Category: Recovery Coaching

Recovery Coaching

  • The Recovery Support that is Available Following Overdose

    What subsequently happens to people who experience a drug overdose and are successfully rescued through emergency medical intervention?

    What is their fate after they leave the hospital or other emergency care setting?

    Missing in the media coverage of the unrelenting legions of drug overdose deaths in the United States is an equally important but less heralded story. What happens to people who experience a drug overdose and are successfully revived through emergency medical intervention? What is their fate after they leave the hospital or other emergency care setting? The Connecticut Community for Addiction Recovery (CCAR)  and other  grassroots recovery community organizations (RCOs) nationwide are influencing positive outcomes to overdose by placing recovery coaches with first responders and doctors in the emergency departments in hospitals to advance recovery options for the revived overdose patients.

    The Connecticut Community for Addiction Recovery (CCAR) is one of several hundred recovery advocacy and recovery support organizations (RCOs) rising on the American landscape in the last two decades.  CCAR began piloting an Emergency Department Recovery Coach (EDRC) Program in March of 2017. Through this program, CCAR-trained recovery coaches are on-call for hospital emergency rooms to offer assistance to patients and their families during an emergency room visit resulting from an adverse drug reaction or other alcohol- or another drug-related medical crisis. An evaluation of EDRC services provided between March and November 2017 within four collaborating hospitals revealed the following. CCAR-trained recovery coaches provided recovery support services to 534 patients/families during the 8-month evaluation period with a relatively even distribution of services provided across the four hospitals. Of those served by the EDRC, the majority were in the ER due to an alcohol- or opioid-related condition; 70% were male; and 5% were seen more than once during the evaluation period. Most importantly, of the 534-people interviewed, 528 were assertively linked to a detoxification program, inpatient or outpatient treatment, or community-based recovery support resources.

    A more formal and sustained evaluation of the EDRC program is underway in collaboration with Yale University, and the program is now being expanded to an additional four hospitals. Funding support for the EDRC comes from the Connecticut Department of Mental Health and Addiction Services through support of the federal block grant and a Targeted Response to the Opioid Crisis Grant from the Substance Abuse and Mental Health Services Administration.

    CCAR’s EDRC program has many distinct features worthy of replication and local refinement. Among the more striking of such features are the following-

    • The EDRC program is governed by a formal agreement between CCAR and each participating hospital that delineates the roles and responsibilities of each party.
    • The EDRC program is currently staffed by one Recovery Coach Manager and 9 full-time Recovery Coaches (RCs).
    • Emergency Department Recovery Coaches (EDRCs) are recruited and screened (2 interviews with background and reference checks) based on desired experience, skills, and a good work history, but also for what our EDRC manager, Jennifer Chadukiewicz, calls “a servant’s heart.”
    • All EDRCs go through more than 60 hours of training and spend the first weeks shadowing tenured EDRCs. The training includes the CCAR Recovery Coach Academy© (30 hours) as well as topical trainings, e.g., Narcan (naloxone administration), medication-assisted recovery, ethical decision-making, crisis intervention, and conflict resolution. Hospital specific training includes such areas as fire/general safety, OSHA, blood borne pathogens, infection control, hazardous materials, and HIPPA regulations.
    • EDRC Recovery Coaches are employed by CCAR rather than the hospitals and enter the hospitals as service vendors and “guests” who defer to leadership of ER staff.
    • The RCs are paid a livable wage ($20-$25/hr. to start plus benefits, health insurance, etc.) that allows them to work full time and support themselves and their families while affording time away for rest and self-care.
    • EDRC coverage is provided from 8 am to 12 midnight, seven days a week, 365 days a year.
    • Patients have the option of enrollment in enhanced Telephone Recovery Support (TRS) program (i.e., patients receive daily support calls for the next 10 days and then weekly if desired).
    • EDRC’s provide assertive linkage and transportation (when needed) to treatment and recovery support resources.
    • The EDRCs spend considerable time with community providers and other stakeholders building collaborative relationships that facilitate this patient referral and service linkage process.
    • CCAR provides each hospital emergency department with “prescription pad” style resource handouts that can be attached to discharge paperwork and given to patient friend/family member.

    There are critical windows of vulnerability and opportunity within addiction and recovery careers that serve to plunge one deeper into addiction or mark the catalytic beginning of a recovery process. The reversal of a drug overdose or treatment of other drug-related medical crises can constitute a recovery tipping point.

    The emergency room is not the only critical point of potential intervention to reduce the risk of drug-related deaths and to promote addiction recovery. For persons with a history of addiction, the days and weeks immediately following release from a correctional facility, release from an inpatient or residential detoxification/treatment program without medication support, or cessation of medication-assisted treatment, and even transfer from one medication-assisted treatment provider to another all constitute a zone of heightened risk for re-initiation of risky drug use and death. Altering such risks and tipping the scales toward recovery stabilization, recovery maintenance, and enhanced quality of personal/family life in long-term recovery should be the goals of every community. Recovery community organizations like CCAR are showing us how this can be done.

    This blog was written by William White, Rebecca Allen & Phil Valentine. It was originally posted on the William White web site: www.williamwhitepapers.com on January 18, 2018

    Connecticut Community of Addiction Recovery (CCAR) is one of the nation’s first RCOs, CCAR pioneered what have since become standard RCO service fare: recovery-focused professional and public education, legislative advocacy, recovery community centers, recovery celebration walks and conferences, recovery support groups, training for recovery home operators, face-to-face and telephone-based recovery support services, family-focused recovery education and support services, and collaboration with research scientists on the evaluation of the effects of peer support on long-term recovery outcomes. As an example of its reach, CCAR’s Recovery Coach Academy curriculum has been used in the training of more than 20,000 recovery coaches in more than 33 states and in such countries as Sweden, Vietnam, Canada, and Spain.

  • 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

  • What is a recovery coach?

    In 2013, I published Recovery Coaching – A Guide to Coaching People in Recovery from Addictions, since then the duties and responsibilities of recovery coaches, peer recovery support specialists and professional recovery coaches have expanded significantly.

    In this article, I hope to define some different recovery coaching titles for those interested in becoming a recovery coach, what certifications they should seek, the places they could work and what they can anticipate as compensation for their work.

    What kind of certification should a future recovery coach receive?

    Recovery coach training and certification is a requirement in this field. Coaching certification and training is one of the fastest growing aspects of the healthcare field. The number of recovery coaching training and certification courses has expanded to over 300 institutions nationwide. Many employers require recovery coach and peer recovery support specialist certifications. In the links section of this web site is a state by state listing of all the organizations that offer certifications for addiction recovery coaches. If you are reading this to receive basic recovery coaching information, first decide if you enjoy working with people in recovery from substance misuse or want to work with people in recovery from a mental health or behavioral health disorder.

    Are you interested in working with people in recovery from addictions or in recovery from a mental health or behavioral health diagnosis?

    A nearly universal definition of a peer recovery support specialist or a recovery coach is “an individual with the lived experience of their own recovery journey and wants to assist others who are in the early stages of the healing process from psychic, traumatic and/or substance misuse challenges, thus, this peer can aid and support another peer’s personal recovery journey”. Some certifications for a peer recovery support specialist give an individual the training necessary to work with individuals with a behavioral health disorder or a mental health diagnosis. These certifications include more training on the nature of behavioral health disorders, the medications used to treat these disorders, crisis interventions, life/occupational skills, and trauma informed care. A recovery coach working with people in addiction recovery does not necessarily need these types of training. In this article, I will focus on the recovery coach working with people in recovery from substance misuse.

    The individuals that work with people in recovery from substance misuse are called recovery coaches, as well as peer recovery support specialists (PRSS), peer recovery support practitioners (PRSP), recovery support specialists (RSS), sober companions, recovery associates or quit coaches. In all cases, they support individuals in recovery from addiction(s), which can include alcohol, drugs, gambling, eating disorders as well as other addictive behaviors.

    The basic recovery coaching credential is required. If you want recovery coaching certification, google this term with the region you live in. For addition recovery coaching education, I suggest: adding certification for treating co-occurring disorders, training on the application of Narcan which includes the certification for coaching persons detoxing from an opioid overdose, also certification for counseling individuals in Suboxone or Methadone treatment also called Medication Assisted Treatment (MAT) and Medication Supported Recovery (MSR), certification for spiritual recovery coaches and credentials for coaches working with individuals with behavioral addictions such as sexual compulsivity, internet gaming and gambling disorders. If you would like to work in an inpatient treatment center, drug and alcohol counseling certification maybe required.

    Recovery coaching credentialing has expanded to include coach supervision certification, which is training for individuals who want to manage other recovery coaches. Also there is an elevated level of certification called professional recovery coaching. A professional recovery coach is an individual that has been coaching for several years, has hundreds of coaching hours under their belt, manages other coaches and/or has received other coaching credentials. A professional recovery coach is sometimes referred to as a life recovery coach. A professional recovery coach can receive training from any of the organizations that train peers or recovery coaches, and in addition, they can receive training from the International Coach Federation’s accredited life coach training program or a professional recovery coach certification from Recovery Coaches International. Recently, Connecticut Community of Addiction Recovery (CCAR) has started developing a Professional Coaching Certification.

    Where do you want to work?

    Some recovery coaches seek to work at a recovery community organization (RCOs) or a recovery support center. An RCO is an independent, non-profit organization led and governed by representatives of local communities of recovery. The recovery coaches at these recovery community organizations work with people of all financial means, addicts that are homeless, offenders, even professionals like nurses, teachers, lawyers and highly educated individuals, who have hit bottom. Sometimes, the recovery coaches at these centers receive a salary from the RCO. RCO recovery coaches can also be volunteers, opting to perform their coaching duties for no reimbursement at all.

