Category: Uncategorized

  • Child Pornography — Part Two

    The Child Pornography Industry

    manhattan_bridgeThe pornography industry nets approximately $13 billion dollars of revenue in the United States, alone. Illegal child pornography revenue is around $3 billion annually and is one of the fastest growing businesses online (Top Ten Reviews, 2005)[1]. In 2014, the Internet Watch Foundation found 31,266 individual child abuse domains or URLs, a 137% increase from 2013. Today, there are estimated to be more than one million pornographic images of children on the Internet, with 200 new images posted daily. The U.S. Customs Service estimates that there are more than 100,000 websites offering child pornography — which is illegal worldwide. The fastest growing demand is for images depicting the worst imaginable type of abuse and images of the youngest children. Of P2P users arrested in 2009, 33 percent had photos of children age three or younger and 42 percent had images of children that showed sexual violence. More than half of all illegal sites reported by the Internet Watch Foundation are hosted in the United States. Illegal sites in Russia have more than doubled from 286 to 706 in 2002 (National Criminal Intelligence Service, 8/21/03). One can only imagine how much free child pornography transfers hands on an annual basis. Who is possessing all of this child pornography?

    What does an Internet viewer of underage pornography look like?

    Federal child pornography charges are leveled against judges, politicians, doctors, teachers and other well-regarded members of society more frequently than you would ever imagine. If you remember in 2015 alone, Glee co-star Mark Salling, TV producer on Law and Order Jace Alexander, and the Subway spokesman, Jared Fogle were all arrested for possession of child pornography. National Juvenile Online Victimization Study found that men who view child pornography include those who are:

    • Sexually interested in prepubescent children (pedophiles) or young adolescents (hebephiles), who use child pornography images for sexual fantasy and gratification
    • Sexually compulsive, meaning they are constantly searching for new and different sexual stimuli
    • Sexually curious, downloading a few images to satisfy that curiosity
    • Interested in profiting financially by selling images or setting up websites requiring payment for access

    These offenders weren’t concentrated in any specific geographic location, and their levels of income and education varied widely. Two-thirds were single, about one-quarter lived with children under the age of 18 and about one-quarter had problems with drugs and alcohol. In 2009, similar to 2006, about 20 percent of the offenders were between the ages of 18 to 25; while the majority of men who viewed child pornography were 26 or older. The National Crimes against Children Research Center reported the great majority of those arrested were non-Hispanic white men and less than 1 percent were women.

    Possession of child pornography is a felony under federal law and in every state. If you know of anyone producing or promoting child pornography, please report them through the National Center for Missing & Exploited Children’s CyberTipline: 1 (800) 843-5678. If you are concerned about what you or a loved one has been looking at while online, seek the help of a professional who specializes in this area.

    References used in this blog:


    [1] Ropelato, Jerry. Top Ten Reviews. Top Ten Reviews, Inc. 5 December, 2005. http://internet-filter-review….pornography-statistics.html

    My Kid’s Browser: http://www.mykidsbrowser.com/internet-pornography-statistics.php

    International Watch Foundation 2014 Annual Report: https://www.iwf.org.uk/accountability/annual-reports/2014-annual-report

     Center for Problem-Oriented Policing, POP Center, The Problem with Child Pornography on the Internet, Guide No.41 (2006), by Richard Wortley and Stephen Smallbone

    Enough is Enough web site: http://www.enough.org/inside.php?tag=stat archives#3

    National Juvenile Online Victimization Study

    J Clark Baird, web site of a Kentucky criminal defense attorney, http://kyfederalcriminallawyer.com/practice-areas/federal-child-pornography-charges/

    SASH- Society for the Advancement of Sexual Health- http://sash.net/

  • Child Pornography – Part One

    Child Pornography – Part One

    manhattan_bridgePossession of child pornography is a felony under federal law, as well as every state. Because I am a recovery coach, I know some offenders, and I had some questions. I wanted to know more about these viewers of child pornography. Are they all potential hands-on offenders? Is this a victimless crime? What is the demographic of the users of underage pornography? I found there were some staggering statistics about child pornography. That billions of dollars are generated annually by child porn. The volume of pornography shared for free is incredible. That one image is all that is required to be convicted and eventually spending 15 years on probation under Megan’s Law. I wondered what were the costs to maintain the non-violent offenders of Megan’s Law, for life? This blog post, as well as others that follow, will explore the issues.

    How is child pornography viewed?

    Peer-to-peer (P2P) computer platforms are the most likely portal to view underage or child pornography. These are sites that share files for free. There are also for-profit pornography sites, which charge viewers a monthly membership fee. The for-profit pornography sites do list child porn sites, but are well hidden, because to do so is illegal. A person really has to dig and search diligently to find these child porn sites. Then there is the Dark Web.

    How does a P2P Network work?

    Peer-to-peer Networks or file sharing networks are vast global systems that can be located anywhere in the world. P2P networks are used by millions of people in order to acquire, for free, popular music, current television shows, movies, electronic books, and other digital material. The software allows users to log onto any P2P network and download files from other P2P network users.

    Limewire, Gnutella, or other file sharing programs are downloaded to your computer in order for you to view files. Users create copies of movies, book or photographs, and place them into folders that are accessible to other peers. Users search by using keywords, just like you search on Google, to find these folders. Type in what you are looking for, and these keywords are broadcast to the network of participating peers and again, just like Google, files appear below the search box.

    There are several reasons P2P networks are particularly attractive to child-pornography traffickers. First, child pornography on P2P networks is free. Any person with access to the Internet can connect to a P2P network. Secondly, P2P networks do not make use of servers, which means users can transmit illegal material without oversight from an online service provider like Google, EBay or NetFlicks. P2P networks are an anonymous way used to view, buy or sell anything online. The Dark Web, however, is more anonymous.

    What is the Dark Web?

    The “Dark Web” is an encrypted network that exists between Tor servers and their clients. These Tor servers are set up to be anonymous. After downloading a Tor browser bundle, clients can search the Dark Web, a supermarket of illegal activity, for drugs, weapons, murder for hire or pornography. For a porn addict, the Dark Web has anything that addict could want. Porn mixed with anonymous high-speed Internet is a lethal mix.

    Next week, I will discuss more detail the demographic of the average child-pornography viewer and the legal consequences.

    If you know of anyone producing, promoting or possessing child pornography, please report them through the National Center for Missing & Exploited Children’s CyberTipline: 1 (800) 843-5678

     

  • 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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  • Believe Change is Possible

    manhattan_bridge_post_versionAs a recovery coach, I work with people trying to change a habit. We work on finding different ways of responding to a trigger. For some seeking recovery, they want to find an easier, softer way. Others think willpower is all they need to get sober. But that doesn’t always work. As Charles Duhigg describes in his book, the Power of Habit, for a habit to be changed, people must believe change is possible..

    Where does this belief come from? Habit change can emerge from a tragedy or from some kind of adversity. Many addictions have been successfully abandoned when an individual hits bottom and finally seeks treatment. Many people give up smoking after a diagnosis of heart disease or when a family member is being treated for lung cancer.

    A Harvard study in 1994 examined people that had radically changed their lives. Some had experienced the death of a loved one, divorce or life-threatening illness. Others radically changed their life from observing a friend experience a disaster. Tragedy plays an important part of having an impact on one’s life. But equal to tragedy facilitating change, the same amount of people made change happen in their life because they were surrounded by supportive friends that encouraged change. The Harvard study sites a woman that changed the direction her life when she took one psychology course at a local college and found a group of like-minded individuals. Another man came out of his introverted shell when he joined an acting group. So for change to happen for many, it didn’t take a life shattering event, it simply took a community of believers.

