How the Family System Affects Addiction Treatment

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Family Addiction Treatment

The idea of the family being a system comes from Dr. Murray Bowen who developed the Bowen family systems theory in the 1950s.  He also is credited for defining the field of family therapy.  The reason this advent is particularly important to treatment providers and those seeking long-lasting recovery is because much of the research that came about in the decades to follow demonstrated that the strong ties between family members deeply affect recovery.

The way that individual family members are often looked at, in this day and age, is in isolation to one another. This is best highlighted by interventions. Many of us have been exposed to interventions for addiction on television, in films and in our real lives. Being that we live in a highly individualistic society, the ambush intervention style seems effective at first glance. A whole family gets together and ambushes the addicted individual in order to get them into treatment.  The addicted individual is seen as the problem. While this style does work for some people, it’s not necessarily effective for a lot of people who need help.  Some will either resist the ambush entirely or find that when they return home after addiction treatment, they have no idea how to cope with an unhealthy home environment. What that means is that the individual is at higher risk for relapse.

One of the problems with dealing with addiction in this way, as we’ve come to find, is because of the lack of understanding of the family unit being ONE emotional unit. Starting with the Bowen family systems theory may help us to build our understanding. First, the theory tells us that the family is one emotional unit rather than just a sum of its parts. The Bowen Center’s website also says that “Families so profoundly affect their member’s thoughts, feelings, and actions that it often seems as if people are living under the same ‘emotional skin.’”

Since the development of this theory, many experts have taken a magnifying glass to parent-child and other family relationships. For example, Dr. Rosemary Ellsworth Brown has written about controlling parenting styles being intimately tied to addiction. Bill Woodbury has presented the idea of “enable-ism” to the world through his book. And, Susan Jackson has expounded on the work of William L. White to show how whole families can heal together and support each other’s recovery, or conversely cause harm to one another without even realizing it.  In such situations, some would say it is best to treat whole families rather than individuals in isolation.

In order to learn more about family systems, check out Dr. Jessica Rodriguez’s presentation at the Rancho Mirage Network Luncheon wherein she discusses strategies and interventions.

Addiction Therapeutic Services is a leading treatment facility in Rancho Mirage not only because of our highly experienced clinical staff, but also because we involve the families of addicted individuals as much as we possible can. We host family weekends where we offer Family Addiction Treatment where the entire family can receive psychoeducation and get to know more about their loved one’s struggles.  We also host community education programs that are free of charge for the public.  If you’ve been in the dark about your loved one’s addiction and want to learn more, give us a call at 760-322-1777.

Addiction Therapeutic Services’ Clinical Director Shares Insights From A Musical Journey

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Insights from a Musical Journey

Musical JourneyThe creative arts are a powerful way to understand and explore life experiences. In fact, addiction recovery and the deeper search behind the recovery process are often best understood without words. So how does the lifelong musical journey of a Psychologist affect his own life and the life of those in recovery?

Dr. Ray Montella, Addiction Therapeutic Services’ Clinical Director, has been playing bass since he was 13 years old and has some valuable insights on this.  

“I just turned 63 so if my math is correct that would be half a century,” he says.

Dr. Ray’s friends started a band. One was a drummer and another a guitar player. The eldest played piano.  Dr. Ray wanted to be in this band… and the only missing instrument was the bass!

Playing bass was such an integral part of Dr. Montella’s life that even when he was pushed out of the noisy rock band – because he aligned more with the musical stylings of artists like Crosby Still & Nash – he kept on playing.  He joined the school band where he learned to read and write music.  From there he progressed to concerts and performances.

“I played for shows back then… for people that kids won’t remember, like Rita Moreno. She was Maria in the movie West Side Story,” he says. “ I played for Jerry Lewis and many others that are no longer with us. Did some Broadway shows and theater as well but my real love is jazz, Motown and Funk.”

Dr. Ray posits that music is a combination of math, science, physics, patterns and creativity.

“There is an architecture to making it all work but sound effortless. Therapy is no different to me. A person’s life is also a combination of those things, we sometimes call it the mind, body, soul connection.  Definably, there is a science to observing patterns and a discipline to putting together the building blocks to one’s life. The variation in one’s experiences from another’s are endless as are the possible combinations of music. Life, like music, has dissonance and harmony depending on the combinations of vibrations or frequencies,” he says. “ It takes a skilled, talented and practiced musician to learn how to navigate and interpret the instrument and then transpose it into a sound.”