    Recovery coaches can be employed by treatment centers coaches, developing a coaching relationship with a client outside of the clinical treatment. They can escort a client home from a treatment center and stay with the client for a period of time, insuring they do not relapse after discharge. More half way houses or sober living environments are employing recovery coaches. In fact, many recovery coaches have opened a transitional living home or a supportive sober living environments. They act as a recovery coach and a house manager at the same time, their presence adds to the quality of the recovery experience for the residents. Recovery coaches can work in emergency departments in hospitals, detoxification centers or sobering centers; working with individuals in crisis, either detoxing from an alcohol or opioid overdose.

    Lastly, some recovery coaches run their own coaching business. They will visit clients or talk with them over the phone or on SKYPE. These recovery coaches market themselves by contacting a treatment center’s aftercare coordinator or will seek referrals from therapists. The client is billed directly for the coaching services, there is no insurance coverage for a recovery coach.

    How much do you want to be paid for your services?

    Recovery coaches are paid a variety of rates. A recovery community organization, a treatment center, sober living environment or social services agency recovery coaching rates are from $12-$18 per hour. If a recovery coach receives their salary from a social services agency, or a recovery community organization that agency may have received a grant to run a peer program from the State or Federal government.

    A professional life recovery coach can bill from $35 up to $100 an hour for their coaching services. These professional recovery coaches bill their clients directly and incur expenses for running their coaching practice such as insurance, travel and overhead. This ‘pie in the sky’ $100 per hour fee of a professional recovery coach is not for the inexperienced or newbie coach. There are significant responsibilities a recovery coach has for their client, primarily keeping them free from relapse or overdose, or in other words- keeping them alive.

    Soon, there will be reimbursement from health insurance companies for recovery coaching for individuals who are diagnosed as dependent on a substance. New York 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, Pennsylvania, Maryland and Massachusetts, are formulating similar Medicaid payment plans, but these reimbursements are not yet in place. However, currently, private independent health insurance companies do not cover the services of a recovery coach working with an individual in recovery from an addiction.

    In less than five years the field of recovery coaching has grown significantly. With the advent of the Affordable Care Act and the legislation to fight addiction, the 21st Century CURES and the CARA Acts, recovery coaching is now recognized as one of the most important tools to initiate and maintain long term recovery. This recognition will continue as the benefits from recovery coaching continue to be realized.

     

  • 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?

  • What is a recovery coach?

    What is a recovery coach, a peer recovery support specialist or a professional recovery coach?

    In 2013, I published Recovery Coaching – A Guide to Coaching People in Recovery from Addictions, since then the duties and responsibilities of recovery coaches, peer recovery support specialists and professional recovery coaches have expanded significantly.

    In this post, I hope to help define for those interested in becoming a recovery coach what certifications they should seek, the places they could work and what they can anticipate as compensation for their work.

    What kind of certification should a future recovery coach receive?

    Recovery coach training and certification is a requirement in this field. Coaching certification and training is one of the fastest growing aspects of the healthcare field. The number of recovery coaching training and certification courses has expanded to over 300 institutions nationwide. Many employers require recovery coach and peer recovery support specialist certifications. In the links section of this web site is a state by state listing of all the organizations that offer certifications for addiction recovery coaches.

    If you are reading this post to receive basic recovery coaching information, first decide if you enjoy working with people in recovery from substance misuse or want to work with people in recovery from a mental health or behavioral health disorder.

    Are you interested in working with people in recovery from addictions or in recovery from a mental health or behavioral health diagnosis?

    A nearly universal definition of a peer recovery support specialist or a recovery coach is an individual with the lived experience of their own recovery journey and wants to assist others who are in the early stages of the healing process from psychic, traumatic and/or substance misuse challenges, thus, this peer can aid and support another peer’s personal recovery journey.

    Some certifications for a peer recovery support specialist give an individual the training necessary to work with individuals with a behavioral health disorder or a mental health diagnosis. These certifications include more training on the nature of behavioral health disorders, the medications used to treat these disorders, crisis interventions, life/occupational skills, and trauma informed care. A recovery coach working with people in addiction recovery does not necessarily need these types of training. In this blog, I will focus on the recovery coach working with people in recovery from substance misuse.

    The individuals that work with people in recovery from substance misuse are called recovery coaches, as well as peer recovery support specialists (PRSS), peer recovery support practitioners (PRSP), recovery support specialists (RSS), sober companions, recovery associates or quit coaches. In all cases, they support individuals in recovery from addiction(s), which can include alcohol, drugs, gambling, eating disorders as well as other addictive behaviors.

    The basic recovery coaching credential is very broad. If you want more specific training, one can add certification for treating co-occurring disorders, the application of Narcan which includes the certification for coaching persons detoxing from an opioid overdose, certification coaching individuals in Suboxone or Methadone treatment also called Medication Assisted Treatment (MAT) and Medication Supported Recovery (MSR), certification for spiritual recovery coaches and credentials for coaches working with individuals with behavioral addictions such as sexual compulsivity, internet gaming and gambling disorders.

    Recovery coaching credentialing has expanded to include training for individuals that want to supervise other recovery coaches, or an elevated level of certification called professional recovery coaching.

    A professional recovery coach is an individual that has been coaching for several years, has hundreds of coaching hours under their belt, manages other coaches and/or has received other coaching credentials. A professional recovery coach is sometimes referred to as a life recovery coach. A professional recovery coach can receive training from any of the organizations that train peers or recovery coaches, and in addition, they can receive training from the International Coach Federation’s accredited life coach training program. Recently, Connecticut Community of Addiction Recovery has started developing a Professional Coaching Certification.

    Where do you want to work?

    Some recovery coaches seek to work at a recovery community organization (RCOs) or a recovery support center. An RCO is an independent, non-profit organization led and governed by representatives of local communities of recovery. The recovery coaches at these recovery community organizations work with people of all financial means, addicts that are homeless, offenders, even professionals like nurses, teachers, lawyers and highly educated individuals, who have hit bottom. Sometimes, the recovery coaches at these centers receive a salary from the RCO. RCO recovery coaches can also be volunteers, opting to perform their coaching duties for no reimbursement at all.

    Recovery coaches can be employed by treatment centers coaches often escort a client home from a treatment center insuring they do not relapse in the first 30 days after discharge. More half way houses or sober living environments are employing recovery coaches. In fact, many recovery coaches have opened a transitional living home or a supportive sober living environments. They act as a recovery coach and a house manager at the same time, their presence adds to the quality of the recovery experience for the residents.

    Recovery coaches can work in emergency departments in hospitals, detoxification centers or sobering centers; working with individuals in crisis, either detoxing from an alcohol or opioid overdose.

    Lastly, some recovery coaches run their own business. They will visit clients or call them over the phone or use SKYPE. These recovery coaches market themselves by contacting a treatment center’s aftercare coordinator, maintaining a web site or will seek referrals from therapists. These coaches meet face to face with the client weekly and will work with them over the phone or face to face on a regular basis. The client is billed directly for the coaching services.

    How much do you want to be paid for your services?

    Recovery coaches are paid a variety of rates. A recovery community organization, a treatment center, sober living environment or social services agency recovery coaching rates are from $12-$20 per hour. If a recovery coach receives their salary from a social services agency, or a recovery community organization that agency may have received a grant to run a peer program from the State or Federal government.

    A professional life recovery coach can bill from $35 up to $100 an hour for their coaching services. These professional recovery coaches bill their clients directly and incur expenses for running their coaching practice such as insurance, travel and overhead. This ‘pie in the sky’ $100 per hour fee of a professional recovery coach is not for the inexperienced or newbie coach. There are significant responsibilities a recovery coach has for their client, primarily keeping them free from relapse or overdose, or in other words- keeping them alive.

    Soon, there will be reimbursement from health insurance companies for recovery coaching for individuals who are diagnosed as dependent on a substance. New York 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, Pennsylvania, Maryland and Massachusetts, are formulating similar Medicaid payment plans, but these reimbursements are not yet in place. However, currently, private independent health insurance companies do not cover the services of a recovery coach working with an individual in recovery from an addiction.

    In less than four years the field of recovery coaching has grown significantly. With the advent of the Affordable Healthcare Act and the newest legislation to fight addiction, the 21st Century CURES and the CARA Acts , recovery coaching is now recognized as one of the most important tools to initiate and maintain long term recovery. This recognition will continue as the benefits from recovery coaching continue to be realized.

  • 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

  • Is Recovery Coaching Effective?

    Is Recovery Coaching Effective?

    manhattan_bridgeTreatment professionals and researchers are calling for a change in the treatment model for substance use disorders (SUD). This change calls for shedding the acute care model (28 days of SUD treatment will fix you) to a continuum of care models, similar to how chronic diseases like diabetes or arthritis are treated. (Humphreys & Tucker, 2002; Institute of Medicine, 2005; McLellan et al., 2000; White, Boyle, Loveland, & Corrington, 2005).

    At the same time, the mental health and the substance abuse treatment fields have merged, creating the behavioral health field. With this merger, the recovery-oriented systems of care model (ROSC) has become the accepted approach to treatment for those with mental and substance use disorders. This holistic approach, rather than focusing on the addiction, considers the whole person and how they interact in real life. ROSC emphasizes that recovery depends on the connection of mind, body, and spirit, motivating addicts to choose to improve their mental health, their physical health, and to embrace a spiritual component of their recovery (SAMHSA, 2011). This multi-system approach has ROSC counselors encouraging visits to the general practitioner, the OBGyn and the dentist. They assess for co-occurring disorders and embrace one-on-one therapeutic treatment and group therapy. And ROSC practitioners embrace mutual support programs, such as AA, NA or even nontraditional mutual support groups like SOS, or Women for Sobriety. A spiritual program is also encouraged. Lastly, the newest introduction to the treatment field is the recovery coach.

