Category: Anger

  • Recovery Rising – A memoir of William L White

    Recovery Rising is the memoir of foremost recovery researcher and advocate, William L White. It has just been released on Amazon. White, for over five decades has had different roles in the addiction treatment field, beginning in Chicago’s inner city as a street worker working with addicts and the homeless, an addiction counselor, clinical supervisor, treatment administrator, educator, clinical and organizational consultant, and research scientist to being honored as the addiction field’s preeminent historian, one of the fields most visionary voices and a most prolific author.

    In Recovery Rising, William White’s ideas, methods, and organizational studies emerge to give the reader an idea on how dynamic a leader White is in the modern addictions field. These stories, sometimes poignant, sometime humorous always are revealing and informative. Williams White’s life work has been affirmed by this memoir and (hopefully) a younger generation of addiction advocates and professionals will be inspired by his story  to continue his good work.

    This link to his book on Amazon is:

    https://www.amazon.com/Recovery-Rising-Retrospective-Addiction-Treatment-ebook/dp/B07526ZDVD/ref=sr_1_1?s=books&ie=UTF8&qid=1506351061&sr=1-1&keywords=recovery+rising

  • Lions, Tigers, Bears and the Yellow Brick Road to Recovery

    This is a guest post by Steve Devlin, a recovery coach from Philadelphia PA, and a long time friend. I chose to post this over the Holiday weekend, because it brings me such joy, and brings back wonderful memories of watching the Wizard of Oz on TV during the 60’s. Thank-you Steve, and Happy Holidays to all of my readers.

    Over the past week, I have been thinking about the Serenity Prayer and its connection to the Wizard of Oz.  Some of you might be looking at your computer and wonder if I have lost my mind.  I beg for your patience and to hear me out.  First a caveat or two.  I represent only myself in this message.  The second caveat is this message was inspired by a share I heard at a 12-step meeting.  The person who said it gave me permission to use it.  So here we go!

    We all know the Serenity Prayer.  “May God grant me the serenity to accept the things I cannot change, the courage to change the things that I can, and the wisdom to know the difference.”  And almost everyone knows the story of the Wizard of Oz or at least the movie version of the story. Dorothy is not happy with life on the farm, runs away, is swept up in a tornado, lands in a strange place, and gathers three companions on her journey to the Emerald City to meet the Wizard.  On the way, she must deal with witches – good and bad – flying monkeys, and castle guards before she finds she always had the power to grant her wish of returning home.

    So what does this story have to do with the Serenity Prayer, let alone recovery?  We cannot find fulfillment, happiness, or peace in our lives. We run away and just when we realize that we have run too far, we are swept up in the tornado (or drug of our choice).  Its path of destruction destroys the landscape of our lives and carries us far away. Thankfully, when the storm passes we land in a new brightly-colored world filled with sober people singing about the blessings of recovery.  Yet our own work is just beginning.  There is a road we must follow with steps leading to the Emerald City of sobriety.  We also learn that we cannot walk the path alone.  There are still temptations, flying monkeys, people, places, and things calling us back to the darkness.  However, as we follow the path we first find the companion of serenity – the heart to love ourselves and others.  A new heart also gives us the gift of forgiveness and acceptance.

    The second companion is the courage to move forwards even when encountering lions, tigers, and bears.  It is courage which lets us turn over our lives, let go of character defects, and make amends.  It is also courage that lets us pick up the phone or go to a meeting.

    Finally, there is wisdom, which gives us the ability to see choices in our lives and to know what we can and cannot change.  After long periods of feeling tied up like a scarecrow on a post, we are set free to walk a brick road of new life.  Of course, finding these three companions to fight back addiction is only part of the story and the Emerald City is not the ultimate destination.  Our companions bring us to the shining light of recovery, but we must take the gifts back home and use them in our daily lives outside of the rooms.

    I wish recovery was as easy as clicking our heals together.  Finding our way home takes work but with heart, courage, and wisdom we can overcome all the flying monkeys and stay out of the way of tornadoes.  We also learn that the greatest companion of recovery is gratitude which was always just in our own backyard.

    Question: Who are your companions on the brick road?

  • Getting through the tough times

    As a recovery coach, I often see my clients need help getting through the tough times, without using, picking up or acting out. Recently, I personally encountered some rough patches in my life, so, I went to my library of recovery books. Several years ago, when I was experiencing trouble living life on life’s terms, I became an avid reader of Pema Chodron.

    Pema Chodron Celebrates her 80th Year

    Pema Chodron, is a Buddhist nun, she was born in 1936, in New York City, and is celebrating her 80th year. After a divorce, in her mid-thirties, Pema traveled to the French Alps and encountered Buddhist teacher Lama Chime Rinpoche, and she studied with him for several years. She became a novice Buddhist nun in 1974. Pema moved to rural Cape Breton, Nova Scotia in 1984, ­­­to be the director of Gampo Abbey and worked to establish a place to teach the Buddhist monastic traditions (waking before sunrise, chanting scriptures, daily chores, communal meals and providing blessings for the laity). In Nova Scotia and through the Chodron Foundation, she works with others, sharing her ideas and teachings. She has written several books, and in my time of deep spiritual need, I went to her book “When Things Fall Apart”.

    A Compassionate Tool

    Drawn from traditional Buddhist wisdom, Pema’s radical and compassionate advice for what to do when things fall apart in our lives helped me. There is not only one approach to suffering that is of lasting benefit, Pema teaches several approaches that involve moving toward the painful situation and relaxing us to realize the essential groundlessness of our situation. It is in this book, I discovered a simple breathing exercise, I can use during these chaotic times so I can move into a better space. Pema advocates this tool as a breathing exercise, although this exercise could also be considered a mindful meditation.

    I use Chodron’s tool whenever and wherever life hits me below the belt. I share this tool with my clients. It is all about breathing and consciously repeating words to yourself to accompany the breathing. Since we breathe every day, it is indiscernible whether you are using this tool as you travel on the bus commuting home from work, in a conference room with your boss, or when you are feeling low and want to curl up in a ball and die.

    Breathe

    Breathe. Pema explains in her book, when things get way too complicated; step back and breathe. When the force of the world, the politics of the U.S., Great Britain or Italy start weighing heavily on your mind, breathe. When you look at all the pain around you and feel powerless to do anything, breathe.

    Pema explains, inhale and say silently to yourself breathe in the pain, then exhale and say breathe out relief. Then, inhale, and say silently to yourself breathe in the relief, and exhale and say breathe out the pain. I find I need about 15 minutes of conscious breathing, breathing in the pain and breathing out relief, works for me. After doing this, I find I have new energy or something else crosses my path to move me into a more uplifting space.

    Chodron’s exercise places me in a space I need to be. If I continue to be in that “negative space” of worry or feeling powerless, then absolutely nothing will be accomplished that day. I know we all have something to accomplish every day, whether it is just getting out of bed, taking a shower and brushing our teeth or running a Fortune 500 company, this exercise gets us from zero to ten in fifteen minutes. It is the boost we need.

     So, I invite you to try this simple exercise…and remember…keep breathing

     

  • A new ER resource – recovery coaches

    manhattan_bridgeIn Rhode Island, more than 1,000 addicts have been brought from the edge of death due to an opioid overdose, thanks to first-responders and emergency room workers using the new lifesaving drugs Narcan and Naloxone. When patients are overdosing, first-responders or ER nurses administer these new drugs, which reverse an opioid overdose. The ER staff members use it so often it’s become a verb, as in: “we Narcaned him.”

    In 2015, a pilot program to train law enforcement officers to use Narcan and Naloxone prefilled syringes or nasal spray was started in the New Jersey counties of Monmouth and Ocean. It has been successful in reversing over 400 potentially fatal overdoses. Narcan kits are now available in police cars, ambulances, public transportation centers and even at your local CVS. But the growing number of overdoses has stretched the emergency room doctors and nurses to a breaking point.

    When Narcan patients come to the ER, they can be angry and disorientated, when upon waking they find their high is gone. Emergency rooms are handling a lot of overdose patients, and the work can be frustrating. These patients are combative, upset, demeaning, often yelling or physically acting out. ER personnel, not trained in detox reactions, are perplexed. They are being pulled away from the people who have more medically-critical needs.

    In a relatively short period of time, Naloxone and Narcan are emerging as very one-dimensional treatments. They are lifesavers, but don’t treat the real problem that brings the patient into the emergency room. Another similar one-dimensional treatment is using a defibrillator for a heart attack, it saves the life but it doesn’t treat the heart disease. Using Narcan does not treat the disease of addiction.

    As a result, emergency room physicians, first-responders and treatment experts across the country say the same thing, without a mechanism to connect the overdose patients to addiction services, Narcan and Naloxone only create a revolving door in emergency rooms. Some addicts have returned from the edge of death four and five times, thanks to Narcan injections or nasal sprays.

    In Rhode Island’s hospitals, and in hospitals throughout New Hampshire and New Jersey, ER doctors have called on a relatively new resource to help: the recovery coach. These coaches are not ER employees but are part of a new plan to assist ER personnel in dealing with the detoxing victims of an opioid overdose. These recovery coaches work with the detoxing patients, allowing the ER staff to continue with their tasks of treating others that come into an emergency room. These recovery coaches are peers, many of them former addicts trained to work with an overdose patient coming down from the opioid. These coaches are trained to move the patients into long-term treatment programs for their drug addiction.

    “The goal of the LifelineED program is to get individuals who were Narcaned into detox and treatment,” says Sharon Chapman, program supervisor of the LifelineED program at Center for Family Services in Voorhees, NJ. “Our Recovery Coaches and Patient Navigators work with each individual to help get them into a treatment facility. It’s important for these patients to know they’re not alone, we offer support to help the patients and their families as they go through the recovery journey.”

    These recovery coaches offer peer-to-peer support. There’s nothing like being approached by another recovering drug addict who can help you in your time of need, who knows exactly what you’re going through at that moment. Often, they use information and resources that the hospital staff might not have, such as a list of treatment programs, how to go through the intake process, as well as spending time to educate addicts’ families about the treatment process and how to recognize early signs of the addiction. Of course, the patient decides whether they will take part in treatment, but willingness is the strongest when the patient realizes they just have been given a new “lease on life.” Emergency staff acknowledge it’s helpful to have recovery coaches who can spend time with a patient, and can begin moving them into treatment. These coaches know the recovery terrain better than the ER nurses and physicians. Patients have the option to go to a treatment center, or if they choose to go home, they take the recovery coach’s number with them. The recovery coach or the patient navigator will follow up with them, and assists in helping the patient take the next steps towards recovery. Overdose victims are willing to let recovery coaches into their homes to talk about the program immediately after their overdose. Some need time to come to the realization that if they don’t accept the offer of treatment, there may not be another opportunity. Finding the time for a home visit is something that the ER staff could never do.

    Funding for these ER Recovery Coaching programs is popping up all over the United States, since President Obama and Michael Botticelli, the Director of National Drug Control policy, have requested over $1 billion dollars to be placed into the 2017 budget to fight this growing opioid epidemic. This funding request surpasses the $400 million amount Obama signed for in the 2016 budget, which was a jump of $100 million over the 2014 budget, all in hopes of addressing this harrowing epidemic, which has ravaged communities in all corners of the U.S.

    If you are interested in learning more about working in an ER room as a recovery coach, here are some resources:

    Providence Center-AnchorED

    Holly Fitting

    Phone: (401) 528-0123 / Email: hfitting@provcntr.org

    528 North Main Street,

    Providence, RI 02904

    https://providencecenter.org/services/crisis-emergency-care/anchored

    Attn: Melissa Silvey

    311 Route 108,

    Somersworth, NH 03878

    Phone: (603) 516-2562 / Email: info@onevoicenh.org

    Sharon Chapman, Program Supervisor

    108 Somerdale Rd,

    Voorhees NJ 08043

    http://www.centerffs.org/programs/lifelineed

    Phone: (856) 428-5699 x116 / Email: lifelineED@centerffs.org

    Attn.: Michael Santillo

    16 Spring Street

    Paterson, NJ 07501

    Phone: (973) 754-6784

    http://evasvillage.org/recovery-center.shtml

    • Barnabas Health Opioid Overdose Recovery Program

    Phone: (732) 914-3815

    1691 U.S. 9, Toms River, NJ 08754

  • Why Can’t You Do the Dishes? Part 2

    This week’s guest blogger, Jeff Garson from Radical Decency Group, shares with us a very common example of a partner/spouse/husband/wife interaction. A husband and wife are about to leave for work and his wife, looking at a sink filled with breakfast dishes, says, “Why can’t you do the dishes?” A fight ensues.

