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TinyBuddha writes

“To be happy with yourself, you’ve got to lose yourself now and then.” ~Bob Genovesi

At a holiday party last December, I ran into a friend from college who I hadn’t seen in twenty years.

“What’s going on with you? You look great!”

“Oh, well… My mother passed away and my husband and I divorced.”

“Oh Jeez! I’m so sorry,” he said. “That’s a lot! So, why do you look so great?”

Perhaps it wasn’t the greatest party conversation, but I did with it smile.

“It was the hardest year of my life, but I’m getting through it and that makes me feel good.”

Sure, what he didn’t know was that I had spent many weeks with the blinds closed. I cried my way through back-to-back TV episodes on Netflix.

I knitted three sweaters, two scarves, a winter hat, and a sweater coat.

I had too many glasses of wine as I danced around in my living room to pop music, pretending I was still young enough to go to clubs.

And at times it was hard to eat, but damn if I didn’t look good in those new retail-therapy skinny jeans.

Another friend of mine lost his father last spring. When he returned from the East Coast, I knew he would be in shock at re-entry. I invited him over for a bowl of Italian lentil and sausage soup.

As we ate in my kitchen nook, he spoke of the pain of the loss of his father, and even the anger at his friends who, in social situations, avoided talking to him directly about his loss.

Looking down at my soup, I said, “Grief is a big bowl to hold. It takes so many formations, so many textures and colors. You never know how or when it will rear its head and take a hold of you. Sometimes you cry unfathomably, some days you feel guilty because you haven’t cried, and in other moments you are so angry or filled with anxiety you just don’t know what to do.”

Grief is one of those emotions that have a life of their own. It carries every feeling within it and sometimes there’s no way to discern it.

One of the greatest teachings in Buddhism is the lesson of impermanence—that everything that comes into being will go out of being.

But impermanence is just a concept until you face the ugly beast straight into his beating, bulging red eyes.

These are the things that helped me get through such a trying time:

1. Self-care, self-care, self-care. (Oh, and did I say self-care?)

The shock of loss to all of our bodies—emotional, mental, physical, and spiritual—is superb. When we wake in the morning, we question the very nature of who we are. Upon awakening there is a split second when everything is okay in our world.

And then we remember. The storm clouds cover our head again.

Our bodies need to be fed during this time, in order to handle such trauma. Self-care is personal, but I did the things I knew my body wanted:

Lots of baths, fresh pressed organic juices, sticking to a daily structure, such as meditating in the morning, exercising, journaling, reading inspiring books, talking with friends, getting out in sunshine, taking walks, admitting my weakness, and learning to nurture myself.

These were the base things that I knew I needed.

2. Accept there’s a lot you don’t know.

When the pain of loss happens, it’s like a lighting bolt comes and shakes the foundation of the ground. We question everything—our identity, who we are, where we come from, and where we’re going. There is power in surrendering to the unknown.

In coming to accept that we no longer have control over what happens to us, we realize that what we once knew we no longer can know. In fact, much of the spiritual experience is coming to realize all that we are not, and less about what we think we are or what we know.

Here, there is great freedom. And it helps us to meet life’s adversity with courage, head-on.

3. Allow time and space.

I learned once in a counseling psychology class that it takes two years to grieve the loss of a loved one. In human time, that seems like an eternity. There are stages. And each stage brings a remembrance, especially once you start hitting the “year marks.”

During the last year, each “mark” felt like Valentine’s Day without a lover. “Oh, this is the day I knew my marriage was over,” “Oh, this is the day my mother died,” “Oh, this was the last holiday we spent together…”

Recognizing that grief needs time and allowing space for the grief process to unfold gave me permission to hold that great bowl.

4. Accept that sometimes you have a bad day for no apparent reason.

Months, even over a…

Read more!

USN writes

When Kristen was 14, she started drinking alcohol alone at night in her room. She suffered from anxiety and depression after her mother, a longtime alcoholic and anorexic, committed suicide when Kristen was 11. Over the next few years, Kristen also smoked marijuana, took pills, used LSD and experimented with crystal meth.

At her public high school outside of Philadelphia, she was a partier, one of the “cool kids” and “a badass who used [drugs] all the time,” she recalls.

At 15, Kristen entered her first treatment center, which she ran away from the first day and left for good after less than a month. After returning to school, she began using again and was seated next to a drug dealer in a class meant to help students suffering from mental health issues.

Eventually, Kristen returned to treatment for six months, but it was a bumpy ride. She broke a coffee pot at a treatment center to cut herself with a glass shard and spent a brief period of time at an inpatient psychiatric unit.

Now, at 19 and with two-plus years of sobriety, Kristen is set to attend Pennsylvania State University’s Brandywine campus in the fall after graduating from The Bridge Way School – the high school that she says saved her life.

The Bridge Way School, which opened in 2011 and is housed in a Philadelphia synagogue, is one of 38 “recovery high schools” around the country. The schools have an average of 30 students and provide academic and therapeutic services to students working toward recovery from substance abuse or dependence.

At Bridge Way, students participate in group and individual counseling sessions, have an individualized program including structured events and meetings after school, and undergo random drug testing. Unlike at their old schools, where Bridge Way students say they were often offered drugs, students rely on a strong culture of support to stay sober and hold each other accountable if they suspect someone has returned to using.

For students like Kristen, returning to the same school after treatment wasn’t an option. She needed a completely new environment where she wouldn’t be tempted to return to her old habits.

“I think I would probably be dead – just being candid,” says Kristen, who attended Bridge Way for two years after returning from her six months of counseling and treatment.

She now has a full life to plan. “I never thought I was going to live past 18, so to have to piece together this life I never thought existed, it’s kind of cool,” she says.

Kristen plans to transfer to Pennsylvania State University’s main campus in State College after two years and is already involved with its recovery community. She also represents Bridge Way through speaking arrangements to be a voice for young people in recovery, and is heavily involved in Narcotics Anonymous.

Research has shown the effectiveness of recovery schools and how they are helping students like Kristen, and state lawmakers are listening.

In a 2009 study evaluating students at more than a dozen recovery schools, participants said they only stayed sober 32 percent of the time before entering their respective schools, compared to 82 percent after they began their programs.

Among some other findings, the study showed that over 70 percent of the students said they were performing better academically in their recovery schools and nearly 60 percent said they felt better emotionally.

Andy Finch, one of the study’s authors and a co-founder of the Association of Recovery Schools, tells U.S. News he is analyzing data from a new study comparing students who entered recovery schools after receiving drug and alcohol treatment, and those who attended other schools.

“The general finding was the effects of recovery high schools was positive across many categories – the substance use categories, academic outcomes and mental health outcomes,” says Finch, who also co-founded a recovery high school (now closed) in Nashville and a collegiate recovery program at Vanderbilt University.