    As mental health and addiction treatment services are adopting this recovery-oriented approach, the emphasis on incorporating various forms of recovery coaching or peer-based recovery support into treatment services is growing rapidly. Peer-based recovery support services are defined as

    “the process of giving and receiving nonprofessional, nonclinical assistance to achieve long-term recovery from mental health and substance use disorders” (Borkman, 1999)

    This support is provided by “peers,” “peer-recovery support specialists,” “recovery coaches,” “peer mentors,” or “peer support specialists” who have lived and experienced personal recovery (Borkman, 1999). The peers assist others in initiating, maintaining and embracing recovery from their mental health or substance use disorders.

    As recovery coaches and peers begin to infiltrate treatment centers and recovery support, community organizations, there is a needling question that arises: are recovery coaches effective in the recovery process?

    Studies have been completed on the effectiveness of recovery coaches aiding in individuals achieving long-term recovery since 2005. Many were small studies, some were not exactly scientific, nor could other studies stand up to researcher’s scrutiny. None of the studies had the critical mass to come to a clear conclusion. Ellen L. Bassuk, M.D., Justine Hanson, Ph.D., R. Neil Greene, M.A., Molly Richard, B.A., and Alexandre Laudet, PhD began examining the 1,221 studies that analyze the effectiveness of peer-delivered, recovery support services for individuals in recovery. They wrote a systematic review called Peer Delivered Recovery Support Services for Addictions in the United States: A Systematic Review.

    This compilation of all the current studies is to create an appraisal, and summarization of the success of peer-delivered, recovery support services, using strict scientific criteria. As part of their review process, the 1,221 studies were screened, but only nine studies were deemed to meet the strict review requirements.

    The nine studies examined the effectiveness of recovery support services that were delivered by a peer using a wide range of interventions and models. These studies also examined the variety of locations that offered peer support, including peer-run, drop-in centers (Ja et al., 2009), peer-run, recovery community organizations (Kamon & Turner, 2013), and Veteran’s Administration medical outpatient clinics (Bernstein et al., 2005).

    This review showed peer-delivered recovery support services accomplished the following successful outcomes:

    1. Decreased alcohol use
    2. Decreased drinking to intoxication by reducing the odds of drinking to intoxication by 2.9 percent (Smelson et al. 2013)
    3. Peer participation lowered re-hospitalization rates, meaning only 62 percent of participants from the peer based support group were re-hospitalized compared to 73 percent of those not receiving peer based support (Min et al. (2007)
    4. Increased post-discharge sobriety time was achieved by the individuals receiving the peer intervention (O’Connell et al. 2014)
    5. If peers led groups in life-skills training, those participants had 14.8 fewer days drinking
    6. Peer recovery support affected those discharged from inpatient treatment by maintaining a post-discharge sobriety rate of 43 percent to 48 percent as compared to 33 percent sobriety for those not receiving peer based support (Tracy et al. 2011)

    Overall, the review of these studies indicate that peers involved in recovery support interventions have beneficial effects on participants. While the reviewers can conclude that there is evidence supporting the effectiveness of peer-delivered, recovery support services, they acknowledge that additional research is necessary to determine the usefulness of peer support services. While this knowledge is encouraging, research in this area is just emerging, and there is a strong need to improve outcomes by completing future studies.


    References

    1. Humphreys, K., & Tucker, J. (2002). Toward more responsive and effective intervention systems for alcohol-related problems. Addiction, 97(2), 126–132.
    2. Institute of Medicine (2005). Improving the quality of health care for mental and substance use conditions. Washington, DC: National Academy Press.
    3. McLellan, A. T., Lewis, D. C., O’Brien, C. P., & Kleber, H. D. (2000). Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. JAMA, 284(13), 1689–1695.
    4. White, W., Boyle, M., Loveland, D., & Corrington, P. (2005). What is behavioral health recovery management? A brief primer. (Retrieved from www.addictionmanagement.org/recovery%20management.pdf).
    5. Substance Abuse and Mental Health Services Administration (SAMHSA) (2011). SAMHSA’s Working Definition of Recovery. (Retrieved from http://www.samhsa.gov/recovery/).
    6. Borkman, T. (1999). Understanding self-help/mutual aid: Experiential learning in the commons. New Brunswick, NJ: Rutgers University Press
    7. Borkman, T. (1999). Understanding self-help/mutual aid: Experiential learning in the commons. New Brunswick, NJ: Rutgers University Press
    8. Ja, D. Y., Gee, M., Savolainen, J.,Wu, S., & Forghani, S. (2009). Peers Reaching Out Supporting Peers to Embrace Recovery (PROPSPER): A final evaluation report. San Francisco, CA: DYJ, Inc. for Walden House, Inc. and the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (Retrieved from http://www.dyja./com/sites/default/files/u24/PROSPER%20Final%20Evaluation%20Report.pdf).
    9. Kamon, J., & Turner,W. (2013). Recovery coaching in recovery centers: What the initial data suggest: A brief report from the Vermont Recovery Network. Montpelier, Vermont Evidence-Based Solutions (Retrieved form https://vtrecoverynetwork.org/PDF/VRN_RC_eval_report.pdf).
    10. Bernstein, E., Bernstein, J., Tassiopoulos, K., Heeren, T., Levenson, S., & Hingson, R. (2005). Brief motivational intervention at a clinic visit reduces cocaine and heroin use. Drug and Alcohol Dependence, 77, 49–59
    11. Smelson, D. A., Kline, A., Kuhn, J., Rodrigues, S., O’Connor, K., Fisher, W. Kane, V. (2013). A wraparound treatment engagement intervention for homeless veterans with co-occurring disorders. Psychological Services, 10(2), 161–167.
    12. Min, S. Y., Whitecraft, E., Rothbard, A. B., & Salzer, M. S. (2007). Peer support for persons with co-occurring disorders and community tenure: A survival analysis. Psychiatric Rehabilitation Journal, 30(3), 207–213. http://dx.doi.org/10.2975/30.3.2007.207.213.
    13. O’Connell, M. J., Flanagan, E., Delphin, M., & Davidson, L. (2014). Enhancing outcomes for persons with co-occurring disorders through skills training and peer recovery supports. Unpublished manuscript.
    14. Tracy, K., Burton, M., Nich, C., & Rounsaville, B. (2011). Utilizing peer mentorship to engage high recidivism substance-abusing patients in treatment. The American Journal of Drug and Alcohol Abuse, 37(6), 525–531
  • Recovery Coach Training Organizations – Free Listing

    adultlearnersDoes your organization want a free listing for your recovery coaching certification training? Every year this website updates the list of over 300 agencies, organizations and schools that offer certification training for recovery coaches working with people in recovery from addictions. This list receives over 45,000 hits a year. Please fill in the comment section below if you offer certification in recovery coaching, and your organization will be presented in this free listing.

    Provide all of the pertinent information: institution name, address, email, web site, the person in charge of the training registration and their phone number, date of training and costs. Clarify that this training is for recovery coaches working in the addictions field. This listing is free.

    You can fill out the comment section below or send an email to: melissakilleen@mkrecoverycoaching.com

  • 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.

  • 20 Question Assessment – Is this a healthy relationship?

    two people on a beachAs a recovery coach I guide a lot of people in the “realm” of healthy relationships. Many ask — is this a healthy relationship? Some clients have not been in a relationship for several years, and are attempting to dip their toes into dating. Others might have just left a relationship, and are trying to figure out whether to stay away from a former lover. Even more of my clients who are in relationships can’t figure out if the relationship is healthy or not.

    Healthy vs. Unhealthy Relationships

    My coaching clients know the “type” of person they want, but realize they keep picking the same unhealthy man or woman, just in a different body. They return time and time again to these relationships because they seem comfortable, reminding them of their family, or first marriage etc. When this happens I urge my clients to actively try to change the relationship selections they make. It is often very difficult for someone to see if the relationship they are in is healthy or unhealthy. I often review the qualities of a healthy and an unhealthy relationship with them. Do these attributes describe your relationship?

    • Healthy-Equality — Partners share decisions and responsibilities. They discuss roles to make sure they are fair and equal.
    • Unhealthy-Control — One partner makes all the decisions and tells the other what to do, or tells the other person what to wear or who to spend time with.
    • Healthy-Honesty — Partners share their dreams, fears, concerns with each other. They tell each other how they feel and share important information.
    • Unhealthy-Dishonesty — One partner lies to or keeps information from the other. One partner keeps secrets or withholds information from the other.
    • Healthy-Physical Safety — Partners feel physically safe in the relationship and respect each other’s physical space.
    • Unhealthy-Physical Abuse — One partner uses force to get his/her way (grabbing, hitting, slapping, shoving).
    • Healthy-Respect — Partners treat each other like they want to be treated and accept each other’s opinions, friends, and interests. Partners in a healthy relationship stop what they are doing, look their partner in the eye and listen to each other.
    • Unhealthy-Disrespect — One partner makes fun of the opinions and interests of the other partner. He or she may not show any care for your property or throw out your personal possessions.

    Is This a Healthy Relationship? — 20 Question Assessment

    I suggest answering these questions to figure out if you are in a healthy relationship?

