Addiction Treatment: What Level of Care Do You Need?
You or a loved one has made the difficult but life-changing decision to get help for substance abuse. Now you need to determine what kind of addiction treatment you need to get better. The best way to ensure you’re entering the appropriate level of care is to work with a behavioral health professional. They are specially trained to assess your situation and can help you find the best addiction treatment program based on: A resource some clinicians use to guide this process is The American Society of Addiction Medicine (ASAM) levels of care. This is a set of ASAM patient placement criteria that provides guidelines for assessing the appropriate type of treatment for an individual. It’s a multi-dimensional approach for clinicians and care managers that allows for: The ASAM criteria helps people struggling with substance use disorders obtain the tools and services that will promote long-term recovery for their individual situation. ASAM Levels of Care Criteria ASAM criteria helps determine what level of care you need. The ASAM encourages patients to walk through the criteria with their therapist so they can be an active and educated participant in their treatment plan. These are the six dimensions of ASAM criteria used by clinicians to help guide treatment decisions: #1 Acute Intoxication and Withdrawal This ASAM criteria dimension considers your substance use patterns and risk for drug or alcohol withdrawal symptoms. This may include: #2 Biomedical Conditions and Complications Identifying factors that could impact withdrawal and addiction treatment is the focus of the second dimension of ASAM criteria. This includes any current physical illnesses and chronic conditions. Guidelines can help determine if you are able to manage these conditions on your own or if additional support is needed during the recovery process. #3 Emotional, Behavioral, or Cognitive Conditions and Complications The third dimension of ASAM criteria looks at psychiatric and mental health issues that can complicate treatment or create risk. Considerations include: #4 Readiness to Change The fourth dimension of ASAM criteria assesses the degree to which you’re ready to make a change. This includes both internal and external factors that have motivated you to get help. Your clinician may refer to The Stages of Change, which can help determine readiness and how aware you are of the relationship between addictive behaviors and negative life consequences. This considers factors like: #5 Relapse/Continued Use, Continued Problem Potential This fifth ASAM dimension identifies your risk for continued relapse. You’ll look at impulse control capabilities, coping skills, and past patterns of substance abuse. ASAM criteria for dimension five evaluates your: #6 Recovery and Living Environment The sixth dimension of ASAM criteria assesses your living situation and the level of support or roadblocks to recovery. For instance: Addiction treatment occurs on a continuum, with a range in the level of structure, intensity, and monitoring. The ASAM criteria puts addiction treatment on a continuum of five levels of care that are designated in Roman numerals from 0.5 to IV. Within each level of care, there are decimal number rankings from .1 to .9 to signify the intensity of services within those designations. ASAM criteria is not a one-time assessment. It’s used to assess and reassess your needs throughout the course of care. It not only helps you enter the appropriate level of care but can also guide your ability to “step up” or “step down” in treatment. Depending on your needs, addiction treatment may include some or all of the following: Medical Detox The first step in treatment is often medical detox. This is the process that eliminates drugs and alcohol from your system. During detox from alcohol or drugs, you may experience uncomfortable or life-threatening withdrawal symptoms, so it’s best to undergo detox with the help of medical professionals. At a detox center, you’ll get 24-hour support. Staff will help manage drug or alcohol withdrawal with research-backed medications, monitor your vital signs, and immediately attend to urgent medical situations. Residential Treatment Residential addiction programs provide you a place to live onsite while receiving treatment. Also known as inpatient treatment, you’ll attend groups, activities, and therapy during the day and retire to the treatment centers’ residences in the evenings. This option gives you space and distance from everyday triggers so you can focus on yourself and learn the relapse prevention skills for long-term recovery. Partial Hospitalization Program (PHP) Partial hospitalization programs (PHP) provide frequent and structured programming without the 24-hour feature of inpatient treatment. Partial hospitalization programs usually run around six hours a day, five days a week. While attending a PHP, some people prefer to live in a sober-living residence rather than home. This can minimize triggers and provide peer support outside of treatment hours. PHP programs typically have individual and group therapy as well as direct access to psychiatric care to monitor and manage co-occurring and post-acute withdrawal symptoms. Intensive Outpatient Program (IOP) Intensive outpatient programs (IOP) are structured clinical programs in an outpatient setting. Group and individual sessions are usually offered several times throughout the week. An IOP program provides structure and support while you navigate early recovery in everyday life. IOPs meet less than PHPs and can serve as a step down as you gain more confidence in your sobriety. Hours vary, but generally IOPs meet for about three hours a day, three or four times a week. Outpatient Program (OP) Outpatient programs (OP) help you keep a foothold in addiction treatment as you attend work or school and return to everyday responsibilities. Hours are less than PHPs or IOPs, with some programs only meeting one to three hours per week. OPs are typically scheduled sessions tailored to help you achieve goals related to addictive behaviors, behavior/emotional issues, and coping with stressors without the use of substances. The goal is to achieve stability in recovery and develop outside supports. Get Help For Addiction Because each person comes with their unique journey and experience, treatment is not “one size fits all.” Using multi-dimensional criteria allows for assessment of the whole person to match
What’s the Difference Between Counselor and Psychologist? What About MSW, LPC, More?