At Bridge Way, 92 percent of students who graduate from the program go on to attend college, and students express how much better they are doing in all aspects of life.

Other research shows that eight out of 10 students relapse within the first six months of returning to their old school, according to Bridge Way’s Head of School Rebecca Bonner.

Students at Bridge Way stress that they needed a completely new environment after treatment, where they wouldn’t be tempted to fall back into their old behaviors. They also say the extra resources their public schools provided them were not enough.

It seems there’s a lot of misconceptions on the 12 steps and how they facilitate long-term sobriety. Awhile back, I attended a lecture by a prominent addiction researcher who said the greatest threat to 12 step communities was a “mixed message.”

What he was essentially saying is that people who go to 12 step meetings for a short time develop misguided notions about the program. They, in turn, pass along these ill-conceived ideas to individuals they know. Thus, some who might need the assistance of sober fellowships never find the rooms of recovery due to rampant stereotypes.

I know this firsthand. A relative of mine was court-ordered to 12 step meetings. When I asked him what he thought about it, he replied, “It’s a cult.” If I was thinking about going to a recovery meeting, I’d think again in light of this information.

In keeping with traditional 12 step structure, here are the top 12 misconceptions I hear about the sober community:

Discovery Place goes on to write. 

1. 12 step meetings are religious.

This is, without question, the most common misconception I hear. While there is no denying the spiritual aspect of a 12 step program, I don’t think this argument holds up to scrutiny.

First, a 12 step program doesn’t require you to believe anything. That is stated in the literature. Second, there are atheists and agnostics I personally know who have long-term sobriety in 12 step programs. Third, people from all walks of faith participate in sober fellowships. There are Christians, Buddhists, Hindus, Muslims, even Pagans. I’ve never heard of a religion where all other religions come together and coexist peacefully.

2. 12 step meetings are a cult.

Cults and the 12 Steps

This is another common stereotype. I’m really not sure how recovery meetings came to be compared with groups led by Jim Jones and the Branch Davidians. But somehow, we did.

Cults require you to believe in a particular dogma. 12 step fellowships do not.

Cults do not let you leave the group without consequences, usually severe. 12 step fellowships allow you to come and go as you please.

Cults have beliefs that are viewed as dangerous by the rest of society. 12 step fellowships have suggestions, which if practiced, do nothing but promote positivity.

I’ve never heard of a recovery community committing mass suicide. Or thinking that a comet was a sign of apocalyptic doom.

3. 12 step meetings brainwash you.

Group of old people

False. Recovery communities exist to support one another towards the common goal of sustained abstinence from mind-altering substances.

It is repeatedly stated in the literature that the 12 step program is a suggestion, not a requirement. Groups like Alcoholics Anonymous openly acknowledge that other methods to achieve sobriety exist.

There is an oldtimer I know who will readily admit that 12 step fellowships brainwash you. According to him, “Yeah, they brainwash you. But my brain needed to be washed.” Funny guy.

4. 12 step meetings are just a bunch of old people.

There may be meetings dominated by an older demographic, but most towns offer a variety of recovery meetings. Many of these groups are populated by younger adults.

I’ve been to meetings with dozens and dozens of adults under 30 who are staying sober.

5. 12 step meetings will make you want to drink.

One of the most surprising things a newcomer notices when he or she starts attending 12 step meetings is a lack of discussion on drinking or drugs. In fact, “war stories”, tales of drinking escapades or drug-induced debauches, are frowned upon in the sober community.

Many meetings specifically request that participants refrain from telling these types of stories. For the most part, recovery groups center discussion on personal and spiritual growth. They talk about how the outside world impacts their internal landscape, and how to react in healthy fashion.

6. 12 step meetings will convince you that you are alcoholic or addicted to drugs, even if you aren’t.

False. The literature explicitly states that identifying as an alcoholic or drug addict is left to an individual’s discretion. There are, however, meetings where only people who identify as an alcoholic or drug addict are permitted to share.

This isn’t an attempt to censor those who are on the fringes about whether they are alcoholic or addicted to drugs. Rather, it’s an effort to keep harmony within the group.

7. 12 step meetings are a place for convicts and washouts.


While the rooms of recovery are open to anyone, convicts and washouts included, 12 step meetings aren’t dominated by criminals.

What you will find in recovery groups are people, some from criminal backgrounds, some not, dedicated to a healthy way of life free from drugs and alcohol.

What you won’t find in recovery groups is a meeting full of rough neck, criminally-affiliated gangsters. Most of the people with criminal backgrounds have transformed their lives anyway. Their days of crime are long gone. And the ones I have met were good people.

8. 12 step meetings are for the weak.

Laughable. You are talking about a group of people who had an intense love affair with alcohol, drugs or both. Now they live a life completely free from substance abuse. But they’re weak?

12 step programs have made me stronger. I wasn’t able to last a day without alcohol, pot, heroin or some other drug. Without these meetings and the fellowship that goes with it, I wouldn’t be a contributing member of society today.

12 step meetings exist for people who want to strengthen their life on the inside and out. Is a team stronger than an individual? Absolutely. The same principle applies to living sober – a group of people, coming together for a common goal, are stronger together than apart.

9. 12 step meetings are boring.

Louis CK

There’s a reason oldtimers tell newcomers to, “…pull up a chair, it’s the greatest show on Earth.” You’ll laugh like you’ve never laughed before. You’ll hear stories that tug your heart like nothing else. And you’ll develop bonds you previously thought impossible.

Sure, some meetings are boring. The old saying is, “If you haven’t been to a bad meeting, you haven’t been to enough meetings.” But I genuinely look forward to the meetings I attend. An incredible sense of camaraderie and comedy pervade the atmosphere. If you go to several sober meetings at several times and places, you’ll find the ones you love too.

10. 12 step meetings are just a place for people to complain about their lives.

You’ll definitely find situations in 12 step meetings where someone expresses dissatisfaction with life. Who can honestly claim they don’t get discouraged from time to time?

Yet complaining about life is frowned upon, and in some cases expressly prohibited, in recovery meetings. In many circumstances, people present their troubles to color the solution to problems via 12 step application.

You won’t find a lot of complaining at sober meetings. If you do, find a new meeting.

11. 12 step meetings have a low rate of success.

Most comprehensive addiction studies point towards a high level of success for members of 12 step fellowships.

Even National Geographic noted the level of success that the 12 steps have with people battling drug addiction and alcoholism.

Other studies confirm the suspicions of National Geographic. In short, the 12 steps work. See the “Related Articles” section below for more studies on the effectiveness of 12 step programs.

12. 12 step meetings will introduce me to people who sell hard drugs.