    1. Has your partner shared their hopes and dreams for the future, such as where s/he wants to live 5 years from now?  Yes [   ]   No [   ]
    2. Do you and your partner discuss what to do regarding a holiday weekend’s activities? Yes [   ] No [  ]
    3. Do you flinch when your partner makes a sudden action with his/her arms?
      Yes [   ]   No [   ]
    4. Do you go to your bedroom in order to avoid interaction with your partner?
      Yes [   ]   No [   ]
    5. Do your feelings matter to your partner?  Yes [   ]   No [   ]
    6. Would you call your partner’s humor cynical, cutting or belittling?  Yes [   ]   No [   ]
    7. When you suggest something to be completed in the manner you would like, are your suggestions ignored?  Yes [   ]   No [   ]
    8. Do you feel like you have to hide things (gifts, clothes, make-up) from your partner? Yes [   ]   No [   ]
    9. Does your partner compliment you in front of others?  Yes [   ]   No [   ]
    10. Can you mention something you like or admire about your partner?  Yes [   ]   No [   ]
    11. Is your partner glad you have other friends and activities?  Yes [   ]   No [   ]
    12. Is your partner happy about your accomplishments and ambitions?  Yes [   ]   No [   ]
    13. Does s/he talk about her/his feelings?  Yes [   ]   No [   ]
    14. Does s/he really listen to you?  Yes [   ]   No [   ]
    15. Does your partner have a good relationship with his/her family?  Yes [   ]   No [   ]
    16. Does your partner have good friends?  Yes [   ]   No [   ]
    17. Do you and your partner spend time with these friends?  Yes [   ]   No [   ]
    18. Does s/he have interests besides you?  Yes [   ]   No [   ]
    19. Does s/he take responsibility for her/his actions and not blame others for his/her failures?  Yes [   ]   No [    ]
    20. Does your partner respect your right to make decision that affects your own life?
      Yes [   ]   No [   ]

    If you have answered “NO” to more than 12 of these questions, I suggest you look into how to cultivate a healthier relationship, perhaps by seeking the advice of a counselor or therapist.

  • A Call for Clinical Humility in Addiction Treatment

    by William White and video featuring Chris Budnick

    The history of addiction treatment includes a pervasive and cautionary thread: the potential to do great harm in the name of help.  The technical term for such injury, iatrogenesis (physician-caused or treatment-caused illness), spans a broad range of professional actions that with the best of intentions resulted in harm to individuals and families seeking assistance. My recounting of such insults within the history of addiction treatment (see endnotes 1, 2 and 3 below) also includes the observation that such harms are easy to identify retrospectively in earlier eras, but very difficult to see within one’s own era, within one’s own treatment program, and within one’s own clinical practices.

    The challenges for each of us who work in this special service ministry and for william_l_white_portrait_1the specialized industry of addiction treatment include conducting a regular inventory of clinical and administrative policies and practices to identify areas of inadvertent harm, altering conditions linked to such harm, making amends for such injuries, and developing mechanisms to prevent such injuries in the future. In my own professional life, many of the projects in my later career were products of such an inventory and served as a form of amends for actions I took or failed to take in my early career due to lack of awareness or courage. (See endnote 4 and 5 for two vivid examples.)

    There have also been times I have taken the larger field to task for practices I deemed harmful. I have suggested at times that what were perceived as personal failures to achieve lasting recovery could be more aptly characterized as system failures (endnote 6). I have suggested at times that the field was becoming addicted to professional power and money and that the field itself was in need of a recovery process that should include processes of rigorous self-inventory, public confession, and amends (endnote 7 and 8).

    The shift from acute care models of addiction treatment to models of sustained recovery management (RM) and recovery-oriented systems of care (ROSC) involves dramatic changes in clinical practices, including a shift in the basic relationship between the service provider and service recipient. The service relationship within the RM/ROSC models shifts from one dominated and controlled by the professional expert to a sustained recovery support partnership, with the provider serving primarily as a consultant to the service recipient’s own recovery self-management efforts. Those who have made this relational shift inevitably look back on areas of potential harm that emerged from the expert relational model they once practiced. And then the question inevitably arises, “How does one make amends for past harm in the name of help within the context of addiction counseling?”

    Chris Budnick, an addictions professional in North Carolina and founding Board Chair for Recovery Communities of North Carolina, Inc. (RCNC), recently responded to that question by preparing a formal letter of amends to the individuals, families, and communities he has served. Below is the text of that letter, which was presented at the North Carolina Recovery Advocacy Alliance Summit, February 24, 2016. (The link to the video is: https://www.youtube.com/watch?v=A5MYhZbnhfU)

    Chris-Budnick LCSW,LCAS,CC,MSWMy name is Chris Budnick and I am a Licensed Clinical Addiction Specialist. I first began working in the addiction treatment and recovery field in 1993. 

    There are many components involved in the broad issue of substance use disorders and recovery. Employers, first responders, the criminal justice system, policy makers, politicians, companies, advertisers, treatment providers, addiction professionals, the recovery community, families, and the individual with the substance use disorder. Of all these components, individuals with substance use disorders face the greatest scrutiny, stigma, discrimination and blame. For too long they have stood alone bearing the full brunt of this responsibility while systems of care and policies impacting housing, education, and employment have largely conspired to undermine any chance of sustaining recovery.

    Last week I found myself approaching a police department to apologize for failing them. When they reached out to us in the middle of the night seeking services for a young woman we told them “no.”  “We can’t help her tonight.”  She was killed within hours of this decision leaving behind a 2-year-old daughter.  I told the officer that we pledge to do better.

    This experience has nudged me to put to paper ideas that I’ve articulated and ideas I’ve only contemplated. I feel compelled as an addiction professional to make amends and pledge to do better.

    While I have changed my attitudes and practices over the years, I have not spoken up to say I’m sorry. So here are the things I want to make amends for:

    • I’m sorry for all the barriers you confront when trying to access help.
    • I’m sorry for contradictory “sobriety” and “active use” requirements you encounter when trying to access services.
    • I’m sorry for the harm that has come to you, your family, your unborn children, and your community when you have not been provided services on demand.
    • I apologize for expecting that you will provide all the motivation to initiate recovery when I have assumed no responsibility for enhancing your readiness for recovery.
    • I am sorry for creating unrealistic expectations of you.
    • I’m sorry for provider success statistics that have misled you and your family.
    • I’m sorry that I have discharged you from treatment for becoming symptomatic. I’m even more sorry, though, for abandoning you at your time of greatest vulnerability. And I am sorry for how this failure has contributed to the heartbreak of your loved ones.
    • I am sorry for abandoning you when you have left treatment, either successfully or unsuccessfully.
    • I am sorry for the irritation in my voice when you have returned following a set-back because you didn’t do everything that I told you to do.
    • I am sorry for my arrogance when I’ve assumed that I am the expert of your life.
    • I am sorry for privately finding satisfaction in your failure because it reinforces the fallacy that I know best and if you just do as I say, you’ll recover.
    • I am sorry for not celebrating as enthusiastically your successes when you have achieved them through a different pathway or style then me.
    • I am sorry for being a silent co-conspirator for the stigma that has resulted in systems of punishment and discriminatory policies and practices.
    • I’m sorry for turning you away from treatment because you’ve “been here too many times.”
    • I’m sorry for not referring you to different services when you have not responded to the services I offer.
    • I am sorry for allowing you to take the blame when treatment did not work instead of defending you because you received an inadequate dose and duration of care.
    • I am sorry for reaping the benefits of recovery yet failing to do everything I can to make sure those benefits are available to anyone, regardless of privilege, socio-economic status, education, employability, and criminal history.
    • I’m sorry for being an addiction professional who has not provided you with the recovery supports needed to sustain recovery. More importantly, I apologize for conspiring through silence and inaction with a system that ill prepares you to achieve success.
    • I’m sorry for not calling to check on you when you don’t show up for treatment. I’m sorry for not calling to support you after you leave treatment.
    • I’m sorry for letting society maintain the belief that you used again because you chose to.
    • I’m sorry for not fighting for adequate treatment and recovery support services. All persons with substance use disorders should be entitled to a minimum of five years of monitoring and recovery support services.
    • I’m sorry for not advocating for you to have opportunities to gain safe and supportive housing and non-exploitive employment.
    • I am sorry for being so self-centered that I only think about you in the context of treatment while failing to fully understand the environmental and social realities of your life and how they will impact your ability to initiate and sustain recovery.
    • I am deeply sorry to your loved ones who have been robbed of chances to have a healthy member of their family. I am deeply sorry to your community, who has been robbed of the gifts that your recovery could have brought them.
    • I’m sorry that systems of control and punishment has been the response to communities of color during drug epidemics.
    • I am sorry that through my silence and inaction that I have contributed to belief that persons with substance use disorders are criminals and should be punished.
    • I am sorry for not speaking as a Recovery Ally to families, friends, neighbors, colleagues, policy makers, and public officials about why I support recovery.
    • I’m sorry for all the things that I have left off this list because I’ve failed to regularly solicit your feedback about how effective I have been in supporting you in your recovery.

          This sorrow is the foundation of my commitment to improve the accessibility, affordability, and quality of addiction treatment and recovery support services and to create the community space in which long-term personal and family recovery can flourish.

                                  -Chris Budnick, Licensed Clinical Addiction Specialist

    This is a remarkable statement worthy of emulation. I look forward to the day when leaders prepare such a statement of amends to individuals, families, and communities on behalf of American addiction treatment institutions. I look forward to the day when clinical humility becomes a foundational ethic guiding the practice of addiction counseling.  WW

    I honor and applaud Bill and Chris for bringing this message to clinical professionals across the nation. It is time to shed and change these old models that have not been working and embrace these new tenants that Bill, Chris and many others espouse.  Truly such client-centered treatment can change the course of recovery for many. MK


    End Notes

    This post was previously published on William White’s web site- www.williamwhitepapers.com on April 29, 2016. William White and Chris Budnick authorized this reposting.