When asked how his personal, musical background affects his clients, he says “A bass player needs to understand the intent and pattern of the drummer’s rhythms, and the melody and harmony from the other instruments in order to find the link that connects them. That is the skill I use when looking at a person’s life to see, in essence, what music they have composed that created the harmony or dissonance…and then help them compose a song they want to sing.”

Many treatment centers, like ATS, have included Creative Expression as a part of their Intensive Outpatient group schedules.  ATS’s Creative Expression curriculum includes Poetry in Motion, Arts and Crafts, Intentional Collaging, Creative Rituals and many more classes that are set to specially curated musical soundtracks. Each of the classes invite clients to bring their artistic knowledge, musical knowledge included, to enrich the experience with new layers of beauty and understanding .  The visual, auditory and tactile experiences are often insightful and even profound.
Dr. Ray likes to encourage clients to find whatever expression gives them a creative outlet and feels that music not much different than therapy. To compare therapy to music…you have to learn and develop your theory and scales first so you can execute the music. In therapy we are putting together the scales, therapy and techniques so one can then go play and know how to be proficient in the expression and performance of their life. Playing music is the end product of the hours put into practice and understanding.”
He ends by saying, “When it’s time for the performance…it’s time to stop analyzing and just feel the fruits of the hard labor of your practice.”

Achieve a Calmer Mind with Compassion Attentiveness Therapy

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Compassion Attentiveness Therapy

“You need get out of your head!”

You are certain to have heard this emphatic plea from a loved one or a therapist at one or more stages of recovery. But whether you have fully taken it in and understood how to move out of that busy and tortuous head space is a different matter. People often think of self-care as the means to building healthy life patterns and thoughts, but it’s possible that another way to approach this is to care for both oneself and others at the same time.

According to therapist, Saleem Noorali, LCSW, there is a way to step outside of the noisy mind space and achieve multiple layers of mental peace at the same time. Noorali coined and branded Compassion Attentiveness Therapy, a new mode of treatment which promotes a healthy relationship with self, humanity and all living things. While there seems to be step-by-step widening of a lens going from self-compassion toward all living things as a part of this model, Noorali suggests that the steps are more effective when occurring simultaneously.

“When you’re engaged in kindnesses toward others, you’re outside of your thought loops,” he says.

An article called “A Wandering Mind is a Less Caring Mind: Daily Experience Sampling During Compassion Meditation Training,” was published in The Journal of Positive Psychology that reports what happened during a Compassion Cultivation Training that lasted 9-weeks. In the program, people engaged in compassion meditations twice a day for the length of the experiment. The results showed that compassion meditation was associated with reduced mind wandering for unpleasant thoughts and increased mind wandering to pleasant thoughts, and that both were associated with increased caring behavior for oneself and others.”

On May 26, 2016, Noorali presented at the Addiction Therapeutic Services Luncheon where he expounded on his own Compassion Attentiveness model. “Compassion Attentiveness Therapy isn’t just a therapeutic model, it’s a way of life that needs to be understood and applied by both client and therapist alike.”

While some might argue that compassion attentiveness could cause compassion fatigue, Noorali relies on ancient wisdom to say that “Compassion fatigue is not as a result of too much compassion, but as a result of incomplete compassion.” Self-care and self-love are essential for the therapist and the client equally. Where there is incomplete compassion due to a therapist not taking steps toward a compassionate life, services to clients will inevitably suffer.

In addition to talking generally about the importance of the new model, the May Luncheon presentation also placed a magnifying glass on daily rituals. While people have heard about rituals and often use them to create good habits, few have delved deep into the broader concept of the ritual. The similarities between group rituals, such as ones often seen in AA meetings, and the micro-rituals performed in the solitude of one’s own home on an ordinary morning are astounding once understood in closer detail and can even help people become more calm and mindful. A ritual demonstration was led by Samira R. Noorali, a multi-disciplinary artist, and involved components of music, poetry, movement and community participation.

Noorali has put forth several articles that help both therapist and client to understand how compassionate acts can shatter faulty perceptions and how new compassionate behaviors can lead both parties to flourish exponentially. Read them at RecoveryView.com!