I’ve been around 12 step recovery for almost 3 years, continuously sober now for almost 2 years. In that time, I have never been approached by anyone trying to push hard drugs.

Maybe it does happen. But I’ve never seen it personally or heard anyone who has.

Find out for yourself whether a 12 step program can help you or a loved one. Attend at least 6 or 7 open meetings at various locations. The Big Book of Alcoholics Anonymous states that, “There is a principle which is a bar against all information, which is proof against all arguments and which cannot fail to keep man in everlasting ignorance – that principle is contempt prior to investigation. -Herbert Spencer

See whether the rooms of recovery will help you. Participate and genuinely exert yourself, then decide if the misnomers are true.



ASAM writes

ASAM defines addiction as a “primary, chronic disease of [the] brain … [with] characteristic biological, psychological, social and spiritual manifestations.” It isn’t just a social or criminal justice problem—it’s a medical and public health problem. Medical diagnosis and treatment are appropriate responses to addiction; ASAM’s definition points out that “without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.” So it is a serious, potentially fatal illness, but it is treatable: recovery is possible, and happens for millions of individuals with this disease every year.

Recovery is an interesting concept. It implies not only improvement, but potentially remission. The term describes a process as well as a destination. And the underlying premise of recovery is that of hope–hope that a person with a potentially fatal illness can avoid a catastrophic outcome. “Recovery activities” are not professional treatment, but can promote recovery just as professional treatment can. One of the most familiar “recovery activities” engaged in by persons with addiction is participation in the activities of Alcoholics Anonymous (AA).

ASAM’s definition of addiction document concludes that “treatment of addition saves lives,” and it points out that “in some cases of addiction, medication management can improve treatment outcomes,” and that “in most cases of addiction, the integration of psychosocial rehabilitation and ongoing care with evidence-based pharmacological therapy provides the best results.” Much of “what’s new” in the professional treatment of addiction in the past two decades has involved new pharmacological therapies that have been brought into the marketplace. But psychosocial interventions, which are “not as new,” are the foundation of the treatment most persons receive when they seek assistance from an addiction treatment professional or agency.

Traditional addiction treatment in America is derived from multidisciplinary treatment of chronic mental disease and the peer-support program of Alcoholics Anonymous, founded in 1935 by two middle-aged men who leaned on each other for hope, and described in the eponymous book published in 1939. Its subtitle indicates it is a how-to description of the path of recovery. It describes twelve steps in the process of recovery outlined by the authors. One of the evidence-based practices of modern addiction treatment, as outlined by the federal Substance Abuse and Mental Health Services Administration’s registry of Evidence Based Programs and Practices, is Twelve Step Facilitation Therapy.

There are many kinds of counseling and psychotherapy that can be helpful for the person with addiction, beyond non-specific “supportive psychotherapy” that can be offered in any setting, along with medication management or apart from such an approach. Cognitive Behavioral Therapy is arguably the most widespread ‘evidence based practice’ offered to persons with addiction. This approach challenges irrational thoughts, understands automatic thoughts and thought chains, understands the thoughts and feelings that can lead to relapse behaviors and seeks to minimize relapse by specifying unhealthy cognitions and providing practice in decoupling an unhealthy thought (“stinking thinking,” as some people say) from an unhealthy action. Dialectical Behavioral Therapy and Mindfulness Meditation are two approaches that have enjoyed increased popularity in addiction treatment in this century.

But Twelve-Step Facilitation therapy is still a tried-and-true proven approach. It is far more than advising a patient to “go to AA” and providing them a list of meeting locations and times. In Twelve-Step Faciliation, the therapist actively probes and nudges, encouraging not only attendance, but participation, in meetings; it explains the potential benefits of working with a sponsor and promotes the individual developing a relationship with a sponsor; it explores problems or psychological resistances to attendance, participation, actual “working the steps,” and the development of a sponsor-sponsee relationship; and it opens the door to “AA-related activities” such as volunteer service to one’s AA “home group” or AA “clubhouse” and involvement with AA-related social events, retreats, and local and state conventions.

Is Twelve-Step Recovery an antiquated concept or intervention? Many addiction specialist physicians contend that while the majority of continuing medical education in addiction, aimed at sharing novel breakthroughs and improving practice and outcomes, addresses pharmacotherapies, it is the psychosocial therapies which warrant at least equal attention. Some addiction medicine physicians are concerned that not only do biological interventions predominate in continuing education curriculums, but they dominate graduate medical education in addiction, and some of these physicians are concerned that fellowship training programs in addiction as well as residency programs in primary care, psychiatry, and other medical specialties should include training about and in Twelve Step Facilitation and on Twelve-Step Recovery in order for the physician to have an appropriately well-rounded educational experience and a full skill and knowledge base in the rapidly-growing specialty of addiction medicine.

Twelve-Step Recovery addresses the psychology of the person with addiction as well as the individual’s spirituality–his/her values, his/her connectedness to others, and his/her willingness to engage with others and humbly ask for help. The process of change in Twelve-Step Recovery starts with an acceptance that when friends or loved ones point out that things are amiss in one’s life, they are likely correct, and things have likely become unmanageable. And while taking personal responsibility and accepting accountability for one’s actions are considered key steps, Twelve-Step Recovery outlines that excessive self-reliance and the firm stance that “I can get myself out of this,” and “I know what to do about this,” will be roadblocks to recovery from addiction. “Getting out of oneself” and recognizing that one doesn’t have all the answers, and humbly asking for help from another human being—from a health professional or from a lay person—are behaviors and behavioral styles that are promoted by Alcoholics Anonymous and related “Twelve-Step” programs of peer support.

The term “self-help” is often used to describe AA groups, but it is somewhat of a misnomer: it isn’t “professional help,” but it is more about listening and accepting guidance from a peer or mentor than it is about using “self” to move beyond active addiction. And while Twelve-Step approaches accept that addiction is a disease and isn’t simply a sign of “moral weakness,” there is a focus on values and morals in Twelve-Step Recovery, as the individual is encouraged to engage in a process of taking a “moral inventory” of one’s life and past actions in preparation for “making amends” to others, as indicated, possible, and appropriate.

The endpoint of “recovery” from addiction, if there is an endpoint, is to change one’s life for the better, to gain stability in one’s life, and to become more functional in one’s family and in one’s community. Being responsible, being reliable, being interested in others and not just in oneself, and being a loving being who cares about and is helpful to others, are all part of recovery.