    What could have happened is an honest, problem solving discussion; that is, mutual and authentic exchange. Instead, the typical outcome is a cycle of escalating attacks and counter-attacks.

    As a child of our fight or flight culture, the wife, ever vigilant to the possibility of attack, sees the dirty dishes as evidence of danger: That her needs are being ignored; that love is being withdrawn. With her fight or flight physiology activated, her words seek to deal with the perceived source of the attack: Her husband, evidenced by his past behaviors including, very particularly, the choices he’s made in the run-up to this current interaction.

    The husband is equally focused on the immediate past; moving into defense mode; judging and criticizing the words that just came out of her mouth. Why? Because in his culturally reinforced, overly vigilant state, he also feels under attack: Unappreciated, devalued, unloved.

    What is so sad in all of this is that there is nothing to defend – on either side. As a functioning couple, they have each put enormous amounts of time and energy into the relationship and are vitally invested in seeing it continue. Beneath the bickering is a vast reservoir of trust and love. So, the perceived attacker isn’t a source of danger at all. He/she is, instead, the other partner’s staunchest ally in life.

    Given this reality, the couple would be better served by focusing, not on illusory dangers from the recent past, but instead on the near future. Why? Because they each want to increase the love flowing back and forth between them, and the best way to do that is to focus on what they do next, rather than picking apart choices already made.

    Here’s how it would work.

    The wife wants to be loved in a specific way – by coming home to a clean kitchen. So she would ask for what she longs for: “Honey, it makes me feel great when you do the dishes before you leave in the morning.”

    Now, he is set up for a positive, loving response (“sure, I’ll do my best to do it”) rather than a defensive counter-attack (“I am not a bad person for forgetting to do the dishes this morning”). Alternatively, he might acknowledge her desire but say, “My mornings are really tight. Taking time to do the dishes is tough.”

    Importantly note this; that if this second alternative is his authentic response, the couple is still set up for a positive outcome. With defensiveness eliminated and the needs of both partners on the table – hers, for a completed chore (and a concrete expression of love); his, for a routine that accounts for the pressures he feels – creative problem solving can flow from the common goal, shared by both partners: How can I best meet my needs AND the needs of this partner I dearly love?

    A similar transaction can also be initiated from the husband’s end of the conversation. Instead of rising to the bait of her nascent reactivity ( “why can’t you do the dishes”) with a counter-attack, he can thank (yes, thank!) his wife for raising the issue. Why? Because he now has a more vivid roadmap for loving her. And in this frame of mind, he will be able, once again, to move toward a forward-looking outcome that attends, with equal attentiveness, to his needs and hers.

    While this different way of treating our intimate partner may seem a little unusual and strange, it is only because we are so relentlessly pushed toward very different ways of thinking, feeling and acting. The sad reality is that these more loving techniques are seldom taught and find precious little reinforcement in our culture.

    Hopefully, this post has introduced some healing correctives in your intimate relationships – and in all other areas of living as well.

    Jeff Garson, a Philadelphia based psycho -therapist and attorney, is the originator of Radical Decency and his weekly blog called Reflections.   If you want to contact Jeff or the Decency Group, or if you want to be added to the Reflections e-mailing list, contact Jeff at info@thedecencygroup.com.

    The Reflections, published weekly by The Decency Group, explore the philosophy’s application in all areas of living — from the most private and personal to the most public and political. Earlier Reflections are available at www.radcialdecency.com.

  • Why can’t you do the dishes?

    Guest blogger Jeff Garson from Radical Decency Group shares with us a very common example of a partner or spouse interaction. A husband and wife are about to leave for work and his wife, looking at a sink filled with breakfast dishes, says, “Why can’t you do the dishes?” His response: “Look, I have a really busy morning. I usually do them. Give me a break.”

    What happens next?

    A disagreement and argument.

    Jeff asks “Is our approach to living – are our habits of thinking, doing or saying allowing us, in every interaction, to express our needs in constructive ways and, equally, to hear the needs of others?” Jeff, a therapist and attorney from Philadelphia states we are innately, empathic beings, however, we need some skills that will allow us to more easily and instinctively move toward some more empathetic choices in our interactions.

    In this week’s post, Jeff helps us out with some new choices:

    The formulation sounds simple. But as I have discovered in my work as a psychotherapist and coach, and in my own relationships, its application is frustratingly difficult. The reason? Because, when disagreements arise, we are culturally wired to lapse into the fight or flight ways of being, or the culture’s “compete and win, dominate and control” mindset that has so deeply engrained in our habitual ways of being in the world.

    In this post, I work through one very common example of this phenomenon. A husband is about to leave for work and his wife, looking at a sink filled with breakfast dishes, says, “Why can’t you do the dishes?”

    Even assuming a relatively restrained tone in the “music” of these communications, their fight/flight motivation is unmistakable. Both partners remember the past hurts and will mix it with what just happened, the dirty dishes. Now they are locked into judgment mode; a hallmark of fight or flight mindsets.

    The wife, thinking her words were relatively neutral words, doesn’t realize they are words of judgment and attack: You didn’t do something – something you were supposed to do – and (by reasonable inference) something you all too frequently fail to do.

    nAnd how does the husband respond? Equally focused on the past, he counterattacks. Instead of dealing with the merits of the issue – who should do the dishes and when – a response that would invite further dialogue – he seeks to disqualify his wife’s position: You are wrong on the facts AND emotionally out of line in even raising the issue (“give me a break”).

    What very often happens next is – each person, being subtly attacked, feels disconnected and sore. But the interaction is, in their minds, too minor to be worthy of further discussion. Better to absorb the pain and head to work.

    What could have happened is an honest, problem solving discussion; that is, mutual and authentic exchange. Instead, the couple chooses to get into it, and the far more typical outcome is a cycle of escalating attacks and counter-attacks.

    Her: “You’re always have an excuse!”

    Him: “You never stop complaining, get off my back!!”

    And round and round it goes, until one or both of them goes cold and withdraws; that is, retreats into the flight part of fight or flight. They both go to work; mad.

    When it comes to our romantic partner, most of us have some sense of how to charm and seduce; an unsurprising fact given the endless stream of books, movies, and ads that promote and teach these ways of interacting. And yet, at the same time, we have little guidance in the art of lovingly engaging with our partner at our points of sensitive difference – even though much of the hard work of relationship needs to be done in precisely these small moments.

    So why does this strange dichotomy exist? Why do we, as a culture, neglect this vital relational skill even as we celebrate and promote romantic seduction? Because “charm and seduce” – a wonderful gift, when done with judgment and respect – is also entirely consistent with our culture’s predominant values. In this all too typical version, seduction is an effort, through a series of manipulative moves, to get our partner to feel and act in specific ways; ways that very much suit our purposes – but not necessarily theirs.

    By contrast, a loving engagement with our partner in tense times is the antithesis of this competitive/manipulative mindset. For this reason, the predominant culture has an unacknowledged but powerful interest in minimizing this skill; an interest unerringly reflected in the marginal attention it receives in popular culture.

    Thus, one of the key challenges, implicit in my approach to living is to learn to fight well, weaning ourselves from our current fight or flight ways, replacing them with more mutual and authentic ways of interacting.

    What would that look like? Check out my next post next week.

    Jeff Garson, a psycho -therapist and attorney, is the originator of Radical Decency and his weekly blog called Reflections.

    You can contact Jeff at: wjgarson@thedecencygroup.com or the Decency Group, if you want to be added to the Reflections e-mailing list, at info@thedecencygroup.com.

    The Reflections, published weekly by The Decency Group, explore the philosophy’s application in all areas of living — from the most private and personal to the most public and political. Earlier Reflections blogs are available at www.radcialdecency.com.

  • The Top Ten Warning Signs You Are Talking to an Online Catfisher-Part 4

     innocence-en-dangerHow can you protect yourself from a Catfisher or an online predator?

    Why do they do what they do? Catfishers want something from you. These are people that are not motivated by love, but are driven by money, perverse sexual desires and criminal intent.

    • Money is usually the first thing predators want from adult contacts
    • They want to win you over and manipulate you, so you begin to desire them in a sexual way and that means you will begin to trust them
    • They will use your photographs and distribute them to other online predators, they will re-post the pictures online in sexual forums or just enjoy your photographs themselves, privately
    • They want to have conversations with you, texting or otherwise, in order to get sexually aroused during the conversation
    • Any of the above contacts will enable these predators to black-mail, extort or rape you

    Scary Stats

    There are some scary statistics on Catfishers or online predators.

    • An estimated 725,000 people are aggressively pursued online for sex or extortion annually in the US
    • In 2005 alone, 25% percent of rapists used online dating sites to find their victims
    • In 2011, the FBI Internet Crime Complaint Center lodged 5,600 complaints from victims of “romance scams” or “catfishers”
    • Reports say victims of these romance scams have lost over fifty million dollars—however authorities know this figure is much higher because many victims are too embarrassed to report the incidents
    • Every 2 minutes a person in America is sexually assaulted
    • 1 out of 4 children in the U.S. have been sent pictures of people who were naked or having sex by an online predator
    • Each year Internet predators commit over 16,000 abductions, over 100 murders, and thousands of rapes
    • Over 39,000 verified Registered Sex Offenders have profiles on social media sites
    • 1 out of 5 kids have been solicited for sex on the Internet
    • 1 out of 4 kids have been contacted online by a person not representing themselves in a true or accurate way
    • Only 25% of kids tell parents or adults about any online encounters
    • 77% of the time, the targets for online predators are usually in the 11-14 year-old-age range
    • 25% of children that were surveyed were exposed to unwanted pornographic material

    Dating Safety Tips

    Online dating often leads to offline dates, which may end up as a successful relationship. However, before you meet someone in person, take all the time you need to get well-acquainted with this person, so there is hopefully nothing to worry about when you meet face-to-face. Sexual assault on a date is definitely not an everyday occurrence, nonetheless, you need to ensure your personal safety when planning to meet someone for a first date. Take the time to really get to know a person and dangerous incidents are less likely to occur.

    The predators need to be exposed, if you or anyone you know has been contacted by an online predator or has received unwanted solicitation from someone online, call the police and notify the social networking site on which the contact was made.

    • NEVER give out your personal information or home address online, even giving out the town you live in can reveal too much information to a predator
    • Don’t reply to social media messages from people you don’t know
    • NEVER meet face-to-face with someone you have just met online, give yourself and the contact at least 3 weeks to get to know each other before a face-to-face is planned
    • Never download image files from an unknown source, they could contain sexually explicit images that could put you in a compromising legal situation
    • Avoid chat rooms or discussion forums that are sexually proactive
    • If you receive uncomfortable or frightening material, end the communication, block the person from contacting you and report them to the dating site or the social networking site
    • If you receive an unwanted solicitation call 911, contact the dating site or the social networking site and report the perpetrator immediately

    Sexual assault and date rape are definitely not common occurrences when meeting an online date. Read and follow the safety advice for first date meetings that have been outlined on your online dating site, so you are well-prepared. In addition, here are some of tips that will be useful too.

    • Always take the time to get well-acquainted with someone before you plan a meeting. Talking to this person online or on the phone for three weeks is a good amount of time to ensure this person is safe to meet
    • Bookend the date, which means you notify a friend where the date is, whom the date is with and when the date starts and then again, contact the same friend when you leave the date, to ensure you are home and are safe
    • Meet in a public place, like a restaurant, coffee shop, and drive your own car or know the public transportation schedule in order to leave to catch the last bus. At no time should this first date drive you home
    • While on the date, always be very aware of your surroundings. Keep an eye on your drink at all times. Date rape drugs are very easy to drop into any drink. Drinking coffee with a lid on the cup is probably your best defense against this kind of occurrence
    • Getting a girl drunk is a common ploy for a predator, so watch how much alcohol you drink. In fact, many online dating site guidelines do not recommend going to a bar or having a drink on the first date
    • Be cautious during your first few meetings with this person. Have the dates in open public places and stay away from dark and deserted situations
    • Never go to this person’s home or to a hotel until months into your dating experience

    What do you do if you have been assaulted?