Many who are considering mental health treatment wonder about the letters behind people’s names. They can be a bit confusing and even intimidating. There are many different job titles, licenses, and jargon in the mental health and addiction treatment spaces. And different states have different names and regulations for essentially the same roles. This can add to the confusion, but we’re here to break it down for you. The Difference Between Counselor and Psychologist There are a few major roles that are important to understand right off the bat. Counselor and psychologist are two of them. A counselor and a psychologist perform two different job functions, meaning they do different things for their clients. A counselor has a master’s degree in either counseling, social work, or psychology. They perform individual, group, and family therapy. Techniques they may use are cognitive behavioral therapy, EMDR (eye movement desensitization and reprocessing), biopsychosocial assessments, and many more. They specialize in treating a wide variety of mental health conditions and addictions. A psychologist tends to do more assessments. They hold a doctoral degree in psychology. This means they have extensive knowledge of the scientific research underlying mental health disorders. They often perform comprehensive psychological evaluations. These differ from the biopsychosocial assessments that counselors do. Psychological evaluations usually include several tests, like IQ tests, ADHD assessments, record collection, and interviews. Psychologists often perform therapy as well. Finally, it’s important not to get either of these titles confused with psychiatrists. Psychiatrists focus primarily on medication. They have the same level of education and training as doctors and nurse practitioners, but they specialize in how brain chemistry produces mental illness and/or addiction. They may perform assessments and diagnose people as well. Their role then shifts to medication management rather than counseling. What Do All These Licenses Mean? PhD – Clinical Psychologist A clinical psychologist holds a PhD in clinical or counseling psychology. A clinical psychologist can administer psychological and personality tests. They can also diagnose mental illness and provide therapy. In some cases (dependent on their state and their training), they may prescribe medication. You might have heard that PhD programs are only for people who do research, but this is not usually the case. PhD programs in clinical psychology vary in focus. They will always provide extensive training in psychotherapy. If you’re referred for a psychological evaluation, you’ll likely see a clinical psychologist. There’s a good chance you’ll see one for therapy as well. PsyD – Clinical Psychologist A provider who holds a PsyD in psychology is almost identical to the above PhD. Like a PhD, the Doctor of Psychology degree (PsyD) prepares people to practice psychology in many clinical settings. They may provide therapy as well. But someone with a PsyD focuses more on clinical practice and less on research. A PsyD will perform the same services for clients as someone with a PhD. MSW – Clinical Social Worker A provider who holds an MSW (Master of Social Work degree) can provide mental health services. They include psychotherapy, diagnosing mental health conditions, and performing biopsychosocial assessments. Clinical social workers are not trained to administer psychological and personality tests. Social workers have skills and theories to challenge social injustice and change systems of care. The Master of Social Work offers coursework in: Clinical practice Social administration Public policy Research Ethics An MSW degree can lead to many different career paths in the public health and medical fields. There are different levels to the social work licensure process. Somebody who has obtained the highest level of license usually has the acronyms “LCSW” after their name. This stands for “licensed clinical social worker.” An MSW may perform any number of services for you, like: Counseling Case management Community organizing If the provider you’re seeing has any acronyms with a “C” for “clinical,” this indicates they most likely practice in behavioral health. Other non-clinical MSWs often don’t get extra licensure. MA/MS Counseling – Licensed Professional Counselor A provider who holds a master’s degree in counseling can provide many mental health services. These include psychotherapy, diagnosing mental health disorders, and performing biopsychosocial assessments. A master’s in counseling prepares an individual for a variety of counseling options, like: Marriage and family therapy Rehabilitation counseling Vocational counseling Mental health counseling Students in Master’s in Counseling degree programs study counseling theories and techniques. They may also study psychological testing, ethics, research, cultural perspectives, and psychological development. There are different levels to the professional counselor license process. Somebody who has obtained the highest level of license to practice will usually have the acronyms “LCPC” after their name. This stands for “licensed clinical professional counselor.” An LPC can do everything an MSW can do within behavioral health. They may have extra training in a wider variety of counseling approaches. They may also have deeper knowledge of histories and theories. Unlike MSWs, they don’t have training in systemic injustice and community organization. MA/MS – Clinical Counseling Psychology A professional counselor is a provider who holds a master’s in clinical psychology. In some states, they can do the same as a clinical psychologist can. In most states, they perform the same functions as the other master’s-level clinicians. They will have the “Licensed Clinical Professional Counselor” title. MFT – Marriage and Family Therapist A provider who holds a master’s in marriage and family counseling can do the same things as the other master’s-level clinicians listed above. There are a lot of similarities between this role and clinical counselors—so many, in fact, that the Bureau of Labor Statistics groups the two together. However, an MFT places a focus on treating couples and families. Marriage and family therapists can work with individuals as well. MD or APRN – Psychiatrist A psychiatrist is a medical doctor who completed medical school. They are trained to diagnose mental health disorders and prescribe medication. Psychiatrists usually focus on prescribing psychiatric medication. In rare cases, they may perform therapy as well. Psychiatrists can also be APRNs, or “advanced practice registered nurses.” These professionals need to
What Is Harm Reduction in Substance Abuse?
