All posts by Tom Rohrer

Professional Outpatient Treatment Programs

Professional Outpatient Treatment Programs

Professional Outpatient Treatment Programs (OPTs) are a good choice for people with a primary or secondary addiction to drugs and alcohol.

Professional outpatient treatment programs are good choices — this is especially true if you have no medical complications, it’s your first treatment, you must stay working, or if you want to stay close to home because of certain obligations.

Though most OPTs are centered around alcohol and drug addiction, with a bit of research, hopefully you can find a local OPT program that focuses on your addiction.

Professionally run outpatient programs, such as those that are 12-Step or self-help based, offer a treatment system and are educational and personal-growth oriented, giving you a chance to deal with the issues behind your addiction. Limited individual and family counseling is often included in these programs, offering you a basic foundation for recovery. Added counseling is often needed.

Intense Day Treatment: Sessions start in the morning and go through late afternoon, usually five to six days a week. They offer basically the same program that inpatient programs offer but for fewer hours a week and at a much lower cost, which varies widely.

Outpatient Treatment: Sessions last two to three hours each day, three to six times per week, for six months to a year. They usually include brief to long-term continuing support of up to several years and are primarily held in the evening. They provide much of the same program structure that inpatient programs offer, but over a longer period of time. Therefore, they are less intense and cost much less. Again, the cost ranges widely.

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Professionally Run Groups for Addiction Treatment

Professionally Run Groups for Addiction Treatment

Most professionally run groups for addiction treatments handle drug and alcohol addiction or codependency.

Thanks to awareness and online communication, more professionally run groups than ever have arisen that focus on other types of addiction. But many more options are needed.

Sharing personal issues and information in front of other people can feel uncomfortable, even scary. Yet, many people will benefit more from a group than from individual work. A professionally run group can cost $15 to $60 per hour. Groups ran by interns or through a nonprofit agency may cost less. Most meet weekly for one to two hours.

Professionally run groups have several important advantages over peer run groups, including:

  • More consistent.
  • Less likely to have interpersonal issues.
  • Have a wider range of resources.
  • Likely to provide members with emotional help to resolve issues and move on.

There are several types and styles of professional groups. Common ones are:

  • Educational: Informational, held for a few weeks.
  • Psycho-Educational/Coaching: Informational, goal setting, solution finding, emotional and practical support; either time-limited or ongoing.
  • Therapeutic: The support and guidance to explore, gain insight, grow, and resolve deeper emotional issues; usually on-going time line.

Working with a Group

Those who feel guilty, shy, or vulnerable, or those who want to go deeper into their issues and grow quicker, may benefit from individual work before they take on group work, but they should remain aware that support and carefrontation of peers can be very effective in breaking down defenses (especially denial and minimization) and dealing with the many issues of recovery. In mainstream treatment, clients are challenged by carefrontation, but never attacked, emotionally broken down, or morally judged. Most groups meet at least once a week for between one and two hours.

Codependent recovery support groups offer the support to focus on yourself, not others. This isn’t easy for most co’s, who usually have strong defenses regarding their addiction to be needed by others. Expect to be carefronted until you’re truly able to focus on yourself.

Adult Child of Alcoholics or dysfunctional families (ACA/ACOA) groups are helpful for support and carefronting of childhood issues. Because of the deep emotional intensity of such old issues, personal psychotherapy can also be very beneficial. The individual work involved in psychotherapy gives you personal time, a safe environment, and the guidance of a therapist.

The style and cost for codependent recovery groups and ACA/ACOA groups are similar to other recovering support groups. They have their unique focus.

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Training Treatment Professionals

Training Treatment Professionals

The counseling staff in treatment programs will have a range of training treatment professionals.

Since most programs treat drug and alcohol addiction, a majority of addiction training is D&A focused. There are many training resources available to those involved in addiction treatment; they include university degrees, various addiction certification programs (through schools and independent groups), professional societies, community workshops, in-house training, and public seminars. Scholastic achievement is important, but it doesn’t include much hands-on experience. Therefore, competent professionals keep evolving through a variety of training opportunities.

Some counseling staff will be in recovery from their own addictions. Personal recovery gives one valuable, personal, but limited experience. Having undergone recovery doesn’t necessarily give the staff member the complete knowledge, techniques, and experiences that a professional needs to help his or her clients. When working with counseling staff, question, listen, and clarify as you get to know them so that you acquire some sense of their training.
For entry level positions, the addiction treatment field requires counseling staff to be in recovery for at least two years. Other positions may require three to five years. Overall, the years of experience for any one staff member can vary, including high positions like clinical directors. Sometimes, an organization will advertise the combined years of experience of the entire history of their staff, earning them a desirable reputation. The reality could be different. The present staff may have far less experience; therefore, the organization’s reputation may not be justified.

