• Leading Edge Psychotherapy: The psychotherapy team

    Posted on July 24, 2013
    A psychotherapy team involves multiple therapists who meet successively with the same client for individual therapy. Therapy 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 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 tests, etc.) can detect/diagnosis an established me...
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  • Are Non-12-Step Recovery Approaches Effective?

    Posted on July 24, 2013
    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 a non-12-step (alternative) approach.  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 they had freely chosen to attend,...
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  • Choices in Addiction Treatment and Recovery

    Posted on July 24, 2013
    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...
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  • Debunking the Myth about AA

    Posted on July 24, 2013
    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. In fact, 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 actually 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/Effectivenes...
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  • Self-empowering addiction support groups

    Posted on July 24, 2013
    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 support abstinence, with Moderation Management supporting both abstinence and moderation with alcohol. SMART Recovery http://smartrecovery.org Women for Sobriety http://womenforsobriety.org LifeRing Secular Recovery http://lifering.org Secular Organizations for Sobriety http://www.sossobriety.org Moderation Management http://moderation.org/ All of these non-profit organizations are active communities of recovery with websites, publications and face-to-face meetings in some locations. Several also have online meetings and active message boards.
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  • Biological-Psychological-Social-Spiritual: Which Support Group Covers Them All?

    Posted on July 24, 2013
    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 “bio-psycho-social-spiritual” 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 in nature, 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, the...
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  • Balancing individual and community needs

    Posted on July 24, 2013
    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. 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 of oneself. Perhaps the influence of capitalism has promoted an excessi...
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  • Do-It-Yourself Moderate Drinking

    Posted on July 24, 2013
    Do-It-Yourself Moderate Drinking Are you interested in moderating your drinking? Many individuals are! Here are two books which provide everything you need to know about 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, ...
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  • Two family attitudes that promote addiction recovery

    Posted on July 24, 2013
    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 really 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 goin...
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  • The Disadvantages of Understanding Addiction as a Disease

    Posted on July 24, 2013
    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.” In fact 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 ...
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