    “Change occurs among people”

    Todd Heatherton, Dartmouth College Lincoln Filene Professor

    A community of non-smokers talk about how great it feels like to be a non-smoker. How nice it is not to have your hair smell like an ashtray. Your spouse commented on how fresh his clothes smell, now that you have stopped smoking. And co-workers admire you for having the strength to stop smoking. These like-minded people can also resolve some negative feelings, as well. Such as what to do after a meal, when the habit of lighting up a Marlboro is the most strong. Or how to refrain from smoking in your car. These friends are there for you to call, text or email whenever the urge to smoke becomes unbearable. Support from a community and their confidence in you, bolsters the strength you need to believe you will not pick up a cigarette.

    For habits to change permanently, people must believe change is possible. This same process makes any mutual support group very effective – the power of a group to teach individuals that they can believe it is possible to change. This belief happens when people come together to help one another to change. Whether the group is Nicotine Anonymous, a grief support group or massive amounts of volunteers descending on New Orleans, post Katrina, to re-build the city to it’s former glory.

    Change is easier when it occurs within a community.

     

     

  • Service keeps you sober — Research is proving this age-old slogan

    manhattan_bridgeEver since I walked into the rooms, I heard the phrase “Service keeps you sober.” I already knew I was a helping type of person, in fact in my addiction it was called being a rescuer. So I stayed away from service for the first few years. When I was ready to do service, I remember desperately waiting the required three months of sobriety to chair my first meeting. Then praying to receive special dispensation to be a meeting list coordinator at the Intergroup/Regional level, because I only had six months, not the required one year of sobriety. I learned why service kept me sober. It occupies the time I would be spending acting out with doing good things. Well, that’s what I thought.

    Service might be the key to staying sober

    Maria Pagano, an addiction researcher at Case Western University, thinks service to others might be the key to staying sober. In recent years, a growing body of research has found that helping others brings measurable physical and psychological benefits to the helper. Building on this work, Pagano is exploring the surprising benefits of altruism for people battling addiction. Her studies have shown that addicts who help others, even in small ways—such as calling other AA members to remind them about meetings or setting up chairs before a meeting—can significantly improve their chances of staying sober and avoiding relapse.

    Surveys and studies say that abuse of alcohol and narcotics is rising among young people  and drug-related deaths have doubled among middle-class whites. Many addicts who exit treatment programs relapse within the first 90 days of being discharged, leaving treatment professionals yearning for more effective treatment strategies. If getting addicts to do service is key to their recovery, as Pagano believes, it could revolutionize the addictions treatment field.

    Pagano was familiar with the research on helping when she joined Brown University’s Center for Alcohol and Addiction Studies Center in 2002. As she learned more about the different treatments for addiction, she was surprised that there seemed to be no one looking at the role of doing service.

    “It was all about what services to give these suffering patients,” she says, “and nothing about getting them active or about how their own experiences about getting sober and being sober can be useful to others.”

    Addicts help their recovery by helping other people

    She decided to explore the impact that helping others could have on people in recovery. Looking at data from one of the largest studies of addiction to date, with 1,726 participants, conducted by the University of Connecticut, Pagano was able to measure it by looking at how many study participants became AA sponsors or completed the 12th step of AA, which involves helping others in recovery.

    When she compared helpers to non-helpers in AA, she found that 40 percent of the addicts that did service or the “helpers” avoided taking a drink in the 12 months following their stay at treatment facility, while only 22 percent of “non-helpers” stayed sober. These results have rarely been seen in addiction treatment studies before.

    In fact, age, gender, income, work status, addiction severity level, or level of antisocial personality disorder of the participants in the study didn’t matter. None of these characteristics predicted helping behavior. “Someone from Yale to jail had an equal chance of being a helper,” Pagano says.

    Only one factor seemed related to helping; those who were more depressed starting out in their recovery were more likely to help. This seemed counter-intuitive, given that depressed people often suffer from lethargy and a sense of helplessness. But according to Pagano, this is exactly the kind of thinking about depression that gets recovery therapists in trouble.

    “In the treatment field, we have this notion that says, ‘Oh, don’t ask too much of the client, especially if they’re depressed. They just need to rest,’” she says. But when she studied the effect of helping on clinical depression, she found that, after six months of doing service, people who had been depressed had their depression levels drop significantly—below the level of what’s clinically considered “depressed.”

    Pagano and her colleagues devised a more precise measure of helping behavior called the SOS (Service to Others in Sobriety) scale for use in future studies. This scale lists 12 helping behaviors that are built into AA and Narcotics Anonymous (NA) meetings—like picking up the phone and calling a fellow AA or NA member, contacting someone to encourage meeting attendance, setting up chairs before the meetings, or becoming a sponsor.

    Maria Pagano’s research suggests addicts help their recovery by helping other people. “This is a no-brainer,” she says. “It’s as essential as medication-assisted therapy.”

    You can’t be ruminating or feeling bitter if you’re feeling moved by helping someone else.

    With a grant from the John Templeton Foundation and funding from the National Institute on Alcohol Abuse and Alcoholism, Pagano used the SOS scale to look at 200 adolescents undergoing treatment for alcoholism or drug addiction in Northern Ohio. Her results showed that kids with higher helping scores on the SOS had significantly lower cravings for alcohol and narcotics, reduced feelings of entitlement, and higher “global functioning”—a measure used by clinicians to reflect participation in groups, getting along with others, and academic performance, among other behaviors.

    In fact, Pagano found that even risk factors like having alcoholic or drug-addicted parents, learning problems, physical disabilities, or additional psychiatric diagnoses didn’t change the effect of helping others; helping still had a positive impact.

    Pagano’s analysis makes a significant contribution to the research that shows adolescents benefit from helping others. Pagano’s research is unique and cutting edge, because no one has really studied helping in the context of recovering from addictions.

    AA folks recognized the benefits of service in AA, but there was no research to back it up. Maria Pagano is bringing good science to this age old-slogan “Service keeps you sober”.


    Resources used in this blog

    Learn more about Maria Pagano’s work on her website, Helping Others Live Sober.

    Pagano, M. E., Kelly, J. F., Scur, M. D., Ionescu, R. A., Stout, R. L., Post, S. G. (2013). Assessing Youth Participation in AA-Related Helping: Validity of the Service to Others in Sobriety (SOS) Questionnaire in an Adolescent Sample. American Journal on Addictions 22(1), 60-66.

    Pagano, M.E., Post, S.G., & Johnson, S.M. (2011). Alcoholics Anonymous-Related Helping and the Helper Therapy Principle. Alcoholism Treatment Quarterly 29(1), 23-34.

    Pagano, M.E., Krentzman, A.R., Onder, C.C., Baryak, J.L., Murphy, J.L., Zywiak, W.H., & Stout, R.L. (2010). Service to Others in Sobriety (SOS). Alcoholism Treatment Quarterly 28(2), 111-127. PMC3050518.

    Pagano, M.E., Zemore, S.E., Onder, C.C., & Stout, R.L. (2009). Predictors of initial AA-related helping: Findings from Project MATCH. Journal of Studies on Alcohol and Drugs 70(1), 117-125. PMC2629624.

  • On the Nature of Addiction and the Loss of Hope

    On the Nature of Addiction and the Loss of Hope

    Guest post by David Chapman

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

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

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

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

     

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

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

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

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

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


     

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

     

  • How can you heal the trauma within?

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

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

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

    Treatment for Trauma

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

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

    Trauma Recovery Tips

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

               1: Don’t isolate

               2: Stay grounded

               3: Take care of your health

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

     

  • Is there a trauma-addiction connection?