Harm reduction is a relatively new movement. The goal of harm reduction strategies is to keep you as safe as possible if you’re abusing drugs until you’re ready to get help (i.e., reduce harm when it can’t be eliminated). Harm reduction accepts that complete abstinence is not always possible. With this mindset, harm reduction strategies and programs can have a life-saving impact. Harm reduction strategies may include needle exchange programs to limit the spread of infectious diseases through the use of dirty needles as well as supervised injection sites that aid in reducing the number of drug overdose fatalities. The focus is to lower problematic drug use and improve lives. Harm reduction typically involves community resources and seeks to reduce stigma related to drug addiction and serve everyone without discrimination. The journal Pediatrics & Child Health reports that harm reduction began as a public health policy aimed at people who can’t stop using drugs. Drug addiction is a chronic disease with relapse rates of 40 to 60%. Complete abstinence is not always feasible for everyone. In response, harm reduction provides resources to people who need them while reducing the stigma surrounding drug use and addiction. Harm reduction strategies can: There is some controversy around harm reduction programs since they do not expect participants to stop using all drugs. Many people believe full abstinence is the only path to recovery. Harm reduction proponents argue that harm reduction strategies, programs, and policies have been shown to save lives. Harm Reduction International reports that harm-reduction strategies are evidence-based, and they’ve had a positive impact on many communities. Types of Harm Reduction Strategies There are several types of harm reduction strategies aimed at people who aren’t ready to get substance use disorder treatment. These include: #1 Needle Exchange Programs Sharing needles can increase your risk of contracting an incurable infectious disease. According to the Centers for Disease Control and Prevention (CDC), needle exchange programs (NEPs) can lower the risk of contracting blood borne infections, such as viral hepatitis and HIV. Needle exchange programs are community-based. They provide sterile needles and syringes to drug users in hopes of reducing the harm from sharing dirty needles. Most of the time, needles and syringes are provided at no charge, and safe disposal sites are also available to drop off used injection drug paraphernalia. In addition to new and sterile syringes and needles, NEPs may also provide: #2 Medication-Assisted Treatment (MAT) MAT programs include both medications and therapies as part of a treatment plan for opioid abuse and addiction. Medication-assisted treatment is often offered through opioid treatment programs (OTPs) that are regulated and accredited by the Substance Abuse and Mental Health Services Administration (SAMHSA). Medication-assisted treatment involves the use of maintenance medications, such as methadone or buprenorphine-based medications. These medications help you sustain recovery by easing cravings and opioid withdrawal symptoms. You’ll feel less of an urge to abuse more potent and shorter-acting opioids like heroin and prescription painkillers. Federally regulated OTPs include counseling, education, medical care, and additional treatment as needed. MAT services can be offered in the following settings: #3 Naloxone Programs Seventy percent of all U.S. drug overdoses were attributed to opioids in 2019. The high rate of opioid overdoses is a public health emergency. Naloxone is an opioid antagonist medication that helps to reverse an opioid overdose when administered quickly. It can be distributed through injection or as a nasal spray. Many states have standing orders in place that allow naloxone to be dispensed from local pharmacies to people in need, even without a prescription. This means that if your loved one battles opioid addiction, you can often get a prescription for Narcan (naloxone). This may enable you to save their life in the event of an overdose. Naloxone programs are often part of community-based operations. Many offer training and education on: The CDC says that dispensing naloxone to laypersons can save lives and is a cost-effective public health service. The Good Samaritan Law prevents prosecution of anyone using drugs if they administered the naloxone and/or called emergency personnel to help someone in need. #4 Supervised Injection Sites A supervised injection facility is a place you can go to use pre-obtained drugs in a safe environment with clean needles and syringes. These harm reduction centers are staffed with health care professionals who can administer aid if you overdose. The focus is on preventing negative consequences of drug use like overdoses and diseases like HIV, as well as promoting healthy practices for people struggling with addiction. Supervised injection sites are also known as: Some research suggests safe injection sites can decrease the transmission of infectious diseases that are spread by the use of dirty needles, and they can reduce drug-related morbidity and mortality. Supervised injection sites can provide: If you haven’t heard of them, don’t be surprised—there are currently no legal harm reduction centers in the U.S. There are approximately 120 harm reduction centers in more than 10 countries, including: Although there are none in the United States, movements in New Jersey, Colorado, and California are picking up speed. There is a lot of controversy surrounding these programs. Critics believe that supervised injection locations enable drug abuse and make it easier to maintain active addiction. They believe that people who use drugs may push dosage limits even higher because medical staff are on site. #5 Moderation Management The majority of people who drink alcohol do not battle alcoholism, but many struggle with problem drinking. Most of the treatment options and support groups, including 12-step programs, address alcohol addiction and the need for complete abstinence. The nonprofit Moderation Management, or MM takes a different approach. Moderation management strategies address risky drinking patterns and seek to improve overall quality of life by reducing negative behaviors and the harm associated with problem drinking. It does not require 100% sobriety. It allows drinking in moderation. The group’s harm reduction strategies teach members to: Moderation management programs let members decide how they want to cut back on drinking. According
I Don’t Want to Go to Rehab