There is a group of physicians within ASAM who are concerned that twelve-step recovery is not being taught to new physicians entering this field (most physicians currently enter addiction practice in mid-career, rather than straight out of residency training). Referring to themselves as “Like Minded Docs,” they communicate regularly among each other, leaning on each other via email for support and guidance, and occasionally reaching out to ASAM regarding policies of the Society. One of their stated concerns is that continuing education programs for physicians newly involved with addiction or considering a mid-career switch into addiction medicine have more content on pharmacotherapies and less content on psychosocial therapies, and that Twelve-Step Facilitation therapy and twelve-step recovery overall are at risk of becoming ‘dying arts.’



Hazelden writes

When academics and members of Alcoholics Anonymous meet, they tend to confirm how much they differ.

People in AA see themselves as part of a fellowship, bonded by the shared disease of alcoholism and relying on a spirituality that defies measurement.

In contrast, university-based researchers want numbers–objective outcome measurements for treatment based on the Twelve Steps and results that can be replicated. AA testimonials are interesting, researchers say, but we need more reliable evidence that joining a Twelve Step fellowship changes people over the long term.

Given their divergent perspectives, we might expect these two groups to keep a polite distance or even harbor some mutual suspicion. But today that expectation cannot hold. A growing number of researchers not only profess respect for AA, they see the Twelve Steps as essential to addiction treatment.

Researchers call for reconciliation with AA
This reconciliation of the scientific community with AA has been hard-won. For decades, only a few studies documented the effectiveness of Twelve Step-based treatment.

That’s understandable. To preserve anonymity, AA keeps few statistics other than numbers of groups and members. For the 65 years of its existence, AA has grown by anecdotal accounts of recovery among its members–not by the results of research published in peer-reviewed medical journals.

When approached by outside observers, some members of AA even express caution. Charlie Bishop, coauthor of To Be Continued: The Alcoholics Anonymous World Bibliography 1935-1994,1 argues that scholars who try to categorize AA as a form of therapy do it a disservice. According to Bishop, AA can be properly taken only on its own terms as a spiritual fellowship, not merely a treatment strategy or way to modify behavior that can be couched in modern psychology.

“Research on AA should be approached gingerly,” Bishop adds. “The underlying difficulties of applying the scientific method to spirituality should give every scholar pause. If a scientist were to ask an AA old-timer how AA works, the answer Just fine! could be expected.”

However, that wasn’t always the answer to expect from professionals in psychology and medicine. “It’s been very fashionable among psychologists to badmouth AA–without, by the way, having ever attended an AA meeting,” says Thomas McClellan, PhD, director of the Treatment Research Institute at the University of Pennsylvania, Philadelphia. “It gets under the skin of psychologists–the idea that you’re powerless, the idea that there are catch phrases and simple things done by lay people that will be powerful tools.” Today, professionals with such attitudes owe AA an apology, adds McClellan.

Robert Fiorentine, PhD, director of Research Training at the UCLA Drug Abuse Research Center, echoes this call for conciliation. “There has been hostility among researchers partly because of the spiritual emphasis of AA,” says Fiorentine. “There is still hostility, but because of the recent evidence indicating the effectiveness of the Twelve Steps in assisting in recovery, this hostility among researchers seems to be diminishing.”

Largely responsible for this change in attitude is a spate of studies about AA and the Twelve Steps–about 150 of them since 1980. But the most significant studies documenting Twelve Step efficacy have come in the last five years.

Project MATCH supports Twelve Step-based treatment
One of the largest and most widely quoted studies to support the “AA works” philosophy is Project MATCH, published in 1998. This federal effort was supported by the National Institute on Alcohol Abuse and Alcoholism.

The study’s title captures its aim: finding ways to match people with the kind of addiction treatment best suited to them. Doing this means looking for “client attributes”–personal characteristics–that reliably predict how well people will do when assigned to specific kinds of treatment. Examples of those attributes are anger and readiness to change. Project MATCH examined 21 such attributes.

In addition, Project MATCH compared three kinds of treatment, each delivered via individual outpatient therapy:

  • Twelve Step Facilitation Therapy, grounded in AA’s concepts of alcoholism as a disease of the mind, body, and spirit and lifelong abstinence as the only sane response. This form of treatment guides clients through AA’s first five steps. It also actively encourages people to attend AA meetings, keep a journal of their experiences at meetings, read AA literature, and practice AA principles “in all our affairs.”
  • Cognitive Behavioral Therapy, which helps people master skills that are essential to staying sober, in particular, relapse prevention. This means learning to identify cravings for alcohol and respond to those cravings in ways other than drinking. Some of those skills include challenging the thoughts used to rationalize drinking and avoiding the “people, places, and things” linked to alcohol or other drug use.
  • Motivational Enhancement Therapy, designed to help clients discover and act on their personal reasons for staying sober. Motivational enhancement therapists help clients move through six specific stages of change: pre-contemplation (not considering a behavior change), contemplation (considering a change), preparation, action, maintaining the change, and coping with relapse.

Researchers could hardly have chosen three approaches that differ so much.

Cognitive Behavioral Therapy offers technique after technique for helping people change their thinking (cognition) and action (behavior). It’s true that the Twelve Steps also guide people to release “stinking thinking” and change behavior. However, AA members put these attempts to change in the context of surrender to a higher power. Cognitive Behavioral Therapists, ground in social learning theory, make no such assumptions about the need for “conscious contact.”

Motivational Enhancement Therapy also differs from the Twelve Steps. In this form of therapy, counselors make no attempt to guide clients through a step-based program of recovery. Instead, counselors offer non-judgmental feedback on clients’ behavior, emphasize personal responsibility for change, and offer a menu of options for new behaviors. Sometimes Motivational Enhancement Therapists offer outright advice.

Among these three approaches, Twelve Step Facilitation is the only one that specifically encourages people to reach out to other recovering alcoholics. Helping clients to actively work the Twelve Steps is the primary goal, as opposed to learning skills that the therapist teaches or responding to therapist feedback.

For Project MATCH, 806 clients in five outpatient treatment centers were randomly assigned to these three treatments. Researchers also interviewed and assessed clients to rate them on relevant attributes

The overall results were reported in 1998: Almost 30 percent of these clients were abstinent three years after treatment. And even those who drank during those three years abstained, on average, two-thirds of the time. Of the 21 client attributes, two were the most powerful predictors of long-term drinking outcome: readiness-to-change and self-efficacy (clients’ confidence in their ability to abstain).

Project MATCH found few differences in outcomes among the three treatments. This means that Twelve Step Facilitation held its own, working as well as Cognitive Behavioral Therapy and Motivational Enhancement Therapy. In fact, Twelve Step Facilitation offered a statistically significant advantage when total abstinence was the desired outcome.

Steps help clients who have social support for drinking
Another relevant study comes from Richard Longabaugh, EdD, associate director of the Center for Alcohol and Addiction Studies at Brown University, Providence, Rhode Island, and his colleagues.3 This study, part of Project MATCH, clearly demonstrates the advantage of Twelve Step Facilitation for clients with a particular attribute: social support for drinking.