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

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

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

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

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

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

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

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


    References used in this post:

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

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

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

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

    and  http://healmyptsd.com/


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  • Addiction is a Symptom of Untreated Trauma

    manhattan_bridgeI am a recovery coach. A recovery coach or sober companion is often called in to work with the most difficult addict, the chronic relapser. A chronic relapser is an individual that has been to several rehabs, often 7, 8 or 9 visits in less than five years. Who has not been able to put together 90 sober days, except in treatment. Whose family, spouse or children have given up on them. In reality, a chronic relapser is an addict that is acting out compulsively in their addiction. The chronic relapsing in their addiction is a sign or a symptom of an unresolved traumatic occurrence in their youth. Their addiction is a symptom of untreated trauma.

    Often, calling a recovery coach is the last resort.

    My first job, of course, is to make sure this person doesn’t drink, use or act out. And to find some redeeming qualities of this addicted person so I can approach healing the behaviors driving the addiction. This is the key point that brought me to the understanding that many of my clients have experienced some form of trauma, early in their childhood or adolescent lives.

    “What is addiction, really? It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood.”    — Alice Miller, author of Breaking down the Wall of Silence

    I always ask the client for their story. I provide all of my clients the ACE study questions. ACE means Adverse Childhood Experiences. The ACE study is an ongoing collaboration between the Centers for Disease Control and Prevention and Kaiser Permanente’s Health Appraisal Clinic in San Diego. It started in 1976 with the purpose of finding more about childhood trauma, and the later-life health and well-being of participants. (For more information on ACE, see my blog post dated August 20, 2015). The ACE study poses such questions as: Did you move a lot? Did you ever go hungry? Did you experience a childhood that was less than nurturing? Did you ever have a moment that overwhelmed you? Did you live through an ordeal that changed how you think about people, places or things? The results of the ACE questions, and the addict’s story that comes after it, always profoundly moves me. I get a much more honest story than most clinicians, mainly because of these questions.

    The reason it’s significant for me to identify and acknowledge trauma, is because research proves that trauma can activate behaviors that lead to addiction. My clients are using a drug or alcohol as a way of self-protection, of calming down, as life preservation. Everyone in the rooms (AA, NA meetings) knows addicts “use” in order to “numb out.” Well, let’s rethink that, turning it a bit to say: victims of trauma are really using a drug or drink to:

    • Stay safe: After trauma the addict’s own mind can feel like a danger zone, which makes being “out of it” feel safer than being in it.
    • Escape memories: Unwanted and unresolved memories have a way of popping up incessantly after trauma; addictions offer the mind a different area of, or reduced capacity for focus that helps suppress reminiscing.
    • Soothe pain: Substances or the adrenalin rush of self-destructive behaviors change the addict’s body chemistry, releasing endorphins and other mood enhancers that reduce discomfort.
    • Be in control: Sometimes, engaging in addictive behaviors can lead an addict to feel strong, resilient and courageous, an experience that is tremendously alluring when trauma from the past intrudes on the present.
    • Create a world the addict can tolerate: The intense feelings brought on by fear, memories and anxiety can make any moment seem overwhelming. The release of tension brought on by addiction-oriented behavior helps facilitate a manageable experience.
    • Treat yourself the way you feel you deserve: Trauma can leave an addict feeling less-than, worthless, hopeless, and damaged. The more self-destructive the addict behaves, the more it can feel like he or she is living in alignment with who they truly are. While this is false, it can help reduce feelings of otherness and disconnection.
    • Redefine who the addict really is: Trauma changes an addict’s identity all the way down to the core of their beliefs and self-definition. It can seem as if no one understands them. Engaging in addictions can help create a sense of community by connecting the addict to others who feel, see, think and behave as they do. Addictions can help the addict revise their self-perception by allowing them to engage in and act out behaviors that allow them to feel stronger, more courageous, capable, etc., than trauma has left them feeling.[1]

    This puts the addiction-trauma link into perfect perspective for me, and I hope it opens some eyes for other addicts, alcoholics, and clinicians that are reading this post. Next week’s post will go on to explain the scientific research that backs up this discovery that addiction is just a symptom of untreated trauma.


    Research used in this blog:

    Centers for Disease Control and Prevention, http://www.cdc.gov/violenceprevention/acestudy/about.html

    Adverse Childhood Experiences Study, Posted on August 20, 2015 by Melissa Killeen, http://www.mkrecoverycoaching.com

    [1] Trauma and Addiction: 7 Reasons Your Habit Makes Perfect Sense, by Michele Rosenthal. Published on March 30, 2015 in Behavioral Health, Living in Recovery, Living with Addiction and at http://www.recovery.org


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    What is a state certification board?

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

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

    What is Reciprocity?

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

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

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

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

     

    melissa-new-post

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

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

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

    What is a Recovery Coach?

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

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

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

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

    Is recovery coaching covered by insurance?

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

    What is a peer to peer recovery support specialist?

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

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

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

    What is a professional recovery coach?

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

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

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

  • The Family Relationship Consultant

    by Ronald B Cohen, MD

    According to Ronald B. Cohen, MD, an experienced Bowen Family Relationship Consultant, and this week’s guest blogger, we all struggle with balancing emotional closeness and distance in our families or origin.

    Learning and Doing

    “How long can we go on being angry?”

    — Elie Wiesel

    Consequently we can all benefit from relationship coaching and consultation. This guest blog, originally published on the FamilyFocusedSolutions.com web site in May 2015, can be found in its entirety along with social media comments and links to related blogs, at http://www.familyfocusedsolutions.com/the-family-relationship-consultant/. You may also share your thoughts and experiences concerning the primacy of relationships in your life in the “Post Comments” box on the original blog.

    Relationships matter. We all belong to families whose emotional connections greatly impact our lives. The behavior of any member of a family affects every other member in some way. We exist in our relationships and our inescapable connection to our family of origin.

    Families are systems of interconnected and interdependent individuals, none of whom can be understood in isolation. The family system resides in the self as much as the self-resides in the family system. Bowen Family Systems Theory (BFST) understands family functioning and behavior as arising from an emotional system that is a universal feature of all living things.

    All families have a set of rules, roles and relationship requirements. None of us can ever completely emotionally leave the family we grew up in, nor do we have a choice as to whether or not we deal with them. Even choosing not to deal with them is a way of choosing to deal with them. It just means we leave an awful lot of what’s going on unspoken and have no control over the outcome.

    The goal is to change your relationships with other members of your family of origin to improve your life and your family’s life regardless of what anybody else does. If you change yourself, you fundamentally change the nature of your relationships. Taking responsibility for what you can take responsibility for and attending to your needs in the context of intimate relationships, opens the door to facilitating healing of the entire family.

    Coaching and Relationship Consulting based on Bowen Family Systems Theory (BFST) involves joint observation, investigation and research about present day and historical family functioning. The process of self-differentiation is built upon ownership of one’s emotional reactivity. A primary prerequisite for engaging in the process is to develop realistic expectations when moving toward changing your part in your family’s dance.

    You are learning how to deal with differences without losing connections.

    Bowen preferred the “Coaching” nomenclature because his theoretical underpinnings, process of interaction, and desired outcomes were so different from conventional psychotherapy that the term therapy did not capture all of its essential aspects. The journey of self-differentiation may be described as “Growing in the ability to be fully responsible for my own life while being committed to growing closer to those I love.”

    Autonomy and emotional connection become congruent and not adversarial.

    The “work” itself is an individual and somewhat solitary undertaking that emphasizes self-directed effort. Learn to observe non-reactively the relationship patterns in your original family and explore your role in these patterns. Strive to bring your behavior more in line with your deepest beliefs, even if this means upsetting family members by disobeying family “rules.”