    If you believe you may be a victim of sexual assault, the first thing you should do is immediately contact the police and report the crime, no matter how small you might think the crime is. It is common for victims to blame themselves in a case of assault, however you must always remember that this predator had absolutely no justification to attack you. It is also very important to protect your health, go to the hospital and request to have a sexual assault forensic exam, the staff will administer some tests that are compiled into what is sometimes known as a “rape kit.” These exams will preserve possible DNA evidence and you will receive important medical care. You don’t have to report the crime to have this exam, but the process gives you the chance to safely store evidence, should you decide to report the crime at a later time.

    • If you feel you cannot handle going to the hospital alone, try asking an understanding family member or friend to escort you to the hospital.
    • If necessary, you can also speak with a rape hotline operator, an experienced therapist or social worker who can help you deal with it. For more information, reference the local hotlines and services that are featured below
    • If you choose not to have a sexual assault forensic exam, it is also a good idea to to go to a clinic or to see a doctor who can test you for sexually transmitted diseases (STDs)
    • To find a location near you that performs sexual assault forensic exams, call the National Sexual Assault Hotline at 800-656-HOPE (656-4673) or talk to your local sexual assault service provider

    Here are some National Resources for Victims of a Catfisher

    General Information:

    Internet Crime Complaint Center (IC3)                             https://www.ic3.gov/                                                                                                           A partnership between the Federal Bureau of Investigation (FBI) and the National White Collar Crime Center (NW3C).

    National Sexual Assault Hotline: National hotline, operated by RAINN, that serves people affected by sexual violence. It automatically routes the caller to their nearest sexual assault service provider. You can also search your local center here. Hotline: 800.656.HOPE (656-4673)

    National Sexual Violence Resource Center: This site offers a wide variety of information relating to sexual violence including a large legal resource library.

    National Organization for Victim Assistance: Founded in 1975, NOVA is the oldest national victim assistance organization of its type in the United States as the recognized leader in this noble cause.

    National Online Resource Center on Violence Against Women: VAWnet, a project of the National Resource Center on Domestic Violence hosts a resource library home of thousands of materials on violence against women and related issues, with particular attention to its intersections with various forms of oppression.

    U.S. Department of Justice: National Sex Offender Public Website: NSOPW is the only U.S. government Website that links public state, territorial, and tribal sex offender registries from one national search site.

    The National Center for Victims of Crime: The mission of the National Center for Victims of Crime is to forge a national commitment to help victims of crime rebuild their lives. They are dedicated to serving individuals, families, and communities harmed by crime.

    Child Abuse/Sexual Abuse:

    National Child Abuse Hotline: They can provide local referrals for services. A centralized call center provides the caller with the option of talking to a counselor. They are also connected to a language line that can provide service in over 140 languages. Hotline: 800.4.A.CHILD (800-422-2253)

    Darkness to Light: They provide crisis intervention and referral services to children or people affected by sexual abuse of children. Hotline calls are automatically routed to a local center. Helpline: 866.FOR.LIGHT (367.5444)

    Cyber Tip Line: This Tipline is operated by the National Center for Missing and Exploited Children. Can be used to communicate information to the authorities about child pornography or child sex trafficking. Hotline: 800.THE.LOST (800-843-5678)

    National Children’s Alliance: This organization represents the national network of Child Advocacy Centers (CAC). CACs are a multidisciplinary team of law enforcement, mental and physical health practitioners who investigate instances of child physical and sexual abuse. Their website explains the process and has a directory according to geographic location.

    Stop It Now: Provides information to victims and parents/relatives/friends of child sexual abuse. The site also has resources for offender treatment as well as information on recognizing the signs of child sexual abuse. Hotline: 888-PREVENT (888-773-8368)

    Justice for Children: Provides a full range of advocacy services for abused and neglected children.

    Domestic, Dating and Intimate Partner Violence:

    National Domestic Violence Hotline: Through this hotline an advocate can provide local direct service resources (safe-house shelters, transportation, casework assistance) and crisis intervention. Interpreter services available in 170 languages. They also partner with the Abused Deaf Women’s Advocacy Center to provide a videophone option. Hotline: 800-799-SAFE (800-799-7233)

    National Teen Dating Abuse Online Helpline: This online helpline assists teens who are, or may be, in abusive relationships. Call 1-866-331-9474, chat at loveisrespect.org or text “loveis” to 22522, any time, 24/7/365

    Americans Overseas Domestic Violence Crisis Center: The center serves abused Americans, mostly women and children, in both civilian and military populations overseas. In addition to providing domestic violence advocacy, safety planning and case management, the center assists victims with relocation, emergency funds for housing and childcare, and funds for payment of legal fees. International & Toll-Free 866-USWOMEN (866- 879-6636) (Available 24/7/365)

    National Coalition against Domestic Violence: The national coalition of Domestic Violence organizations is dedicated to empowering victims and changing society to a zero tolerance policy. Call the Nat’l #DomesticViolence Hotline 1-800-799-SAFE (799-7233) if you or someone you love is a victim and needs help

    Incest:

    (See also resources on Child Abuse/ Sexual Abuse above)

    Survivors of Incest Anonymous: They provide information on how to find incest survivor support groups in your area and empowers individuals to become survivors and thrivers.

    GirlThrive: Girlthrive Inc. honors teen girls and young women who have survived incest and all sex abuse through thriverships, opportunity and education.

    Stalking

    Stalking Resource Center: The Stalking Resource Center is a program of the National Center for Victims of Crime. Their website provides statistics on stalking, information on safety planning and other resources.

  • The Top Ten Warning Signs You Are Talking to an Online Catfisher-Part 2

    manhattan_bridge_post_versionAre you talking to someone online? Do you trust them? Could they be a catfisher, a scammer, a scallawag or a con?

    I recently returned to online dating after ending a long-term relationship. With a profile depicting a self-supporting, intelligent woman, I was contacted by ten men, and nine of those contacts were scammers or catfishers. Nine out of ten! That is why I am writing this blog post, to make people aware of the dangers of online catfishers or scammers.

    I will outline some typical characteristics and warning signs of an online scammer and offer suggestions on how to protect yourself from catfishers. The good news is that you can protect yourself by learning how to spot a phony while dating online. Tyler Cohen Wood is an expert in social media and cyber issues. She is a Cyber Branch Chief for an Intelligence Agency within the Department of Defense (DoD). She is the author of the book — Catching the Catfishers: Disarm the Online Pretenders, Predators and Perpetrators Who Are Out to Ruin Your Life, and has outlined these indicators that the person you are speaking to online, may be a catfisher.

    1.What if this person won’t video chat?

    Using SKYPE, FaceTime, Google Hangouts or even SnapChat with a person whom you meet online is normal practice in online dating. If a person makes excuses every time you want to SKYPE, consider it a red flag. Be concerned if the area code of their cell number is a not listed in the domestic list of area codes or they cannot come up with a good reason they have such a number. Areas codes that start with 473, 809, 284, 649, 654 and 876 are international, and are known to have been used for scams. Also be aware if there is a very bad connection every time you speak to them (such as a poor international connection) or no voicemail is attached to the number. This person is hiding something that they don’t want you to know.

    2. What happens when you Google them?

    Almost everyone in the United States has some sort of Internet presence. It is very rare that someone would have none at all. If you do basic research, such as conducting a search using a portal like www.WhitePages.com, www.Spokeo.com, or by looking through social media sites, and can’t find anything about this person, that is also a red flag. Most professionals will at least have a LinkedIn page. If you cannot find anything on the Internet about a person, they might not be telling you their real name, which again, is a red flag. However, anyone can very easily create a fake LinkedIn or Facebook page, so be cautious.

    3.Check public records.

    Do some reconnaissance by using search engines to find public records- www.intelius.com, or www.publicrecords.searchsystems.net. If a person says they own a house, you will be able to easily see where it is and how long they have lived there. You can also find legal documents like bankruptcy filings, divorce records and death records.

    4.Do they send real time photos of themselves?

    When people are communicating online, they will frequently send each other selfies, in real time. During a conversation, ask to see a photo of the person right then. If they refuse, or make some excuse, again, another red flag. If they have only sent you one or two photos, it is likely that they took those photos from someone else’s Facebook page or from somewhere else on the Internet. Don’t be fooled by photos of kids, or the snap of a potential romantic interest with his elderly Mom. We all post photos of our family members on our Facebook page! Do a reverse image Google search — right-click on their photos, copy the URL, and paste in the box at images.google.com. Google will then search for other sources of that image online.

    5.How many “real” friends and work colleagues are on this person’s social media sites? How many people communicate with this catfisher?

    You can get to know a lot about a person’s friends and family based on the banter they engage in on social media. How many posts are started by the potential catfisher? How many responses? Does the person seem to have real friends who carry on real conversations? Do they tag their photographs? On LinkedIn, do they have colleagues who have endorsed them? Contact a few friends for a reference check.

    6. Do they deflect or never answer your questions when you ask detailed, specific questions?

    Do they avoid answering your probing questions? Do you find that they deflect from your original question and the subject changes? Do you stop probing as a result? These too are warning signs. If you feel as if you are the only one sharing information and they are not giving away any details, consider this, yep, a red flag.

     

    Next week I will continue with Tyler Cohen Wood’s indicators that you are talking to a predator online and offer suggestions on how to protect yourself.

  • Ten ways of Improving Your Chances of Keeping that New Year’s Resolution

    calvin-hobbes-new-year-resolution1Make a list and think it through

    It’s that time and everyone is thinking of New Year’s Resolutions. You’re itching to get rid of that bad habit right now, but consider this: think it through. I know you have heard that AA saying “Baby Steps” before…but sticking to a habit change is not trying to be perfect right out of the gate. So before you start trying to change a habit, consider thinking about it thoroughly for a month or two. First, list every reason you want to stop, figuring out what triggers or cues you react to, what routine you fall into as a result of that trigger and experiment with the types of rewards you are looking for from that habit. Write down and record every time you catch yourself doing the habit, and soon a pattern will appear. Maybe checking out a few twelve step programs or a therapy group can give you an idea of outside support options. You will be better prepared to conquer the habit after processing it during the next few weeks.

    2.  Identify your triggers

    By doing this review you will see you do the same behaviors, in the same place, at the same time. If at 3:00, you go on a smoke break in your car, the time and the car itself can become a trigger (or cues as Charles Duhigg author of The Power of Habit calls them). These actions can become a cue to start a habit —sometimes these cues are very subtle to notice. As AA says “Avoid People, Places and Things.” Identify and understand your triggers. These triggers fall into one of the following five categories:

    1. Location, a bar, your ex-girlfriend’s neighborhood, a bakery
    2. Time, 3:00, happy hour, visiting family
    3. Emotional State, Hungry, angry, lonely or tired
    4. Other People, the ex, your Mom, Dad or that annoying co-worker
    5. An immediately preceding action, or what happened just before you picked up that joint? An argument with your spouse? Anticipating that your boss will ream your butt at work this morning for being late? Packing the car to see the folks for the holidays?

    3.  Delayed Gratification and Contingency Management

    There are some other simple psychological tricks you can employ as well, such as delayed gratification and contingency management. The 20-Second Rule is an example of delayed gratification: Make bad habits take 20 seconds longer to start. For example, move junk food to the back of the pantry, or leave the credit cards at home so you don’t over spend on lunch. A program sister suggests a Rule of Five, delaying the behavior until you have 5 glasses of water, or walk for 5 minutes or call five 12 step program people. Consider rewarding yourself for not relapsing, it’s called contingency management. Suggest this to yourself: if I don’t act out for 60 days, I can lead the Sunday night 12 step meeting or if I don’t drink now, later tonight, my wife and I can be intimate, or if I don’t use this week my IOP counselor will give me a free lunch coupon for the Olive Garden.