To rate clients on this attribute, researchers looked for specific information, such as the:

  • Number of people in the client’s social network.
  • Amount of contact that the client had with key people in this network.
  • Number of heavy drinkers in the network.
  • Number of people who abstained from drinking and the number of recovering alcoholics in the network.

In short, clients with high support for drinking had close friends and family members who drank at higher levels and offered lower levels of support for abstinence.

Longabaugh and his coauthors predicted that Twelve Step Facilitation Therapy would lead to better treatment outcomes for these clients. To test this hypothesis, researchers measured the number of days that clients abstained from alcohol during a three-month period–37 to 39 months after treatment. Researchers also measured client involvement in AA during and after treatment.

Results confirmed the prediction: Clients with high network support for drinking who took part in Twelve Step Facilitation had 83 percent abstinent days; those who received Motivational Enhancement Therapy had 66 percent.

What’s more, even the clients who received Motivational Enhancement Therapy had more abstinent days if they attended AA after treatment. For clients with low network support for drinking, there was no significant difference between Twelve Step Facilitation and Motivational Enhancement Therapy.

Researchers drew two primary conclusions from this study: Twelve Step Facilitation “may be the treatment of choice” for alcoholics with networks that support drinking. And, alcoholics with such networks should consider joining AA–regardless of the type of treatment they receive.

Our study has clear clinical significance, says Longabaugh. It tells the clinician that once we know the client’s support for drinking, we know how important the AA component can be to his or her recovery.

For his work on this study, Longabaugh received the Dan Anderson Research Award for 1999 from Hazelden. This award recognizes researchers who advance scientific knowledge in the field of addiction recovery.

Steps and treatment offer ‘additive effect’
More support for the Twelve Steps as treatment tools comes from the work of Fiorentine. For one study, he and colleague Maureen P. Hillhouse, PhD, followed 356 clients entering outpatient treatment in Los Angeles.4 The researchers interviewed and assessed each client twice–within one week of entering treatment and again about eight months later.

Fiorentine was especially interested in answering these questions:

  • Do people join Twelve Step groups (such as AA and Narcotics Anonymous) as an alternative to treatment?
  • Why do people who are currently active in a Twelve Step group choose to enter treatment?
  • When people are involved in a Twelve Step group before entering treatment, are they more likely to complete treatment?
  • Are longer stays in treatment associated with higher levels of involvement in Twelve Step groups?
  • When people take part in treatment and Twelve Step groups, do they experience an “additive effect”–higher rates of abstinence due to both kinds of participation?

The data provided answers to each question:

  • Two-thirds of the outpatient clients were attending a Twelve Step group when they entered treatment.
  • Most clients entered treatment to support a “global lifestyle change”–not to simply stay off drugs or comply with a court order.
  • Clients who attended Twelve Step meetings at least once per week before treatment stayed in treatment longer–an average of four weeks more–and were also more likely to complete treatment.
  • The longer clients stayed in treatment, the more likely they were to contact a sponsor at least once per week.
  • Clients who stayed in treatment longer, completed treatment, and attended Twelve Step groups weekly had significantly higher rates of abstinence than those who did not meet these three criteria.

Fiorentine concluded that people used Twelve Step groups and outpatient treatment as “integrated recovery activities,” not mutually exclusive options. When clients combine treatment and Twelve Step groups, they experience a powerful advantage over using treatment or groups alone. In summary, treatment and Twelve Step groups are best viewed as a “both-and” proposition, not “either-or.”

Treatment tends to be of a limited duration, whereas Twelve Step participation recommends lifelong, regular participation and a sponsorship relationship. Fiorentine speculates that “this regular, continuous, and personal affiliation may be one reason why Twelve Step membership is more effective than treatment in promoting long-term recovery.” Another reason is that Twelve Step philosophy accurately depicts the nature of addiction, particularly the notion of powerlessness over alcohol and other drugs, adds Fiorentine.

In other research, Fiorentine determined that those who accept the fact that they are powerless over alcohol and other drugs are significantly more likely to maintain long-term abstinence.5

Minnesota Model produces consistent results
Closer to home is a study published by Randy Stinchfield, PhD, associate director of the Center for Adolescent Substance Abuse at the University of Minnesota Medical School, Minneapolis, and Patricia Owen, PhD, director of the Butler Center for Research at Hazelden.6 This study focused on outcomes of the Minnesota Model treatment as delivered at Hazelden in Center City, Minn.

Stinchfield and Owen collected data on 1,083 men and women at four points: when they entered treatment at Hazelden, and at one month, six months, and 12 months after treatment. At the 12-month point, 53 percent of these people said that they’d abstained from alcohol and other drugs during the year after treatment. Another 35 percent said that they’d reduced their chemical use. Between 70 and 90 percent of these clients also reported improved quality of life in areas such as family relationships and job performance.

These results, consistent with other studies of Minnesota Model treatment, compare favorably with outcomes reported for other private treatment programs.

Keep in mind that the Minnesota Model, with a Twelve Step foundation, fuses many elements: a residential setting, group therapy, individual counseling, lectures, discussions, assignments, attendance at Twelve Step meetings, and more. And as part of the model, clients receive services from a team of counselors, nurses, physicians, psychologists, recreational therapists, and spiritual care specialists. Treatment is individualized, and aspects of Cognitive Behavioral and Motivational Enhancement Therapy are woven in.

But what unifies these disparate elements is Twelve Step philosophy: lifelong abstinence is the goal of recovery, and frequent attendance at Twelve Step meetings is the primary way to maintain abstinence over the long term. Stinchfield and Owen put it this way: “The primary agent of change is group affiliation and practicing behaviors consistent with the Twelve Step program of AA.”

Researchers offer kudos, caveats
The studies summarized above offer a sample of the latest round of Twelve Step research. There are more. For instance, the Chemical Abuse Treatment Outcome Registry includes studies showing a correlation between high abstinence rates and AA participation.

According to Owen, many studies of Twelve Step-based treatment published since 1995 have used more sophisticated designs and statistical analyses than earlier studies. Among members of the research community, that translates into more credibility for the Twelve Steps.

“It used to be that studies just offered a straight correlation between AA attendance and abstinence,” Owen says. “Now studies are looking at all the other variables that are involved to see how important AA involvement is.” Among those variables are client characteristics, types of treatment, and length of treatment.

While recent studies point to the power of the Twelve Steps and AA fellowship, they do come with some caveats.

One is that treatments such as Twelve Step Facilitation are technically not the same as AA. In Project MATCH and related studies, this treatment is based on individual counseling sessions with an ultimate purpose of guiding people to join AA. But in itself, AA is not a counseling or treatment program.