    You can make change in your family relationships even without the participation of other family members. If you want your life to be better you have to do the work.

    Remember, you are completely in control of your process and end up in a better place whether or not anybody else in the family signs on.

    The lives of our children and our children’s children are deeply affected by how we live our lives. Healing current relationships avoids leaving a damaging legacy for our descendants.

    Consultation with a well-trained Bowen Family Systems Theory “Coach” can help develop a solid self in the wider historical context of our most important relationships.

    Best of luck on your unfolding journey of a lifetime.

    Ron Cohen MDRonald B Cohen, MD is a Board Certified Psychiatrist and Bowen Family Systems Theory Coach and Relationship Consultant in Great Neck, New York. He can help develop a solid image of your ‘self’ in the wider historical context of your most important relationships. To request more information or contact Ron Cohen directly for any reason, please email him at: RBCohenMD@FamilyFocusedSolutions.com or call him at: (516) 466-7530

  • Bob Timmins – A Titan in the World of Recovery Coaching.

    manhattan_bridge_post_versionBob Timmins, an addiction specialist who is credited with salvaging the lives of a long list of celebrity drug users by steering them onto the path of sobriety and helping them stay there, died of respiratory failure in 2008 at his home in Marina del Rey after battling years of chronic obstructive pulmonary disease. He was 61 [i]. Though little known by the public at large, Timmins was a titan in the world of recovery coaching.

    Some of his clients — members of the bands Red Hot Chili Peppers, Mötley Crüe and Aerosmith — have spoken publicly about Timmins’ role in helping them battle drug abuse. But most celebrities preferred anonymity, a request Timmins took pride in honoring. “Bob has helped everyone from the owners of sports franchises to heads of movie studios to Grammy-winning, internationally known music idols . . . as well as the most down and out homeless person who comes to him for help,” said Michael Nasatir, a friend, and a criminal defense attorney in Santa Monica, who worked with Timmins early in his career.

    What Timmins knew about drug abuse, recovery and redemption was learned from experience

    Robert Wayne Timmins was born in Los Angeles on Sept. 27, 1946, the son of a police officer. His mother suffered from paranoid schizophrenia, and when Bob was 9 years old, she attempted to murder him. Timmins was placed in foster care, by ninth grade he lived on the streets, was a heroin junky, and as  a convicted felon, he spent time in San Quentin. It was in San Quentin that Timmins met Danny Trejo, they were cell mates and prison gang members, these two were familiar with all forms of prison violence. Yet, it was Trejo that introduced Bob to the 12 step rooms. When Trejo left San Quentin, he told Timmins to look him up after his release. Four years later, expecting to start-up exactly where he had left off before entering San Quentin, Timmins showed up at Trejo’s doorstep. Danny Trejo took him to his house, and offered him a spare bedroom to stay in. When Timmins said “Come on, let’s do some things…” in response, Trejo took him to a 12-step meeting. Trejo introduced him to Eddie, his first sponsor, and the rest, let’s say is history. Bob Timmins credits Trejo and Eddie, with turning his life around. Eddie was Timmins’ sponsor until Eddie died with 47 years of sobriety. Timmins said “If I didn’t get a sponsor and jump into recovery, I wasn’t going to stay long enough to get anything.” [ii]

    In the years that followed, Timmins helped found and was involved with several organizations, including the CLARE Foundation, Cinco Swim Sober Living Home, the recovery centers Impact House and Cri-HELP in Los Angeles as well as the National Association of Drug Court Professionals. Early in his career he began working with troubled youths, including a young Jeff McFarland.

    “I met him when he worked at a rehab hospital I was in,” said Jeff McFarland, who is now an attorney. “I was a 19-year-old drug addict and criminal, and he helped me turn things around. He had instant credibility. When you spoke to him, you knew that he had lived the life that you live. And he understood.” Today, McFarland is the chair of The Timmins Foundation [iii]. The Timmins Foundation is a nonprofit organization established in memory of Bob Timmins, whose work changed Jeff McFarland’s and countless other young people’s lives. The Timmins Foundation supports a “Bob Timmins Bed” that provides beds for inpatient treatment or residence in a sober living home for a year to clients that are unable to afford the entire cost on their own. The Timmins Foundation seeks to provide financial support for the early intervention and treatment of substance abuse, which Bob knew could prove to be the difference between a life well-lived and a life wasted. The Foundation goes into the community, seeking out young adults in need of treatment and builds a sense of purpose for young adults in post-treatment recovery [iv].

    In courts across the nation, Timmins was an expert witness and a consultant in the development of treatment plans for addiction-related offenders. He assessed drug addicts before they went to trial, he advised them and suggested to the judge to place them into treatment instead of incarceration. Judges and lawyers paid Timmins for his expertise in selecting a proper program for a defendant, “but the amount we paid him was a joke compared to what he did,” said Bernard Kamins, who served as a Los Angeles County Superior Court judge from 1985 to 2007 and worked with Timmins in the California Drug Court system. “Here’s this guy who for $150 would get somebody straightened out. . . . He knew the right places to put people, and he gave them two things: hope and motivation. As a judge I couldn’t do that,” Kamins said. Timmins steered clients to 12-step meetings and helped them find sponsors. But Timmins did more, drawing from the people he knew and had helped in the past, he could put an addict in contact with a youth homeless shelter, admit them into a treatment center at no cost, introduce them to the president of a recording studio or aid in their admission into USC. Timmins was that type of guy.

    Working with celebrities did not leave Timmins star-struck

    In the entertainment industry, Timmins influenced the way recording labels treat artists by requesting amenities such as “safe harbor rooms”:  hospitality suites that are clean of drugs and alcohol. In the entertainment industry, drugs and alcohol were given freely to the artists to stimulate their creativity and as perks for their performance. As a recovering entertainer this was a very dangerous environment to be in, Bob changed this dynamic in the industry. After the 1995 death of Shannon Hoon of the group Blind Melon from a drug overdose, Michael Greene, president and CEO of the National Academy of Recording Arts and Sciences announced the first industry wide symposium on the subject of drugs in rock and asked Bob Timmins to help. Beside “safe harbor rooms” and contractual guidelines that advocate sobriety, the symposium and Grammy.org helped Timmins and Howard Owens start the MusiCares Foundation, and MAP, the Musician’s Assistance Program, which provide assistance to musicians, including those suffering from addiction. MusiCares provides a safety net of critical assistance; services and resources that will cover a wide range of financial, medical and personal emergencies for music people in times of need. MusiCares celebrated 20 years in 2013.

    In a 1991 article in GQ magazine; he said “I see them as human beings first. I see them in their pain and try to help them through a suicide attempt or whatever’s going on”[v]. Bob Timmins was one of the most influential foundational thinkers in recovery coaching, developing the concepts of sober companionship, recovery coaching and legal services coaching. Through the years he tirelessly helped rock star, millionaire or skid row addict with the same compassion and conviction, whether he was compensated handsomely or graced with a humble handshake and a thank you. Bob was a milestone in the recovery coaching movement.