Click Here to Watch the presentation by Saleem Noorali, M.A., L.C.S.W. and Samira R. Noorali, J.D. on “Compassion Attentive Therapy”

Simulation Experiences: Traditional Psycho-Education and Beyond

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Simulation Experiences

We’ve all heard treatment centers use “client-centered care” in their marketing taglines, but have you wondered what that really means?  At the University of Southern California C-Suite Invitational last week, Dr. Eric Coleman invited professionals from all over the healthcare industry to reflect on what those words mean. The Professor of Medicine and Head of the Division of Health Care Policy and Research at the University of Colorado Anschutz Medical Campus noted, that it goes beyond the genuine desire of business leaders to run “patient-centered” facilities, and enters the realm of helping clients to learn how to self-support.  For those in recovery, that means going beyond psychoeducation and integrating simulation activities into the treatment experience.

Client-centered care involves educating clients on their addiction and other afflictions but goes beyond traditional classroom work to include real-life simulation experiences.  Clients must form a close relationship with their recovery, beyond learning facts about addiction, in order to embody their goals.

It is important to note that enrolling in a psycheducation program is essential because it lays the foundation that is required to enlist long-term commitment to recovery.  In these classes, or “groups,” clients are often offered information regarding the medical aspects of addiction, life skills, and sometimes even co-occurring mental disorders.  In these sessions led by facilitators, counselors or therapists, clients come to understand why long-term dedication to abstinence and recovery is required, and why periodic drug usage or other stressors to the mind and body could be harmful or even fatal.

However, psychoeducation may not be enough to guide clients through the nitty gritty of complex life scenarios.  A truly client-centered facility’s psychoeducation program will help a client to implement his or her personal plan for recovery and assist that client in leveraging all of the tools that are available to them at the treatment center and beyond.  That’s where simulation experiences come in.  They allow clients to begin to understand the subtle details of real-life situations.

Simulation exercises bridge a gap that the theories in ordinary psychoeducation classes often leave out.   To begin with, the activities help clients to learn how to implement the tools they have picked up, like communication skills, and put them into action. Simulation also pushes forward positive changes in the brain.  The saying, “practice makes perfect,” is highly applicable to simulation exercises because the activities, when repeated, are likely to change aspects of the neurocircuitry of the brain. Another thing to consider is that the client will have a less stressful environment to practice in. Therefore, practice in a clinical setting prior to discharge can set the stage for better performance after discharge!  While transitioning to sober living or another residential environment post-treatment inevitably comes with challenges, this kind of preparation for self-support is invaluable.

Psychoeducation and simulation go hand-in-hand and can easily be interwoven in a treatment program.  Most importantly, paving a client’s transition using both methods could help him or her to understand how and when to reach for resources, as well as how to self-empower in difficult situations as the journey to healthier states of being carries forward.

Positive Psychology in Addiction Treatment

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Have you heard the buzz about the power of positivity? It’s hard to avoid if you have access to YouTube videos, a bookstore or a friends that have been swept up by one of the many  positive-thinking movements in pop culture. Are you telling yourself that changing your viewpoint can’t possibly change your reality? Are you not quite buying into the idea that changing your perspective or being more grateful for positive can change your life? Well, consider that there is a whole academic discipline devoted to studying how people can be happier and more fulfilled through positive thinking.  The research conducted by Positive Psychologists over almost two decades is ridiculously compelling and may just pull all of you skeptics over to the other side of the fence – the side of optimism.

What’s amazing about positive psychology is not just the subject matter studied (i.e. strengths, well-being and optimal functioning of an individual), but the fact that “positivity” sometimes forms the basis for research itself.  In Amy R. Krentzman’s article entitled, “Review of the Application of Positive Psychology to Substance Use, Addiction, and Recovery Research,” she says:

“The Hoxmark poster and the theoretical and empirical work described in this review suggest that positive psychology has begun to be applied to theory, research, and intervention in substance use disorders. Although positive psychology and the recovery movement share similar interests and emphases, they differ in important ways that frame the current discussion. Within the field of addiction, the recovery movement is a multi-faceted grassroots effort led by individuals who are themselves in recovery from substance use disorders. The movement is built on a recovery-oriented, rather than a pathology-oriented, framework from which addiction and its resolution are understood. Working from an established set of values and goals, participants in the recovery movement work collectively to remove obstacles to treatment, support multiple paths to recovery, and make larger social systems more supportive of recovery lifestyles (White, 2007).”