Addictive patterns appear in most individuals. Counseling staff who know their own addictive patterns are more likely to have empathy and to fully understand the experience of addiction and recovery. Every professional has something to offer. Take what you can from all the staff.

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A Brief Look into Deeper Focused Psychotherapy

Deeper Focused Psychotherapy

 Deeper Focused Psychotherapy

Insight, in general, focuses on identifying issues, especially unconscious conflicts, from your personal history. Deep psychotherapy is based on the belief that having knowledge of what is wrong (cause) and the means to fix it will result in a decision to fix it (effect). This is a big assumption. Though promoted often, insight gained through deep psychotherapy doesn’t always help treat an addiction. Some examples of deep psychotherapy:

Client Centered Therapy: A flexible, indirect method, which aids the client in finding their own solutions to their issues; widely adapted and used in many approaches.

Narrative Therapy: Therapeutic focus on the client’s dominant story; explores harmful perceptions you have and how they came about.

Psychoanalysis: A psycho-dynamic approach which raises your awareness of hidden conflicts from childhood, the root causes of feelings and expectations, and how they affect you today; examples include Ego Psychology and Jungian Psychology.

Transactional Analysis: Uses parent, child, and adult ego states to explain how we live out our childhood life script.

Other Approaches: There are many others, but again, too many to list here.

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Examples of Results-Oriented Psychotherapy Types

Results-Oriented Psychotherapy

Here are examples of results-oriented psychotherapy types

Behavioral: Both negative and positive behaviors are observed and tracked. Positive behaviors are supported and encouraged; negative behaviors are discouraged. Techniques like the Red Dot Reminder Check-In System are used regularly for results-oriented psychotherapy.

Biofeedback: Instruments are used to retrieve physical feedback of your body (pulse, temperature, etc.) so you can learn how to control your ability to relax, alleviate pain, and reduce your stress levels, benefiting your health and performance in recovery.

  • Neurofeedback (NFB): A type of biofeedback that uses real time electroencephalography (EEG) to illustrate brain activity to control the central nervous system.

Body therapies: There are several types of body therapies and all have a physical focus and style; movement and somatic therapies are examples.

Cognitive Therapy: Thoughts and language, and the feelings and behaviors that result, are examined, assessed, and changed to ensure they are accurate and useful. There is special attention placed on mental perceptions, with the intention of inspiring positive feelings and behaviors.

  • T.E.A.M. Therapy: Testing, Empathy, Agenda Setting, & Methods; provides an individualized framework for conducting evidence-based cognitive therapy. It is known for producing fast results.
    Emotional Freedom Techniques (EFT): Purports to manipulate the body’s energy field by tapping on acupuncture points; some think it’s controversial.

Exposure: Intentional contact with a hot trigger in a controlled environment. This results in a gradual lessening of the effects of the specific trigger. After each session, it’s important to totally disconnect from the trigger and reconnect with the present. There are several types of exposure therapies, including EMDR.

Eye Movement Desensitization & Reprocessing (EMDR): Uses cross-hemisphere brain stimulation technology, quickly neutralizing the intensity of triggers; it is used along with other therapy approaches.

Hypnotherapy: Hypnosis is used as part of the therapeutic process to modify the unconscious mind’s negative thoughts and behaviors, such as habits, physical pain, or stress-related issues.

Motivational Interviewing: Focuses on motivation to resolve a conflict (use vs. recovery); it examines and clarifies the best decision to make (recovery).

Neuro-Linguistic Programming (NLP): In NLP, the focus is on language and behavior re-patterning. It emphasizes techniques for personal, relationship, and professional development.

Psycho-Spiritual Approaches: A specific religious or spiritual path, or a general spiritual approach, is brought into the work. Many professionals avoid psycho-spiritual approaches.

Re-patterning: Approaches that shift negative patterns to healthier ones. Examples are NLP and Resonance Re-patterning.

Reality Therapy: A straight-talking, problem solving approach that looks at issues, feelings, and solutions realistically.

Other Approaches: There are many other psychological, psycho-physical, and psycho-spiritual approaches that could be helpful, but there are far too many to describe.

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Professional Therapeutic Styles

Professional Therapeutic Styles

Therapeutic styles – how recovery is approached – differ between counselors, coaches, therapists, and other treatment professionals.

Well-trained professionals will often use a style that combines several approaches in therapeutic styles. In early recovery, the best approach is a straightforward one.

It’s vital that you receive quality treatment and that you are comfortable within your professional relationships, especially when you reach a stage of planning deeper, long-term work, the type only a licensed psychotherapist can provide. To help ensure your recovery is successful, you must be on the same wavelength with the people you work with in terms of the therapeutic style that is best for you. This may not happen overnight. Give the relationship you have with a professional time to develop, but immediately talk to the person about any concerns that may arise.

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Psychotherapists

Psychotherapists

Who are psychotherapists?