    Hear Bob Timmin’s AA Story, this is a must hear:

    http://timminsfoundation.org/Speech2005b.html

     

    References:

    [i] Addiction specialist worked with celebrities OBITUARIES / Bob Timmins, 1946 – 2008 March 08, 2008| Jocelyn Y. Stewart | LA Times Staff Writer- jocelyn.stewart@latimes.com

    [ii] Christopher Kennedy Lawford “Moments of Clarity: Voices from the Front Lines of Addiction”, Harper Collins NY

    [iii] Addiction specialist worked with celebrities OBITUARIES / Bob Timmins, 1946 – 2008 March 08, 2008| Jocelyn Y. Stewart | LA Times Staff Writer- jocelyn.stewart@latimes.com

    [iv] The Timmins Foundation, 865 S. Figueroa St., 10th Floor, Los Angeles, CA 90017. http://timminsfoundation.wordpress.com/2008/12/20/the-timmins-foundation/

    [v] Addiction specialist worked with celebrities OBITUARIES / Bob Timmins, 1946 – 2008 March 08, 2008| Jocelyn Y. Stewart | LA Times Staff Writer- jocelyn.stewart@latimes.com

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  • Alcohol Kills One Person Every Ten Seconds

    manhattan_bridge_post_versionThe misuse and abuse of alcohol affect the lives, health and well-being of billions of people. A World Health Organization 2014 report stated the consumption of alcohol led to 3.3 million deaths around the world. In essence, the report says that alcohol kills 1 person every 10 seconds.

    Shekhar Saxena, head of the World Health Organization’s Mental Health and Substance Abuse department, reports that there are roughly 3.25 billion people in the world that drink, and these drinkers consume an average of 4.5 gallons of pure alcohol a year. China is estimated to increase it’s per person, per year alcohol consumption ratio by an additional 1.5 liters of pure alcohol by 2025.

    According to SAMHSA’s National Survey on Drug Use and Health (NSDUH), more than half of all U.S. adult citizens drink alcohol, with 6.6% meeting criteria for an alcohol-use disorder.

    One in 10 deaths among working-age adults aged 20-64 years are due to excessive alcohol use.

    A CDC study, published in June of this year, found that nearly 70% of deaths due to drinking involved working-age adults, and about 70% of those deaths involved males. Nearly 88,000 people die in the U.S. from alcohol-related causes annually, making it the third most preventable cause of death in the United States. In 2013, fatal accidents involving an alcohol-impaired driver accounted for 10,076 deaths or 30.8 % of all driving fatalities.

    Men are more likely than women to experience alcohol-related deaths. Although more women are drinking today as compared to 2012, of the 88,000 alcohol related deaths, approximately 62,000 were men and 26,000 were women. This study proclaims that excessive alcohol use can shortened the lives of working-age adults by about 30 years.

    Alexandra Sifferlin for Time Magazine reported that harmful alcohol use not only leads to addiction, but it can put people at a higher risk of over 200 disorders like liver disease, tuberculosis and pneumonia.

    Binge drinking can damage the frontal cortex and other areas of the brain

    The CDC report shows that 16% of drinkers partake in binge drinking, which is the most dangerous form of alcohol consumption. Some of the risks associated with binge drinking are well known. It increases the risk for sexual assault, violence and self-harm. But the physical effects of such behaviors on the body are often not discussed. According to the National Institutes of Health (NIH), there’s strong evidence to suggest that regular binge drinking impacts executive functioning and decision making by damaging the frontal cortex and other areas of the brain.

    According to the 2013 The National Survey on Drug Use and Health (NSDUH), approximately 5.4 million people (about 14.2%) in the age range of 12-20 years, were binge drinkers (15.8% of males and 12.4% of females).

    One in every four families are impacted by alcoholism

    More than 10% of U.S. children live with a parent with alcohol problems, according to a 2012 study.

    According to Herma Silverstein, author of the book; Alcoholism, one of every four families has problems with alcohol.

    The CDC study also found that about 5% of the alcohol related deaths in the U.S. involved people younger than age 21.

    In 2012, 58.3% of people who tried alcohol for the first time were younger than 18.

    Drinking during pregnancy can cause brain damage to the infant, leading to a range of developmental, cognitive, and behavioral problems, otherwise called Fetal Alcohol Spectrum Disorders (FASD). People/children with difficulties in the following areas may have FASD or alcohol-related birth defects:

    • Coordination
    • Emotional control
    • Learning challenges
    • Socialization skills
    • Focus in class, holding down a job

    These statistics are over powering and most definitely build an excellent argument to stop drinking, especially over this Fourth of July long holiday weekend. Please share these statistics with a friend, post on your social media pages, re-publish in your blog, or newsletter.


    References used in this blog:

    The National Institute on Alcohol Abuse and Alcoholism (NIAAA) is one of the 27 institutes and centers that comprise the National Institutes of Health (NIH). NIAAA supports and conducts research on the impact of alcohol use on human health and well-being. http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics

    Preventing Chronic Disease (PCD) is a peer-reviewed electronic journal established by the National Center for Chronic Disease Prevention and Health Promotion. The mission of PCD is to promote the open exchange of information and knowledge among researchers, practitioners, policy makers, and others who strive to improve the health of the public through chronic disease prevention. http://www.cdc.gov/features/alcohol-deaths/

    The National Survey on Drug Use and Health (NSDUH) provides national and state-level data on the use of tobacco, alcohol, illicit drugs (including non-medical use of prescription drugs) and mental health in the United States https://nsduhweb.rti.org/respweb/homepage.cfm

    Substance Abuse and Mental Health Services Administration (SAMHSA), is an agency of the U.S. Public Health Service in the U.S. Department of Health and Human Services. http://www.samhsa.gov/

    Alexandra Sifferlin, (2015) What Drinking Does to Your Body over Time, Time Magazine, http://time.com/author/alexandra-sifferlin/

    And

    Alexandra Sifferlin, (2014) Alcohol Kills 1 Person Every 10 Seconds, Report Says, Time Magazine, http://time.com/96082/alcohol-consumption-who/

    Silverstein, Herma. (1990), Alcoholism. New York: Franklin Watts http://allpsych.com/journal/alcoholism/#.VZQkhWPH_VI

     

  • On the Role of Peers in Recovery

    This article was published in thefix.com on June 10,2015. Click here for the article:

    http://www.thefix.com/tags/professional-voices

     Do peers have a unique way of connecting with clients?

    As the treatment of addiction moves inexorably toward inclusion in the larger healthcare system, with its standards of evidence-based care, there is also a movement towards the use of peer counselors with “lived experience” with addiction. Are peer counselors able to connect with and help persons struggling with addiction in a unique way? Do the outcomes achieved in employing peers suggest that they should be more widely used, and supported by public funding? Melissa Killeen opens the conversation and highlights a case in which peer counseling played an integral role…Richard Juman

    A peer recovery support specialist has many job titles across the United States and around the world. They may be called certified recovery support practitioners, recovery advocates, peer mentors or recovery coaches. They tend to be employed at recovery community support centers, at hospitals, behavioral health agencies or addiction treatment centers. The peer recovery support specialist may be working with substance misusers, traumatic brain injury clients, behavioral health clients or clients that identify with all of these diagnoses. Certified peer recovery support specialists are generally employed by the facilities at an hourly rate for their services; for the client, peer recovery support services are typically free. In this article, I will focus on the peer recovery support specialists working in the addiction field.

    Recovery community support centers, financed with state and federal funding, some with funding from churches or individuals, are slowly taking hold and becoming more prevalent. The recovery advocacy organization Faces & Voices of Recovery, developed the Association of Recovery Community Organizations that unites and supports a growing membership of over 100 recovery community support organizations, although there are many organizations which have not yet become members of ARCO. For example, in my neck of the woods, there are currently 12 recovery community support organizations in Pennsylvania and 10 in New Jersey. Recovery community support centers can provide computer training, job interviewing skills training, resume writing, legal assistance, parenting skills training, social services linkages, 12-step meetings and even haircuts! It is important to highlight that these are non-clinical settings. Treatment is not provided—these are healthy places where people with current or past histories of addiction can go as an alternative to hanging out at a bar or on a street corner. Recent research completed by Chyrell Bellamy, MSW, PhD and Michael Rowe, PhD, both assistant professors at Yale University, concluded that working with peers in a recovery community environment may reduce alcohol use, drug use, and criminal justice charges for at-risk populations.