    4. Reframe that habit thought

    Even if we hate the habit we’re doing, like smoking or over eating, we tend to continue doing it because it provides us with some sort of satisfaction or psychological reward. Catch yourself thinking any positive thoughts or feelings about your bad habits (like: if I have a drink, I will not feel so nervous around my in-laws) and reframe these thoughts to remind you of the negative aspects of your habits. Maybe think this thought instead, “One drink is too many and a thousand drinks is not enough.” That is reframing the habit thought.

    5.  Willpower is in limited supply

    Research has shown that we don’t have unlimited willpower (it didn’t take scholarly research to confirm this for you!) The truth is we’re constantly exercising willpower and self-control. The problem is that willpower is like a muscle, capable of fatigue and a muscle can’t be flexed forever. Researchers placed some study participants in situations in which they had to practice self-control—like not eating chocolate-chip cookies in front of them. While another group could eat as many cookies as they wanted. Then both groups were given a second test that required self-control.

    The results? The group that had to resist the cookies did not perform as well on the second task. The group that was allowed to eat as many cookies they wanted, excelled at this second self-control test. The conclusion was that those who had to exert more willpower in the first task exhausted their willpower strength, and were unable to exert the self-control needed for the second task.

    Just place yourself in a similar situation, think of you controlling yourself from strangling your self-absorbed-narcissistic colleague during a staff meeting, then around to 3:00, a typical smoke break time for you, you are triggered. You want to not smoke, but low and behold, a cigarette seems like just the reward you need.

    6.  Make a plan for relapses

    Chances are you’re going to have bad days. Setbacks are normal and we should expect them. Have a plan to get back on track. Recovery coaches call this a relapse prevention plan (click here to link to Mary Ellen Copeland’s WRAP Plan). Coaches have the client write a relapse prevention plan directly after a slip as a way to understand what happened and how to avoid it next time.

    7.  Harm Reduction Option

    Every recovery coach anticipates a relapse, they acknowledge it will happen and attach no shame or guilt to a slip. Often, choosing an action based on Harm Reduction, (which is most often recognized as distributing clean needles to intravenous drug users to reduce HIV infection) is a good alternative. Some Harm Reduction ideas are: smoke a cigarette instead of a blasting a whole stick, limit yourself to buying a lottery ticket instead of logging on to a gambling web site or eat a cup of fruit yogurt instead of a chocolate chip cookie.

    8.  Change takes a village

    With making a resolution to change, don’t attach it to the ever failing New Year’s Resolution. Attach it to a positive change within you. Let people know about it. Ask for help, even if it is a nagging wife or over- bearing parent. Better yet, join a 12 step group. Research shows change happens when you have support from others.

    9.  Make a Plan

    Once you have figured out your ‘habit loop’, your cues/triggers, the routine you use, and the reward you expect, you can begin to shift your behavior. All you need is a plan. Open your-self up for improved, healthier routines; such as meditation, an afternoon walk, a talk with a co-worker or new way to drive home. These will become very good sources of generating your rewards and within 30, 60 or 90 days it will become a habit. Just give it time and

    10. Don’t give up! Keep trying!! It’s progress not perfection!

     

    Happy New Year!

    Special thanks to Charles Duhigg author of The Power of Habit for supplying all of this excellent information on changing a habit and to Calvin and Hobbes for making fun of it!

     

  • Stop calling it behavioral health!

    Stop calling it behavioral health! Does the term cause stigma and discrimination?

    By Robert Kent JD and Charles Morgan MD

    Reprinted from thefix.com, originally published on 11/12/15

    When somebody is treated for smoking cessation, the care will probably be provided within the behavioral health system. If that person is later diagnosed with lung cancer that will be treated over in physical health. If she becomes depressed, that’ll be managed back over in behavioral health. But if the depression causes digestive problems, that aspect of the patient’s health and health care will be treated…you get the picture. Many “behavioral” issues are driven by biological or hereditary conditions, and yet physical and behavioral health are frequently organized, paid for and managed in two entirely different systems. Two key figures at OASAS, which oversees one of the largest addiction treatment systems in the country, argue that the divide between physical and behavioral health, and the term itself, can lead to stigmatization and discrimination against people with “behavioral disorders.” Robert Kent, J.D., the general counsel at the NYS Office of Alcoholism and Substance Abuse Services (OASAS), leads OASAS’s work to implement health care and insurance reform for the Substance Use Disorders system in New York. Charles Morgan, MD, is the medical director of OASAS and a physician who has devoted over three decades to working with people and families affected by addiction. They both want you to “STOP CALLING IT BEHAVIORAL HEALTH!”… Richard Juman, PsyD.

    We believe that it is time to stop calling substance use disorder and mental health “behavioral health.” We are unabashed advocates and supporters of the substance use disorder (SUD) treatment, prevention and recovery system. We are regularly amazed by the stories of people who are now able to live their lives in recovery because of the work done by the people in our system. We need to talk about these disorders in a language that reflects their true nature; they are medical conditions, the origins of which lie in the person’s brain, and the effects of which extend into every part of that person’s life, and as with other illnesses, virtually always into the lives of the people who are touched by the patient.

    The term “behavioral health” is imprecise, since it doesn’t indicate whether one is talking about a mental health condition or a substance use disorder. More importantly, the concept of “behavioral health” as separate from the rest of health care has allowed insurance and managed care companies to create rules for managing services which have denied people access to needed services. If you follow the logic of using the term “behavioral health,” then people with type 2 diabetes, heart disease and asthma could very accurately be identified as having a “behavioral health” issue, as their chronic medical condition is aggravated by their behaviors. But we would never do that with those disorders.

    Constellations of behavior manifest from many chronic medical conditions, some of which are construed as “medical” and others as “behavioral.” The bifurcation is as illogical as it is stigmatizing. People aren’t expected to be able to shrink their own tumors or cure their own infections, but they are expected to control their own behavior. Consequently, calling psychiatric and substance use conditions “behavioral” puts the onus on the patient, often to his tragic detriment in the form of discrimination in housing and employment or the realm of criminal prosecution.

    An individual with a substance use disorder has a natural, predictable disease course, one that is responsive to treatment, allowing for recovery. While we obviously do not want these symptoms to continue, blaming a person for their “behavioral health” issues, rather than treating them, is as counterproductive as blaming a person with epilepsy for falling down when they have a seizure, or blaming the person who is allergic to bees for disrupting the annual family reunion picnic because s/he needs emergency care when s/he is stung. Since we do not want such problems to continue or to be ignored, being judgmental or pejorative about them is harmful because it impedes treatment. In the case of the person with a bee allergy, we would instead encourage him to carry an EpiPen, and we would work to remove any barriers that might prevent him from doing so. We would also remove the bees’ nest!

    With regard to the methods and rules used by the insurers and managed care companies that operate in “behavioral health,” some of our recent initiatives provide ample proof of the impact of using the term. Thanks to the leadership of New York Governor Andrew Cuomo, we now have a state law that requires insurance and managed care companies to have the decision-making criteria they use to manage substance use disorders reviewed and approved by OASAS. Our review of the criteria being used revealed that SUD level of care decisions were being significantly influenced by a person’s past failures or relapses, by whether they had “failed first” at a lower level of care before they sought a higher level of care, and by their “motivation” to seek help.

    Some insurers, and even some providers of care, use the term “motivation” to exclude people from treatment. This is in contrast to the concept of motivation as described by the stages of change model, or in motivational interviewing technique, where a patient’s level of motivation is understood in order to allow for effective treatment. These types of rules would never be allowed for other chronic medical conditions like diabetes, heart disease, and asthma. Would we deny a diabetic their insulin because they ate chocolate cake the night before? Would we deny the person with heart disease medications because they ate chicken wings and french fries? Of course not, because we do not think of those other chronic medical conditions as behavioral in nature. Unfortunately, there is a bias towards thinking of SUDs as behavioral, and then allowing the punishment of the behaviors that are symptomatic of the condition.

    Finally, and most importantly, we believe use of the term “behavioral health” plays a major role in the continued stigmatization of those with an SUD. Such terminology reflects a misunderstanding of SUD, and allows us to perpetuate the myth that the illness is volitional rather than based in biology. Critics of our stance tell us we are absolving people of responsibility for their actions, when in fact we are doing quite the opposite. By delineating the true nature of the illness, we can allow patients to get proper treatment for their illness. Blaming people for addiction would be like blaming people with irritable bowel syndrome for the symptoms of their disease. Acknowledging the disease of IBS allows for proper treatment, which then allows people to be more functional and self-actualized in a way that allows them to take responsibility for their recoveries and to get relief of debilitating symptoms. Similarly, when we treat SUD rationally in this way, rather than as a series of “volitional behaviors” that those afflicted should be able to stop if they were properly motivated, people affected by SUD can then take responsibility for their illness and get effective treatment.

    With regard to the stigmatization of people with SUD, researchers estimate that only one in 10 people who have an SUD actually seek help. While we know there are many reasons people do not seek help, we know that the stigma associated with SUD has a significant inhibitory impact.

    We should listen to the experts. The American Society of Addiction Medicine (ASAM) defines addiction as follows:

    Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

    Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

    Michael Botticelli, the director of the White House Office of National Drug Control Policy, has talked recently about the language we use impacting whether people seek help for an SUD and he has encouraged us to use different language. We know that some will disagree with our viewpoint and some will dispute the basis used for making it. We also know that we can only change what we do, and we can hope others will do the same.

    It is essential that we start thinking of substance use disorders and describing them by using the same language that we use when we describe other chronic medical conditions. The language is critical here: Let’s change the world by changing the way we think about, and talk about, the medical conditions formerly known as “behavioral health.”

    This article written by Robert Kent and Dr. Charles Morgan was reprinted with permission from the 11/12/2015 issue of theFix.com https://www.thefix.com/stop-calling-it-behavioral-health

    Robert A. Kent serves as the General Counsel for the New York State Office of Alcoholism and Substance Abuse Services. In this role, Mr. Kent provides overall legal support, policy guidance and direction to OASAS Commissioner Arlene González-Sánchez, the Executive Office and all divisions of the agency. Robert is leading the OASAS efforts to implement Governor Cuomo’s Combat Heroin and Medicaid Redesign Team initiatives.

    Charles W. Morgan, MD, FASAM, FAAFP, DABAM is the Medical Director of OASAS. He has worked in the field of Addiction Medicine for over three decades and is a Fellow of both the American Society of Addiction Medicine and the American Academy of Family Medicine. Dr. Morgan has expertise in all modalities of patient and family healthcare.

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    Thank you for your response. ✨

  • On the Nature of Addiction and the Loss of Hope

    On the Nature of Addiction and the Loss of Hope

    Guest post by David Chapman

    The normal state of a productive and happy human existence includes a sense of hope. Dave Chapman block golf shirtThe  nature of addiction exhausts all sense of hope.

    The sense of hope is based on the understanding that the process of productive effort usually results in some observable, measurable improvement in the quality of one’s life and the lives of those important to the individual. The nature of having an addiction means the loss of this hope.

    “I will restore my own sense of hope. I know if I exert control over my environment and my actions I will regain control of my life and I will have reason to be hopeful once more.”

    If I chop some large amount of dry wood and keep it dry, my family and I will be warmed throughout the winter, our ability to survive the winter and the possibility of our thriving in the spring will be augmented. The hope of minimizing suffering, increasing comfort and sustaining enhancements in the quality of our lives is significantly based on the belief that the productive effort is worthwhile and that similar efforts in the future will also be worthwhile.

     

    The act of putting rational expectation – hope – into productive effort is based initially on trial and error. As demonstrated by observation and experience, it is then continued in the manner found to be most efficient.

    I contend that addiction is more than chemical dependence. It is significantly, I believe, fueled by a sense of hopelessness resulting from the brutalization of our rational, reasonable expectations.

    Children who are raised in emotionally irrational or physically violent households have their natural sense of hope altered and sometimes, sadly, destroyed altogether. Hope is similarly damaged in an adult body politic where effort goes unrewarded beyond a level of primitive sustenance and/or when participation in the political process is deemed to be futile and ineffective.