Then there are the inherent difficulties of treatment research–problems that dog anyone who attempts the task. In their study of treatment outcomes at Hazelden, Stinchfield and Owen offer these examples:

  • After they leave treatment, people can be hard to find. They move, change phone numbers, or just don’t respond to requests for follow-up interviews. It’s hard to know whether these people are staying sober or not.
  • Though many would like to say that addiction treatment leads clients to a life of sobriety, researchers cannot technically make this inference. In order to conclusively demonstrate that treatment itself changes people, researchers would have to randomly assign clients into groups that receive treatment and those that dont; then researchers could compare abstinence rates across groups. However, this procedure involves withholding treatment from some people–an obvious ethical problem.
  • Many studies depend on self-reports. That is, the results depend on recovering people to tell the truth about whether they’re staying clean and sober.

Researchers are finding creative ways to overcome these difficulties. For example, self-reports can be verified in several ways. One is to look for consistent answers to questionnaire items: If a person claims to be abstinent but still reports problems associated with drinking, this contradiction raises a red flag. Researchers can also interview family members and friends of the recovering person to double check the accuracy of that person’s responses.

AA endures
None of the caveats have to be a problem for people who seek sanity, support and sobriety in AA. People who wish to stop drinking or other drug use can continue to enter the fellowship of recovering people at any time. Based on the latest research, these people are making a smart decision. And even when research results are pending, AA’s doors are always open.

AA’s spirit of tolerance, embodied in the slogan Live and Let Live, offers another way to reconcile research with “real-world” practice of the Twelve Steps.

McClellan agrees, even though he concedes that many people who attend AA during treatment do not end up attending regularly. “AA isn’t for everybody,” he points out. “But what needs to be said–and it’s time for psychologists and other professional people to say it–for those who attend, it works damn well.”


Elements BH write

  1. You’re wondering if or worried that you might have a problem. The very fact that something is making you wonder if your alcohol or drug use is a problem is usually a good indicator that it is. Whether it’s “just a feeling” or something more – for example, you occasionally drink to the point of passing out or went through your prescription of Vicodin far too quickly – don’t ignore it. Pay attention to those worrisome thoughts – they may save your life or at least steer you away from disaster down the road.
  2. Others have expressed concern about your alcohol or drug use. If someone who loves you or knows you well has expressed concern about your alcohol or drug use, don’t be too quick to write them off. Chances are they have your best interests at heart and don’t want to see you destroy your life.Even if you disagree or think they’re blowing things out of proportion, consider the possibility that they may be right. While some people do have family members or close friends who are prone to judging or lecturing, the vast majority of people will only broach such a sensitive subject with you if they feel it’s necessary.And if several people have expressed concern, well, let’s just say the writing’s on the wall that you most likely need alcohol and drug treatment.
  3. You’re hiding your use from close friends or loved ones. Perhaps you’re justifying this because you don’t want others “in your business”, or you feel your loved ones would be judgmental. But if you feel the need to be secretive about your use, that’s typically a red flag that you have a problem. Granted, if you’re using illegal drugs (which suggests a problem in and of itself), hiding the fact is not uncommon. But again, the very fact that you’re willing to engage in illegal activity and risk serious legal problems is an indicator that something is seriously wrong.Perhaps you find yourself using alone, using when your spouse or family or roommate has gone to bed, or locking the bathroom or bedroom door when you’re using. If someone dares interrupt you or violate your privacy, you feel irritable or get angry at them. The question to ask yourself is, why the need for all the secrecy and privacy if you don’t have a problem? Your answer to that should give you a lot of clues regarding whether or not your need alcohol or drug rehab treatment.
  4. You use alcohol or drugs to cope with stress or numb painful feelings. Mental health professionals, as well as drug and alcohol specialists, refer to this as “self-medicating”. Whenever alcohol or drug use becomes a “need, that’s a telltale sign that there’s a problem. Additionally, using a substance as a means of coping often turns into a vicious cycle. Each time you feel better after drinking or using, it reinforces the pattern.On top of that, substance use problems create other problems in your life – relationship problems, health problems, legal problems, and / or financial problems. With each new problem comes even more stress, and an increased need to use (or self-medicate) even more. This vicious cycle can easily spiral completely out of control.Pay attention to what you tell yourself every time you use or take a drink. If you often find yourself saying “I need a drink” (or something similar) whenever you feel stressed, that’s a red flag that there’s a serious problem brewing.
  5. Your performance is suffering. If you’re experiencing a decline in your performance at work, at school (if you’re a student), or in your parenting, (or any other area of your life), that’s a strong sign that your alcohol or drug use is a problem. In some cases, the decline is gradual – and harder to spot. In others, it can be fairly rapid.Drugs and alcohol can impact your ability to think clearly. They can also disrupt your sleep, making it difficult to be alert and focused during the day. If you’re noticing – or others (like your boss) are commenting on – a decrease in your ability to perform, take heed before there are inevitable consequences.

The five signs listed above are significant, but there may be others as well. While each of these could be due to other things as well, they often accompany substance abuse problems and support the need for alcohol or drug rehab treatment:

  • Memory problems
  • Neglecting responsibilities
  • Changes in sleep or appetite (that can’t be appropriately attributed to something else)
  • Neglecting your personal hygiene or appearance
  • Borrowing money or selling possessions to buy drugs or alcohol
  • Doctor shopping
  • Mood swings
  • No longer engaging in activities that you once enjoyed
  • Withdrawing from family and friends
  • Frequent injuries or accidents
  • Feeling the need to lie or be evasive

Having an alcohol or drug problem doesn’t make you a bad person. It doesn’t mean you are weak, undisciplined, or lacking in morals. Admitting that you need help is hard, but you deserve to live a life that is fulfilling and unencumbered by alcohol or drug problems. Alcohol or drug rehab treatment is available if you’re willing to acknowledge the signs and take that first step.


The Mayo Clinic writes-

Treating compulsive gambling can be challenging. That’s partly because most people have a hard time admitting they have a problem. Yet a major component of treatment is working on acknowledging that you’re a compulsive gambler.

If your family or your employer pressured you into therapy, you may find yourself resisting treatment. But treating a gambling problem can help you regain a sense of control — and perhaps help heal damaged relationships or finances.

Treatment for compulsive gambling may include these approaches:

  • Therapy. Behavior therapy or cognitive behavioral therapy may be beneficial. Behavior therapy uses systematic exposure to the behavior you want to unlearn and teaches you skills to reduce your urge to gamble. Cognitive behavioral therapy focuses on identifying unhealthy, irrational and negative beliefs and replacing them with healthy, positive ones. Family therapy also may be helpful.
  • Medications. Antidepressants and mood stabilizers may help problems that often go along with compulsive gambling — such as depression, OCD or ADHD. Some antidepressants may be effective in reducing gambling behavior. Medications called narcotic antagonists, useful in treating substance abuse, may help treat compulsive gambling.
  • Self-help groups. Some people find that talking with others who have a gambling problem may be a helpful part of treatment. Ask your health care professional for advice on self-help groups, such as Gamblers Anonymous and other resources.