Going to drug rehab isn’t exactly at the top of anyone’s list of things they want to do, but many times it’s a necessary step toward taking back your life, or even saving your life. You may have several reasons why you don’t want to go to addiction treatment. Many of these reasons are probably excuses tied to myths about addiction or what drug and alcohol rehab is like. Some of the reasons why you don’t want to go to rehab may include: 1. I’m Scared of Detox. Many people have an inaccurate idea of what detox is like. Hollywood often paints a picture of someone alone in a bare room going through painful withdrawal symptoms without help. That’s simply not the truth. When you go through medical detox at an addiction treatment center, you’re under 24/7 care from health professionals. They use research-backed medications to help ease withdrawal symptoms. While this doesn’t eliminate all discomfort from drug or alcohol withdrawal, it makes it much more comfortable. Detox specialists also regularly monitor your vital signs and make sure you’re safe. You’ll typically have your own room with a bed and other comfortable furnishings. 2. My Substance Abuse Isn’t Bad Enough for Drug Rehab. If your drug or alcohol use even has you wondering about addiction treatment, it’s time to take a closer look. Same goes for loved ones or employers who’ve confronted you about drug and alcohol use. If people are noticing your substance use and questioning whether you have a drug or alcohol addiction, chances are there’s reason for concern. Maybe you think just because you don’t drink or use drugs every day, you don’t have a substance use disorder. Perhaps you point to the fact that you can hold a job, go to school, or manage family and personal obligations as a reason why you don’t need help. The reality is, left untreated, addiction gets worse. Repeated drug and alcohol abuse changes how your brain functions, and you’re going to need to keep increasing substance intake to get the desired effect, or even worse, to stave off withdrawal symptoms. Not to mention, the long-term impact of drug and alcohol misuse is eye-opening. Depending on the substance, amount, how long you’ve been using it, and your individual make-up, drug and alcohol abuse can lead to: Alcohol abuse and drug addiction come in many forms. For instance, maybe you’re misusing prescription medications. Perhaps you’re only engaging in “heavy” drinking or recreational drug use occasionally. Regardless of the situation, substance abuse can alter your perception of the situation. While things may not be “that bad,” history tells us that with continued drug and alcohol abuse things tend to get worse before they get better. If you’re contemplating whether you need addiction treatment, the best thing you can do is get an assessment from a professional. 3. I Can’t Afford Addiction Treatment. The cost of drug and alcohol rehab is a concern for many people. The truth is addiction treatment may be more affordable than you think. Most insurances have a behavioral health component that may pay for treatment fully or partially. Medical detox is considered a medical necessity by most insurances and should be covered. Insurance coverage for substance abuse varies by provider and state. The best way to determine the cost of drug rehab is to verify your insurance coverage through the addiction treatment center. For instance, Footprints to Recovery offers free insurance benefit checks. We work directly with your provider to understand exactly what is covered and out-of-pocket costs and relay all that information to you. If you don’t have insurance or your insurance doesn’t cover drug rehab, there are other options. Some treatment centers offer payment plans for self-pay clients. You can also consider a lower level of care. For instance, maybe your insurance doesn’t cover residential treatment, but may offer some coverage for outpatient treatment or intensive outpatient treatment. Finances need not stand in the way. There are ways to get the help you need. 4. I Can’t Take Time off Work or School. The thought of taking time off work for alcohol or drug rehab can feel overwhelming. You may worry that your job will be in jeopardy if you do so, and of course there’s the financial concerns of not collecting a paycheck while you’re away. You should know that there are laws that prevent employers from firing you for taking a leave of absence to get this kind of help. The fact is, not getting help now may cost you your job down the road anyway. 5. I Can’t Take Time Away from Family. It’s not easy to carve out this time for yourself, but it is going to help you and your family in the long run. Ask yourself if you’re really there for your family in ways you’d like to be right now. Sacrificing a short amount of time for addiction treatment can create monumental, lasting positive change in your life. If inpatient drug rehab isn’t doable, consider outpatient rehab, which usually has day and evening hours, so you can maintain work or family obligations. All in all, it’s a worthy debate that ultimately your life will ‘remain on hold’ if you’re not seeking positive change. Why worry about putting life on hold when your life will perpetually be on hold while battling substance abuse? Try and do some positive thinking, imagine what living life clearly without being in active addiction will do for your physical, mental, and overall health. This is the time to rally your resources and loved ones to help with family and other responsibilities, so you can get the help you need to make a better life for all of you. 6. I Can Handle This on My Own. Quitting drug and alcohol abuse on your own is extremely difficult once you’ve developed a chemical dependency. Some people find they can quit for a little while, but the cravings and withdrawal symptoms continue to drive them back
6 Celebrities in Recovery
Celebrities in recovery are a reminder that addiction doesn’t discriminate based on status and wealth, and everyone must do the same work to stay sober. Athletes and celebrities sometimes use substances to cope with the pressure they feel to be perfect. They’re in the public eye and constantly evaluated based on their performance. They’re also not immune to the everyday stress that comes with being human while having to perform or compete at top levels. Stress can be a major factor in why athletes abuse drugs and alcohol. That stress manifests as competing in your respective sport for years on end and the toll it takes on your body and mind. Drugs and alcohol can help athletes temporarily numb the physical pain that comes with pushing their bodies to extraordinary limits. However, substance use can lead to addiction and significant negative side effects that impact physical and mental health. Celebrities and athletes provide some of the most incredible examples of perseverance and victory over alcohol and drug addiction. No one is safe from its consequences. 1 – Celebrities in Recovery: Michael Phelps Michael Phelps is the one of the greatest Olympians of all time, winning 23 gold medals during his Olympic swimming career. In 2008, Phelps was portrayed negatively in the public eye despite being awarded Sportsman of the Year by the U.S. Olympics Committee and Male Athlete of the Year by the Associated Press. Past consequences of his substance use were brought forward, including a drinking and driving charge at the age of 19 following the 2004 Olympics in Athens. Pictures circulated in the media with him holding drug paraphernalia. In 2014, Phelps was arrested again for drinking and driving. Phelps attributes each incident involving alcohol and drugs to a way he coped with mental health issues, stress, and pressure. He has been very open about the impact of being an Olympic athlete and actions he had to take to support his recovery in the documentary, “The Weight of Gold.” 2 – Celebrities in Recovery: Darren Waller Darren Waller is an all-pro football player for the Las Vegas Raiders. His addiction to drugs almost cost him his shot at being on the football field. Waller was becoming a force to be reckoned with in football while privately fighting a battle with addiction. In 2015 Waller was drafted in the 6th round of the NFL draft by the Baltimore Ravens. Waller shared that he couldn’t even be happy about it because all he was worried about was how to get his next high. In 2016, Waller should have been on the field playing his first NFL season – instead, he spent the first four games suspended on the bench after violating the League’s substance use policy. The following season, Waller was suspended for the entire season without pay after losing consciousness from taking prescription pills laced with fentanyl. When he came to, Waller knew he had to make a change. He did make that change, and in 