    Video: https://www.youtube.com/watch?v=A5MYhZbnhfU

  • Faces and Voices in Recovery Develops an Addiction Recovery Toolkit

    Faces and Voices in Recovery Partnering with Members of Congress to Offer Comprehensive Addiction Resources

    2016 logoFaces & Voices of Recovery, in collaboration with the Addiction Policy Forum and the House of Representatives Bipartisan Task Force to Combat the Heroin Epidemic developed a comprehensive addiction resources toolkit to help the families impacted by the heroin and opioid epidemic. This week, Members of Congress will unveil this toolkit on their websites and in their district offices and will train their office staff to provide key resources to families and individuals in their communities facing addiction. This toolkit is a resource that every recovery community organization, treatment center, doctor’s office, library as well as every family and individual should have access to.

    More Americans die every day from drug overdoses than from car accidents – an average of 129 people per day, with six out of 10 deaths related to opioids. This toolkit was developed in response to the fact that a majority of those who need help with addiction issues are not receiving it. In 2014, only 11 percent of the approximately 22.7 million Americans who needed treatment for substance use received it, according to the Office of National Drug Control Policy.

    “We are honored to partner with Members of Congress to offer individuals, families and communities important resources that will help them find support to achieve long-term recovery. We have offered our expertise for this toolkit and are pleased that Members of Congress understand the importance of making this information easily accessible and available in each Congressional district across the nation.”   -Executive Director Patty McCarthy-Metcalf

    Leading national and community organizations contributed to this comprehensive set of resources that includes resources around prevention, drug treatment, recovery support and general information for families, community organizations, schools, and parents concerned about addiction and seeking support. The groups who contributed to this guide include: Community Anti-Drug Coalition, the National Council, the National Association for Children of Alcoholics, the Partnership for Drug-Free Kids, Shatterproof, Faces & Voices of Recovery, Legal Action Center, National Institute of Drug Abuse, and the Office of National Drug Control Policy.

    In preparing this toolkit, Faces and Voices of Recovery strengthens it’s mission and dedication to organizing and mobilizing the over 23 million Americans in recovery from addiction to alcohol and other drugs, our families, friends and allies into recovery community organizations and networks, to promote the right and resources to recover through advocacy, education and demonstrating the power and proof of long-term recovery.  Faces & Voices of Recovery is the parent organization of the Association of Recovery Community Organizations (ARCO) which unites and supports the growing network of local, regional and statewide recovery community organizations (RCOs). ARCO links RCOs and their leaders with local and national allies and provides training and technical assistance to groups. ARCO helps build the unified voice of the organized recovery community and fulfill our commitment to supporting the development of new groups and strengthening existing ones.

    Link to Tool kit: http://media.wix.com/ugd/bfe1ed_439f2d84f59c4461a4eef39a7b00596d.pdf

  • How do I get recovery coaching certification?

    manhattan_bridgeOne of the most frequent questions I receive is “How do I get my recovery coaching certification?” The second most frequent question is “How do I get my peer recovery support-specialist certification?”

    A recovery coach and a peer recovery support-specialist (focusing in addiction recovery) execute the same job, the positions simply have a different title. Just like a certified drug and alcohol counselor (CADC) has the same job description as a certified addiction counselor (CAC).

    Peer recovery support-specialists can also be certified to assist individuals in mental health recovery; slowly but surely, states are requiring different certification training for these two different peer classifications.

    The most important considerations in obtaining your recovery coaching credentials are:

    1. Receive your training from an organization that is recognized by your state certification board to give the training (Google the Certification Board in your state, and go to the end of this post for a link).
    2. In the event your state does not offer certification for recovery coaches or peer recovery support-specialists, look up the IC&RC, the International Certification & Reciprocity Consortium, (http://www.internationalcredentialing.org/ ). Read about the Internationally Certified Peer Recovery (ICPR) certification tests from the IC&RC. This IC&RC certification is a credential that is recognized by almost every employer.
    3. Every state has different fees (the IC&RC has fees as well). Expect the following fees: To register for the test: $150-$250. To order study materials: $80-$100. To renew your certification: $100-$150. Renewal is necessary every two-five years. Remember, every state is different in their fee or renewal structure; this is only a guide.
    4. After taking the test, and receiving a passing grade, you are required to complete a certain amount of “practice” or internship hours. These hours vary from state to state. New Jersey requires 500 practice hours. The hours can be completed as a volunteer recovery coach at a social services agency, or as a paid recovery coach at an agency, or with private clients.
    5. These practice hours must be under the supervision of a licensed clinical supervisor (LCS) or certified, recovery coaching supervisor. A licensed clinical supervisor is a licensed counselor, psychologist or social worker that has completed training to oversee the management of other practitioners. Usually one hour of supervision is required for every 40 hours of client contact a coach may have. Documentation of these supervisory sessions are required and will be submitted to the certification board with your certification application.
    6. Once your practice hours and documentation of the supervision are completed, you submit the paperwork to your state’s certification board. When the certification is approved, you are issued the certificate.
    7. It is important you retain this certificate, because every job you apply for will ask for a copy of this document.
    8. Throughout the next few years, you must regularly take continuing education courses for the renewal of your certificate. Every certification board outlines the courses and number of continuing education credits you are required to complete.

    If you want to know where you can take the training courses to be a recovery coach, please go to my web site and look for approved training organizations in your state. Here is a link to this list: http://www.mkrecoverycoaching.com/recovery-coach-training-organizations/

  • Recovery Coaching Texas Prison Style

    Kyle Gage PhotoKyle Gage lives in Longview, Texas, and he is a recovery coach. Longview is a little oil and manufacturing town a couple of hours east of Dallas-Ft Worth and about an hour west of Shreveport, Louisiana. The small town has had some illustrious citizens: Forest Whitaker was born in Longview, and Matthew McConaughey went to Longview High School in the ‘80s. Kyle had less of an illustrious impact on Longview.

    A Hard-Earned Recovery 

    Kyle entered his first rehab at 17. He enrolled in a boarding school for troubled teens. He continued in and out of rehab many times, trying to do it his way. At twenty, he knew he had to change, so he attended some NA meetings, through which he stayed clean for about 6 months. Then he used. He tried to keep things under control, and managed to avoid any serious consequences for about a year, but then one day he was pulled over by the police, who found methamphetamine.

    In lieu of jail time, he agreed to treatment. After his treatment episode he remained clean on probation, in part because he was receiving regular tox screens. Staying clean was motivated by his desire to stay out of jail. For 7 months he was sober, but then he started to drink. Eventually, drinking turned to using drugs. Because of his fear of failing a tox screen, he stopped reporting to probation and went on the run. Kyle was picked up a few months later for the probation violation and was sent to the James Bradshaw State Prison in Henderson, Texas.

    He got no help for his recovery in the state prison, drugs being as easily available there as they were on the streets. Upon his release he began using again and was eventually arrested for burglary. He went to treatment but left against medical advice. He went to live at an Oxford House, and remained clean for 2-3 months. The stinking thinking eventually returned, so he drank and drinking led to using. In a very short time, he was arrested. At 26-years-old, he was facing two consecutive ten-year convictions for burglary and grand theft auto. Kyle knew this was serious.

    He asked the judge for help, and the judge gave Kyle ten years of deferred adjudication. Deferred adjudication is a form of a plea deal, where a defendant pleads “guilty” or “no contest” to criminal charges in exchange for meeting certain requirements laid out by the court. In Kyle’s case, these terms were that he go into an inmate drug-treatment program, attend Drug Court upon his release, make a commitment to outpatient treatment, perform community service and complete probation within the allotted period of time ordered by the court.

    Kyle was sentenced to six months at the Clyde M. Johnston Unit, the Texas correctional institution’s Substance Abuse Felony Punishment Facility in Winnsboro, Texas. This facility is Texas’s drug treatment program for offenders. He received a lot of treatment and therapy at the Johnston Unit, where Kyle realized that he needed to embrace recovery.

    Embracing Recovery

    For Kyle, embracing recovery in prison began by helping others: helping others gave him hope. He was the person that led the NA meetings in his dorm. The counselors at Johnston announced that a recovery coaching certification course for the inmates would start at Johnston. They said they only had room for ten men. Kyle applied. He was hoping they would pick him, but he was nervous because he knew that it was very competitive and they were only picking one person per dorm.

    Kyle’s mother found the book Recovery Coaching—A Guide to Coaching People in Recovery from Addictions on Amazon.com and sent it to Kyle. Kyle read it before he even got accepted into the class, which he eventually was. He excelled in helping others in the Unit embrace recovery. He graduated the recovery coaching class and was even invited to talk to the Unit’s next class of recovery coaches.

    Coaching Other Offenders

    The primary counselor notified Kyle that he wanted him to talk to an offender that was a disciplinary problem. Jason was 19-years-old, (his named has been changed for this post) and faced 10-15 years for aggravated assault. Jason was a first-phase client, which meant he had only been at the Johnston Unit for 30 days. He was a meth addict, and he was having trouble adjusting to the Unit: He had issues with people in his dorm. He didn’t attend AA or NA meetings. He didn’t want to be in recovery. He wanted to give up, and fantasized about “rendering his sentence.” The inmates call it “getting sent back to county.” Rendering a sentence means to go back to the original courthouse and say to the judge “Thanks, but I would rather serve 10 years for aggravated assault than spend any more time in therapy and treatment for my drug addiction.” Sound crazy? According to Kyle, that is what goes through the heads of many offenders. The grip of the addiction is so strong that living life sober is frightening. Many choose to self-sabotage by creating problems, by assaulting or threatening another inmate and receiving an extension of their sentence.