    In my view, the most important service that a recovery community support center offers is the assignment of a peer recovery support specialist or recovery coach to work with each client that comes to the center. At the outset, the peer recovery support specialist meets the client and sets up a schedule upon which the client and peer will meet. The format and structure varies widely, with some relationships based on daily phone calls and others on weekly face-to-face visits. The actual length of a coaching engagement will also vary. The McShin Foundation suggests that, as at the community recovery support centers run by the Virginia-based foundation, a 90-day limit is placed on the coaching assignment. However, other organizations, like the Hartford-based Connecticut Community for Addiction Recovery, does not place an arbitrary limit on the length of coaching time. Instead, it recommends that standards of goal achievement, like drafting a recovery plan, a relapse prevention plan and/or attaining sobriety goals, be used to determine the length of engagement.

    What do peer recovery support specialists actually do for their clients? Here is one example:

    In 2013, I helped create the first community recovery center in southern New Jersey, one of only a handful of recovery centers in New Jersey at the time. Heather Ogden-Busch was one of the first people we hired at the Living Proof Recovery Support Center in Voorhees, NJ. At the time, because she had many years of sobriety and experience in sponsorship, she naturally fell into the role of a peer recovery support specialist, or recovery coach. On Heather’s first day at the recovery support center she received a call from a member of her 12-step group. This member relayed the story about another member from the meeting, Beth (not her real name), who had relapsed on heroin. Beth was living in a trailer with her boyfriend, who was also addicted to heroin, and she was not doing well. Beth wanted to stop using. Heather called her immediately.

    At the time, Heather was aware that there was some really powerful heroin circulating in the Philadelphia/Camden region. Several young people had overdosed recently, including one of Heather’s sponsees. She relayed this information to Beth, and asked Beth what she wanted to do. Beth said she wanted to get out of her boyfriend’s trailer and go into rehab. She had no job, no money and no connection with her parents, with no possibility of financing a rehab stay. Heather and her colleagues at the Living Proof Recovery Center jumped on the phones to find a detox and a treatment center that would have an opening for Beth.

    Within one day, Heather had scheduled an intake appointment for Beth at a detox hospital in New Jersey. Beth would also have a bed reserved for her at a Christian-based treatment center in Brooklyn, NY, if she successfully completed detox. Luckily, Heather knew of another treatment center, also faith-based, in Chicago, with the financing available for the treatment as well as funding for the airplane flight.

    Beth was not particularly religious, but knew she needed treatment and agreed to go to detox then to treatment in Brooklyn. Over the weekend, Heather and Beth met together at the recovery center, called the detox hospital and went through the intake process. The same procedure was necessary for the Brooklyn treatment center. Heather and Beth made those calls together. By Monday of the next week, two days after Beth consented to go to detox, Heather had arranged for a sober friend to drive Beth to the northern New Jersey detox hospital. She also had arranged for the same person to drive Beth from the detox to Brooklyn when Beth was discharged.

    One week passed, and Beth was being discharged from detox. Unfortunately, the Brooklyn treatment center did not have an immediately available bed, but Beth was next in line for a bed as soon as it was available, in a few days. Beth had to return to her boyfriend’s trailer to wait for the call from the treatment center. Beth did not have a phone, so it was Heather that would field the call from the treatment center. Beth had at least three days to wait and hopefully, remain clean. Heather pulled in all of the support she could muster. Beth had escorts to every NA and AA meeting in the area. Members of the 12-step community drove Beth to Suboxone maintenance appointments. Every night, Heather and Beth talked. Every morning Heather called the treatment center to find out if the bed was available. By Wednesday morning, Beth and Heather were driving up the NJ Turnpike to Brooklyn, and Beth was still clean.

    The story doesn’t end there, because the job of a peer recovery support specialist is as important after the client comes out of treatment. Beth was in Brooklyn for 28 days. While Beth was working on her sobriety, Heather was lining up a room at an Oxford House, miles away from the trailer and the addicted boyfriend. Within one day after being discharged from the Brooklyn treatment center, Beth was in an Oxford House, had a temporary sponsor and was enrolled in an intensive outpatient program. Her parents were so proud of Beth’s achievements they had paid for the first two month’s rent at the Oxford House.

    Heather remained Beth’s peer recovery support specialist and required Beth to come to the recovery center every day to volunteer. Beth answered the phone, made copies, attended 12-step meetings, and learned about co-occurring disorders. She participated in a resume-writing workshop and a financial planning workshop. Beth got a job as a waitress at a local family-style restaurant that did not serve alcohol and for the first time she opened her own checking account. By her third month at Oxford House, she was able to pay her own rent.

    Heather guided Beth to enroll in a co-occurring program associated with her outpatient program. Beth now sees a therapist every week, and a psychiatrist monthly for her psychiatric disorders; because of her low income these services and her Suboxone treatment are free. She came to understand that her drug and alcohol usage was a form of self-medicating her mental illness. Nine months later, Beth remains an active participant in a local recovery support center and she is sober. Every month, her Suboxone dosage is reduced and she will celebrate one year clean from heroin in 60 days. Her goal is to be free from Suboxone and after one year of total sobriety, she can begin the 156-hour training to be a certified recovery support practitioner (CRSP), which is the peer recovery support specialist certification in the state of NJ (www.certboard.org).

    Melissa Killeen is a recovery coach, author of the first book on Recovery Coaching: Recovery Coaching a Guide to Coaching People in Recovery from Addictions and the recipient of the 2015 Vernon Johnson Award from the Faces & Voices of Recovery.

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  • What is Non-Suicidal Self-Injury?

    Non Suicidal Self Injury PhotoThe terms non suicidal self-injury (NSSI), self-harm, self-mutilation, self-abuse, or self-injury (SI) refer to the act of purposely harming oneself. Often referred to as “cutting,” which describes one common way in which people hurt themselves. Cutting isn’t the only way a person can engage in self-injury. Some examples of self-injury are:

    • Cutting
    • Sticking objects into the skin (broken glass, pins, excessive piercing)
    • Banging head against the a hard surface
    • Scalding or burning oneself
    • Trichotillomania (pulling out hair)
    • Hitting oneself with a hard object such as a hammer
    • Skin picking or pulling off scabs
    • Intentionally interfering with wound healing
    • Swallowing poison or other inappropriate objects
    • Breaking bones in the hands and feet

    Non suicidal self-injury is not behavior with any suicidal intent. If suicide does happens, it happens by accident. It can be particularly challenging for people to understand the purpose that self-injury serves. People self-injure to cope with internal emotions, to stop bad feelings, to relieve emotional numbness, to punish themselves, to obtain a sense of belonging, or to get attention. Self-injury may serve as a way to express emotions unable to be put into words, to feel a sense of control when finding one’s self in a painful environment. SI can be a means of decreasing anxiety by distracting themselves by self-harm. Self-injury can be a means of relieving guilt, or helping the person to feel alive. Studies conducted by Matthew Nock, from Harvard and Mitchell Prinstein from Yale suggest that there are four primary reasons for engaging in self-harming behaviors:

    • To reduce negative emotions,
    • To feel “something” besides numbness or emptiness,
    • To avoid certain social situations,
    • To receive social support.