    When we attempt to adjust our behavior to what we think are the demands or desires of those exerting control of our physical and intellectual environment, but those irrational behaviors continue, the ensuing sense of hopelessness – hopelessness based on rational observation – will continue and can threaten to become permanent.

    The addicted personality may be able to overcome a physical addiction. However, until a sense of rational hopefulness is restored and we can believe that our thoughts and actions will have a beneficial impact on our lives, the spiritual addiction will probably not be overcome.


     

    Dave Chapman is our guest blogger this week. Dave was born in Newark, New Jersey and grew up in the suburban town of Glen Ridge, New Jersey. He has been a shoe shine boy, a moving man, a golf caddy, a limousine driver, a truck driver, worked retail at The Home Depot, a life insurance agent, a stock broker and financial advisor. He studied the humanities and comparative literature at Ohio Wesleyan University. In addition to his motivational speaking and John Maxwell coaching affiliation, Dave is a freelance writer and teaches several classes in the Humanities as an Adjunct Professor at the Osher Lifelong Learning Institute at Rutgers University. He can be contacted by email at: davechapman@wellsaiddave.com

     

  • How can you heal the trauma within?

    manhattan_bridgeTrauma changes you. You might not necessarily like that change. How can you heal the trauma within? You have the ability to transform yourself into a healthier person. You have enormous healing potential; the goal is learning to access it—and then to use that potential to heal the trauma, release the addiction(s), and obtain a glorious new life.

    Without your consent, trauma can change you, often into a person you’d rather not be.                                                -Michele Rosenthal

    Working through trauma can be scary, painful, and sometimes retraumatizing. Because of the risk of retraumatization, this healing work is best done with the help of an experienced trauma specialist. The clinical term for a therapist that has experience in treating trauma  is a trauma informed therapist. The therapist will be able to answer questions as to his/her experience in trauma informed care over the phone. You want to ask if they are experienced in EMDR, Light Entrainment or Somatic Experiencing.

    Treatment for Trauma

    When you are triggered by a trauma memory, your nervous system gets stuck in overdrive. Successful trauma treatment revisits these traumatic memories, and allows you observe the trauma and your “fight-flight-freeze” response. The therapist will establish a sense of safety and help you resolve the past traumas. The following therapies are commonly used in the treatment of PTSD, emotional and psychological trauma:

      • Somatic Experiencing:  Somatic processing of trauma takes advantage of the body’s unique ability to heal itself. The focus of therapy is on bodily sensations or movements (like excessive leg movement, wringing of your hands or profuse perspiration) rather than thoughts and memories about the traumatic event. By concentrating on what’s happening in your body, you gradually get in touch with trauma-related energy and tension. The therapist will encourage you to safely release this pent-up energy through shaking, crying, and other forms of physical release.
      • EMDR (Eye Movement Desensitization and Reprocessing): This practice incorporates two paddles that when held in your hands vibrate, and a headset that sends a low tone alternating from one ear and then to the other ear. The tones and the vibration of the paddles distract the conscience mind, allowing for the unconscious or sub-conscience memories to arise. The therapist and you explore these memories and discuss them to attempt to resolve the feelings around the trauma.
      • CLEAR Therapy (Colored Light Entrainment and Re-patterning) Clear Therapy is a method of releasing unresolved core emotional issues using colored light. When a flashing light is emitted into the eyes, the brain adopts the rhythm of the strobe. In the initial intake session, you will look at 11 different colors of flashing light and the therapist is able to pinpoint issues based on what you see in each color. In the following sessions, the feedback from your perception of the colors enables the therapist to uncover core beliefs that drive your thinking, feelings or behavior. CLEAR is coordinated with eye movement (see EMDR), breath work and meridian-based therapies (see EFT) to facilitate rapid resolution of the problem.
      • LST (Light Stimulation Therapy) LST enhances learning abilities and performance by stimulating the eye and brain with light. A LST session has you sitting comfortably in a darkened room, looking at a waveband of colored light which is focused directly on your eyes. It is advised to have 3 to 5 sessions per week until a total of 20 sessions is completed. At the end of the 20-sessions, there is a reevaluation to determine the necessity of further treatment.
      • The Brain and Brainwave Entrainment-The DAVID Device: The senses of sight and hearing, by their very nature, provide a favorable environment for affecting brainwaves. By presenting pulsed audio and visual stimulation to the brain, the brain begins to vibrate at the same frequency as the pulsed audio from the DAVID Device. The device sends flashes of lights into a pair of glasses, and pulsed tones through a pair of headphones to gently guide the brain into altered states of consciousness.
      • The Green Wave Therapy: The Green Wave Therapy is a technique that combines green laser light, micro current energy, and some of the principles of EMDR [Eye Movement Desensitization and Re-patterning], and EFT [The Emotional Freedom Acupressure Technique]. You will rest on a massage table, and a micro current device focuses on the region between your eyebrows. You hold the EMDR paddles in your hands as they pulse rhythmically. You also wear a headset that delivers audio tones in unison with the paddle’s vibrations. The practitioner stands back about 4-5 feet and circles the entire body with green laser light. With every 1-2 minute pass, the clinician checks the level of distress you are experiencing while thinking about the trauma.
      • Emotional Freedom Technique (EFT): Based on impressive new discoveries involving the body’s energies, EFT has been reported to be 80% clinically effective in relieving Trauma. The EFT procedure involves tapping with the fingers on points on the body that are associated with acupuncture pressure points. While doing the tapping sequence, distressful thoughts and/or events are targeted and healing statements are repeated out loud. EFT often works where nothing else will. It is rapid, long lasting and gentle. No drugs or equipment are involved. It is easily learned by anyone in less than an hour. EFT techniques can be taught and be self-administered.

    Trauma Recovery Tips

    Recovering from emotional and psychological trauma takes time. Give yourself time to heal and to mourn the losses you’ve experienced. During your trauma therapy here are some self-help strategies to keep you healthy and continue the healing between your therapeutic sessions:

               1: Don’t isolate

               2: Stay grounded

               3: Take care of your health

    Don’t try to force the healing process. Be patient with your pace of recovery. Finally, be prepared for difficult and volatile emotions. Allow yourself to feel whatever you’re feeling without judgment or guilt.

     

  • Is there a trauma-addiction connection?

    manhattan_bridgeIs there a trauma-addiction connection? Adverse childhood experiences (trauma) are well known to significantly increase the risk of psychiatric disorders in adulthood. Ample evidence has shown that childhood trauma endangers the brain’s development, structure and function. Several traumatic experiences could make a person susceptible, later in life, to problems related to memory, judgment, reasoning, and could affect emotional and decision-making skills. Psychiatric illnesses, including schizophrenia, major depression, bipolar disorder, Post-Traumatic Stress Disorder (PTSD), and addiction, are also linked to adverse childhood traumatic experiences.

    Traumatic life experiences, such as physical and sexual abuse as well as neglect, occur at alarmingly high rates in the United States and is considered a major public health problem. Other examples of traumatic life experiences could be witnessing family violence, parental separation and divorce, experiencing a catastrophic weather event such as Hurricane Katrina, losing your home as a result of a wild fire, moving several times in childhood or going hungry.

    The link between traumatic experiences and substance abuse has been well-established. For example, in the National Survey of Adolescents, teens who had experienced physical, or sexual abuse or assault were three times more likely to report they had abused a substance than those without a history of trauma.

    In surveys of adolescents receiving treatment for substance abuse, more than 70% of the adolescents reported a history of some sort of trauma.

    While experiencing a trauma doesn’t guarantee that a person will develop an addiction, research clearly suggests that trauma is a major underlying source of addiction behavior. Founder of HealMyPTSD.com and author Michele Rosenthal culled statistics from a report issued by the National Center for Post-Traumatic Stress Disorder and the Department of Veterans Affairs to show the strong correlation between trauma and alcohol addiction:

    • Sources estimate that 25 and 75 percent of people who survive abuse and/or violent experiences develop issues related to alcohol abuse.
    • Accidents, illness or natural disasters translate to between 10 to 33 percent of survivors reporting alcohol abuse.
    • A diagnosis of PTSD (post-traumatic stress disorder) increases the risk of developing alcohol abuse.
    • Female trauma survivors face increased risk for an alcohol-use disorder.
    • Male and female sexual abuse survivors experience a higher rate of alcohol- and drug-use disorders compared to those who have not survived such abuse.
    • 27 percent of veterans in Veterans Administration care diagnosed with PTSD also have Substance Use Disorder (SUD)

    Similar research linking trauma and addiction exists for other habitual behaviors, including sexually compulsive behavior and eating disorders. Delving deeper into the trauma-addiction connection tells us that addiction is a coping mechanism. Addictions often help reduce the sensation of the overwhelming anxiety, stress and fear that trauma triggers create. Individuals participating in the research confirm that addictions are implemented as an attempt to self-manage (or self-medicate) what comes up for them when unmanageable trauma memories appear. These forms of self-management or self-medication are used as a positive survival instinct, but have very negative consequences. The key is to recognize the use of substances to manage trauma responses and to choose another tool for self-management.

    Next week’s post will go further exploring the link of addiction and trauma.


    References used in this post:

    Department of Veterans Affairs Teesson M, Ross J, Peters L (2006) Trauma, PTSD, and substance use disorders: findings from the Australian National Survey of Mental Health and Well-Being. American Journal of Psychiatry. 2006 Apr;163(4):652-8., http://www.ncbi.nlm.nih.gov/pubmed/16585440

    Public Interest Directorate- Children, Youth, and Families, An American Psychological Association Directorate-Advancing the creation, communication and application of psychological knowledge to benefit society and improve people’s lives. Activity Summary- August 2012 – August 2013Website: http://www.apa.org/pi/families/index.aspx

    Kilpatrick DG, Saunders BE, Smith DW.(2003). Youth Victimization: Prevalence and Implications [Electronic]. U.S. Department of Justice, Office of Justice Program, National Institute of Justice. Available at: http://www.ncjrs.gov/pdffiles1/nij/194972.pdf

    Michele Rosenthal (2015) Trauma and Addiction: 7 Reasons Your Habit Makes Perfect Sense, Published on March 30, 2015 in Behavioral Health, Living in Recovery, Living with Addiction and at Recovery.org website: http://www.recovery.org/pro/articles/trauma-and-addiction-7-reasons-your-habit-makes-perfect-sense/

    and  http://healmyptsd.com/


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  • What kind of credential do I need to be a Professional Recovery Coach?

    What kind of credential do I need to be a Professional Recovery Coach?

    manhattan_bridge_post_versionWhen I published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013, the term professional recovery coach or professional recovery life coach was not in frequent use.

    A professional recovery coach is trained in professional coaching techniques, which means he or she has been educated in group dynamics (how people act in a group), how to develop high performing individuals (leadership) or how to facilitate change. Additionally, they have training in the addiction recovery models, motivational interviewing and Harm Reduction. They may use their experiential knowledge of their own recovery to augment their professional recovery coaching faculties. Professional coaches work in many fields: executive coaching, business coaching, finance coaching, wellness coaching or life coaching. Recovery coaching fits nicely into the life coaching model.

    International Coaching Federation (ICF)

    There is one worldwide organization that is recognized as issuing professional coaching credentials, the International Coaching Federation (ICF), http://coachfederation.org. There are three levels of ICF coaching credentials. The Associate Certified Coach (ACC) Credential is for the coach who is just beginning in the field, and is the first credential that can be completed with ICF. The Professional Certified Coach Credential (PCC) is for the more experienced coach and the Master Certified Coach (MCC) Credential is for the expert coach.

    When seeking to be credentialed as an Associate Certified Coach (ACC), the coach has to have completed an entire ICF Accredited Coach Training Program (ACTP). On the ICF website is a list of all of the accepted training programs from which the ICF will accept training credentials. The ICF does not offer a unique recovery coaching credential, nor a peer recovery-support credential.

    There is one organization, Family Recovery Resources, listed in the ICF Accredited Coach Training Program that offers a family-in-recovery coaching course for a family recovery coach certificate. There are no other recommended organizations that offer any recovery coach orientated courses. If a recovery coach has received training from any organization specializing in recovery coaching training, it is likely that the training would not be credited toward an ICF certificate. There is a very interesting selection of courses in the ICF Accredited Coach Training Program, such as executive coaching, end-of-life coaching, divorce coaching, Neuro-Linguistic Programming, wellness coaching, conflict coaching and several other excellent learning opportunities, on the ICF web site.