Treatment for compulsive gambling may involve an outpatient program, inpatient program or a residential treatment program, depending on your needs and resources. Treatment for substance abuse, depression, anxiety or any other mental health disorder may be part of your treatment plan for compulsive gambling.

Relapse prevention

Even with treatment, you may return to gambling, especially if you spend time with people who gamble or you’re in gambling environments. If you feel that you’ll start gambling again, contact your mental health professional or sponsor right away to head off a relapse.


more writes

Help for Methamphetamine Addicts

According to the Drug Enforcement Administration:

  • Nearly 12 million people have abused methamphetamine in their lifetime.
  • Estimates state that about 130,000 people try meth for the first time each year.
  • Almost 2% of high school seniors admitted using meth for nonmedical reasons.

Fortunately, effective treatments exist for people trying to quit methamphetamine. Although the best treatment will be tailored to the person, possible options for someone abusing methamphetamine include:

  • Inpatient substance abuse rehabilitation.
  • Outpatient treatment programs.
  • Individual behavioral therapy sessions with a therapist, counselor or other addiction treatment professional.
  • Family therapy.
  • Support groups.

Approaching a Loved One About Meth Addiction

If your loved one is currently abusing meth, it may be time to consider talking to them about their drug use and treatment options. Meth is a dangerous drug and abuse can lead to death. In 2011, methamphetamine overdose accounted for nearly 160,000 of admissions to the emergency room.

No one wants to witness a loved one battle an addiction to meth, as it can severely impact not only their quality of life but also others in their support system. You may have even witnessed your loved one’s physical and mental health change or deteriorate as a result of the drug use.

Given the serious health risks of a meth addiction, it is important to have the conversation early. You may just save the life of someone you love.

If you are worried or nervous about how your loved one will react to a confrontation about their meth addiction, you are not alone. It is common to feel anxious before talking to someone about their substance use. Fortunately, there are many programs available to help you work through these emotions and prepare for your conversation. One tool is called Community Reinforcement and Family Training (CRAFT) and it has proven to be successful in engaging loved ones into treatment. CRAFT teaches family and friends positive ways to practice self-care, reward non-using behavior, and understand a loved one’s triggers for drug abuse.

Given the serious health risks of a meth addiction, it is important to have the conversation early. You may just save the life of someone you love.

Methamphetamine Addiction Treatment

Even with meth’s strong addictive qualities, available treatment options have been successful in ending use and enabling recovery from the substance. Options for treatment that may take place in an inpatient or outpatient setting include:

  • Behavioral therapy. Formal therapy is often the most effective type of treatment for someone addicted to methamphetamine. The best forms of behavioral therapy are those that utilize aspects of cognitive-behavioral therapy (CBT) that address the thoughts, feelings, and behaviors that lead to and sustain continued use and contingency management (CM) approaches like:
    • The Matrix Model – A 16-week system that combines individual, group, and family therapy with 12-step meetings and drug testing.
    • Motivational Incentives for Enhancing Drug Abuse Recovery (MIEDAR) – A CM program that rewards abstinence from meth with behavioral incentives and rewards.
  • Support groups. Support groups provide the benefit of informal treatment, fellowship, and encouragement to participate in sober activities. Twelve step programs are the best-known support groups, but others exist. Meetings are led by members rather than a professional.
  • Family education and therapy. Substance abuse and addiction have the power to influence the entire family unit. Additionally, the family unit has the ability to influence the addiction. By engaging in family therapy, both the individual using meth and their loved ones will learn more about addiction and measures to improve their relationships and responses to use.

A treatment program that utilizes many different interventions for recovery and also makes plans for a comprehensive aftercare program will allow the recovering addict to learn the skills needed to prevent relapse, and live a healthy sober life.

Is Methamphetamine Addictive?

With its powerful and quickly delivered high, methamphetamine is considered to be one of the most highly addictive of the street drugs. Meth acts as a stimulant within the body, which means the substance:

  • Speeds up various processes in the body.
  • Increases energy.
  • Increases alertness.
  • Decreases sleep behavior.

Many addictive substances, including methamphetamine, manipulate the levels of the neurotransmitter dopamine. Increased dopamine activity may play a role in mediating a pleasurable, rewarding sensation whenever methamphetamine is used. This rewarding sensation compels the user to continue taking methamphetamine even in the face of negative consequences(a primary indicator of addiction) or choose using over other pleasurable activities or responsibilities.

What are the Signs of Methamphetamine Addiction?

Someone under the influence of methamphetamine may exhibit the following signs of a meth high:

  • Intensely pleasurable rush / euphoria.
  • High energy and motivation.
  • Altered sleeping patterns.
  • Diminished appetite.
  • Higher body temperature.
  • Quicker heart rate.
  • Faster breathing.

As initially rewarding as it may be, the high from meth comes with an array of unwanted and harmful effects. Someone using meth may display:

  • Anxiety, nervousness, and worry.
  • Inability to sleep.
  • Mood changes with depression.
  • Confusion or forgetfulness.
  • Aggression.
  • Symptoms of psychosis–hallucination, delusions, and paranoia.

Another telling sign that someone is addicted to methamphetamine is their behavior when they are not under the influence. Since many use methamphetamine in “binges” that involve steady use for several days, there will be a crash that follows. A crash is marked by excessive sleeping and periods of inactivity lasting for several days.

Someone may be abusing meth to accomplish tasks like studying for school or completing a projectsince the substance can create long periods of focus and energy.


Muri Wood writes

The National Institute on Drug Abuse reports that drug abuse treatment doesn’t need to be accepted voluntarily in order to be effective. In fact, a push from a family, an employer or the legal system could be just the thing an addicted person needs in order to change his or her habits for good. This can be welcome news for the parents of addicted teens, as they may struggle to get their charges to do even simple tasks like cleaning their rooms and washing their clothes. Figuring out how to make these teens do something monumental like enrolling in rehab can be difficult, and in some cases, it might even be impossible. However, there are a few things parents can say, and a few things they should avoid, as they attempt to find a solution that could help their troubled children.