2021, Waller was named the Las Vegas Raiders’ nominee for the Walter Payton NFL Man of the Year Award, which recognizes an NFL player for outstanding community service off the field and excellence on the field. He also established the Darren Waller Foundation, through which he teaches kids and teens that drugs and alcohol are not the answer and encourages them to look for other ways to find fun and enjoyment in life. 3 – Celebrities in Recovery: Chris Herren Chris Herren played professional basketball from 1999 to 2006. During much of his career, he grappled with addictions to OxyContin, Vicodin, and Percocet. In 2008, Herren was using heroin when he crashed his vehicle into a pole. He was pronounced dead for 30 seconds. Herren says that day was the day he began his journey toward recovery. Since achieving sobriety, Herren wrote a memoir and started The Herren Project, a nonprofit devoted to helping those affected by addiction. He opened his own addiction treatment center and has been touring the country since 2012, telling his story of addiction and recovery to inspire change and hope. Herren also launched Project Purple, an anti-substance use campaign he references in his speaking engagements. 4 – Celebrities in Recovery: Darryl Strawberry Los Angeles native Darryl Strawberry was the number one overall pick in the 1980 MLB Draft by the New York Mets. Strawberry won National League Rookie of the Year in 1983 and led the National League in home runs in 1988. Strawberry also suffered from cocaine addiction and alcohol addiction throughout his career. His addiction led to three suspensions during his baseball career and several arrests. Strawberry credits his faith and his wife as the pillars of his recovery. He is currently sober and has opened several substance use disorder rehabilitation centers to help others struggling with alcohol and drug use. 5 – Celebrities in Recovery: Mickey Mantle Mickey Mantle, known as “The Mick” played centerfield for the New York Yankees his entire baseball career, from 1951 until 1968. He is a seven-time world champion; was selected three times as the American League Most Valuable Player (MVP); made the All-Star Team 16 times; won the Triple Crown achievement; and is a member of the National Baseball Hall of Fame, among many other accolades. It’s for these awards that Mantle is often referred to as the greatest switch hitter of all-time. He had a wife and four children. During and after his baseball career, Mantle suffered from alcohol addiction. He had his first drink at age 19 with a teammate and continued to drink after that. Mantle publicly came to terms with his alcohol addiction and stopped drinking in 1994 as he watched not only himself but his sons struggling with substance use. In recovery, Mantle made amends with his estranged ex-wife and found direction through his faith. 6 – Celebrities in Recovery: Robert Downey Jr. Movie star Robert Downey Jr. has a well-publicized history of addiction. Downey Jr. says he spent most of his early days as an actor impaired by drugs
Using Expressive and Experiential Therapy to Heal in Addiction Treatment
More than 23 million Americans suffer from addiction to drugs or alcohol. Unfortunately, 75% of them report not receiving any form of treatment for their addiction. If you do choose to get help, picking the right treatment can feel overwhelming because of the many different options. In the world of addiction treatment, talk therapy is the most well-known approach, but it’s not the right fit for everyone. Talk therapy can be scary, especially when you’re expected to discuss past trauma and difficult emotions. You might find it hard to describe your experiences, or you may not be ready to talk about them yet. Recently, other therapy approaches have gained the spotlight, including expressive and experiential therapies. These therapies focus on engaging in specific activities and experiences. They go beyond traditional talk therapy and provide unique ways of healing. Experiential and Expressive Therapy for Addiction Imagine addiction as an iceberg: The part above the water—that you can see—is just the symptom of something deeper. It shows only part of what is going on. The unseen part of the iceberg represents the trauma or pain that is driving the addiction. Therapy that addresses only the tip of the iceberg isn’t effective, and it means a higher chance of relapse. Experiential and expressive therapies provide a way to see what is below the surface. By exploring and resolving root causes, the chances for recovery are much better. Until past traumas heal, people tend to continue old behaviors. While all effective therapy should address the root cause(s) of addiction, experiential and expressive therapies provide unique alternatives to traditional therapy. They can also be used in conjunction with other therapies. Beyond healing past traumas, experiential and expressive therapies can help you: What Is Experiential Therapy? Experiential therapy grew out of experiential learning theory and comes in many forms, but it’s main goal is to help people heal through doing. It uses different activities and experiences as ways to engage in the addiction recovery process. Experiential therapy is often used alongside traditional talk therapy. Here are a few common examples of experiential therapy: Adventure therapy uses recreational activities, like hiking, backpacking, or rock-climbing, to aid in recovery. The thought of doing these things may feel uncomfortable, or even scary, but working through these hard activities can improve your problem-solving skills. Adventure therapy also supports trust-building and teamwork. Martial arts, like Jiu jitsu, are becoming more popular in treating addiction. They promote personal discipline and focus on the present moment and can also help establish a sense of personal control. This is helpful because as someone addicted to a substance, you may have felt out of control for a long time. Volunteering – Studies show volunteering helps in recovery from mental health problems and addiction. Addiction can cause people to focus inward—only on themselves. Volunteering is a way to shift the focus to others. People who volunteer report increased empathy and compassion. It can also provide community and connection. There are many ways to volunteer. You could: What Is Expressive Therapy? Expressive therapy combines psychology with different creative outlets. This therapy comes from the belief that everyone can express themselves through creativity. It encourages healing and growth in a non-traditional way. Because everyone expresses themselves differently, this is a very flexible therapy. Here are a few common examples of expressive therapy: Art therapy is about creative expression using various types of art, such as: Creating art is a way to promote: In addiction treatment, art therapy helps people express emotions without having to come up with words to talk about them. Art therapy also increases emotional understanding and confidence. Dance therapy comes from the idea of the mind-body connection. It uses movement to support all parts of you: emotional, physical, and mental. The purpose of dance therapy is more than exercise; movement expresses emotion and allows you to connect with your body. Bibliotherapy uses the written word to help the healing process. You may read specific books recommended by your therapist, compose poems, and/or write or tell stories. Bibliotherapy provides a unique space for expressing your feelings and emotions, and it can help you work through past hurts and tap into a creative side you may have been missing. Music can increase positive feelings in your body and your mind, and while music therapy can just involve listening to music, it’s also diverse! You could create music yourself by playing an instrument or writing song lyrics, or you could sing. Music therapy might also combine another activity (such as journaling) with the music process. Drama therapy is one of the most engaging therapies. It uses role-playing and other theater practices (like improvisation, projection, and metaphor) to help you share your stories. It can also help with expressing feelings and strengthening relationships. Drama therapy allows you to take on other “roles.” For many people, it can feel “safer” to convey their thoughts and feelings as someone else. Drama therapy also creates the opportunity to re-enact difficult experiences from the past, which can be healing. This expressive therapy can be done by yourself, as part of a couple, or with family members or other groups. If you’re interested in learning more about experiential and expressive therapy to help you work through your addiction and live a sober, happy life, contact Footprints to Recovery today. References