    Self-harm is a complex disorder and often a symptom of other types of mental health disorders. Self-harm is self-destructive. People hurting themselves produce neuro-peptides or endorphins, which are the same chemicals that cause a “runner’s high” that make them feel happier and more relaxed. There are additional ways of producing endorphins: unprotected sex, violent or kinky sex, getting a piercing or a tattoo for the pain of the act, starving yourself, compulsive exercise, all night club hopping, and of course excessive use of drugs and alcohol. All of these are self-destructive but they’re not necessarily considered self-injurious.

    The typical age for the onset of self-injury is age 14 and may continue to age 20. Each year, 1 in 5 females and 1 in 7 males engage in self-injury. Females comprise 60% of those who engage in self-injurious behavior.

    Estimates vary widely but statistics indicate that 3% to 38% of all adolescents and young adults identify as self-harmers. 90% of the people who engage in self-harm begin during their pre-adolescent or early teen years. Studies have shown that children as young as seven years old have engaged in self-harm. Many of those who self-injure report learning how to do so from friends or web sites that advocate self injury.

    Studies conducted with university students demonstrated that 17% of the students interviewed discussed a lifetime prevalence of considering or using self-harm, with 13% reporting that they had engaged in self-harm more than once. Self-injury may begin during the college years, with surveys reporting that 30% to 40% of college students report engaging in self-harm for the first time after the age of 17. Self-injurious behaviors may last a life time. Nearly 50% of those who engage in self-injury activities have been sexually abused. Approximately two million self-injury cases are reported annually in the U.S.

    There are so many myths about self-injury, that’s why it’s important to know about self-mutilation facts when responding to people who engage in this type of behavior. Read through these bullet points about approaching someone who engages in self-injury:

    • Remain calm and caring
    • Accept him or her even if you disagree with the behavior
    • Know that this represents a way of dealing with emotional pain
    • Listen with compassion
    • Avoid panic and overreaction
    • Do not show shock or revulsion at what they’ve done
    • Do not use threats in an attempt to stop the behavior
    • Do not allow him or her to recount the self-injury experience in detail as it may trigger another session
    • Do get appropriate help for him or her from a qualified mental health professional

    The best way to help is to stay informed about self-injury facts. The more you know about the causes of self-injury, motivations, and appropriate responses, the more effective you’ll be when dealing with someone who engages in this activity. Contact the International Society for the Study of Self Injury for more information (http://itriples.org/).


     

    Research Used in this Blog:

    International Society for the Study of Self-Injury, http://itriples.org/

    Teen Line On Line.org:  https://teenlineonline.org/youth-yellow-pages/cutting-and-self-injury/?gclid=Cj0KEQjw-tSrBRCk8bzDiO__gbwBEiQAk-D31VIqd8MEI8gI0p_Gq6WrQdhUb-N90S1ozvt6Lfve-HAaAhFW8P8HAQ

    Teen Hotline: 310-855-4673

    S.A.F.E. Alternatives, Telephone- (800)-DONTCUT  or   (800)-366-8288

    info@selfinjury.com, www.selfinjury.com

    Matthew K. Nock, and Mitchell J. Prinstein, (2004,5) A Functional Approach to the Assessment of Self-Mutilative Behavior, Journal of Consulting and Clinical Psychology, American Psychological Association, 2004, Vol. 72, No. 5, 885–890 0022-006X/04/ DOI: 10.1037/0022-006X.72.5.885. http://www.wjh.harvard.edu/~nock/nocklab/Nock_Prinstein_JCCP2004.pdf

    The Healthy Place- Self Injury, Self-Harm Statistics and Facts, by Samantha Gluck, http://www.healthyplace.com/abuse/self-injury/self-injury-self-harm-statistics-and-facts/

    Why Would Anyone want to Harm Themselves, Non Suicidal Self Injury (NSSI) Blog by Naghma Khan, a Clinical & Addictions Psychologist in India, http://www.mkrecoverycoaching.com/2012/04/13/why-would-anyone-harm-themselves/ or http://unwrappingminds.wordpress.com

     

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  • Six Signs of Resistance to Change
    and What To Do About Them

    manhattan_bridge_post_versionIt is hard seeing your client struggle through resistance to change. Facing a difficult emotional experience, and at the same time, wanting to escape it. Struggling in sobriety, mourning the loss of the addiction, a job, maybe even their family. They are thinking they are of little worth, while working on some of the hardest challenges they have ever faced. Yes, it is hard for the coach to keep pushing; it is just as hard for the client to keep showing up for the appointments and completing the homework assignments. But push we must and the following paragraphs explain why.

    I have a 35-year-old male client with 120 days clean. I can see this change is extremely hard for my client to move through. He has commented that it is like taking a college course, Change 101. He’d really rather go back and do what he has always done: escape, do drugs, it was easier, he knew how to do it, and at least, he limped along. This is what coaches call resistance to change.

    Expecting resistance and preparing how to deal with it is the most crucial part of developing a plan of change for your client.  In order to forecast any type of resistance, a coach needs to understand the most common reasons people object to change. Below are six examples of the reasons underlying a client’s resistance to change. Some will be artfully combined and the order of their prominence will frequently shift. What‘s imperative is that the coach anticipate each instance of resistance, having ready a response in their back pocket.

    1. Denial — I like to use consequences as the perfect wake-up call to denial. This is my classic change-resistance stand-by: When my client says, “I can’t see any reason to change,” my response is adapted from an AA slogan, “If you keep doing the same thing over and over, you’ll keep getting the same results over and over.”

    2. Anger — It’s remarkable how closely these stages of resistance mimic the five stages of grief. In the case of anger, I use the same response I would in replying to a client who is grieving the loss of a relationship. I mix with it a bit of empathy. Rationally, my client understands his live-in girlfriend, his job, or his family is not responsible for the onset of his addiction. I point this out. Emotionally, he may resent anyone for causing him pain or resent his family for placing shame or putting pressure on him. I suggest he may feel guilty for being angry, and this makes him even angrier. Teasing out these threads of anger helps eliminate the “blurred lines” standing in the way of progress.

    3. Fear and Confusion — One of the most common reasons for resistance is fear of the unknown. People will only take active steps toward the unknown if they genuinely believe — and perhaps more importantly, feel — that the risks of standing still are greater than the risks of moving forward in a new direction. Once again, I bring out my bag of slogans and request he use affirmations on a daily basis. One of my favorite quotes is by Eleanor Roosevelt: “Every time you meet a situation that you think is an impossibility, then you meet it and live through it, you find forever after you are freer than you were before.” Another is from Dr Susan Jeffers: “Pushing through fear is less frightening than living with the underlying fear that comes from the feeling of helplessness.” Or Winston Churchill’s quote:  “If you are in Hell, keep going.” The basic emotion of fear jumbles one’s thoughts, resulting in confusion. Using simple affirmations can break through the underlying emotion of fear and help redraw the line, nudging it forward toward change.

    4. Depression — Again, a classic symptom of grief as well as resistance to change. This phase may be eased by a few kind words. However, I have to battle for this particular change model, and fight against my client’s old thoughts of living an “easy life” in addiction. That old life seemed easier than all of this work. So first, I ensure my client is following his medication-assisted treatment protocols. Then, I pull out my depression-buster toolbox: Get some friends and talk about it — my client’s assignment is to have coffee after his next NA meeting and talk specifically about his depression as well as having to work on his relationships. Depression-buster tool number two is to read inspirational messages. My newest favorite book is National Geographic‘s Daily Joy — 365 Days of Inspiration, uniting inspiring words with lovely National Geographic images of the world. Tool number three? Distraction. When depressive thoughts come creeping back in, get out of that bed, no sleeping until noon. Walk, workout, mow the lawn, go to the grocery store and shop for some nutritious ingredients for this week’s meals. Write in your journal, call your coach, talk to your sponsor and best of all, hit your knees and ask your higher power to take from you these thoughts and feelings of depression.

    5. Crisis — No matter what, there will be a crisis during the period of time in which you are implementing change. So ready yourself for it. In this particular coaching situation, a crisis can be deadly, so I pre-empt any thought of my client ‘using’, head-on. I talk about how addiction will transform thoughts of escape or defiance into the thought of using. I urge my client to prepare for this with a Fire Drill:

    “What are you going to do if these thoughts enter your head? Write this down and use it just like a fire drill is used in a school or office. Thinking of using? A bell starts ringing! Call a friend, say the serenity prayer, call me, take a walk, take out the picture of your 5 year old daughter from your wallet, go to a meeting, hug your girlfriend, write in your journal, drink a glass of water and repeat! Continue to do these things until the thoughts pass.

    I have my client write all of these actions of a fire drill down on a 3×5 card and carry it in his wallet. Defining and breaking down a crisis helps, too: Picking up a drug is the biggest crisis; a minor fender bender is not. Heading out to an old drug-dealing location is a crisis; bouncing a check is not. In all cases tell someone, call a sponsor, a NA friend or your coach.

    6. Acceptance — Sometimes it takes a crisis to move to acceptance, and hopefully a minor crisis like a fender bender or a bounced check is the crisis my client will experience to effect this change. He can see the experience of dealing with a crisis as a sober person works more effectively.  Of course, as his coach, I follow up by asking him about the eventual resolution of this minor crisis. I am confident he will see how his change of interaction and communication styles has helped improve the resolution of the crisis. Most importantly, he will have accepted this aspect of change because he has gained a new found confidence in being a sober person resolving a crisis in a orderly and humane way.

    And confidence is really the strength my client has needed all along.

     

  • Is boredom a gateway to relapse?

    manhattan_bridge_post_versionIt’s late in the day on a Saturday. Time slows down. Nothing seems interesting on TV, just reruns of Criminal Minds, another PGA tournament with a splash of MMA Kickboxing. There is a feeling of yearning, but for what? This is boredom. We tell ourselves that we are bored! But what exactly does this mean to us?

    One meaning we give to our boredom is that the TV show we are watching is not interesting. Another meaning might be that the classes we are taking are not teaching what we need to know. Or we wish we lived in a condo instead of this house in the suburbs that needs the lawn to be mowed. In other words, we look to something external to blame. Sound familiar? Boredom is not trivial. It is out of boredom that some people turn to drugs, gambling, over-eating, sex and alcohol abuse.

    Boredom, when chronic, is very stressful and has serious consequences for an addict. For example, we might be waiting for a response from a job interview. The time it takes seems eternally long. Feelings of irritability and anxiety set in. This is where we start to feel stressed. It seems as though the solution is to blame the HR department of this company (that we are very interested in working for), for their ineptitude. Is anger and resentment lurking around the corner?

    Another example might be that boredom would cause someone to lose interest while driving and getting injured because of the lack of attention. How many times have you been driving, become bored with the road and switch into some sort of fantasy, losing your focus on the road and bang! The car in front of you is at a dead stop. My guess is that a good number of traffic accidents are caused this way.

    We are blaming the boredom on something external, like the TV, the HR department or the jerk in the car in front of you. Perhaps it is not. Perhaps boredom is internal in nature. Psychological scientist John Eastwood of York University (Ontario, Canada) and colleagues at the University of Guelph and the University of Waterloo wanted to create a precise definition of boredom, one that can be applied across a variety of theoretical frameworks. Their article, was published in Perspectives on Psychological Science, a journal of the Association for Psychological Science, and the website, ScienceDaily, quotes from the article:

    “Drawing from research across many areas of psychological science and neuroscience, John Eastwood and his colleague[s] define boredom as an aversive state of wanting, but being unable, to engage in satisfying activity.”

    This wanting has a dangerous similarity to the craving of substances experienced by addicts during the withdrawal stage. In other words, if a recovering addict finds themselves bored, they are on the very slippery slope of wanting. Here are some additional analogies:

    • Addicts have difficulty paying attention to their internal thoughts and feelings. They have difficulty focusing on the external or environmental information required for participating in a satisfying activity. Eastman uses these characteristics to define boredom
    • Some addicts are aware of the fact that they have difficulty paying attention. Yes, this is another characteristic of boredom.
    • Addicts tend to blame and/or believe that the environment is responsible for their aversive state. Again, this is a characteristic of a person entrenched in boredom.

    The point is that research indicates that there is a relationship between boredom and lack of attention to what is happening inside and outside of ourselves. But, there is no concrete research linking boredom to addiction or relapse. However, it may be worthwhile to refocus our attention to what we are thinking, feeling and/or to the stimuli in the environment instead of simply chalking it up to being bored. Maybe we can focus by completing 90 meetings in 90 days.

    There is also the concept of embracing boredom. As the Buddhists put it; boredom is a form of impatience. Therefore patience is an antidote. There is nothing that is intrinsically boring. There are examples of prisoners of war, sitting in complete isolation, who are able to focus their minds and find interesting things to prevent boredom. Does this sound like Step Eleven?

    And then we can think about what they say about the weather in Minneapolis:

    Wait, in five minutes things will change.

  • Faces and Voices of Recovery announces the 2015 America Honors Recovery Awards

    Faces and Voices of Recovery AwardsFaces and Voices of Recovery announces the 2015 America Honors Recovery Awards.  America Honors Recovery is the addiction recovery community’s annual awards event to recognize the over 23.5 million Americans in recovery and recovery community organizations.

    Sponsored by Faces & Voices of Recovery, the event highlights the extraordinary contributions of the country’s most influential recovery community leaders to the growing movement to promote the reality of recovery from addiction.

    The recipients will be honored at the July 23, 2015 America Honors Recovery Awards Dinner, starting at 6:30, to be held at the  Hyatt Arlington at Washington’s Key Bridge 1325 Wilson Boulevard Arlington, VA 22209.  If you have any questions, please contact info@facesandvoicesofrecovery.org or call us at (202) 737-0690.  Tickets go on sale starting the week of May 26 at the Faces & Voices Website

    America Honors Recovery salutes the legacies of three dynamic recovery trailblazers who dedicated their lives to removing barriers for individuals and families affected by addiction – Dr. Vernon E. Johnson and recovery advocates Joel Hernandez and Lisa Mojer-Torres.

    The Vernon Johnson Award-

    • Melissa Killeen, Founder & Owner of Melissa Killeen Recovery Coaching, Ms Killeen resides in Laurel Springs, New Jersey
    • Honesty Liller, Chief Executive Officer of the The McShin Foundation, Ms Liller resides in Richmond, Virginia
    • Molly O’Neill, President & CEO of First Call Alcohol/Drug Prevention & Recovery, Ms. O’Neill resides in Kansas City, Missouri

    The Joel Hernandez Award-

    • Utah Support Advocates for Recovery Awareness (USARA) Executive Director, Mary Jo McMillen Salt Lake City, Utah

    The Lisa Mojer-Torres Award-

    • H. Westley Clark, M.D. CSAT

    Director – Retired, University of California, Los Angeles

    The Voice of Recovery Award-

    • Greg Williams

    Director, The Anonymous People, Recovery Advocate

    The Distinguished Lifetime Achievement Award-

    • William White

    Author, Researcher and Recovery Historian

     

    2015 America Honors Recovery Awards Dinner tickets go on sale starting the week of May 26 at the Faces & Voices Website