Focus on Motivation

If they’re asked to do so, parents could likely provide a thousand supporting reasons for a child’s entry into rehab, including:

  • Improved health
  • Better grades
  • Stable relationships
  • Mental health improvement

It’s common for parents to outline these reasons when they discuss rehab with their teens, and unfortunately, these conversations are very one-sided and not very helpful. It’s easy for teens to just tune out and refuse to change when they feel as though they’re being lectured. Deep inside, however, these teens might have a tiny bit of motivation to get sober, and questioning can help parents to seek out that motivation and increase its impact. Parents might ask their children how they think their lives might be different if they were sober, or ask their children to describe one event in which drug abuse made something worse. Parents might also ask their children to describe their life goals, and then describe how drug use could allow them to reach these goals. These questions can force a teen to think about the consequences of drug use, and it could allow them to see that rehab could make their lives just a little better.

Ask for Help

Talking with teens can be difficult, even when parents use the right techniques. Sometimes, underlying conditions are to blame. For example, according to a study in the Journal of Nervous and Mental Disease, about 75 percent of teens who use drugs have an underlying mental health issue. These teens need help, and their parents may not be able to deliver those solutions. In some cases, it’s best for parents to work with a therapist before the teen enters rehab. Teens might willingly accept a few sessions of therapy, as they think it might be easier than entering a full-blown rehab program, and the therapist might be able to continue to boost the teen’s motivation to enter rehab and perhaps give help for a mental illness at the same time. Therapists are adept at working with reluctant patients, and they can use sophisticated techniques that can break through denial and really help teens to improve and get better. For some parents, asking for help is the best way to ensure that the child enters rehab with an open heart, willing to really work and improve.


promises write-

Placing a teen in alcohol or drug rehab is one of the most difficult things a parent will do. While you’re probably relieved that your child is finally getting help, you may also be worried about what the future holds. As a parent, there are actions you can take right now to give your teenager the best chance for recovery from addiction. There are also strategies that will allow you to help yourself and your family weather the challenges of the rehab process.

Helping a Teenager in Rehab

Addiction can have a devastating, long-term impact on your teen’s life. This is why it’s essential to do everything you can to help your adolescent overcome it. As much as therapy aids in recovery, the support and guidance of parents is just as important. In fact, in can be one of the most critical factors in your teen’s long-term success.

• Learn about addiction. Substance abuse is a broad category that includes alcohol, illicit drugs and prescription drugs. Each substance has its own impact on your child’s physical and mental health. Help your teen by educating yourself about his specific addiction, so you’ll understand more about the recovery process. By doing this, you’ll also be prepared in terms of what to expect in the weeks, months, and years ahead.

• Ask questions.
It can be overwhelming and a bit scary to have a teen in rehab. Don’t let your anxiety or sense of overwhelm prevent you from being the best advocate for her. Never hesitate to ask questions about the treatment process or recommendations that confuse you. If you’re concerned about a particular course of treatment, request a second opinion.

• Don’t allow your teen to be in charge. Adolescents can be headstrong and manipulative. Your teen may try very hard to convince you that he should leave rehab early. He may insist — and be quite compelling in doing so -– that he’s “learned his lesson,” or vow to never speak to you again if you don’t comply with his wishes. Expect all sorts of tactics, including crying, threats, cold silences and begging. Listen to your teen, but then explain that you love him and have placed him in drug rehab treatment to save his life.

• Be active in your teen’s therapy. Drug and alcohol rehab for adolescents typically includes family therapy. Make it a top priority to actively participate in your child’s recovery by attending all sessions, even if you need to set aside other commitments to do so. During therapy, you’ll learn how to work with –- rather than against — your teen to give her the best chance for recovery success.

• Have a plan for discharge. Addiction is a chronic condition, and alcohol and drug rehab treatment is just the first part of the recovery process. Work closely with the addiction center’s team to create a plan for your teen’s re-entry into the real world. Set clear house rules before discharge. Rules can include strict curfews, regularly scheduled chores, and expectations regarding school and behavior. Outline the consequences for violations, and, just as importantly, follow through on them. Make sure your spouse or partner is aware of the house rules and is willing to enforce them

• Be alert for signs of cross-addiction. Your teen may be recovering from an addiction to one particular substance, such as alcohol or steroids. However, he may be vulnerable to developing another addiction. Know the signs of addiction to other substances so you can be alert for them when your teen returns home. Don’t store prescription drugs, including painkillers and ADHD medications, in easily accessible places. Always dispose of extra pills properly after you no longer need to take them.

• Be patient. Recovering from any addiction is a long-term process. Your teen will go through different stages along the way. Sometimes she’ll feel positive, other times she may act depressed or pessimistic about her addiction or her recovery. With the guidance of alcohol and drug rehab specialists, she’ll re-learn how to think and feel without drugs or alcohol adversely affecting her brain.

Helping Your Family

One of the biggest obstacles for parents with addicted teens is caring for the rest of the family. The following tips can help everyone cope:

• Seek professional help for yourself. Some parents feel shame and guilt over a teen’s addiction; others harbor anger and frustration toward their addicted child. Many moms and dads weigh themselves down with derogatory statements like “I should have done this…” or “I was a bad parent.” Therapy is a safe place to express those often overwhelming, negative emotions. Your therapist will talk with you about how you’re feeling and help you find healthy ways to cope with negative and conflicted emotions. When you’re emotionally healthy, you’ll be better able to guide and support your teen -– as well as the rest of your family — through the recovery process.

• Make time for yourself. Addiction is an all-consuming condition for addicts as well as their closest family members. While it’s natural for you to feel stress and anxiety when your child is in alcohol or drug rehab, it’s not healthy for you to ignore your own needs. Schedule time to indulge in activities that nurture your own soul. For example, take a long hike, give yourself a brief getaway, or just spend time working on a home project you enjoy.

• Don’t ignore your marriage. It’s possible you’re focusing so much on your teen’s addiction problems that you neglect the relationship with your spouse or partner. Reconnecting with your significant other can be as simple as setting a regular date night, away from the strain of managing an addicted teen. However, if you’re unable to resolve conflicts, consider seeking marriage therapy. A skilled therapist will help you identify the primary problems in your relationship, and help both of you find effective and healthy ways to work through them.

• Spend time with your non-addicted children. It’s easy for a family to get so wrapped up in a teen’s addiction that other children in the home are neglected. Commit to spending regular quality time with your other children. Allow each child to choose an activity he or she enjoys, whether it’s going to a favorite fast food restaurant or spending time at a park. Connect during the course of normal days as well, doing simple things like walking the dog or packing lunch together.

• Break isolation. Substance abuse, along with the shame and stigma that inevitably accompany it, often causes families to withdraw from the world. While isolating from others may feel safer, it is detrimental. Enhance and rebuild your connections with friends and others by taking part in social activities like attending a class, going to church, or volunteering. By reconnecting with your community, you’re giving yourself and the rest of your family a sense of belonging that may have been missing.