Adventure Therapy as Addiction Treatment
Adventure is defined by the dictionary as “an unusual, exciting, or dangerous experience, journey, or series of events.” Adventure therapy is a mental health discipline that uses the natural environment to help you cope with and overcome behavioral, cognitive, social, and affective disorders. You could say recovering from addiction is an adventure—full of unknowns that can be both scary and exciting. Most adventure therapy activities are outdoors, but some may also be indoors. Regardless of location, adventure therapy activities have one thing in common: an element of perceived or actual risk. To confront and overcome risk, you need to rely on trust in yourself, cooperation with others, and stepping out of your comfort zone. When you engage in adventure therapy for drug addiction treatment, you’ll be supported by a mental health professional, who will lead you through activities that promote communication, challenge your mind, and get you out of your everyday routine. How Does Adventure Therapy Work? At its core, adventure therapy is a type of experiential therapy. That means it facilitates talk therapy through hands-on activity. Art, drama, and music are other forms of experiential therapy. Adventure therapy has the added benefit of the natural healing properties of the outdoors. When you take part in adventure therapy, you might: While they may seem exciting or even overwhelming, adventure activities do another important thing: They can help put you in a more relaxed state. While exercising and enjoying time in nature, people find it easier to open up to their therapists or each other. Adventure therapy therefore facilitates talk therapy by helping you feel comfortable and at ease, which can be a difficult place to get to in substance abuse treatment. Many people find that even if they were unwilling or hesitant to engage in treatment before, they feel motivated after completing adventure therapy. Adventure therapy has other therapeutic benefits as well: Who Benefits from Adventure Therapy? Adventure therapy has been shown to be effective for a variety of people in a variety of age groups. While research on this topic has so far been mainly focused on youth (especially adolescents with behavior problems), this doesn’t mean adults don’t benefit from adventure therapy. It just means youth treatment programs are studied more. There’s also evidence that adventure therapy is helpful in treating substance abuse disorders among all age groups. Adventure therapy for addiction treatment is designed to challenge people who have struggled with substance abuse to overcome their perceived limitations, guilt, and other overwhelming emotions and develop an enhanced sense of self. Therefore, adventure therapy is a good fit for: Who Isn’t a Good Fit for Adventure Therapy? Addiction treatment must be individualized because every person’s experience with drugs or alcohol is different. Just as it might take time to discover the right addiction therapy for you, you may find adventure therapy isn’t the best fit. It should be noted that a physical disability doesn’t have to keep you from participating in adventure therapy. The primary benefit of this approach lies in its exposure to nature and some element of risk. These activities can be adapted to suit all abilities and skill levels. Even so, the potential risks of adventure therapy should be weighed against the benefits. Not all those recovering from addiction enjoy being outside and in nature. Some may have anxiety related to the outdoors. Others may have health problems that don’t necessarily keep them from participating in outdoor activities but may keep them from enjoying outdoor activities. Examples of those for whom adventure therapy may not work well include: In short, adventure therapy can only be effective if you’re able to find the outdoors invigorating and enjoyable. How Does Adventure Therapy Compare to Other Addiction Therapies? As with all experiential therapies, adventure therapy is more about doing than saying, at least at first. Its benefits come from the sense of wonder, accomplishment, and pride it can bring you. Other therapies have these same benefits but achieve them through much different means. For example, cognitive behavioral therapy is a traditional talk therapy in which the therapist has a conversation with the client. This conversation doesn’t have to happen sitting across from one other in an office, but it often does. Dialectical behavior therapy, which is typically held as a group with participants sitting in a circle, is also talk-oriented. These approaches rely on cognitive change—changes in the way you think that then impact your moods and behaviors. They teach behavioral skills you can apply to different situations and take into the future. Traditional addiction therapies, like talk therapy, have proved to make lasting impacts. Are the changes that come from adventure therapy sustainable? Studies suggest they are. By definition, adventure therapy is time-limited. Its positive effects may best be sustained by continuing to practice mindful adventure as relapse prevention. Adventure Therapy: Just One of Many Options at Footprints to Recovery Here at Footprints to Recovery, we are proud to offer adventure therapy among our list of holistic and evidence-based treatments. Whether you are new to adventuring or seeking to return to it, this form of therapy could become an integral part of your treatment plan. Being strong and proactive in addiction recovery doesn’t mean you won’t make mistakes. Like a climbing a mountain, the path to recovery involved inclines and dips, corners and traps. Addiction recovery is a continual process of renewal. This journey is an adventure—scary and arduous at times, but in the end, well worth the climb. References
Learning Life Skills in Addiction Treatment
