interested behavior, and altruistic or service behavior. If every member of a group pays attention only to his or her own immediate needs, life becomes very difficult quickly. For instance, a hunter-gatherer group that could effectively cooperate to hunt large animals would have more food, and be safer, than a group that had each member attempting to hunt alone. Solitary hunters are simply not as effective as a well-coordinated team of hunters. You might also be interested in: When Substance Use Affects the Family It is assumed in most Western societies that individuals will naturally “look out for number one.” In some non-Western societies there may be more emphasis on helping others over taking care...

DIY Moderate Drinking Are you interested in moderating your drinking? Many individuals are! Here are two books which provide everything you need to know about DIY moderate drinking. Responsible Drinking: A Moderation Management Approach for Problem Drinkers This book, by Rotgers, F., Kern, M. & Hoeltzel, R. (CA: New Harbinger Publications, 2002) is the basic text of Moderation Management (MM), a support group which helps individuals moderate drinking, or abstain. The first two authors are addiction experts who also volunteer on MM’s Board of Directors. The final author was successful in the MM program. MM offers a summary of its program on its website, and you might wish to start there: www.moderation.org. This book, which provides in-depth coverage of MM’s rationale, the sci...

A. Tom Horvath, Ph.D., ABPP 1)  Stay focused on the desired outcome, not the process.  You may be hoping to find the “right” treatment for a loved one.  Rather than insisting that your loved one do this or that (some treatment program you think will be helpful), focus on what you want: no more (or at least fewer) addiction problems.  Don’t get so caught up in the process of treatment that you lose sight of the goal.  Let your loved one determine what might be helpful.  Any program the user chooses is better than one forced on him or her. Starting with local outpatient treatment often makes more sense than going off for 28 days to residential treatment.  In many cases simply entering individual psychotherapy will be sufficient.  Don’t hold your loved one accountable for going throu...

In the news media, the typical expert describes addiction as a disease. Often these experts work at addiction treatment facilities. It would be easy to conclude that experts agree that addiction is hereditary, incurable, and lifelong. In the addiction field, this view is referred to as the “disease model.” There is significant disagreement about the disease model, but the scientists and professionals who view addiction in other ways do not receive the same media coverage. Why alternatives to the disease model (there are several) do not get more publicity is a story in itself. However, this article will focus on two reasons not to understand addiction as a disease. The first disadvantage of the disease model is that, for individuals with addiction problems, it is distracting. If I dri...