Conducting research and stating conclusions is a specialty of experts, but having the wisdom to step back and demonstrate awareness of an entire scientific discipline… that’s powerful. It’s also demonstrative of the way individuals may want to look at their lives and heighten their own personal awareness.

Positive psychology challenges the way people see themselves and their tendency to want to take control of “reality” as they understand it.  But, if everything depends upon perspective and perception, then what’s real?  As this question disturbs people whose wellbeing depends on fixing their circumstances into one unchangeable idea of reality, it also opens a gateway into happiness for those who are willing align with a more positive perspective.

When new ideas change the way we think and inspire us, we can’t help but ask, is this new way of researching  the end all, and is it replacing what came before? Certainly not.

Kertmaz herself says: “Because the field is new and has been embraced by popular culture, critical thinking is essential both in assessing positive-psychological research and in building good science, not only on its foundation, but on the foundation of the decades of relevant scholarship that preceded it.”  Positive psychology principles are the basis for self-help movements which are often commercial in nature.  The authors of inspiring books and videos may or may not honor the science behind the principles to a tee when they present their own ideas.  That means you may want to avoid conflating science with what could be called “fluff” in the scientific community.  But, of course, you are free to take in ideas that you like from the popular movements, whether proven or not, in order to enhance the best and most positive parts of your life.

Watch Larry Smith, LAADC, CAS, III presenting on “Positive Psychology, Happiness & Addiction Treatment.”

Evening Outpatient Treatment for Addiction Recovery

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Evening Outpatient Treatment offers More Flexibility

These days, people are often strapped for time, cash and support that meets their unique needs for addiction recovery.  The corporate and government employment scene generally keeps people very busy from 8AM to 5PM not including a sometimes lengthy commute.  School schedules are often replete with a variety of course options in the morning but sparse selections at night.  Finally, most people with children simply cannot or will not put their kids on hold during the day, even for much-needed treatment.  These tight and varied schedule demands have caused the need for a paradigm shift in treatment. Many treatment providers have already started offering Outpatient programs to respond the issues of affordability, time and other clinical reasons. Even still, treatment centers are having to continually change how and what they are providing to their clients.

Evening Outpatient Option

Evening Outpatient Programs are one example of customizing treatment for the busy client. It can be extremely helpful for those who want to keep focused on their job or educational aspirations during the day rather than having to shift gears.  EOP, like other outpatient programs, offers clients the opportunity to dig deep into the root causes of addiction with a counselor.  One of the best aspects of EOP is that it’s a great way to close out the day with a recovery-oriented perspective in a group offering lighter fare, like Life Skills.

On another note, these customized programs help to cut the excuses.  For example, there are many high-functioning users out there who have managed to maintain employment, even successful employment, with their substance abuse issues.  These people may find that EOP serves their needs without severely hindering their career dreams. Of course, whether an individual will be best-served by an Evening Outpatient program is a clinical decision and should be determined only by clinical staff.

EOP Treatment Option

While EOP sounds like an easier and more convenient way out of addiction, the program should mirror daytime Outpatient in terms of quality of treatment and the “work” that clients engage in to start and maintain a successful path to recovery.  The number of hours spent in facilitated groups is also the same between EOP and daytime Outpatient.  If a person has opted into EOP, he or she may need to go through drug and alcohol detox and/or residential treatment before starting the program.  Detox and residential programs usually do not have an evening only option, but could save an addict’s life.  They are usually recommended when the severity of the addiction warrants a higher level of care.  Even if you are a busy person, detox and residential care should not be avoided. Like day Outpatient treatment, EOP usually involves process groups and psycho-education classes. At Addiction Therapeutic Services, we are now offering Evening Outpatient Treatment. Our groups include: Relapse Prevention, Family Support Group, Healthy Boundaries, Process Group, and Life Skills which are facilitated by stellar therapists or counselors.

Outpatient Treatment at Addiction Therapeutic Services

ATS believes that treatment is for everyone, and that the program schedule should reflect that. Contact us at (760) 322-1777 for more information on whether Evening Outpatient is the right program for you.