    Jason was referred to Kyle specifically as Jason reminded the counselors of Kyle, with his sleeves of tattoos just like Kyle. Kyle met with him and talked to him about meth, since they shared the same drug of choice. Kyle asked for Jason’s story, and listened. It was different from Kyle’s, but there were many similarities. Kyle shared many of Jason’s traits: Being an outlaw, an outcast, and a gang member. Jason didn’t think the meetings would be beneficial to him. Kyle shared that it was in the 12-step rooms where he truly felt alive.

    Kyle asked Jason about his plan when he gets out of Johnston and allowed Jason to self-actualize as to where he wanted to be in 5 years. Jason broke down and cried during this meeting. He was frightened at what he was facing, he had a lot of anger issues, and he didn’t know what to do. So, Kyle told him what worked for him.

    During the six months that offenders were at the Johnston Unit, there was no chance of them using drugs. The coaches assisted the offenders with embracing recovery, working the 12 steps and learning to use the steps in their daily prison life. Kyle coached men that were violent, had assaulted another men, were disciplinary problems, and where coaching was the last step before they were “sent back to county.” Kyle was there to stop them from rendering their sentence and losing everything. Sometimes an inmate had a family member pass away and the inmate was not granted permission to attend the funeral.  Although this coaching had nothing to do with recovery from drugs or alcohol, the recovery coaches are assigned to console these inmates through the grieving process.

    When inmates were close to being released, having  no experience with 12-step meetings or recovery on the outside, and  having no intentions of asking for help, Kyle gave them some “recovery capital.” He would give them lists of AA and NA meetings near the half-way house to which they were being released.  Kyle would give them information on Community HealthCore, which is a large, social services agency in Texas with outpatient drug and alcohol treatment programs. He would tell them about drug court classes and behavioral health counseling. Kyle and a few of the other recovery coaches in the Johnston Unit were from the Dallas area. When a prisoner would be going to back to the Dallas area, the coaches would refer the offenders to people on the outside who could take them to a meeting.

    Another prisoner, Caleb (his real named also changed) was in the reentry process—in a few weeks he was being released to a half-way house in Beaumont, Texas. Caleb had been in this position before.  As he got  closer to the “door” he became scared, and he was afraid of going back into the real world. He was so sure that he could to do things his way, but in the back of his head, he knew that doing things his way was what had gotten him into prison several times before. Kyle ran the 12-step meetings, and Caleb would attend as a “woodworker” (working wood means doing the absolute minimum, not participating, not getting involved and not believing this program would work for them).

    Kyle was assigned to speak to Caleb.  Kyle asked him what happened after he drank a beer, and Caleb admitted that after he drank one beer, it would soon be a dozen and very shortly, he was thinking about using crack (his drug of choice). Kyle knew this story very well, because it was Kyle’s story. So he shared his story with Caleb. It didn’t seem to work. Caleb kept wood working and didn’t really engage in the program. Caleb was antagonistic, he would challenge the tenets of the program, ask questions about will power, saying recovery was a choice, and that he was “not an addict forever.” He didn’t think that any program would help him, but he knew that if he went out into the real world, he would use again.

    Many offenders self-sabotage their release process by getting into fights and end up staying in prison a few months longer. This happened to Caleb. He remained at the Johnston Unit a few months longer, which was just enough time to let Kyle’s work with him penetrate. Upon his release, Kyle gave Caleb the information on 12-step meetings in Beaumont and he agreed to attend the meetings. Kyle continues to communicate to Caleb, who is sober and has not re-offended.

    At this point, Kyle Gage has been out of the Johnston Unit for about a year. He is wrapping up his Drug Court commitment. He is enrolled in a community college to get his Associates Degree and also works as a new car salesman. Kyle will continue recovery coaching to help himself and others maintain the recovery that he loves.

  • Recovery Coaches to the Rescue

    Recovery Coaches to the Rescue

    FBI PhotoIt is 5:30 am and a band of FBI and local sheriff authorities pull up to a New Jersey suburban house in a development not far from Philadelphia. Adorning Kevlar vests, and windbreakers with the yellow letters FBI on their backs, they storm past a toy doll stroller in the sidewalk. They bang on the door with their fist, demanding “Open up this is the FBI”. After a few more wraps, a bleary eyed woman about 40 years old opens the door a crack and peers out. With a burst of energy, five FBI agents and two local police enter her foyer, issue her a search warrant and spew out demands, only one she actually hears, “Your husband is under arrest for child pornography, where are the computers?”

    Emily, (all real names in this story will be withheld for privacy purposes) is dazed. She is in her bathrobe, and slippers, her hair is mussed, her eyeglasses crooked. She is barely awake. She glances at the stairs. She sees her two children at the top of the stairs, as a troop of agents make their way up to them. The agents ascend, as her girls descend squeezing towards the wall making way for the army of six foot, 250 pound men barreling past them. They are asking “Mommy, what is happening?” A sheriff from the local police department asks where her husband is. She says he is at work; he works the midnight shift at a local hospital. The Sheriff gets on his walkie-talkie and bursts out some demands, heralding a similar event at her husband’s workplace.

    It is 6:00 am, and Tom is just wrapping up from his shift as a nurse. His supervisor walks up to him and a force of blue windbreakers flank him on either side. “Tom,” his supervisor says, “these gentlemen want to see you in my office”. As they turn to go to the office to FBI agents take Tom at the elbows and nearly lift him off his feet. He arrives in the supervisor’s office, is placed in an arm chair and the door slams. Tom hears the words he has feared for the past two decades. “You are under arrest for the possession of, and the suspected distribution, copying, or advertising of images containing sexual depictions of minors.” For some strange reason, Tom is relieved. He thinks “It’s over, it is finally over.”

    It is Monday night, a steady stream of middle aged men drift into a hospital conference room, and take a seat. One of them opens a gym bag and starts to place books, pamphlets and tri-fold fliers on the table. A clear plastic envelope stuffed with one dollar bills is placed next to a thin loose-leaf binder. He sits down, opens the binder, checks the time on his cell phone and says, “Welcome to the Monday night meeting of Sex and Love Addicts Anonymous, my name is Ken, and I am a sex and love addict.” The seemingly normal cohort of men reply, “Hi Ken”.

    The Monday night meeting of Sex and Love Addicts Anonymous begins. The reading is on Step Three; made a decision to turn our will and our lives over to the care of God, as we understood God. During the share a newcomer tells his story about what brought him into the rooms tonight. He is not sure he can be helped. He knows he has been a porn addict for all of his adult life. He says he has just been found out and he has no idea what will happen next, to his life, to his marriage, to his kids. He was advised to go to a 12 step meeting, and luckily he saw this meeting listed.

    The members of this unlikely band of brothers looks at Tom. His head is down. His focus is on the ravaged cuticles of his right thumb. As he raises his thumb to his mouth, a tear rolls down his cheek. They know how he feels. Each one of them have felt this same despair. Joe raises his hand to share. Joe is almost 45, yet one would think he is no older than 35. His Goorin Brothers Slayer cap is on backwards, his flannel plaid shirt is unbuttoned revealing an LA Dodgers vintage t-shirt. Appropriately ripped skinny jeans end in Vans pull ons. He gets current, talking about his therapist, his groups and what the third step means to him. Then he looks directly at Tom. “I know there is no cross talk in this meeting, so let me just say this, Tom, can we talk after the meeting?”

    Joe knows what has happened to Tom. Tom need not even say the word ‘legal’ for the subliminal message to be delivered. Joe knows because it happened to him, less than two years ago. The Cop Knock. The end of life as he knew it. The opening up of a new world. A new life without any more hiding.

    Relief.

    Joe and Tom walk to the café and Joe buys Tom a coke and a sandwich. It is the first thing Tom has eaten in two days. The café is empty, so they find a corner table and sit down. After just a few minutes, Tom’s experience from the last week is told. Joe’s head was nodding the whole time, but he lets Tom talk.

    Before an hour was up, Joe had given Tom the name of three men, Michael, Steve and Mike. Also, the number of an attorney and of a therapist that specialized in treating offenders. As they walked out of the hospital, Joe said the first call should be to Michael. Michael will coordinate everything. And Joe was right, Michael coordinated everything.

    Michael answers the phone at 9:15, and Tom was on the line. Michael was already prepared by Joe’s call, just minutes before. By 10:00, Michael assembled the team and briefed us all. The attorney appointment will be made by Tom. The therapist introduction will be on the phone, and the first group therapy meeting is tomorrow and Joe will bring Tom. Mike and Steve will call Tom daily for support. I am assigned to work with the wife.

    Every one of us responds to this call. It initiates a recruitment effort that rivals the Avenger’s response to Ultron’s threat to eradicate humanity. This team is committed to  respond to any sexual addiction crisis- the family affected by a patriarch’s incest, the individual devastated by sexual abuse, or the man that has heard the “Cop Knock”. We know they feel alone, whether they have been abandoned by their family, abused by loved ones or in this case, arrested for an illegal act. Tom needs his Avengers team to help him, because this is territory he is not familiar with. But this team is very familiar with it; the family dynamics, the law, the courtroom, treatment and therapy, prison and re-entry. We have walked this path, and emerged on the other side, as healthier and better people for the experience. So we are there, in order to keep our sobriety, we are doing service to give back what we have freely received.

  • K9-Free and Effective Porn Blocker for MacBook and iPhones

    block porn


    As a recovery coach, I have been asked by many a porn addict, “what is an effective block to use on their digital equipment?” I say K9. The added bonus – K9  is free. But it is difficult to install. Fortunately, Dr Todd Love, PsyD, JD, MBA, LPC, CSAT, S-PSB, DCC has perfected downloading and installing the highly recommended K9 Web Protection app on Apple products, including MAC computers, MacBooks, iPads and iPhones. Dr Love wants to share this with you.