Psychotherapists are licensed psychologists, licensed clinical social workers, licensed marriage and family therapists, board certified psychiatrists, and licensed mental health counselors who can legally practice psychotherapy. They are qualified to work on all general human issues, such as deep, childhood, and core issues, and any specific areas for which they are trained. This is said to be in their “scope of practice.” Understanding the different certifications, licenses, and other credentials is not necessary to begin recovery, but interview the person you’re considering taking on as your psychotherapist about their background, approaches, and experience to confirm they are a right match for you.

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PROFESSIONAL RECOVERY COACHES

Professional Recovery Coach

Professional recovery coaching is a new field where coaches attend private coaching programs and are certified by private coaching organizations, not the government. A professional recovery coach will focus on your goals and solutions, not on your history – how or why you became an addict. This may be a good option for addicts who have already been in more traditional therapy and have worked through their deeper issues, like those pertaining to childhood, family, and trauma. Professional recovery coaches can also be helpful to those who are in early stages of recovery and trying to focus on immediate goals.

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Professional Help

You need professional help in seeking addiction treatment!

Professionals are a valuable resource for recovery work:

  • Licensed counselors and psychotherapists for deep, personal, relationship, and family work.
  • Coaches for initial recovery and behavioral work.
  • Physicians for medical issues.
  • Health practitioners for nutritional, physical, spiritual, and health issues and development.
  • Body workers, chiropractors, masseuses, personal trainers, and physical therapists for physical help.

It's in your HANDS: Use your HANDS-on method, grip and live Your Recovering Future!

The initial focus should be on your:

  • Thinking and behavior
  • Pressing problems
  • Goal achievement

The mind has a limited amount of energy it can use at once. In early recovery, brief work may be needed to address relationship or family issues, but other core issues, no matter how troubling – like childhood, family, and trauma issues – should be addressed after you’ve stabilized your recovery so that you can focus on more immediate recovery goals.

Selecting A Professional:

Not all professionals know about effective addiction recovery, have good skills, or will work well with you. For instance, a professional with solid experience may have good skills but may not be up-to-date with current resources, which a newly trained person has learned. This can also be true of treatment program staff. Ask the person you’re considering working with about her or his addiction recovery experience and approach to working with clients. A competent professional will answer your questions thoroughly.

Personal work is very desirable, but contain and postpone deeper work!

You want to work with someone who you respect and feel is competent. Ask a friend (minister, teacher, or another professional) for a recommendation or to help you sort out and pick the best person for you. Make a choice and then work with that person for a while.

Many addicts wonder if they should work with a male or female. The gender of a counselor shouldn’t be a big concern unless you have personal issues that make one or the other preferable.

Working With A Professional:

While it’s important to be secure with the professional you select, general anxiety and fear regarding the recovery process may cause you to feel uncomfortable at first. Give a qualified professional a fair chance, unless you have a very negative reaction. This person is supposed to be healthy and competent. If you’re truly trying your best, you should expect the professional to work with your negative attitudes, feelings, issues, and behaviors. Any feeling or topic should be acceptable, even the unusual. However, they should not tolerate dishonesty, extreme negative attitudes (as opposed to minor issues), or a half-hearted effort.

It’s vital that you believe that you’re getting the help you need to recover.

If you feel you have not gotten any real help within ten sessions, but you believe you’ve made a strong effort to be open and honest, and you’ve done what has been asked of you, then you have a valid reason to be concerned. These concerns need to be resolved. Try a few more sessions, but share your concerns with a trusted other. If you still aren’t satisfied after you’ve tried a few more sessions, find someone else to work with before ending the relationship.

Expect quality help, measurable results, & professional behavior!

All professionals must have boundaries. If you think the professional is being improper in any way, take action. It is never okay for a professional to display sexual intimacy or other boundary violations. Immediately find someone new to work with. Furthermore, the professional in question should be reported to his or her certifying organization or state licensing board.

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RECOVERY STRUCTURE

 

Recovery Structure

Live within the recovery structure that you have chosen, built, and maintained.

Look at your life daily and add things you need for your recovery; subtract the things you don’t. Even if it doesn’t feel right in the beginning, do it anyway, because it’s the best thing for you.

Your personal structure will highly influence the ease of achieving and keeping your recovery.

Structure is crucial to recovery; it provides you with the constant reminders necessary to stay focused on your recovery rather than allowing you to go on autopilot and mindlessly respond to whatever comes along, such as the environmental cues that trigger your cravings. You will need to develop a personal structure that will set you up to be successful. Every day (or maybe every hour), have a healthy place to go, supportive people to see, and desirable things to do. Use your reminders to stay focused and move forward. Most successful recovering people started their recovery within the structure of an established program.

The need for extensive structure will continue for many months or even years into your recovery. If you are in a treatment program, as it approaches its end, start preparing to leave that structure and join another program and/or develop your own structure.

Consider: “In my experience, you don’t want… inadequate structure or to use your structure inconsistently.”

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