Ideally, throughout adolescence and young adult life you develop skills that help you deal with difficulties and build resilience. You modify those skills as you continue to grow and experience change. If you’ve struggled with alcohol and drug abuse, you may have either missed out on the opportunity to develop life skills during younger years, or drugs and alcohol have gotten in the way of your ability to self-manage, adapt to change, and develop these capabilities. A lack of life skills can get in the way of your sobriety. That’s why addiction treatment centers emphasize the necessary tools and resources needed to build healthy and positive life skills. A critical component of relapse prevention is learning or re-learning life skills in recovery. Often called “life skills training,” most drug rehabs offer opportunities to practice life skills in recovery as part of their addiction treatment program. This may include anything from building a resume and practicing interview techniques to learning to manage mental health challenges and maintaining healthy relationships. Addiction treatment centers typically have several life skills activities for adults in recovery that cover critical areas like: Healthy Coping Skills When you’re abusing drugs or alcohol, your ability to cope in a healthy way deteriorates, chipping away at your resiliency. Alcohol and drug addiction sometimes serve as coping mechanisms for people who struggle with difficulties like: In drug or alcohol rehab, you’ll learn healthy habits for managing stress, regulating emotions, and dealing with social, emotional, and relational challenges. Structure and Routine During your days of substance abuse, you probably didn’t have much structure to your life. Getting or using drugs or thinking about them occupied your time and dictated how you spent it. Sobriety can leave a void that drugs and alcohol previously filled. That’s why it’s critical to establish a daily routine in addiction recovery. Idle time can lead to boredom, which is a known risk factor of relapse. An addiction treatment program will teach you about the importance of: Self-Care Practicing self-care probably wasn’t at the top of your list when you were using drugs or alcohol. Both your physical and mental health likely took a beating. Taking care of yourself is an integral part of recovery. At alcohol and drug rehabs, life skills activities for adults in recovery include education on ways to practice self-care. Some ways to take good care of yourself: Vocational or Educational Pursuits Having a plan in place for how you’ll spend much of your time after addiction or mental health treatment is an essential life skill in recovery. Studies show that being employed significantly reduces the risk of addiction relapse. If you’re not working right now, going to school or having a volunteer position can provide the same sense of purpose and self-reliance as a job. One of the focuses of outpatient treatment is sometimes helping you figure out these next steps. Staff may help you create a resume and get interviews or fill out school applications. Practical Skills Life skills for recovering addicts also include learning or re-learning practical skills needed in everyday life. If you have a substance use disorder, you may have spent days, months, or maybe even years living for your addiction. Your primary concern was reaching that high or finding that next hit. This can cause you to lose sight of daily responsibilities, such as paying your bills on time, going to work, and taking care of yourself physically and mentally. Training on practical skills is typically part of the day-to-day programming in residential addiction treatment. This may include things like creating a budget and managing finances or planning and preparing meals. Some alcohol and drug rehabs give clients a budget and have them shop for groceries and help prepare meals. This is also the case in many sober-living residences. Social Skills It can be daunting to think of social situations and relationships without drugs or alcohol. It may have been quite some time since you’ve been sober in a social situation. Addiction treatment programs usually provide many opportunities for you to practice being sober and social. For instance, often there are recreation opportunities and outings, so you can get a feel for connecting and having fun without drugs or alcohol. Communication Skills It’s important to learn new ways of communicating to support healthy relationships in recovery. Group therapy will help you learn how to communicate effectively as well as how others perceive you. Family therapy can also be a critical component of learning healthy communication. You may find some people in your life present the same communication problems as you’ve had with loved ones. In both group and family therapy you’ll learn about conflict resolution and ways of relating to others that are supportive and helpful. Knowing When to Get Help Another important life skill in sobriety is knowing when you need help. Being in tune with yourself and your recovery and realizing when you’re at risk of relapse is critical. If you feel like drugs and alcohol are becoming a real option, reach out to a sponsor, loved one, therapist, or recovery center so you can head off a relapse before it happens. References
Contemplating Addiction Treatment? What to Consider & How to Prepare
Addiction is a complex but treatable disease that impacts an individual’s behavior and ability to function through everyday life. When it comes to addiction treatment, it is important to know what treatment options are readily available to the individual. In addition to being aware of the treatment options, it is important to understand that effective treatment is not a one-size fits all model. No single treatment is appropriate for everyone and therefore, finding a treatment program that is person-centered and matches well with the characteristics of individuals is the best route to take. Once the commitment has been made to enter into a substance use treatment program, there are a few things one can do in order to be fully prepared. It is common to feel overwhelmed and stressed about putting things on hold in order to focus solely on one’s recovery; however, it is also important to understand that these things can be dealt with by taking the time to prepare for treatment. Below are some tips on how best to prepare for treatment. First, be sure to understand what the various types of treatment options are and which options fit the individual’s needs at this stage in their recovery. Understanding what one wants out of treatment may help guide them to make a decision on which treatment program to attend based on their needs. Below are some things to consider: What level of care may be most appropriate: 1. Detoxification Services: an inpatient setting where individuals may receive medically supervised detoxification; length of stay is generally 3-5 days) 2. Residential Services: an inpatient setting where individuals may receive a wide array of services at the facility; length of stay can vary from 30-120+ days, usually determined by insurance and clinical support. 3. Partial Hospitalization Program: an outpatient setting where individuals attend treatment a minimum of five times a week for approximately six hours a day; length of stay is generally 30 days or as medically necessary. 4. Intensive Outpatient: an outpatient setting where individuals attend treatment anywhere from three to five days a week for three to five hours a day; length of stay can be one month or longer depending on medical necessity. 5. Outpatient: an outpatient setting where individuals attend treatment anywhere from one to two days a week for three to five hours; length of stay is generally 30 days or longer depending on medical necessity. What type of therapies are important: 1. Individual Therapy: one on one therapy with a licensed clinician. 2. Family Therapy: therapy that includes the involvement of the family or other support systems the patient would like to include. 3. Group Therapy: therapy conducted with two or more individuals present at a time, led by a licensed clinician. 4. Trauma Therapy: a specific therapeutic approach geared towards assisting the patient in recognizing and emphasizing an understanding of how traumatic experiences impact the patient mentally, behaviorally, emotionally, physically and spiritually. As trauma is often prevalent in addiction, this has proven to be especially helpful in treating addiction. 