    Dr. Love is a former IT professional (nearly 15 years as a corporate techie before becoming a psychologist). He specializes in treating cybersex addicts in his practice. Dr. Love has spent years and years (and years and years), setting-up blocks on clients’ systems and then had these clients find ways around the block. The result, in his expert opinion, is a HIGHLY robust and effective, porn-blocking tool.

    For myriad valid reasons, we all spend a large proportion of our time online. So the concept of not having Internet access is antediluvian. Further, using an archaic flip phone is not an option for a career professional in today’s world. Dr Love’s clients require “fully secured, yet fully functional” technology device(s). This is why Dr. Love developed these install instructions for K9.

    Dr. Love is very tech savvy and has documented the K9 configuration for your digital equipment in a 3-part blog series that walks through the details of how to set it up. Below is his personal porn-blocking solution. He has specifically developed a MacBook + iPhone combination that is, in my opinion, really good. It’s somewhat complex, so be prepared. Perhaps invite a geek in a “S” recovery program to assist in the install. The 3-part blog series is on Dr. Love’s website, and the links are below. Feel free to share this information.

    IT is a work in motion, as technology is ever-changing…. Feel free to ask Dr. Love questions, send comments, etc.

    Todd L. Love, PsyD, JD, MBA, LPC, CSAT, S-PSB,

    http://www.doctoddlove.com/about-todd-love/

    todd@doctoddlove.com

    www.doctoddlove.com

    Athens, Georgia

    706-383-7401

  • The Dance of the Love Addict and the Love Avoidant

    A love addict knows they do not want an emotionally unavailable partner, and the love avoidant knows they want an emotionally distant mate. Yet, the love addict and love avoidant still end up being attracted to each other.

    The love addict, having experienced childhood emotional and/or physical abandonment, will look for someone who can dance of a love avoidant love addict“rescue” them. The love avoidant, having experienced childhood enmeshment, will look for a person to “rescue.”

    Love avoidants recognize and are attracted to the love addict’s strong need to be rescued, or their fear of being abandoned. Avoidants know that they have control with a love addict. All they have to do to trigger their partner’s abandonment fear by being distant or threatening to leave. Love avoidants, whenever they pull that ‘I am leaving’ trigger, use it so they are in control. This allows them to be distant, to escape and avoid intimacy whenever they want. The avoidant’s behavior makes the love addict do anything to keep the avoidant, anything at any cost in order not to be abandoned. This interplay is what we refer to as “the dance.”

    What does the love addict/love avoidant dance look like?

    The love addict enters any relationship in a haze of fantasy, whereas the love avoidant feels compelled to take care of a person who presents as “needy,” even though the avoidant is unsure of their long-term staying potential in the relationship. The dance of the love addict and love avoidant goes something like this:

    Love Addict: “I am SOOOOO happy…I met this man and he’s everything I’ve always wanted…he has a fantastic job, loves travelling and loves children. We’re trying to see each other every day and I text him every morning, we talk at least 20 times a day… ”

    Avoidant: “I met this girl, I’m not too sure about her, but she’s nice, I mean…I may as well give it a try…”

    The love addict uses denial to protect their addictive rituals and fantasies, not wanting to look at the avoidant building up walls and starting to back away. The love avoidant, in order not to be controlled and to fulfil his or her duty, appears to be two things: being available to help, maybe even being sexually available, but hiding behind a wall that protects the avoidant from any emotional connection.

    Love Addict: “It’s great, I mean, he works a lot – weekends included – and with his volunteer commitments, we don’t spend a lot of time together but that’s okay….Guess what? He’s invited me for a get-away weekend at the beach!

    Avoidant: “OK…I’d better give her something or she’s really going to get mad….I’m going to send her flowers and maybe book a hotel room at the beach….”

    Something happens and reality comes crashing in on the love addict, the fantasy of a relationship with the perfect person is destroyed. The love addict enters  emotional withdrawal from the fantasy and in this withdrawal phase they experience an overwhelming sense of pain, shame, rage or panic. At the same time, the love avoidant starts to feel controlled or smothered. An entitlement characteristic comes forth and the avoidant says they deserve their independence, their life, they have work or family responsibilities, etc. The avoidant turns from the white knight into a wall of brick.

    Love Addict: “You’ll never believe it…first he said he’d phone me and then he didn’t. At the last minute, he cancelled the weekend at the beach because he needed to work… I don’t know how I can get through this: I feel rejected, abandoned, alone.

    Avoidant: “I can’t believe she’s so angry about me cancelling the trip… I have to work. Where does she think the money comes from for the gifts, the dinners, the flowers? I’m through with her, I am done, this relationship is too much work….”

    To return to the fantasy, and avoid feeling this sense of helplessness and hopelessness, the love addict either medicates, obsesses about the person or starts getting even. The love avoidant begins to feel hurt, and remembers that this is why he choose not to get close in a relationship, they create distance, and wants to numb out. The avoidant will numb out by creating an intensity outside of the relationship, often with substances, risk taking, or by sexually acting out.

    Love Addict: “I’m useless and I will die alone as a bag lady, and homeless. No one wants me. How am I going to live on my own? Maybe if I change, if I go on a diet, say I am sorry…”

    Avoidant: “I can’t breathe anymore… She is always telling me what she needs, wants… Gee, I need some space…I need to relax… I’ll just have this one drink (or joint, affair, etc.).”

    The final part of the dance is for the love addict to return to the fantasy with the same love avoidant partner or find a new love interest…and for the love avoidant they will either return to the relationship with the love addict because they subconsciously fear being alone, and return out of guilt, or they will move on to a new partner.

    Love Addict: “He called me, it’s fantastic! I think he is going to ask me to marry him!” or “You won’t believe it, I met a new guy, he just split up with someone…”

    Avoidant: “If I ask her to marry me, she’ll forgive me for my affair…” or “I can’t handle her anymore…so I met this girl last night…”

    What if you identify with the love addict or the love avoidant ?

    The love addict has a conscious fear of being abandoned and a subconscious fear of being controlled. In contrast, the love avoidant has a conscious fear of being controlled and a subconscious fear of being abandoned. They are two sides of the same coin. Both have experienced childhood trauma, both need to learn about how to face their fears, and their abandonment traumas. Both need to embrace a desire to achieve healthy intimacy with their partner.

    If you find yourself enmeshed in this ‘Dance”, consider speaking to a professional. The Society for the Advancement of Sexual Health has certified therapists in your area that may be able to help.

     

  • 7 questions wives of porn addicts ask

    manhattan_bridge_post_versionPornography addiction is a form of sex addiction. Wives of porn addicts are baffled by this addiction and feel like they are partially responsible for her husband’s behavior. The reasons for this are numerous and include the shame associated with this addiction for both the addict and the spouse, the sense of betrayal, and stereotypes linked to the addiction. Ella Hutchinson, a counselor from Katy, Texas who specializes in counseling wives of sex addicts. She sees women who haven’t told anyone about their husband’s addiction, sometimes for months, years and often they never disclose. The lack of support available to spouses, and often inaccurate information being put out about partners of sexual addicts, can cause a wife to suffer additional trauma. Ella has formulated 7 questions wives of porn addicts ask.

    #1: How can my husband love me and look at porn when he knows it hurts me?

     It is possible for your husband to love you, even though he is looking at pornography. In fact, the two are completely unrelated. Men are better than women at compartmentalization. A man’s brain can be compared to a waffle. There are many different compartments so that he can divide his life up into separate components that don’t touch each other. His marriage and family can be in one compartment, his job in another…you get the point. This is a benefit when a man is fighting in a war and able to focus on the task at hand without worrying about his family back home. But it also makes a man able to look at pornography without thinking about how it may hurt you or his marriage. Women’s brains are more like spaghetti where everything is connected. Women are more likely to be worrying about our kids when we are at work and thinking about work when we are at home.

    When a man becomes addicted to pornography, it can become a perceived need rather than a choice for him until he becomes willing to reach out for help. His use of porn causes a release of the same chemicals involved when a drug is ingested. At the height of his addiction, nothing, not even the risk of losing his job or his marriage, is enough to stop him. This explains how a politician or celebrity can make such risky, career-destroying moves without stopping to consider the consequences.

    Later Ella will discuss the kinds of consequences that can catapult an addict into reality.

    #2: Why does my husband prefer porn and masturbation to sex with me?

     Norman Doidge, psychiatrist and author of the acclaimed book, The Brain That Changes Itself, studied porn addicts. He stated,

    They reported increasing difficulty in being turned on by their actual sexual partners, spouses, or girlfriends, though they still considered them objectively attractive. When I asked if this phenomenon had any relationship to viewing pornography, they answered that it initially helped them get more excited during sex but over time had the opposite effect.

    Your husband had this addiction, or the proclivity toward it, before he ever met you, regardless of what he says. In spite of what you think or even what he might have said, nothing you could do could be enough to sexually satisfy your porn addicted spouse. Pornography presents an unrealistic reality that damages a person’s brain. They become engrossed in this fantasy world where they don’t have to worry about pleasing anyone but themselves and no emotional connection is required.

    While a porn addict desperately craves love and intimacy (something he is probably unaware of), he seeks it out in the exact place that will cause him to become less and less able to experience it. As a counselor, Ella hears sexual addicts talk about their past, it becomes apparent why they are so uncomfortable with the idea of intimacy. This topic is beyond our scope here, but it is important for a wife to be aware that there is a reason her husband became addicted to porn, and that reason is not her.

    #3: Why am I not enough if I am sexually available to him?

    Beyond the intimacy issue, pornography offers the thrill of what is forbidden. The more taboo, the more exciting. This is why a porn addict may progress to looking at more hardcore porn and even pornography involving aspects that a healthy person would consider offensive and grotesque.

    Gary Wilson, human sciences instructor, and Marnia Robinson, author of Cupid’s Poisoned Arrow: From Habit to Harmony in Sexual Relationships, state:

     The uniqueness of Internet porn can goad a user relentlessly, as it possesses all the elements that keep dopamine surging. The excitement of the hunt for the perfect image releases dopamine. Moreover, there’s always something new, always something kinkier. Dopamine is released when something is more arousing than anticipated, causing nerve cells to fire like crazy. In contrast, sex with your spouse is not always better than expected. Nor does it offer endless variety. This can cause problems because a primitive part of your brain assumes quantity of dopamine equals value of activity, even when it doesn’t. Indeed, porn’s dopamine fireworks can produce a drug-like high that is more compelling than sex with a familiar mate.

    #4: He says he looks at porn because I don’t have sex with him enough, am I not pretty enough, am I  too fat, etc. What can I do?

    Ella hears this a lot and it is called justification. Your husband doesn’t want to believe he is sick. If he is not ready to admit he is an addict and take responsibility for his own behavior, he will say anything to convince you, and even himself, that he does not have a problem. Blaming you is an easy way to save face.

    There is nothing you could do to be appealing enough to make your husband stop looking at porn. We see very beautiful women whose husbands no longer desire them, couples where the wife looks like she belongs on the cover of Cosmopolitan magazine or on a model runway, and the husband has admitted to her that he is physically repulsed by her. Ella speaks of another couple who has sex every day, yet she still catches him looking at porn and frequenting adult bookstores. There is simply no credibility to the argument that a wife causes or contributes to her husband’s use of pornography.

    #5: My husband says all men do it. Am I making too big a deal out of this?

    It is unfortunate, but true, that pornography use is overwhelmingly common. This does not make it okay or mean you should turn a blind eye. Ella often hears women say that their husband’s porn use makes them feel cheated on. This makes sense. When a man uses porn he is finding sexual satisfaction from someone other than his wife. So the betrayal a woman feels is natural. God created sex to be between a man and his wife. The Ten Commandments interpret looking at a woman with lust is the same as committing adultery with her in his heart. Looking at porn is purposely choosing to lust.

    #6: My husband refuses to get help or admit this is a problem. How can I make him stop? What are the risks if he doesn’t stop?

    In short, you cannot make him stop. It usually takes something significant to get a man to the point where he is ready to admit his porn addiction. This is what they call “hitting rock bottom”. Sometimes, for a man who has hidden his porn use for years, just getting caught is enough. But more often, it takes losing his job, his wife leaving him, or another monumental event to shake him to the core and wake him up to reality. It may be his porn use progressing to acting out with another person or other people and facing the multiple possible consequences of this, to cause him to recognize his need for help.

    You can insist your husband stop his porn use and you have every right to do so. The compulsive use of porn will, without exception, do damage to your marriage and your family. It affects a person’s sense of right and wrong. It can cause your husband to lose respect for you. You will likely feel him pulling further away from you and your family as he gets more entrenched in this sinful lifestyle. If he refuses help, it will only get worse. Your pleading that he stop will fall on deaf ears if he isn’t ready to hear it. This is a harsh reality, but one too many women just do not get. Some women beg and plead for decades until they grow cold and bitter. Then they tell me that they wish they had left years ago and feel they have wasted most of their life.

    When porn is an issue, it is likely that extramarital affairs are or will become an issue. This means you are at risk of more than the heartache of discovering your husband has been sexual with another person. You are also at risk of STDs or your husband fathering another woman’s child. Additionally, your children are almost guaranteed early exposure to porn, something that was likely a contributing factor in your husband’s addiction.

    #7: Is there hope? Can a man like this change?

    Recovery from sexual addiction is very much possible. Men who get out feel a sense of freedom, as if a huge boulder has been lifted off their chest. It is such a liberating feeling that many men forget that their wives are still grieving from his actions and likely will be for some time.

    For some men, simply the threat of their wife leaving is enough to cause them to get help. But for many others, they need something more. This can cause you, as the wife, to feel helpless. You are not helpless. You can’t control your husband’s recovery, but as the injured spouse, you can control your own. The fact that you need recovery does not mean you are sick or that something is wrong with you, but that you have likely been traumatized by your husband’s behavior. Your recovery includes building up a support system for yourself. Don’t keep silent. Reach out to a trusted friend, your pastor, or a therapist. Keeping this secret will cause feelings of shame, loneliness and isolation. Finding a support group for wives of sex/porn addicts can be very helpful. If there is not one in your area, there are phone support groups available, led by trained life coaches and therapists who have been in your shoes. Finally, learn to recognize your unmet needs and what it will take to meet them. A skilled therapist can help you with this. The absolute best book written for wives is Your Sexually Addicted Spouse by Barbara Steffens and Marsha Means. Ella strongly encourages you to find a therapist (individual and marriage) who is familiar with this book and subscribes to the treatment model described in it. If your therapist isn’t familiar, ask if they’d be willing to read it.

    Beyond self-care, Ella recommends that you take some time to come up with some clear, firm boundaries for your marriage. While this may not result in the desired outcome, it is worth it to put in the effort. At the very least, this is a first step toward helping you get to a place where you can make an informed decision about the direction for your relationship. This means bottom line behaviors that you will not tolerate and actions you need to see happening in order for you to feel safe in your marriage. Your list of unacceptable behaviors may include viewing pornography in the home, inappropriate conversations or relationships with other people, and other possible abusive behaviors toward you that are often present in a sexual addict. The actions you need to see your husband take might be installing a filter on computers and phones, open discussions about where all the money is going with you having access to all accounts, attending sexual purity or sexual addiction support groups, counseling, and talking to a pastor.

    Before you present this to your husband, make sure you are prepared to follow through with consequences if he refuses or does not stick to what he agreed to do. Consequences can be anything from insisting one of you move to a separate bedroom (an in-house separation) to one of you moving out of the home. Your husband will likely be resistant to you setting these boundaries and may accuse you of being demanding and giving him an ultimatum. Do not engage in any kind of manipulative or accusatory conversations with your husband. Learn to recognize this behavior and refuse to participate. It is important that you wait to address your new boundaries until you are able to do so in a calm manner. A therapist’s presence (and guidance beforehand) is a good idea. A good book on this topic is The Gaslight Effect by Dr. Robin Stern.

    If your husband does not follow the boundaries you set, you now have a choice to make. You can choose to accept that your husband is simply not ready to stop his porn use. This means letting go of the nagging, criticism, and efforts to control (which should have stopped already by this point since you have learned they don’t work). If you choose to to not follow through with the consequences, even though he has made it clear through his words or actions that he is not willing to stop, you are choosing to accept his behavior. This will probably require a good deal of emotional detachment on your part. It may be a marriage that looks more like you are roommates. Ella says she has not yet met a woman who has chosen this arrangement and found any kind of long-term life satisfaction in it, but it is an option.

    Your choices may need to include making the necessary preparations in case you need to leave. This may mean getting a job if you don’t work and starting to put money aside. Separation does not mean divorce, but it can be a prelude to it. Ideally, that should not be the goal for separation. The purpose is to show your husband that you are unwilling to share him with pornography. Once he sees you are serious and can no longer be placated with words and half-hearted attempts that don’t last, he is also more likely to take his addiction seriously. Also, getting physical space between you and him can make it easier for you to clear your mind, spend more time in prayer and God’s Word, and make objective decisions about your future. A good Christian counselor can guide you through a therapeutic separation where rules are put in place for you both to follow during this time.

    Many men have escaped the chains of sexual addiction. Here is an important truth to be aware of. Your husband has probably tried to stop more times than he can count. He is not deriving pleasure from his lifestyle. He keeps going back, trying to fill a void that porn will never fill. Willpower is not enough. Recovery from sexual addiction is multifaceted, but includes reaching out to other men who have been there, and often requires professional help as well.

    God must be the central focus in recovery. However, many men have learned the hard way, in the words of author, speaker, therapist and recovering addict, Dr. Mark Laaser, “You can’t pray it away.” If prayer was all we needed then we wouldn’t have to have jobs or pay bills. We could just pray about it and our bank account would never run out and the bills would get paid. If prayer was enough we could eat and drink whatever we want and every check-up would reveal a clean bill of health. But God wants us to do the work, and keep doing it.

    Once a man has decided to become serious about recovery from sexual addiction, there are more steps to take to help the marriage heal. After all, just because the behavior has stopped, it doesn’t mean the damage that has been done will go away. Marriage counseling with a skilled sex addiction therapist is important. Couple’s Intensives are a great way to get a jump start on recovery for the couple. Ella recommends the book Hope and Freedom by Milton Magness to learn more about recovery for you, your husband, and your marriage. You can also read more of Ella’s blogs, learn about her weekend retreats and other issues surrounding marriage and sexual addiction on Ella’s website, Comfort Christian Counseling.

    . . . .

    ella hutchinson photoElla Hutchinson, is a Licensed Professional Counselor with a Bachelor of Science degree in Psychology and a Master’s degree in Counseling from St. Edward’s University in Austin, TX. She is also a member of the American Association of Christian Counselors. In addition, Ella is certified in treating sex addiction and specializes in counseling partners of sexual addicts. She practices at

           Comfort Christian Counseling

    2900 Commercial Center Blvd #101, Katy, TX 77494

    You can contact Ella at:

    http://comfortchristiancounseling.com/

     

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  • 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!