    The ACC applicants must work while they learn, and complete 100 hours of client-to-coach experience during their coach-specific training program. In addition the applicants are required to receive 10 hours of Mentor Coaching, and 100 hours (75 hours to be paid) of coaching experience with at least 8 clients, post training. There is a performance evaluation (audio recording and written transcript of coaching session) and a Coaching Knowledge Assessment (CKA) to complete the ACC credentialing application. The ACC credentialing process costs are dependent on the types of training courses a coach must take to complete the requirements for the certificate. The ACC credentialing process can take from 18 months to two years complete.

    It is my hope that the information transmitted in the past few posts will help a person interested in recovery coaching see the path to certification a bit more clearly. Please feel free to contact me with any questions you have about the path you should take in seeking your recovery coaching training and credentialing.

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  • What training and certificate do you need to be a peer recovery support specialist ?

    What training and certificate do you need to be a peer recovery support specialist ?

    manhattan_bridge_post_versionI published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013. Since then, recovery coach or peer recovery support specialist training has become one of the fastest growing aspects of the coaching field. So, what kind of training and certificate do you need to be a peer recovery support specialist ?

    In 2013, the organizations that offered recovery coach or peer recovery specialist training numbered around 50. Today, the number has grown to 250. Many state certification boards have established recovery coach and peer recovery support specialist certifications.

    The definition of a recovery coach, and a peer recovery support specialist has changed significantly, as well. Now, the term peer-to-peer recovery support specialist defines a coach that works with people in mental health recovery and/or people that are in co-occurring recovery (co-occurring describes when a person has an addiction and a mental health diagnosis). Commonly the coach in this job is called a “peer.”

    Even though most of the state certification boards issue a certificate with the same “title,” (such as certified peer recovery support-specialist) the agencies that are looking for coaches to work with addicts advertise for recovery coaches and the agencies that are looking for coaches to work with people with behavioral or mental health disorders advertise for peers.

    In the treatment field it is common to have states use different terminology and acronyms for a certificate of the same job description. For example, the terminology for a certified recovery coach or peer in New Jersey is Certified Peer Support Practitioner (CRSP).The Alcohol and Drug Abuse Certification Board of Georgia calls this credential a Certified Peer Recovery Coach (CPRC). The Minnesota Certification Board offers a Certified Peer Recovery Specialist (CPRS) credential. There are several different terms for certificates for the same job description throughout the United States.

    As of March 2014, 38 states and the District of Columbia have established programs to train and certify peer-to-peer recovery support specialist working with people in mental health recovery. Eight states are in the process of developing and/or implementing a peer program. For information on locating these agencies go to the International Association of Peer Specialists at: http://inaops.org/training-and-certification/.

    The International Association of Peer Specialists web site features a PDF document that is downloadable, with a list of all of the peer training organizations. This document is entitled: Peer Specialist Training and Certification Programs: A National Overview, and was compiled by the Texas Institute for Excellence in Mental Health, in the School of Social Work at the University of Texas at Austin. This PDF breaks down the peer certifications for every state, gives a web site and email contact for the training organizations as well as the required domains to master, in order to receive the certification. As an adjunct to this PDF, an additional list of recognized peer support training providers is available. The link is: http://inaops.org/training-providers/. If your area is not served by training organizations featured in these two documents, email: training@naops.org to find training in your area.

    What are the peer recovery support specialist guidelines for receiving certification?

    The peer recovery support-specialist application for certification will vary from state to state but essentially the guidelines are similar. Individuals can qualify to become certified peer-to-peer recovery support specialist by meeting the following guidelines:

    • Have a minimum of one year demonstrated recovery time from a significant mental health and/or substance use disorder at the date of application.
    • Be at least 18 years of age.
    • Must have a minimum of at least a high school diploma or GED.
    • Have attended and successfully completed a recognized training curriculum (face to face in a classroom setting or on-line) that totals 40 hours at a minimum and have a valid certificate of completion from that training.
    • Have completed an additional 20 hours of training and have valid certificates verifying attendance and participation in the following training categories: Wellness Recovery Action Planning (WRAP), Person Centered Thinking, Personal Assistance in Community Existence (PACE), Crisis Prevention, Veteran supports and interventions. Applicants can also use other college coursework, if related to the work of a Certified Peer Support-Specialist, if it will enhance the ability to provide services to people with mental health and/or substance use disorders. The applicant must submit an official transcript for review with the application.
    • Acknowledge the peer will follow the ethical guidelines of a peer recovery support-specialist by signing a form stating they have read and comprehend the guidelines
    • Submit two (2) personal reference letters

    What are the costs of Certified Peer Recovery Support-Specialist Training?

    Costs for Certified Peer Specialist training range from $400-$1,000. There are several ways to pay for Certified Peer Specialist (CPS) training. There are a number of programs and organizations that sponsor free Peer Recovery Support-Specialists certification training, continuing education classes, and supervisor training classes. As follows, are some suggestions:

    Offices of Vocational Rehabilitation (OVR) help people with disabilities prepare for and achieve an employment goal. OVR has many offices located throughout United States. If you qualify for OVR services, OVR may pay up to $900 for you to receive certification training.

    County Mental Health and Developmental Services is another source of possible funding. Some county MH/DS offices contract with training vendors to provide a Certified Peer Specialist class in that county. When this happens, a county purchases an entire class (20 seats) from a training vendor. The county then accepts applications from people who want to attend the training. In these cases, the training is usually only open to people who reside in that county.

    The Mental Health Associations of your state may provide low cost Certified Peer Specialist training.

    Review the document, Peer Specialist Training and Certification Programs—A National Overview (http://www.dbsalliance.org/pdfs/training/Peer-Specialist-Training-and-Certification-Programs-A-National-Overview%20UT%202013.pdf ). There are many states, Alabama, Ohio, New Jersey and North Carolina, to name a few that offer free training and are listed in this document.

    Next week’s blog post will review what certification is required to be a professional recovery coach working as a coach that has a variety of coaching credentials.

  • What kind of training do I need to be a recovery coach?

    What kind of training do I need to be a recovery coach?

    manhattan_bridgeI published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013. Since then, recovery coach or peer recovery specialist training has become one of the fastest growing aspects of the coaching field. So what kind of training do I need to be a recovery coach?

    In 2013, the organizations that offer recovery coach or peer recovery-specialist training numbered around 50. Today, the number has grown to 250. Many state certification boards have established recovery coach and peer recovery support specialist certifications.

    Many of the organizations that offer addictions recovery coach training or peer recovery support specialist training are listed on my web site: http://www.mkrecoverycoaching.com/recovery-coach-training-organizations/. For many people interested in being a recovery coach, the training costs, deciding on the best training organization and the training necessary to fulfill the certification requirements can be confusing. So I would like to attempt to clear up this confusion and will answer these questions in this post:

    • What are the guidelines I must meet to apply for recovery coaching training?
    • What kind of training do I need to be a recovery coach?

    What are the guidelines to apply for recovery coaching training?

    Applicants must meet the following guidelines to apply for a training course in order to be a recovery coach or a peer recovery support-specialist. These guidelines are shared by many training organizations and certification boards across the nation as a standard for what a potential recovery coach must have before applying for recovery coaching training:

    • High school diploma, GED or higher
    • Minimum of one year of direct knowledge of sponsorship and 12-step programs
    • Minimum one year of sobriety from substance use or one year sobriety in co-occurring mental health and substance use disorders (self-attestation)

    What kind of training should I look for?

    Certification boards require the coach to receive outside training that fulfills the requirements mandated by the state board. These requirements are often a certain amount of hours training in topics such as addiction recovery theory and models, coaching ethics, motivational interviewing, relapse prevention, nicotine cessation, suicide prevention and HIV-AIDS education. Each state and organization has different requirements. So first check with your state to ensure the course you take will be accepted by the state credentialing board.

    There are trainings offered that can give a coach more information that may not be on the state certification board list, but are very helpful. The kinds of training I found helpful as a new recovery coach were: conflict management, anger management, intervention training, co-occurring disorders, behavioral addictions, the pharmacology of addiction, and psycho-pharmacology as well as knowledge about coaching families in relationships with addicted persons. There are also training organizations that offer three different levels of recovery coaching training: novice, intermediate and master-level coaching certificates.

    The places in which you receive this training are quite diverse. In the links section of this web site, I list over 250 organizations offering recovery coach training. The courses can be online, or in a classroom. The costs for this training is diverse as well, from free (in Ohio) up to $4,000 per course. The length of the course could be three days or four months.

    At no time does taking a recovery coaching course give you an immediate state certification board recovery-coaching credential. It gives you a document (called a certificate) that says you completed the training. There are many coaches who do not seek state board certification, and use this document or certificate from a training organization as adequate proof they are knowledgeable in performing the duties of a recovery coach.

    There is one international credentialing organization, the International Certification and Reciprocity Consortium, commonly known as the IC & RC(http://internationalcredentialing.org/) that runs many state credentialing boards and has developed an exam for a Peer Recovery (PR) Certification. The IC & RC suggests applicants check with their state credentialing board for specific test taking guidelines.

    Are there any additional requirements for recovery coaching certification?

    NAADAC, the Association for Addiction Professionals, and the National Certification Commission for Addiction Professionals (NCC AP) http://www.naadac.org/NCPRSS offer the Peer Recovery Support-Specialist Certification. Similar to the requirements of the IC & RC, the NCC AP recommends, in order to receive certification, a coach read and sign a statement on the application affirming adherence to the Peer Recovery Support-Specialist Code of Ethics. Credentialing boards require supervisors of the coaches-in-training to sign a document verifying they have supervised the coach during the period of the coach’s training. Letters of recommendation are also items required by some credentialing boards. Other state boards require a recent photograph. As always, check with the state credentialing board for specific requirements for credentialing.

    Next week’s post will review what certification is required to be a peer-to-peer support-specialist working with people in mental health recovery.

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

  • What kind of certification do I need to be a recovery coach?

    What kind of certification do I need to be a recovery coach?

    manhattan_bridge_post_versionI published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013. Since then, recovery coach or peer-recovery specialist certification training has become one of the fastest growing aspects of the coaching field. So what kind of certification do I need to be a recovery coach?

    In 2013, the organizations that offer recovery coach or peer-recovery specialist training numbered around 50. Today, the number has grown to 250. Many state certification boards have established recovery coach and peer-recovery support specialist certifications. Yet, for many people that seek to be a recovery coach the qualifications, the training, the requirements for certification, or credentialing seem baffling. So I would like to attempt to clear up this confusion and will answer these questions in this post:

    • What is the process for certification as a recovery coach or peer recovery specialist?
    • What kind of certification should I be focusing on?

    What is the process of being qualified, getting training and then credentialed as a recovery coach or peer-recovery support specialist?

    If you are investigating becoming a recovery coach, I suggest you follow these steps:

    1. Research the training organizations that offer recovery coach training you can afford. Go to http://www.mkrecoverycoaching.com/recovery-coach-training-organizations/ for a list of addiction recovery coach training organizations
    2. Verify that you meet the qualifications to apply for the course (e.g. be 18-years-old, have a GED or high school diploma, one year sobriety from any addiction)
    3. Take and pass the course, retain the coaching certificate for future purposes
    4. Research places like Recovery Community Organizations or treatment centers to work or volunteer as a recovery-coach-in-training
    5. Apply to your state certification board for recovery coach certification (a fee may apply)
    6. Complete the recovery-coach-in-training supervised practice hours that are required by the state board
    7. Send in your application with paperwork verifying the completion of practice hours to the state credentialing board with a certification fee (fee varies for every state, from $100-$250)
    8. Receive your recovery coaching or peer-recovery support specialist certificate
    9. In the next 2 – 5 years take the required courses for renewing this certificate. Refer to your state board for more information on courses and renewal time frames. A renewal fee will be required.

    What kind of certification do I need to be a recovery coach?

    For an addiction recovery coach, the certification and training is prefaced with the terms: peer-support specialist, certified peer-recovery practitioner, recovery coach or peer-recovery specialist. Every state is different and every state uses different names for these certifications. Look for courses that offer the training needed for an addictions coach and a peer working with people in mental health recovery certification. It is the exact same training, in the same exact classroom, for two different jobs descriptions! It may be confusing now, and quite possibly the content and descriptions of  these courses may change going forward. But I would have to have a crystal ball to predict that for certain.

    I suggest you first take a certification training course. You can make the decision after the training is completed to apply for state board certification. As a coach if you are interested in being your own business person, certification by a training organization should be adequate. If you want to work in a treatment center, with a recovery community organization, social services agency or hospital, certification issued by the state’s certification board or the International Certification and Reciprocity Consortium (IC&RC) is required by the institution hiring you. If you want to carry professional liability insurance, or be reimbursed by Medicaid for your services, certification by a state certification board is mandatory.

    What is a state certification board?

    The process for receiving a certificate as a recovery coach is overseen by a state’s certification or licensing board. A state certification board tests and renews practitioner’s (coaches, therapists, nurses, etc.) certificates to ensure their knowledge is up to par. Also, that they have the ethical knowledge to practice in their profession. These processes for certification, such as training, educational requirements, exams and renewal guidelines, varies from state to state. These certification standards are recognized by health care companies, insurance companies, Medicaid, Medicare as well as companies that hire these practitioners.

    These state certification boards are the same boards that issue licenses or certifications for drug and alcohol counselors, and therapists. Some states have combined licenses and certifications boards all in one office, so it could be the same office in which nurses or hairdressers receive their licenses. I suggest you search the Internet for drug and alcohol certification for your state. Then search for the state board website for recovery coach or peer-recovery support specialist certification. As of May 2008, thirty state credentialing boards had developed criteria for the training and deployment of recovery coaches and peer-recovery specialists, so you should have no trouble finding these boards on the Internet.

    What is Reciprocity?

    Reciprocity is a term you will see used often on these board sites. When you are certified through your home state’s certification board, you may have the ability to transfer that credential to another state. This is called reciprocity. State certification boards may offer reciprocity to certified coaches in other states. The state boards have the authority to set reciprocity requirements for coaches to practice in their state. Not all certifications are eligible for reciprocity. It is vitally important that you investigate reciprocity guidelines prior to relocating to another state, because it can be a very complicated process.

    There are national and international recovery coach certifications available. In 2013, the International Certification and Reciprocity Consortium (IC&RC) developed a peer recovery credential. The application for the peer-recovery certification appears on the IC & RC web site. An IC & RC credential is accepted by many agencies and treatment centers when they are hiring recovery coaches.

    In next week’s post I will review what kind of training you need to have in order to apply for recovery coach certification.

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  • What is the difference between a recovery coach, a peer recovery support specialist and a professional recovery coach?

     

    melissa-new-post

    I published my book Recovery Coaching – A Guide to Coaching People in Recovery from Addictions in 2013. A recovery coach, a peer recovery support specialist and a professional recovery coach’s job descriptions have expanded significantly since then. The organizations that offer recovery coach training numbered around 50 in 2013. Today, the number has grown to 250. Recovery coach certification training is one of the fastest growing aspects of the coaching field, with many states establishing recovery coaching and peer recovery support-specialist certifications. Yet, for many people who seek to achieve basic recovery coaching information, the process of training, certification, credentialing or licensing are baffling. With all of this growth and change, anyone who is interested in being a recovery coach is very confused about the necessary training, what to call this training and even what to call themselves! I want to make an attempt to clear up this confusion and answer these questions:

    • What is the difference between a recovery coach, a peer recovery support-specialist and a professional recovery coach?
    • On what kind of certification should a future recovery coach focus?
    • What are the guidelines for certification of a recovery coach?

    (Some of the answers to these questions will appear in upcoming posts.)

    What is a Recovery Coach?

    A recovery coach is a person that works with and supports individuals immersed in an addiction(s), and coaches people in recovery from the abuse of alcohol and drugs, gambling, eating disorders or other addictive behaviors. Sometimes recovery coaches who work with people with addictions have been referred to as a peer recovery support specialist, a recovery support specialist, a sober companion, recovery associate or quit coach. In all cases these terminologies describe the same job description; a person who meets with clients in order to aid in their recovery from addiction(s). Even though many certifications for recovery coaches are classified as peer recovery support practitioner certifications. I prefer to use the term recovery coach in describing a person coaching an individual in recovery from addiction, instead of using the term “peer,” mainly because there is no requirement that a recovery coach be a peer (meaning they are an addict in recovery). Although it may be believed having experiential knowledge is a best practice for a recovery coach, it could be a recovery coach has knowledge of addiction and recovery perhaps by knowing an addict, having a family member with an addiction or taking courses in the treatment field.

    I have kept the term “non-clinical” out of this definition of a recovery coach because over the course of several years, I have seen drug and alcohol counselors, family and marriage therapists (MFTs), licensed clinical social workers, interventionists (LCSWs), psychotherapists and psychiatrists, train to be recovery coaches and then add coaching to their resume. I hear from these individuals that they embrace the coaching approach, and merge the knowledge they have as a clinician or interventionist with recovery coaching methods.

    Some individuals seek recovery and sobriety from addictions by frequenting a recovery community organization (RCOs) or recovery support center. An RCO is an independent, non-profit organization led and governed by representatives of local communities of recovery. There are recovery coaches at these recovery community organizations. These coaches have very diverse backgrounds. I have met coaches that were addicts, homeless, offenders, teachers, lawyers and highly educated individuals, who choose to help another person in recovery. I have seen these coaches espouse 12-step ideologies as well as non-12-step recovery models such as Buddhist Recovery, Moderation Management, Kundalini Yoga or Harm Reduction. Sometimes, the recovery coaches at these centers receive a salary from the RCO, however, the client is not charged for the recovery coaching services. RCO recovery coaches can also be volunteers, opting to perform their coaching duties for no reimbursement at all.

    Lastly, recovery coaches can be employed by treatment centers or sober living homes and receive compensation from them. In cases such as this, the client is billed for the coaching services from the centers or homes. I know many a recovery coach who has opened a transitional living home or a supportive sober living environment. They coach the people who reside at these locations and their presence adds to the quality of the recovery experience.

    Is recovery coaching covered by insurance?

    Unfortunately, the answer to that question is no. No independent health insurance company covers the services of a recovery coach working with an individual in recovery from an addiction. There is currently only one state, New York, that has an arrangement with the state’s Medicaid offices to reimburse for recovery coaching for individuals who are diagnosed as dependent on a substance. Other states, Tennessee, Maryland and Massachusetts, are formulating similar Medicaid payment plans, but these reimbursements are not yet in place.

    What is a peer to peer recovery support specialist?

    A nearly universal definition of a peer to peer recovery support specialist is an individual with lived experience who has initiated his/her own recovery journey and assists others who are in earlier stages of the healing process of recovery from psychic, traumatic and/or substance-use challenges and, as a result, can offer assistance and support to promote another peer’s own personal recovery journey. A peer to peer recovery support specialist is also called a peer, peer support-practitioner, peer mentor, or a certified peer. All of these terms basically describe the same job description. More and more, this job description is focused on the peer to peer recovery support specialist working with a person in mental health recovery.

    The certified peer to peer recovery support specialist workforce is relatively new in the behavioral health field, with state-recognized certification programs first emerging in 2001. Within this short time frame, states have recognized the potential of peer specialists to improve consumer outcomes by promoting recovery. Many social service agencies pay the peer’s salary, and the client does not pay for the coaching. In the mental health/behavioral health field, when referred by a social services agency or mental health treatment organization, reimbursement for a peer to peer recovery support specialist is covered by a health plan or Medicaid.

    Peer to peer recovery support specialists can also work independently from an agency and be reimbursed by the client or a family. Peer to peer recovery support specialists can also choose to provide these services as a volunteer and receive no financial reward.

    What is a professional recovery coach?

    A professional recovery coach, is sometimes referred to as a recovery life coach. A professional recovery coach has experience and training in the recovery models, and training as a professional coach. These professional and credentialed coaching programs are sometimes referred to as life coaching training. A professional recovery coach can receive training from any of the 250 organizations that train recovery coaches, and select not to receive the certificate from a state certification board or the IC & RC (see the certification information in next week’s post). A professional coach can receive training from the ICF – International Coach Federation’s accredited coach training programs, and apply for a credential issued by the ICF.

    A professional recovery coach can assist a client with a variety of coaching interventions including, but not limited to recovery from addictions, dealing with mental health diagnoses, divorce, financial downturns, grieving, career change and even family relationship issues. The client is billed for the coaching services from the professional recovery coach. Again, healthcare plans do not reimburse for these coaching services.

    Stay tuned for next week’s post on certification for recovery coaches.

  • Why I can’t make a good decision when I am fatigued?

    manhattan_bridgeFatigue takes a toll on the brain

    In the August 2004 issue of the journal Sleep, Dr. Timothy Roehrs, the Director of Research at the Sleep Disorders and Research Center at Henry Ford Hospital in Detroit, published one of the first studies to measure the effect of fatigue or sleepiness on decision-making and risk-taking. He found that indeed it does take a toll on effective decision-making.

    Cited in the October 12, New York Times Science section, Dr. Roehrs and his colleagues monetarily rewarded sleepy and fully alert subjects who completed a series of decisions and tasks. At random times, the subjects were given a choice to take their money and stop. Or they could forge ahead with the potential of either earning more money or losing it all if their work was not completed within the time remaining. A kind of “Who wants to be a Millionaire” science experiment.

    Dr. Roehrs found that the alert people were very sensitive to the amount of work and time they needed to do in order to finish the tasks and understood the risk of losing their money if they didn’t. But the sleepy subjects chose to quit the tasks prematurely or they risked losing everything by trying to finish the task for more money, even though it was likely that they would not be able to finish.

    According to the National Commission on Sleep Disorders Research (1998) and reports from the National Highway Safety Administration (NHSA, 2002), a high number of accidents can partly be attributed to people suffering from a severe lack of sleep.

    Each year, according to the NCSDR, the cost of sleep disorders, sleep deprivation and sleepiness is estimated to be $15.9 million in direct costs and $50 to $100 billion a year in indirect and related costs. And according to the NHSA, falling asleep while driving is responsible for at least 100,000 crashes, 71,000 injuries and 1,550 deaths each year in the United States. Young people, in their teens and twenties, who are particularly susceptible to the effects of chronic sleep loss, are involved in more than half of the fall-asleep crashes on the nation’s highways each year. Sleep loss also interferes with the learning of young people in our nation’s schools, with 60 percent of grade school and high school children reporting that they are tired during the daytime and 15 percent of them admitting to falling asleep in class.

    We’ve always known that sleep is good for your brain, but new research from the University of Rochester provides the first direct evidence for why your brain cells need you to sleep, and sleep the right way. The study found that when you sleep your brain removes toxic proteins from its neurons that are by-products of neural activity when you’re awake. Unfortunately, your brain can remove them only while you’re asleep. So when you don’t get enough sleep, the toxic proteins remain in your brain cells, wreaking havoc by impairing your ability to think — something no amount of caffeine can fix.

    Skipping sleep impairs your brain function across the board. It slows your ability to process information and problem-solve, kills your creativity, and raises your stress levels and emotional reactivity. Basically, it affects your decision-making ability.

    Decision Fatigue

    The mental work of making decisions time after time can wear you down. Decision fatigue is the newest discovery involving a phenomenon called ego depletion, a term coined by the social psychologist Roy F. Baumeister. This sort of fatigue can make quarterbacks prone to dubious choices late in the game, a CEO leans toward disastrous dalliances late in the evening or a recovering addict deciding to use after a long day at work. It routinely warps the judgment of everyone, executive, delivery driver, rich or poor — in fact, it can take a special toll on the poor. Yet few people are even aware of it, and researchers are only beginning to understand why it happens and how to counteract it.

    Decision fatigue helps explain why ordinarily sensible people get angry at colleagues, splurge on clothes, pick up candy at the market’s check out lane and can’t resist the dealer’s offer to rustproof their new car. No matter how rational and high-minded you try to be, you can’t make decision after decision without paying a price. It’s different from ordinary physical fatigue — you’re not consciously aware of being tired — but you’re low on mental energy. The more choices you make throughout the day, the harder each one becomes for your brain, and eventually it looks for shortcuts, usually in either of two very different ways.

    One shortcut is to become reckless: to act impulsively instead of expending the energy to first think through the consequences. (Sure, tweet that photo! What could go wrong?) The other shortcut is the ultimate energy saver: do nothing. Instead of agonizing over decisions, avoid any choice. Ducking a decision often creates bigger problems in the long run, but for the moment, it eases the mental strain. You start to resist any change, any potentially risky move — like releasing a prisoner who might commit a crime. So a fatigued judge on a parole board takes the easy way out, and the prisoner stays in prison.

    These experiments on Decision Fatigue demonstrated that there is a finite store of mental energy for exerting self-control. When people fended off the temptation to scarf down M&Ms or freshly baked chocolate-chip cookies all day at the office, they were then less able to resist other temptations, like stopping for a bottle of brandy on the drive home. When they forced themselves to remain stoic during a tearjerker movie, afterward, they gave up more quickly on tasks requiring self-discipline such as brushing their teeth, taking off their make-up or sleeping with the guy that paid for the movie. Willpower turned out to be more than a folk concept or a metaphor. It really was a form of mental energy that could be exhausted.

    In the rest of the animal kingdom, there aren’t a lot of protracted negotiations between predators and prey. A lioness doesn’t arbitrate with an antelope. To compromise is a complex human ability and therefore, it is one of the first abilities to decline when Decision Fatigue sets in. If you’re shopping, you’re liable to look at only one dimension, like price: just give me the cheapest. Or purchase only the products you have coupons for. Or purchase only the items which are covered by food stamps. Or limit yourself to only the $100. you have in your budget for groceries. And now, you have to put away the barrettes you got for your daughter, and the athletic socks for your son. Shopping can be especially tiring for the poor, who have to struggle continually with trade-offs.

    Researchers argue that this sort of Decision Fatigue is a major, and a largely ignored factor in trapping people in poverty. Because their financial situation forces them to make so many trade-offs, they have less willpower to devote to school, work and other activities that might move them up into the middle class. It’s hard to know exactly how important this factor is, but there’s no doubt that willpower is a special problem for poor people.

    Decision Fatigue is a reason that the liquor, candy and soda is displayed in the front of the store, featured prominently near the cash register, just when shoppers have depleted all their decisions in the aisles. With their willpower reduced, they’re more likely to yield to any kind of temptation, but they’re especially vulnerable to booze, candy and soda. While supermarkets figured this out a long time ago, only recently did researchers discover why.

    Despite this series of findings, brain researchers did find that glucose is a vital part of willpower. They helped solve the puzzle of how it increases the brain’s energy. Your brain does not stop working when glucose is low. It stops doing some things and starts doing others. It responds more strongly to immediate rewards and pays less attention to long-term prospects. A perfect environment for alcohol abuse.

    The discoveries about glucose help explain why dieting is a uniquely difficult test of self-control and why even those people with phenomenally strong willpower in the rest of their lives can have such a hard time losing weight. They start their day with virtuous intentions, resisting croissants at breakfast and dessert at lunch, but each act of resistance further lowers their willpower. As their willpower weakens late in the day, they need to replenish it. But to resupply that energy, they need to give the body glucose. They’re trapped in a nutritional catch-22:

    1. In order not to eat, a dieter needs willpower.
    2. In order to have willpower, a dieter needs to eat.

    Fatigue at work

    At work when we are fatigued, we are pretty good at avoiding the urge to spend money, but not so good at resisting the lure of relaxation, such as scrolling through Facebook, online shopping or viewing pornography on the web.  Today there are so many choices to make. Your body may have dutifully reported to work on time, but your mind can escape at any instant. A typical computer user looks at more than three dozen Web sites a day and gets fatigued by the continual decision-making — whether to keep working on a project, or check out YouTube, or follow a link to another interesting research topic or buy something on Amazon. Ever wonder why Cyber Monday is one of the biggest shopping days of the year?

    The cumulative effect of these temptations and decisions isn’t intuitively obvious. Virtually no one has a gut-level sense of just how tiring it is to decide. Big decisions, small decisions, they all add up. Choosing what to have for breakfast, where to go on vacation, what to do next, how much to spend from this paycheck— these all deplete willpower, and there’s no blinking indicator light on your dashboard to warn you that your willpower is low.

    When the brain’s regulatory powers weaken, frustrations seem more irritating than usual. Impulses to eat, drink, spend and say stupid things have no filter and alcohol causes self-control to decline further. The Decision Fatigue effect was even demonstrated with dogs in two studies by Holly Miller and Nathan DeWall at the University of Kentucky. After obeying sit and stay commands for 10 minutes, the dogs performed worse on self-control tests and were also more likely to challenge another dog’s turf. Fatigued humans are also more likely to get into needless fights over turf. In making decisions, they take illogical shortcuts and tend to favor short-term gains (like ending the meeting and going home) and delay reviewing costs (yes even adding numbers up on a calculator is a decision).

    “Good decision making is not a trait of the person, in the sense that it’s always there,” Baumeister says. “It’s a state that fluctuates.” His studies show that people with the best self-control are the ones who don’t schedule endless back-to-back meetings, they avoid temptations like all-you-can-eat buffets, and they establish good sleeping habits. Instead of deciding every morning whether or not to exercise, they work out with a friend. Instead of counting on willpower to remain robust all day, they conserve it so that it’s available for important decisions.

    “Even the wisest people won’t make good choices when they’re not rested and their glucose is low,” Baumeister points out. That’s why the truly wise choose not to restructure the company at 4 p.m. Board meetings are not held at night. Major commitments are not made over cocktails. And if a decision must be made late in the day, they make sure they have eaten something like an apple or an orange to recharge their glucose levels. “The best decision makers,” Baumeister says, “are the ones who know when not to trust themselves.” 

    Next week’s post will feature tips and tools on how to achieve a good night’s sleep.


    Resources for this article came from:

    Baumeister, R.F., & Heatherton, T.F. (1996). Self-regulation failure: An overview. Psychological Inquiry, 7, 1-15.

    Kathleen D. Vohs and Roy F. Baumeister, Running Head: Self-Regulation and Choice-Decision Fatigue Exhausts Self-Regulatory Resources-But So Does Accommodating to Unchosen Alternatives http://www.chicagobooth.edu/research/workshops/marketing/archive/ WorkshopPapers/vohs.pdf

    Baumeister, R. F.; Sparks, E. A.; Stillman, T. F.; Vohs, K. D. (2008). “Free will in consumer behavior: Self-control, ego depletion, and choice”. Journal of Consumer Psychology 18: 4–13. doi:10.1016/j.jcps.2007.10.002.

    Baumeister, R. F.; Vohs, K. D. (2007). “Self-regulation, ego depletion, and motivation”. Social and Personality Psychology Compass 1: 115–128. doi:10.1111/j.1751-9004.2007.00001.x.

    Dr. Timothy Roehrs, (August 2004), The Journal Sleep, http://www.journalsleep.org/PDF/AbstractBook2004.pdf

    Drowsy Driving and Automobile Crashes, NCSDR/NHTSA expert panel on driver fatigue and sleepiness,
    http://www.nhtsa.gov/people/injury/drowsy_driving1/drowsy.html

    Dr. Travis Bradberry (December, 2014), Sleep Deprivation Is Killing You and Your Career , Forbes Magazine,
    http://www.forbes.com/sites/travisbradberry/2014/12/01/skipping-sleep-is-career-suicide/

    John Tierney, (2011) Do you suffer from Decision Fatigue? New York Times Magazine,
    http://www.nytimes.com/2011/08/21/magazine/do-you-suffer-from-decision-fatigue.html?_r=0&pagewanted=print

    Holly Miller (2014) Self-control without a “self?”: common self-control processes in humans and dogs Department of Psychology, University of Kentucky, Lexington, KY 40506-0044, USA.

    Psychological Science (Impact Factor: 4.43). 04/2010; 21(4):534-8. DOI: 10.1177/0956797610364968, Source: PubMed

     

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  • Thinking about my mistakes from the past

    manhattan_bridge_post_versionOne of my clients, Caroline, is a brilliant woman who has hit bottom, very, very hard. She is an Ivy League-educated woman, mother of three, and the wife of a wealthy professional in the suburbs of Chicago. But unfortunately, she drinks. After two years in and out of five rehabs, of countless detox stays, restraining orders and divorce proceedings, she is now 8-weeks sober and living in a homeless shelter in the city center of Chicago. She is working with a family reunification therapist to slowly piece together the relationship she lost with her teen-aged children. Caroline expressed to me that she is afraid her past actions have permanently affected her children, so much so that they will reject her and hate her, forever:

    “I am having an especially hard time with my “past mistakes.” The Daily Reflections yesterday spoke to me about leaving the past baggage behind, which of course I would love to do, but it’s hard. I feel terrible and ashamed of the things I did. I try to stay in the present but right now, in the family therapy sessions, my past mistakes are coming up in such big ways and will continue to do so when I see my children in supervised therapy. I can’t imagine what they think of me, a homeless drunk. I don’t know how to help them put the past behind, but I guess that’s what the therapist is for.”

    I shared with Caroline some thoughts about having an especially hard time with mistakes from the past. Sometimes, I told her, how we deal with our personal mistakes is by beating  ourselves up, by not letting go of a mistake we have made and/or worrying about what other people think about that mistake. Yet, in our recovery, we have an opportunity to let go of those old tapes. However, the tapes that are playing, over and over, in our heads, are actually old tapes from our childhood, remembering how our parents treated us when we made a mistake. Perhaps they “beat us up” either emotionally or physically, or both. Well, it is time to let those old tapes go, because they were never about you and the mistake you made. They were really about your parents who were triggered by your actions into reliving the mistakes they made, and then reacting to them.

    Not letting go is part of our addiction. Let’s say this: we are hardwired for compulsive thought. It is part of us, and in our sobriety our compulsive thought is switched from one focusing on drugs and alcohol (or work, sex, gambling or purchasing things) to something more productive and positive. Just as you are successfully turning off the compulsive thought about using or acting out, it’s time to switch off the compulsive thought about not being good enough and beating up yourself over your past mistakes. You can use these slogans: “Let go, let God,” “lesson learned,” “what is in the past is in the past.” They should be the new words, the new mantra you use to combat these destructive and negative tapes.

    What do other people think about your mistakes? Research proves they think very little about your mistakes. Yes, I know it is your kids, your husband and/or your parents and you worry about what they think of you or how they judge you. But honestly, that same research shows people really don’t spend that much time thinking about you. As much as you think they do, they don’t. Your kids are thinking about what to wear to school, what the new girl in history class thought about what them, or your husband is concerned about the bills or the next Harvard Alumni meeting. The fact is your neighbors don’t think about you at all! Yes, maybe a little gossip in the parking lot of the school, but truly, that two-minute exchange is dwarfed by them worrying about what people think of them. So let that go. People care about themselves. They think about themselves. (Just like you are thinking about yourself, right now?)

    Now here is the most important part of my conversation with Caroline. “I don’t know how to help them put the past behind them.” Caroline is a co-dependent. She is always doing, doing for others. She has placed herself behind her husband, his business, and her children for more than twenty years. It got her a little angry sometimes, and so she drank. Well, things got a little out of hand when she began drinking alcoholically. Caroline thinks she can help her kids put the past behind them. But, she can’t. That is her kids’ job. Yes, she recognizes that a therapist can help her children. But still she wants to do their job for them. No she can’t rob her children of this opportunity. The life lesson her kids will learn about putting things in the past and forgiving, will be one of the biggest “Ah-ha” moments they will have.

    I explained to Caroline the only way that she will be in her kids lives going forward is if she is sober. She said she knew that. The only way she can help her children put the past behind them, is by emulating that for them, by doing a 9th step, by making her amends. She seemed to digest that comment. Today, she had a lengthy session with the reunification therapist, so I am hoping Caroline will call me tonight.