5. Psychiatric Services and Medication Management: services provided by a licensed professional geared towards assisting the patient in managing co-occurring disorders with the support of medications. 6. Medication Assisted Treatment: the use of medications in combination with counseling and behavioral therapies for the treatment of substance use disorders; includes medications such as Methadone, Suboxone, Vivitrol, etc. How else do I prepare: Tell Friends and Family Tell People at Work Prioritize Recovery Regardless of whether or not an individual’s friends and family are aware of their addiction, the people whom they love will more than likely be relieved to know that they are getting the help they need. It is important, to be honest, think about how to tell them and don’t doubt the decision to enter into treatment. The support of one’s family and friends can play a critical role in the success of that individual’s recovery, so being able to tell friends and family what is going on can allow those people to support an individual throughout the process. While being open and honest with family and friends is the best policy, telling people at work is up to the discretion of the individual. Depending on the individual’s work policies around extended leaves of absence, it may be required that the individual disclose the reason for the absence to their Human Resources department; however, individuals are not obligated to tell their co-workers or direct boss the reason for this leave. Addiction treatment is not a one size fits all, so it is important for each individual considering addiction treatment to identify what their needs are and, when seeking out programs, determine if that program can truly meet their needs. Last, but certainly not least, it is imperative that individual’s put their recovery first and foremost. Treatment is being sought because the extent of the substance use has become unmanageable. Entering into Addiction treatment is the time to put the focus on oneself. This is the time to hone in on the healing process, to rebuild one’s life skills and learn to function in life without the use of substances. Committing fully to that journey will allow individuals to experience the true value of treatment and long-term recovery. Remember, addiction is treatable! Don’t ever hesitate to advocate for yourself or a loved one who may be seeking treatment. Take a moment to look at the different options and make the choice that fits your needs or your loved one’s needs at that moment in time. Author: Bonnie Wright, MBA – Footprints to Recovery – Executive Director, Colorado
Why Individual Therapy Is Important for Addiction Recovery
Millions of Americans struggle with addiction, but millions more are in recovery. With the right treatment and a desire to change, a fulfilling life in recovery is possible. Many people will need the structure, support, and evidence-based approaches of an addiction treatment center to get better. These settings give you time and space away from triggers and provide a wide range of therapies. Individual counseling is one of these. What Is Individual Therapy? Individual therapy is also known as: In individual therapy, you’ll work one-on-one with a trained mental health professional to work through issues in a safe space. Your therapist will help you identify unhealthy thoughts and how they contribute to behaviors. You may discuss family, difficult relationships, and past experiences. Your therapist will help you recognize how previous challenges are affecting you in the present day. You may also develop goals for individual therapy. These may include decreasing symptoms of depression or anxiety, building a better support system, or remaining drug- and alcohol-free. It’s a collaborative process, and your therapist will work with you to develop your goals and come up with a plan for achieving them. There are many types of individual therapy that have been proven effective. Some of these include: These are just a few. You can work with your therapist to find out which option is best for you. Why Is One-on-One Therapy Part of Addiction Recovery? Individual therapy can be a powerful intervention in addiction recovery. Many people turn to drugs or alcohol to cope with trauma or negative experiences and emotions. Individual therapy can help address these underlying issues. Addiction can also put you in scary and vulnerable situations, like: There is often a lot of emotional pain to sort through once substances have left your system. An individual therapist can help you work through your feelings and change unhealthy patterns. This process is essential to long-term recovery. Learning to manage your new sobriety is equally important. Things like stress, negative thoughts and emotions, and past people or environments can be triggers for relapse. Individual therapy can help you learn healthy coping skills in the face of triggers. What to Expect from Individual Therapy If you’re considering individual therapy, you may have questions like: Individual counseling sessions typically begin as one-hour long sessions once a week. How frequently you meet with your therapist may vary depending on your needs and where you are in recovery. During your first meeting, the therapist will get to know you and find out more about your background and goals. You may complete documents like initial assessments, medical history, and family history. Future sessions will focus on helping you achieve your goals, work through difficult feelings, and change destructive thought patterns and behaviors. Get the Most Out of Individual Therapy Now that you know what to expect, here’s how to get the most out of individual counseling. How Is Individual Therapy Different from Group Therapy? Individual and group therapy are great tools for relapse prevention. Some people choose to participate in both types of therapy, while others may only take part in one. In addiction treatment, both types of therapies work well together. Group therapy generally involves one or more therapists and around five to 15 clients. Groups may focus on specific topics, such as grief, anxiety, or substance abuse, or more general topics, like improving social skills. One of the main differences between individual and group therapy is that you will receive less individualized attention in group therapy. Group therapy focuses more on clients relating to one another and forming a support system for each other. Some people may not be as willing to share in a group at first. Individual therapy allows those who struggle to talk in group settings work through their issues in a more private setting. Individual therapy also allows for you to make more specific goals for your own recovery. Individual counseling can be a great complement to group therapy. For example, it can be helpful to process topics you learned in group with your individual counselor. This may lead to a deeper understanding of group topics and allow you to process your thoughts and feelings about the group content. Find What Works for You While there is no one route to recovery, long-term individual therapy has been proven effective in helping people avoid relapse. Some benefits of individual therapy include processing traumatic experiences; learning new, healthy coping skills; and learning to navigate triggers—all of which are extremely important in maintaining recovery. If you’re ready to explore addiction treatment options, reach out. We’ll tell you about all the options available to you, and help you find what works best for your needs. References:
