Search Results for: cognitive behavioral therapy

What Is Cognitive Behavioral Therapy?

CBT Triangle

What Is CBT?

What CBT is NOT

Cognitive behavioral therapy should not be confused with the following:

  • Psychoanalysis – This Freudian approach aims to get at the bottom of subconscious determinants of your actions/behavior.
  • Person-centered/ humanistic therapy – This approach involves a mostly-passive therapist that says little during sessions in an attempt to have you resolve your issues independently.

If you have recently started therapy or have been considering treatment for drug abuse, you’re likely to hear about cognitive behavioral therapy (CBT).

CBT is an approach to treatment that was originally developed to treat depression but has been expanded to improve symptoms of various mental health illnesses and issues including:

  • Addiction.
  • Anxiety.
  • Psychosis.
  • Trauma.

A major component of CBT is that thoughts, feelings and behaviors are connected in a way that one influences and is influenced by the others. For example, feelings are impacted by your thoughts and behaviors, and your feelings impact your thoughts and behaviors. This notion gives some level of power to the client to improve the unwanted facet by addressing the other two.

So, if you have feelings that you do not like, you can modify them by changing your thoughts and behaviors.



How Does CBT Aid in Addiction Recovery?

The goal of CBT is to increase your awareness of your thoughts, actions and the consequences of each. Through this process, you gain a better understanding of your motivations and the role of drug abuse in your life.

To learn more about your options for treatment that includes cognitive behavioral therapy, call 1-888-744-0069 and get on your way to a happy, healthy life today.

Cognitive Distortions

Many times, cognitive behavioral therapy will focus on studying your thought patterns to look for negative views of yourself, the world around you and your future. Chances are good that there will be flawed perceptions called cognitive distortions. These distortions are like a dark lens that changes the way you view the world. Some cognitive distortions include:

  • All-or-nothing thinking: Perceiving situations in absolute, black-and-white categories.
  • Overgeneralization: Viewing a recent, negative event as a never-ending pattern of defeat.
  • Mental filter: Dwelling only on the negatives.
  • Disqualifying the positive: Insisting that your positives don’t count because of some other force.
  • Jumping to conclusions: Assuming your thoughts, feelings or beliefs are true without any supporting evidence.

By changing your thoughts to become more positive, you can improve your feelings and behaviors.

Co-occurring Disorders

CBT will also prove helpful in identifying and treating comorbid mental health issues that often accompany addiction. Many people engage in addictive behaviors to escape or avoid emotional pain.

CBT can address those psychological issues directly to:

  • Reduce the underlying reasons for addiction.
  • Prevent future relapse.

What Should I Expect in CBT?

CBT helps clients learn skills that can be used in the present and interventions that can be applied to the future to reduce stress, improve behaviors and increase overall well-being.

CBT Works

Simply, CBT is a frequently used therapeutic style for addiction and mental illness because it works. In fact, CBT has been studied and tested over the years to prove its efficacy and value in a number of settings and for a number of presenting problems.

CBT will look very different depending on the therapist and the setting. A strong benefit of CBT is that it allows for incredible flexibility and freedom. Generally, your therapist will serve several functions during the course of your treatment:

  • Teacher. She will provide education regarding your symptoms, diagnosis and treatment. (Homework may be given to gather more information away from session.)
  • Teammate. As you work through the process, she will assist with your follow-through on planned interventions to achieve your goals.

A typical CBT session will last 45 minutes to an hour and will involve discussing irrational thoughts, negative behaviors, and stress of the last week. From there, your therapist will challenge your negative thinking and faulty beliefs while offering positive coping skills to employ when faced with challenges.

CBT helps clients learn skills that can be used in the present and interventions that can be applied to the future to reduce stress, improve behaviors and increase overall well-being.

Other CBT Techniques

Other interventions in CBT include:

  • Relaxation training for anxiety.
  • Assertiveness training to improve relationships.
  • Self-monitoring education to improve insight.
  • Cognitive restructuring to modify thinking patterns.

Finding Addiction Treatment that Includes CBT

If you are interested in starting cognitive behavioral therapy, you are in luck. Because of its strong reputation for being effective across a range of issues, mental health professionals trained in CBT are widely available. Chances are high that any outpatient individual, outpatient group, inpatient, residential treatment or rehabilitation program you would attend will be staffed with competent CBT therapists.

The best news is that CBT is very low-risk. The odds of something negative or harmful happening from attending a CBT session is minimal. The reward is a different matter.

If you are not convinced that addiction, depression, anxiety or other issues are negatively impacting your life, a CBT therapist can assess your situation and symptoms to see if you meet criteria for a mental health diagnosis. CBT therapists work with people looking to achieve more from life, as well as people with serious mental health and substance use issues.


Other Supplemental Therapies

Another major benefit of CBT is that it integrates aspects of other styles well while allowing clients to benefit from other services. Many CBT therapists utilize aspects of the following orientations into their sessions:

  • Motivational Interviewing – This style of therapy involves a certain method of questioning that is particularly helpful in addiction, and it fits easily with CBT.
  • Holistic Approach – A holistic approach will look at your overall well-being to find ways to improve your physical, emotional and spiritual health.
  • 12-Step Programs – Some differences of opinion exist between programs like AA and NA, but the similarities are enough to make these two interventions work well together. Many clients will attend regular meetings in conjunction with their CBT sessions.
  • Medication Management – When you work with a CBT therapist, they might recommend a psychiatric evaluation. You may be prescribed medication to help improve your symptoms. Many studies show that CBT and medication work better together than either alone.

The best type of treatment for your or a loved one will be tailored to your personal needs. Call 1-888-744-0069 to find a program that incorporates the types of care that you are looking for. Don’t put your physical and emotional health for another day.


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Group Therapy: Substance Abuse Treatment

Group Therapy
Along with individual therapy, family therapy, and medication management, group therapy is an indispensable element of effective substance abuse and mental health treatment. Group therapy is a broad term for any type of therapy aimed at creating symptom reduction and recovery in two or more people 1,2.

 

Group therapy is an option that can be as effective as individual sessions.

Group therapy will have a trained leader conducting the session 3. Unlike family therapy, the members in group therapy will not usually have a pre-existing relationship outside of sessions.

Group therapy sessions can be conducted in varied therapeutic settings and levels of care, including 1:

For someone committed to ending their drug use and beginning a period of recovery, group therapy is an option that can be as effective as individual sessions 3.


Advantages of Group Therapy

Group therapy has a number of advantageous elements that equal or surpass individual therapy, such as the ability to 3:

  • Offer members education about the recovery process.
  • Provide support and motivation from peers to maintain recovery goals.
  • Give members the opportunity to observe issues encountered by others in recovery and observe their methods of problem-solving.
  • Empower group members by encouraging them to offer assistance and feedback to other members.
  • Teach healthy coping skills to manage daily stressors without resorting to substance use.
  • Boost structure and routine in the lives of group members.
  • Build a sense of optimism, self-worth, and belief in the group members.
  • Develop relationships between group members that can be used outside of sessions for support and encouragement.
  • Effectively treat many individuals simultaneously with one therapist, allowing those clients quicker access to therapy.
  • Utilize therapeutic tools (such as challenging irrational beliefs and confronting poor decision-making) to modify behaviors.

Is Group Therapy Right for Me?

People interested in attending a therapy group will need to be matched up with a group that suits their individual needs. Before placing a recovering individual in a group, a provider will consider the individual’s 3:

  • Treatment preferences.
  • Unique needs.
  • Emotional stability.
  • Stage in recovery.

Some people will not be a fit for group therapy based on their current status. This therapeutic method may be inappropriate for those who 3:

  • Refuse group therapy as a viable treatment option.
  • Cannot maintain confidentiality and are at risk for breaking group rules.
  • Are currently in crisis with severe, unmanageable symptoms.
  • Struggle to build suitable relationships.
  • Experience extreme stress around other people and new situations.

Other groups, like women and adolescents, require special considerations when it comes to placement in a therapy group. Some evidence shows that women who participate in women-only groups may have better outcomes than those in groups with men 3. Also, there is some risk that adolescents in group therapy may actually encourage/reinforce substance use with each other 4. Leaders of adolescent groups must be aware of this risk and actively manage it 4.


Models of Group Therapy

If group therapy is recommended for you, there are 5 separate models of group sessions that you may encounter:

Various models of group therapy
  • Psychoeducational groups.
  • Skill development groups.
  • Cognitive behavioral therapy groups.
  • Support groups.
  • Interpersonal process groups.

With a knowledgeable and proficient treatment professional, any model can offer strong benefits; however, certain models may better fit your individual needs. Additionally, some therapy groups may take advantage of several models during the course of the meetings, meaning that they shift from one model to another.

Psychoeducational Groups

The primary focus of a psychoeducational group is to offer education and information regarding general themes of substance use, mental health, related behaviors, and the consequences of these behaviors. These groups might resemble a classroom setting, as the material will be presented through audio, video, or a lecture format 3.

Psychoeducational groups can be helpful for many situations as it teaches members 3:

  • To recognize the impact of substance use.
  • About their condition, the barriers to recovery, and how to live a drug-free life.
  • Beneficial skills like relaxation, meditation, healthy eating, and anger management.

Skill Development Groups

In skill development groups, the group leader will have a similar position as a teacher, but here, the material provided will be more specific to the group members and their individual needs. Skill development groups will depend more on the group interacting with each other rather than only the leader speaking to them 3.

The group sessions will focus on a skill that contributes to the members’ ability to remain abstinent from drugs. Potential group topics include 3:

  • Handling triggers to engage in substance use or related behaviors.
  • Positively interacting and communicating with others.
  • Identifying and modifying responses to anger.
  • Improving parenting skills.
  • Managing financial responsibilities.

Cognitive-Behavioral Therapy Groups

Cognitive-behavioral therapy (CBT) is a widely used evidence-based style of therapy that operates on the idea that negative behaviors are learned and reinforced over time. To change these behaviors, the individual must work to modify the thoughts, feelings, and behaviors that contribute to substance use 2. One example of a thought that may contribute to continued substance use is “I’m a bad person; I don’t deserve to be sober.” By modifying damaging thoughts and beliefs, the individual can accomplish the changes needed to sustain recovery.

To accomplish these changes, a CBT group will 3:

  • Identify the members’ distorted beliefs and problematic behaviors.
  • Teach and encourage the use of new thinking and behavior patterns.
  • Offer relapse prevention training.

Support Groups

As the name suggests, the principle focus of a support group is to offer care and understanding to all members of the group. This support will come from the group leader and from one member to the others. The leader will help members to improve their interpersonal skills as they engage in group discussion, share experiences, and help each other resolve their challenges 3.

The therapist will demonstrate the desired level of communication, model respectful interaction, and provide positive reinforcement for members 3.

Interpersonal Process Groups

Interpersonal process groups attempt to promote healing in members through an understanding of psychodynamics (the way individuals function psychologically). The group leader will note and process 3:

  • How each member is feeling and functioning in the group.
  • How the members are interacting with each other.
  • How the group is performing as a whole.

A focus will be on emotional development and childhood concerns that, when left unresolved, lead to poor decision-making, impulsivity, and unhealthy coping skills. By resolving these issues, the person can improve their judgment.

With interpersonal group therapy, the content covered in each group session is secondary. Rather, the leader looks to see how the group members are behaving and interacting in the present and how their present is being influenced by their past.

A Note on Self-Help Groups

12-step groups and other self-help groups are not considered group therapy. Although they occur in a group setting with people that did not have a preexisting relationship, they lack one key component of group therapy: a professional facilitator.

Group therapies employ various types of mental health professionals to lead the groups. Self-help groups may utilize peer leaders or have a collective approach. Self-help groups provide great assistance to people in recovery, but they are not a professional group therapy option 2.


Group Therapy Categories

Based on the way the group is conducted and who participates in it, different subtypes exist for each of the aforementioned group therapy models.

Fixed and Revolving Groups

Groups can either be fixed or revolving. A fixed membership group is one that begins and ends with the same members throughout. Once the group is initiated, new members are not usually added. These groups generally have less than 15 members and are appropriate for people that are at similar points in their recovery 3.

Revolving membership groups are named for their ability to change members at any time. When someone is appropriate for the group, they will join and then leave when the time is right. These groups will be run constantly with an ever-changing collection of members 3.

Time-Limited and Ongoing Groups

Fixed and revolving groups can be divided further into time-limited or ongoing groups 3:

  • Time-limited groups will ask members to attend for a specified length of time or number of sessions.
  • Ongoing groups will allow members to attend indefinitely based on their symptoms and overall progress.

Each type has strengths and weaknesses, and which one will be best will depend on the unique needs of the individual. All versions can be effective.


Stages of Group Therapy

Regardless of the model or category of the therapy group, it will progress through three general stages. They are 3:

Stages of group therapy
  • The beginning phasegetting started. In this phase, the members will become oriented to the process and learn the group rules and goals.
  • The middle phasewhere change is made. The middle phase should consume the majority of someone’s time in group therapy. Here, the therapist will use their skills to trigger changes in thought patterns and modify behaviors to move towards treatment goals. This is also where meaningful connections between members will be made.
  • The ending phasemoving to closure. Ideally, the relationships with leaders and members will not end abruptly. Any run of regular group therapy must come to an end at some point; however, this end point should be projected gradually to allow for adequate recognition of the accomplishments made over the course of therapy and for addressing any anxiety and/or sadness over the group coming to a close.

Group Leader Roles and Responsibilities

The qualifications and experience of those who lead therapy groups will vary somewhat. Examples of people that can lead groups include 5:

  • Social workers.
  • Psychologists.
  • Psychiatrists.
  • Licensed or certified substance abuse counselors.

Some terms like facilitator, therapist, or clinician are used generally and do not denote specific training or experience.

Leaders should have the following qualities to ensure an effective group 3:

  • The ability to maintain a consistent, safe, supportive environment to promote abstinence.
  • A strong sense of self to manage group members’ symptoms as well as the impact group sessions have on them personally.
  • The ability to listen actively and make the group members feel heard.
  • The use of empathy, the ability to understand what the client is experiencing.
  • The capacity for projecting self-assurance and expertise that provides a role model for members.
  • Creativity and flexibility to react to unexpected, unplanned situations as they present.
  • A strong sense of ethics that is maintained as challenging situations arise.
  • Trustworthiness that promotes openness between members and the therapist.
  • The ability to use humor and levity when appropriate to balance difficult moments.

Some groups will employ a team of therapists to better manage sessions. In substance abuse treatment, all leaders will work professionally to 3:

  • Link the connections between substance use and thoughts/feelings.
  • Limit conflict.
  • Boost motivation.
  • Build coping skills.

Group therapy is a preferred option in many situations for people in various stages of recovery. If you or someone you know could benefit from participating in a therapy group, call 1-888-744-0069 to begin the process and find treatment appropriate.


References:

  1. Substance Abuse and Mental Health Services Administration. (2016). Treatments for Substance Use Disorders.
  2. National Institute on Drug Abuse. (2012). Principles of Drug Addiction Treatment: A Research-Based Guide.
  3. Substance Abuse and Mental Health Services Administration. (2015). Substance Abuse Treatment: Group Therapy – Quick Guide for Clinicians.
  4. National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide.
  5. Substance Abuse and Mental Health Services Administration. (2015). Behavioral Health Treatment and Services.

Eye Movement Desensitization and Reprocessing Therapy

EMDR-treatment-for-young-woman

What Is EMDR?

Eye movement desensitization and reprocessing (EMDR) is a therapeutic style originally developed to address stress, anxiety and depressive symptoms related to traumatic events and memories.

EMDR is used to treat posttraumatic stress disorder (PTSD) and has been shown to be effective in this area since its inception. In fact, depending on the level and complexity of trauma, EMDR is known to be effective in as little as one session. It is important to note, however, that there is still some debate among scholars and clinicians in regards to the validity EMDR research and its effectiveness.

There is hope in recovery. Call 1-888-744-0069 and find treatment now.

The world of psychotherapy is filled with talk therapies like cognitive-behavioral therapy (CBT), rational emotive behavior therapy (REBT), motivational interviewing (MI), person-centered therapy, reality therapy, acceptance and commitment therapy (ACT), and others. These all share the similarities of a having a dialogue between the therapist and the client, but EMDR differs from these. EMDR involves active physical participation on behalf of the patient, namely the purposeful direction of therapist-guided eye movements, in conjunction with therapist-patient dialogue.

EMDR believes that the problematic thoughts and behaviors occur because the traumatic life events were not appropriately processed when they occurred. This lack of processing leads to the events being stored as harmful memories that later disrupt cognitive, emotional, and social functioning.

The goal of EMDR is to reprocess these undesirable memories and experiences. A therapeutic style like CBT would be geared toward exposing the patient to the traumatic thoughts and feelings through imaginary scenes, or, perhaps, by re-confronting the traumatic situation (if possible). EMDR takes a different approach to working with these neurocognitive systems.

The idea behind EMDR is that reprocessing the memories allows them to be assimilated and accommodated in the brain. The act, called adaptive information processing, is at the core of EMDR. The eye movements are reported to aid in the way the information is accepted into the brain’s networks.


Video: EMDR

Credit: Michael Burns


Course of Treatment for EMDR

EMDR has a specific, formulaic approach to treatment based on an 8-phase approach. The therapist will lead the client through each of the phases at a pace that is appropriate for the client’s needs with some sessions accomplishing multiple phases and some phases requiring multiple sessions.

The 8 Phases of EMDR

Phase 1: History and planning. In this phase, the therapist will gather information related to the need for treatment. Current symptoms, past issues, triggers, and unwanted behaviors will be discussed to gain an understanding of the factors involved. An interesting facet of EMDR is that the information does not need to be exhaustive or detailed. At this point, the events can be vague and general as long as they yield targets for EMDR to address.

Phase 2: Preparation. Phase 1 may take a session or two, but phase 2 can take as many as four sessions. A major focus of this stage is building a trusting rapport between the client and the therapist. The relationship is needed so the client will have the comfort to express their feelings to the therapist later in treatment to ensure the best possible outcomes. Along with the trust building, the therapist will discuss the fundamentals of EMDR, the course of treatment, and needed relaxation techniques to use when emotional experiences arise.

Phase 3: Assessment. This phase involves looking at the established targets from phase one. The client will develop a mental picture of that traumatic event, a negative statement from the event, and a positive statement that is the goal belief. So, if the traumatic situation was a car accident, the picture might be broken glass in the car. The negative statement is “cars are dangerous.” The positive statement is “cars are safe most of the time.” Finally, in this phase, clients are asked to rate how strongly they hold these beliefs and their physical and emotional reactions to these ideas.

Phase 4: Desensitization. This phase marks the onset of the reprocessing. Here, the client is asked to become aware of disturbing images, thoughts, feelings, and physical sensations while the therapist utilizes stimulation in the form of instructing the client to shift their eye movements by following the therapist’s hand (though sounds and physical tapping can be used). The client reports the present elements in generalities, and the therapist continues to use the stimulation until the client reports lower ratings of distress.

Phase 5: Installation. Now that the negative image and statements are no longer provoking, the focus can turn towards the positive statement from phase 3. The new belief is given attention while the therapist continues to provide the stimulation in the form of the client’s eye movements, tapping, or sounds. The phase ends when the client reports having a full belief in the positive statement.

Phase 6: Body scan. This phase checks the efficacy of the previous two phases by asking the client to note any negative elements remaining from the target. If the target is unresolved, phase 4 will be restarted to yield the desired results.

Phase 7: Closure. The goal of EMDR is leaving the client feeling better than when she arrived. The therapist will lead the client through some of the relaxations and calming exercises previously learned. Additionally, the therapist will provide information on what the client may expect in between sessions regarding the continued processing of targets.

Phase 8: Reevaluation. The final phase actually occurs at the beginning of the next session. The therapist checks in to ensure that the results noted from the body scan continue. When all targets have been addressed and reevaluation shows no disturbing issues remaining, treatment will end.

The trauma-related use of EMDR can be applied to many situations including:

  • Sexual abuses like rape and molestation.
  • Physical injuries stemming from a range of accidents or intentional violence.
  • Emotional abuse in the form of conflictual relationships.
  • War-related trauma and post-traumatic stress.

It is important to remember that the traumatic events can be experienced directly or to someone close to you. If someone you love was in a dangerous or life-threatening situation, you can develop posttraumatic stress disorder, as well.


EMDR for Addiction

When the model of treatment was created in the late 1980s and early 1990s, EMDR was used exclusively for trauma. How does this fit with addiction treatment? Many people dealing with substance abuse, addiction, and dependence have problems related to trauma.

For some, past trauma is a contributor to addiction, as substance abuse can be a means of self-medication to block out or escape from the harmful memories.

For others, they have experienced trauma during their use. For example, an addict may have been sexually assaulted while under the influence. In such case, the substance use is likely to continue unless the trauma feeding the addiction can be addressed.

Over the years, people have worked to expand and modify EMDR to treat other issues. One such example is called the feeling-state addiction protocol (FSAP). This therapy style is based on the foundations of EMDR but applied to issues related to addiction and compulsion. With EMDR, there is the focus on the negative experience that creates trauma. In FSAP, the focus is on the intense positive experiences associated with destructive, compulsive behaviors that create and maintain addiction. EMDR tries to replace the negatives with positives.

FSAP tries to:

  • Break the connection between the positive feeling and the destructive behavior.
  • Process the negative beliefs associated with the compulsion.
Fusce vitae

FSAP is believed to be effective in the treatment of:

  • Behavioral addictions including gambling, sex, addictive overeating, compulsive shopping, and shoplifting.
  • Substance use disorders including addictions to alcohol, legal drugs like tobacco, prescription drugs, and illicit drugs.
  • Anger.
  • Co-dependent and abusive relationships.

EMDR Therapists

Reports state that over 100,000 EMDR therapists are available around the world with available databases to find ones near you. Therapists are able to receive a certification in EMDR that signifies their ability to accurately utilize the skills.

To get help finding a program that utilizes EMDR, call 1-888-744-0069 today.


Integrating EMDR

In the world of counseling for mental health concerns, EMDR stands out for its unique view of treatment and the methods of improvement.

EMDR is used as a standalone treatment in many situations, but it can also be used in combination with other therapeutic interventions. For example, if a client has issues with depression, addiction, and trauma, the clinician may choose to begin treatment by using EMDR to address the trauma in hopes that reprocessing this information will reduce the other symptoms. If the symptoms do not alleviate completely, the therapist may shift focus by bringing in other treatment options including:

  • CBT, which is used with good results for a range of symptoms related to depression and anxiety.
  • Motivational interviewing, which helps reduce ambivalence related addiction while fostering a greater sense of control in the client.
  • Medication management, which will help limit the symptoms of mental health disorders and reduce cravings associated with the addiction. Medication may not be appropriate during the phases of EMDR, though.

In the world of counseling for mental health concerns, EMDR stands out for its unique view of treatment and the methods of improvement. EMDR is not without its detractors, though, that claim the eye movement portion of EMDR is not essential. Regardless, EMDR has a foundation of evidence to support its role as a helpful method of therapy.


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Dialectical Behavior Therapy

man-in-therapy-getting-treatment-DBT

What is DBT?

Dialectical behavioral therapy (DBT) is a branch of psychotherapy that is rooted in the principles of cognitive-behavioral therapy (CBT) with several modifications and additions. The treatment style was developed originally to aid those with borderline personality disorders (BPD) but has found success treating conditions that are related to or independent from BPD including:

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  • Depressive disorders.
  • Bipolar disorder.
  • Posttraumatic stress disorder.
  • Anxiety disorders.
  • Eating disorders.
  • Substance use disorders.

Like CBT, DBT is a type of treatment that is studied and researched to demonstrate its efficacy in these types of situations. It is shown to be more effective than other types of treatment or no treatment at all.

History and Development

DBT was created in the late 1980s and early 1990s by Dr. Marsha Linehan. While working with clients that engaged in self-injury and had suicidal thoughts, she found the standard CBT principles to be limiting, as they maintained a constant emphasis on changing these behaviors. Because of this, she developed DBT to add validation/acceptance and dialectics (explained below) into the CBT frame.

The validation is added to balance the desire for change with acceptance on behalf of the therapist and client. Validation is not used to permit or encourage unwanted behaviors, only to offer an understanding of why the client would act in these ways.

The addition of dialectics expands on the notion of validation. Dialectics is the idea that:

  • Everything is connected.
  • Change is constant.
  • Opposing forces can be brought together to find balance. This is illustrated in the view that acceptance and taking action to change are unified opposites.

Video: What Is Dialectical Behavior Therapy?

The following video will provide a short but comprehensive overview of DBT – what it means, its goals, and what to expect.

Credit: UC San Francisco (UCSF)


Views and Beliefs 

DBT shares many views and beliefs with CBT, noting that unwanted thoughts and behaviors are learned and reinforced. DBT believes that the interaction between two factors increases the chances of persistent mental health issues:

  • Emotional vulnerability.
  • Invalidating environments.

Someone that is emotionally vulnerable will feel like their life is turbulent and extreme, and they will be quick to respond with strong emotional reactions. This vulnerability can be caused by traumatic events or from the individual’s natural disposition (i.e., genetics).

An invalidating environment is where someone is consistently made felt as though that their feelings are wrong or “bad.” A lack of kindness, respect, and acceptance can produce an invalidating environment.

DBT includes a level of optimism that is not found usually in CBT. DBT conveys that:

  • People are doing the best they can in their current situation.
  • They want situations to improve.
  • People are capable of learning new behaviors to change their lives.
  • The problems are not always the person’s fault, but it is their duty to resolve it.

Goals of DBT 

DBT includes 4 main goals of treatment for the client that are divided into stages.

The Four Main Goals of Treatment

Stage 1: Transitioning from out of control to in control.

This stage is focused on reducing reckless and dangerous behaviors (e.g., self-harming) while building skills that include increasing attention, improving relationships, understanding emotions, and managing distress.

Stage 2: Transitioning from emotional unavailability to emotional engagement.

People will shut down emotions that are too overwhelming to manage. The goal in stage 2 is to fully and accurately experience feelings without relying on avoidance or escape.

Stage 3: Building an ordinary life and solving ordinary problems.

During this stage, the client will focus on problems that are more common and expected. Rather than targeting extreme symptoms like chronic suicidality, the treatment will focus on the relationship conflicts, problems at work, life goals, and more mild mental health symptoms that most people experience.

Stage 4: Transitioning from feeling incomplete to feeling complete/connected. 

The previous stages were focused on reducing the unwanted symptoms, but the goal of the final stage is to allow the client to move towards happiness in the future. DBT believes that finding a sense of connection to the world facilitates this goal.

 


Methods of Change

In DBT, the therapist controls all aspects of treatment planning and movement. The therapist will establish and organize the components listed below. Beyond that, the therapist will direct other care including medication management, substance use treatment, case management, and vocational rehabilitation when needed.

To successfully accomplish the goals of treatment, DBT uses a specialized treatment approach. The approach is comprised of 4 parts with three involving the client and one focusing on the therapist. They are:

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  • DBT group therapy. A major focus of DBT is the use of a skills group where a client will meet with a group of other people that exhibit similar self-destructive symptoms. The skills group will appear like a schoolroom where the therapist will teach a particular topic or skill during the session and assign follow-up homework for the client to practice between sessions. These weekly groups generally last for 2.5 hours over 24 weeks. At times, the groups are broken into four six-week sessions that focus on one skill only.
  • DBT individual therapy. This individual treatment will address past and present client issues as they occur. In some cases, the individual therapist will be the group therapist, but it could be a different therapist depending on the treatment center. Individual therapy sessions will last for about an hour and occur weekly.
  • DBT phone coaching. The therapists will make themselves available to the client to assist with issues as they present during time away from treatment. Like with other treatment styles, it will not be the job of the therapist to instruct the client on what to do. Rather, the therapist will guide the client through options and available resources to improve decision-making.
  • DBT therapist consultation. DBT is an intense course of treatment for the client. The same intensity is present for the therapist as well. To ensure the best treatment is being prescribed and followed through, therapists attend consultation in group or individual settings. These act as a support system to the therapist to discuss their clients, their progress, and the therapists’ reactions. When the therapist is well supported, he can better care for the client. Other theoretical orientations recommend supervision, but DBT is one of a few that demand this focus on the therapist.


DBT Skills

As mentioned, DBT is focused on creating an effective environment for the client to learn and practice skills. The primary skills addressed in DBT are:

  • Mindfulness. This is the act of being completely aware and engaged in one’s current setting. People with mental health or substance use issues often spend increased time distracting themselves, thinking about the past, or worrying about the future. Mindfulness is the practice of being fully immersed in the here and now, with kindness and curiosity towards one’s current experience.
  • Distress tolerance. When people experience distress, there is an urge to reduce or change it immediately. Using a substance during periods of stress is an example of an unhealthy way to manage distress. Distress tolerance teaches how to accept and tolerate distress rather than escape from it.
  • Interpersonal effectiveness. When communication and conflict resolution skills are lacking, problems increase. DBT teaches people to learn how to have happier, more fulfilling relationships through effective interactions with others.
  • Emotional regulation. This is another example of dialectics. Distress tolerance moves towards acceptance while emotional regulation works to identify unwanted feelings and find ways to change them.

These skills are so effective that other styles of therapy have borrowed them and currently use them in a number of settings. People that are interested in DBT but cannot commit to the full treatment plan (including group and individual sessions) can still benefit from these skills.


DBT Effectiveness

DBT has been shown to help clients invest and remain engaged in sessions.

Even though DBT is relatively young in the world of psychology, it has become the standard treatment for borderline personality disorder (BPD). Over the years, its efficacy has spread to include treatment of many self-destructive behaviors like self-injury and substance abuse.

The treatment works to improve the client’s well-being even when he does not meet the criteria for a mental health diagnosis. DBT has been shown to help clients invest and remain engaged in sessions.

Another positive about DBT is that all of the support for the style is backed by scientific evidence. It does not base its accomplishments on anecdotal information collected over the years. Many of the findings related to DBT are available here.


Finding a DBT Therapist

Depending on your location, finding a therapist trained in DBT should not be difficult. Because of its reputation for success, even therapists that were trained before DBT existed have attended trainings on the subject. The institute named for the creator of DBT offers a DBT therapist directory to locate a therapist that completed their training.

If you have questions or need help finding a therapist or a rehab program, call 1-888-744-0069 to speak to someone who can help you find the right care for you or your loved one today.

Resources:

Family Therapy: A Vital Part of Addiction Treatment

couple in therapy

The effects of addiction aren’t limited to the addicted person, and the causes of substance abuse can be varied and complex – family issues can contribute to and perpetuate the illness of addiction. In fact, addiction is sometimes referred to as a “family disease.” Successful treatment, therefore, often incorporates the family of the person struggling with addiction.

Family therapy refers to a group of treatment styles that target the group rather than the individual within the group. All of the styles are based on the notion that families share a connection, and by modifying one component of the system, you can affect the other components. This means the health of a family can play a major role in the success of recovery.

Historically, someone in recovery for addiction would receive treatment independently, often removed from their home, community, and family, but there has been a recent shift towards a more integrated approach to treatment that not only focuses on the individual but their family environment as well.

Family therapy is an example of this kind of treatment. This approach has been shown to provide high benefits with low costs, and organizations including the National Institute on Drug Abuse and U.S. Department of Health and Human Services recommend family therapy be incorporated into any substance abuse treatment program.

Is It Time for Family Therapy?

It might be time for family therapy if:

  • Your family member continues to use substances despite your objections.
  • Your mental and physical health have been negatively impacted by the family member’s use.
  • You want to learn methods to improve your ability to respond appropriately to your family members use.
  • Your family member has not found success from other treatment approaches.
  • You’ve experienced family issues that you (or your loved one) believe have contributed to the addiction.

Many family members of people struggling with addiction feel they don’t need therapy because the addict is the one with the easily identifiable problem. An important consideration is that family therapy can be completed in combination with other treatments like:

  • Individual therapy.
  • Group therapy.
  • Medication management.
  • Residential rehabilitation programs.

There does not have to be a choice between family therapy or others.

It’s also important to understand that therapy can provide support for family members but also boost their loved one’s health and chances of recovery as well.

Since there is no set definition for “family,” family therapy might be appropriate even if you are not technically family. Significant others, friends, and coworkers may choose to attend this form of treatment.


Benefits of Family Therapy

Studies show that treatment approaches that involve the family have better engagement, higher rates of success, and increased aftercare participation.

You can expect many positives to result from the treatment. Benefits of family therapy include:

  • Assisting the substance user to gain awareness of their needs and behaviors.
  • Improving the mental and physical state of the entire family unit.
  • Permitting family members to gain self-care interventions to improve their own well-being.
  • Improving communication styles and relationship quality.
  • Helping families understand and avoid enabling behaviors.
  • Address codependent behavior that may be preventing recovery.
  • Learning and understanding the systems in place that support and deter substance use.
  • Preventing the substance use from spreading throughout the family or down through future generations.

Family therapy will aim to accomplish the above by emphasizing the strengths of the complete family and diminishing the influence of substance use for all members.

Generally, a therapist will engage the family in dialogues focused on developing problem-solving skills, motivation for change, and assigning accountability for all in the family.

Are There Any Risks?

Family therapy, like most other forms of treatment, have some level of risk. The risks of family therapy are very low and include:

  • One member of the family feeling attacked.
  • An escalation of anger and violence in a family member.
  • The substance user being triggered to continue or increase use.

Fortunately, the potential benefits far outweigh the dangers. It will be the job of the therapist to thoroughly screen and assess each member of the family before treatment can begin to ensure safety for all involved.


Types of Family Therapy Available 

couple in therapy

Family therapy for addiction has roots in many established theoretical orientations including:

  • Marriage and family therapy.
  • Strategic family therapy.
  • Cognitive behavioral therapy.
  • Couples therapy.
  • Solution-focused family therapy.

Because of the range of sources, family therapies for substance abuse will look and feel different based on the specific model the therapist is utilizing. Regardless of the style, the therapist will work with the family unit as a complete group, smaller subgroups, and with members individually to create a plan based on the family dynamics in place. Each program will incorporate the family at different levels.

Many specific interventions are suited for family therapy for substance abuse like:

  • Multidimensional family therapy (MDFT). This style is most appropriate for adolescents and includes individual and family sessions occurring in an office, the home, or the community. Individual sessions will work to improve decision-making skills, communication, and problem-solving. The family sessions will explore the active parenting style and ways to positively impact the substance use.
  • Family behavior therapy (FBT). This style has value for both teens and adults. Its broad approach targets the substance use as well as mental health issues including depression and defiance, family problems, employment, and financial concerns. Treatment focuses on building skills to improve home life and developing goals to end substance use while providing rewards for accomplishing these objectives.
  • Community and family approach (CRA). This approach expands past the family to include the community as well. Sessions completed once or twice weekly involve learning ways to improve communication in the family and build a wider support system. The family is instrumental in identifying and modifying their role in the substance abuse.

Find Help

If substance use has been negatively impacting your life and the life of your family members, it may be time to seek family therapy. By engaging in treatment focused on the family, you can make a difference in the life of the addict while improving your own well being.

Call 1-888-744-0069 for more information and treatment appropriate for you.


Sources:

Principles of Drug Addiction Treatment: A Research-Based Guide. (n.d.). Retrieved October 30, 2015, from https://d14rmgtrwzf5a.cloudfront.net/sites/default/files/podat_1.pdf

Substance Abuse Treatment and Family Therapy. (2004). Retrieved October 30, 2015, from http://adaiclearinghouse.org/downloads/TIP-39-Substance-Abuse-Treatment-and-Family-Therapy-55.pdf

Miller, S., & Saitz, R. (2014). Principles of Addiction Medicine (5th ed.) (R. Ries & D. Fiellin, Eds.). Philadelphia: Wolters Kluwer Health.

Rational Emotive Behavior Therapy

young-woman-telling-personal-beliefs-to-therapist

What is REBT?

Rational emotive behavior therapy (REBT) is a psychological orientation created by Albert Ellis in the mid-1950s that puts the focus on thoughts and beliefs. Ellis created this orientation in response to the prevalent therapeutic types of the time. In the 1950s, psychological theory and therapy were dominated by psychoanalysis and behaviorism. Ellis began as a trained psychoanalyst but began to view the style as something that only addressed the surface of the client’s needs and could even make symptoms worse.

It’s never too late to start your journey to recovery. Call 1-888-744-0069 and get help today.

Psychoanalytical thought is based on the idea that people are driven by unconscious motivation for sex and power. Behaviorism is based on the idea that people are a product of their environment and will continue engaging in behaviors that are rewarded and reinforced.

Ellis thought these theories were incomplete because they did not attend to the thoughts of the individual. He believed that it was the patterns of thought that lead to the development and perpetuation of psychological issues like depression and anxiety. This concept became the central focus of his theoretical orientation, REBT.


The Importance of Beliefs

Ellis wanted to give more attention to the thought processes of people, but he took it a step further to focus on their beliefs. He saw a belief having two components:

  • The first is the thought, which is how someone subjectively views a situation.
  • The second is the emotional component, which is how someone feels about that thing.

Ellis recognized that people have many beliefs that guide their lives. He separated these beliefs into the categories of positive beliefs and negative beliefs:

  • Positive beliefs are ones that are accurate, valid, and factual.
  • Negative beliefs are usually inaccurate, invalid, and false.

Having more negative beliefs will make someone feel worse, and more positive beliefs will lead to increased happiness and a greater sense of well-being. Ellis wanted to find ways for people to develop more rational, emotive beliefs. This is where the name rational emotive behavioral therapy came from.

The 3 Basic Musts of REBT

During his work on beliefs, Ellis found that people had endless versions of irrational beliefs. Despite the differences, he found that the majority could be placed into three major categories based on their theme. These themes are sometimes referred to the three basic musts of REBT. They include:

The irrationally high expectation of oneself to be exceptional and perform at outstanding levels.

I MUST do the best. I MUST show people how good I am. Of course, people cannot be the best in all situations, so anytime they do not meet or surpass their expectations, they will be let down and disappointed. They will feel like failures.

The irrationally high expectation of others.

Here, someone believes that others must always treat them with kindness and fairness. If others do not meet this expectation, they will be labeled as trouble, flawed or no good.

The irrationally high expectation to always get what you want.

In a very self-centered way, this belief marks the demand for only what you want, when you want it. It feels like a tragedy to not get what is desired.


The ABC Model

The focus on beliefs is the center of REBT. REBT works with the notion that situations and events in life do not lead to the unwanted feelings or symptoms; rather, it is the individual’s beliefs about the event that lead to the consequence. Instead of saying, “This person made me use drugs,” REBT would focus on the belief, making statements like “This person offered me drugs, and I believed that they would solve my problems, so I used.” In REBT, that faulty belief in the middle is the problem, even more so than being offered to use a substance.

To illustrate this point, REBT uses the ABC model (sometimes called the ABC Theory of Personality or the ABCDE Model of Emotional Disturbance). In this theory:

  • A represents the activating event. This is the situation that triggers the start of the cycle. The activating event can be a person, place, thing, event, or thought. It can be from the past, in the present, or in the future.
  • B is the belief that you hold about activating event.
  • C is the consequence of the belief. It can be a thought, feeling, or behavior.

The Power of Beliefs

Consider the following examples of the ABC model, noting how differing beliefs can lead to a range of consequences — even when the activating event remains the same.

A – Your spouse comes home late.

B – You believe your spouse is a lying, cheating jerk.

C – You feel angry and irritable. You yell at your spouse and demand that they leave.

A – Your spouse comes home late.

B – You believe your spouse is a loving and caring person, and maybe they got caught up at work.

C – You feel happy to see them and ask if they had a nice day.

A – Your spouse comes home late.

B – You believe your spouse is weak, fragile, and easily hurt.

C – You feel worried and scared. You considered calling the police and local hospitals to find them.

This exercise could go on endlessly, which illustrates the power of beliefs. A range of consequences can stem from only one activating event since the belief filters the information and distorts it into something different. Looking at the examples above — it is easy to see which belief is the positive one and which are the negative ones.


Disputing Irrational Beliefs

In the ABC model, disputing irrational beliefs comprises the D. For there to be an improvement in symptoms and functioning, one must challenge his irrational beliefs. By doing this, the person will reduce the negative influence the thought pattern has on their life and, in turn, leave room for more rational thoughts to emerge.

Ellis understood that each person has some level of irrational beliefs, and that it was impossible to completely remove all irrational beliefs from the thought process. The goal of disputing beliefs is to reduce the major contributors to unwanted thoughts, feelings, and behaviors to result in lowered symptoms.

The process of disputing irrational beliefs is broken down into 3 steps. They are:

Fusce vitae

1. Detect. Before you can dispute an irrational belief, you have to recognize the presence of a belief. Along the way, you can gain an understanding of where it came from and the role it serves. The act is accomplished by being more aware of your thoughts and reactions to situations. Asking, “Why do I feel this way?” is a great starting point.

2. Debate. Once the belief has been identified, you can begin weighing the evidence for the belief being accurate or inaccurate. Defending both points of view can lead to a clarified perception of the situation.

3. Decide. The final step of the disputing process is to decide if your belief is rational or irrational. The best way to determine this will be to note the consequence of the belief. Many beliefs that lead to unwanted consequences are irrational.


What Should I Expect in REBT?

Many therapists integrate the focus on thoughts, feelings, and behaviors of cognitive therapy with the focus on irrational beliefs of REBT. This can result in a more thorough treatment that addresses more aspects of the individual.

Beginning treatment in REBT will be an easy process, but asking for REBT by name may lead to some confusion. During the same time Ellis was working on REBT, a person named Aaron Beck was creating his own brand of therapy called cognitive therapy. Over the years, the ideas of these two men began to merge because of their similar goals and views. Now, both of these therapeutic orientations exist under the umbrella term of cognitive-behavioral therapy (CBT).

Many therapists integrate the focus on thoughts, feelings, and behaviors of cognitive therapy with the focus on irrational beliefs of REBT. This can result in a more thorough treatment that addresses more aspects of the individual.

A session that involves REBT or CBT will last for about an hour with the therapist serving as an educator and a teammate interested in aiding your ability to accomplish your goals and lead a happier life. They will work with you to identify and dispute your irrational beliefs, since the process can be intimidating and overwhelming at times. Additionally, your therapist can suggest alternate ways of thinking that will aid in symptom relief.

The total course of treatment can be as short as a few sessions or as long as years depending on your needs. To find a treatment program that incorporates REBT or any other therapy type, call 1-888-744-0069 today.


How Does REBT Aid in Addiction Recovery?

If someone is facing recovery from addiction, REBT will inspect many of the beliefs that encouraged use in the beginning, maintained use through addiction, and are contributing to cravings or yearning for the substance in the present.

Also, REBT will impress the importance of acceptance in 3 forms:

  • Acceptance of self.
  • Acceptance of others.
  • Acceptance of the world.

REBT is a useful therapeutic tool because it works alongside other helpful interventions including:

  • Motivational interviewing.
  • Medication management.
  • 12-step programs.
  • Community treatment.

REBT is used to treat a host of physical and mental health issues as well as addictions. Best of all, REBT is a low-risk treatment style with a great deal of potential for positive gain. To find a program that incorporates REBT and/or other treatment types, call 1-888-744-0069 to speak to a treatment support specialist today.


Resources:

Refusing to Give In: 8 Ways to Beat Cravings

Cravings are a normal part of addiction recovery. No matter whether you haven’t used in months or you just stopped using this week, you’re likely to experience an urge to use at some point.

Urges are relentless, finding you at your weakest point and trying to convince you that you don’t really want the change you’ve worked so hard to accomplish. Drug cravings can quickly lead to a relapse if not handled appropriately.

Here are 8 ways to stop the urge to use.

1. Self-Talk

When a craving arises, resist the urge to use by talking yourself out of it using logic and reason. Because a craving can often be “myopic” and prevent you from seeing the big picture outside the immediate moment, you can prepare a list ahead of time and have it handy to read to yourself when a drug craving comes on.

This list may contain all the reasons that you’ve chosen to quit in the first place as well as all of the negative consequences that could occur if you choose to use.

2. Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) provides a myriad of techniques to use to cope with cravings when they arise. These include redirection, distraction, and visualization.1

When a craving arises, you may choose to redirect your attention to something else or distract yourself until the craving inevitably passes. Visualization techniques can also help you relax during a craving as you may imagine yourself in a relaxing setting.

CBT techniques can help you to spot cognitive distortions in your thinking. A common cognitive distortion that occurs during a drug craving is called catastrophizing. When you are experiencing a drug craving, you may catastrophize the situation by thinking things like “I’m never going to be able to make it through this” or “This feeling will never go away if I don’t give in and take this drug.” CBT techniques can help you to decatastrophize the situation and see it more objectively.

3. Get a Hobby

Hobbies not only build character and encourage joy, but they can provide an excellent means of distraction during a drug craving. Many times cravings arise out of boredom as the mind tries to find a way to fill a “void” or empty space. A hobby provides something else to engage in other than drug use.

Some hobbies you might try taking up include sports, cooking, arts and crafts, dancing, hiking, fishing, or video games.

4. Surf the Urge

Rather than trying to stop the urge all together, surf the urge instead. Urge surfing is a mindfulness technique that rests on the principle of accepting a craving for what it is rather than resisting it and wanting it to go away.

To practice urge surfing, when you feel a craving coming on, stop and acknowledge it. Accept it completely for what it is and don’t try to make it go away. Sit down, close your eyes, and observe the thoughts in your mind and sensations within your body. It helps to verbally acknowledge the thoughts and feelings during the experience.

For example, you might say to yourself, “I feel uncomfortable and I am thinking about using drugs,” or “My palms are sweaty and my heart is beating fast.” Describe as many thoughts and sensations as possible until you no longer feel the craving. Urge surfing can help you realize that cravings come in waves and will eventually pass.

Basically, rather than trying to push them away, accept that they are there and ride them out.2,3

5. Self Care

Practicing good self-care such as eating healthy and exercising regularly can help promote physical health and emotional well-being, which will not only make you less likely to want to use drugs but will make you more resilient and better able to deny a craving when it does arise.

6. Know Your Triggers

During recovery, certain people, places, and things will inevitably make you want to use drugs. Knowing what your triggers are can help prepare you for the possibility of a craving and allow you to avoid it when possible.

Try making a list of your triggers and consider which ones you can honestly avoid. Recognize that there will be some triggers that are unavoidable, so come up with strategies for dealing with the cravings that may arise when you are triggered.

7. Reach Out to Others

If you feel a craving coming on, attend a support group where you can talk with other recovering addicts about your conflicting desire to use and commitment to stay sober. Consider calling your sponsor when the urge to use arises—he or she may be able to talk you out of it. If you don’t have a sponsor, check with your group leader about possibly getting one.

8. Remove Bad Memories

Many therapists offer what’s called memory reconsolidation, which helps treat cravings by consolidating and removing memories that are associated with drug use. By eliminating these memories, it can help you experience less cravings triggered by environmental cues that may be associated with memories of drug use.4

Sources

  1. NIDA. (2012). Principles of Drug Addiction Treatment: A Research Based Guide.
  2. Nauman, E. (2014). Can Mindfulness Help Stop Substance Abuse? University of California, Berkeley. Greater Good: The Science of A Meaningful Life.
  3. Bowen, S. & Marlatt, A. (2009). Surfing the urge: brief mindfulness intervention for college student smokers. Psychology of Addictive Behavior, 23(4):666-71.
  4. Torregrossa, M. & Taylor, J. (2013). Learning to Forget: Manipulating Extinction and Reconsolidation Processes to Treat Addiction. Psychopharmacology (Berl), 226(4): 659-72.

9 Things People Get Wrong About Anxiety. #6 Makes it Worse!

With more than 40 million Americans over the age of 18 currently struggling with some form of anxiety, there’s a lot of misinformation floating around out there. From old wives tales to downright dangerous “cures,” if you’re struggling with an anxiety disorder, one of your first orders of business should be separating fact from fiction.

One important fact that a lot of people don’t realize is that “anxiety” is actually a blanket term that represents a group of disorders. Each anxiety disorder has different symptoms, but all the symptoms cluster around excessive fear and related behavioral disturbances.

The following conditions are all unique forms of anxiety disorders:

  • Panic disorder.
  • Social anxiety disorder.
  • Specific phobias.
  • Generalized anxiety disorder (GAD).

Obsessive Compulsive Disorder (OCD) and post-traumatic stress disorder (PTSD) are also anxiety-related disorders, although they have been grouped separately in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Anxiety is big business in the United States. According to The Economic Burden of Anxiety Disorders, a study published in the Journal of Clinical Psychiatry, we spend a whopping $42 billion each year in the name of treating anxiety.

Some sufferers self-medicate, while others pretend their anxiety doesn’t exist – both of which lead to negative outcomes. To help you better understand and manage your anxiety, let’s take a look at nine common myths related to these disorders and the people struggling with it.

Drugs and alcohol might give you a moment’s relief from the effects of anxiety, but in the end these substances will work against you.

Here are the 9 most common anxiety myths.

Myth #1. Anxiety Isn’t Really an Illness

While it’s true that a small portion of human anxiety is natural, extreme forms of anxiety are a completely different animal. When anxiety takes on the form of a disorder, it causes problems in your everyday life to the point of total impairment. And though we can’t see anxiety on x-rays or detect it in blood samples, this very real condition can be diagnosed and treated.

Myth #2. You Should Always Avoid Stressful Situations

In a perfect world, we’d all be able to avoid the stress and strain of everyday life. Since that’s not possible, we have to learn how to deal with stressful situations in a way that is healthy. One thing to remember is that it’s absolutely possible to be anxious and still accomplish things each day.

Not every unexpected situation or event is going to cause you to feel those waves of anxiety. Avoiding crowds, open spaces, public speaking or arguments with a family member only reinforces the anxiety. In fact, this notion is the basis of the most popular forms of treatment today, such as exposure therapy, as well as acceptance and commitment therapy (ACT)—which encourages patients to do what is important to them, regardless of the uncomfortable thoughts and feelings that may arise.

Myth #3. Breathing Into a Brown Paper Bag Decreases Anxiety

This is one of, if not the, oldest wives tales for people having an anxiety attack. When overcome by symptoms of a panic attack, many people take short, rapid breaths; some people even hold their breath. This reduces the oxygen intake and increases your heart rate. To prevent hyperventilation, many rely on the brown paper bag trick, but studies of its effects are mixed. And for some, carrying around a brown paper bag all the time actually increases anxiety.

“Carrying a paper bag is what I would consider a safety behavior,” says Greg Hajcak, Ph.D., an associate professor of psychology at Stony Brook University in New York. He goes on to say that safety behaviors are essentially forms of avoidance that keep you stuck in anxiety. They don’t make you feel safe; they make you feel more anxious.

Myth #4. Just Wait it Out…Anxiety Always Gets Better With Time

This train of thought is not only misguided; it’s also dangerous to your health. According to most experts, people with anxiety disorders put off seeking treatment for about 10 years.

Instead of being proactive in treating an anxiety disorder, they delay getting help in the hopes that things will “get better” at some point. Truth be told, anxiety generally worsens over time. It doesn’t just dissipate and become a problem of yesteryears.

Another concern is that more than half of those diagnosed with an anxiety disorder are also struggling with some form of depression—both of which need to be addressed.

…more than half of those diagnosed with an anxiety disorder are also struggling with some form of depression—both of which need to be addressed.

Myth #5. There’s No Treatment for Worrywarts

Experts agree that anxiety is likely genetic to some degree, but it’s absolutely a condition that can be managed. We now have effective treatments for all forms of anxiety, from multiple types of medication to therapy and exercise.

If your mother was a “natural worry wart,” that does not mean you have to accept that trait and doom yourself to a life of debilitating anxiety. The most effective approach, according to Dr. Hajcak, is cognitive behavioral therapy, or CBT. In a Journal of the American Medical Association study of 134 older adults, CBT reduced anxiety symptoms far better than other approaches and those positive effects lasted for at least 1 year.

Myth #6. A Couple Glasses of Wine or Smoking Pot Are Good Anxiety Solutions

Self-medicating is a common problem among people with anxiety disorders. It’s common, but certainly not effective or long-lasting. And another very real problem with self-medicating is that, in a relatively short amount of time, you can develop an addiction on top of your anxiety disorder. Before you know it, you’ve got two very real and very dangerous conditions on your hands.

Drugs and alcohol might give you a moment’s relief from the effects of anxiety, but in the end these substances will work against you. It’s just not worth it.

Myth #7. If You Really Wanted To, You Could Snap Out of Your Anxiety

If this misguided train of thought sounds familiar, that’s probably because you’ve heard it in conversations about drug addiction. It’s really easy for people who have never struggled with anxiety or chemical dependency to hand out advice in the form of “just get over it.” Dismissing someone’s anxiety only exacerbates the problem; their fears are very real to them in the moment.

“People who say that don’t really understand the degree to which someone is experiencing anxiety,” says Dr. Hajcak. Instead, try saying something like, “I know you’re scared, but you’re safe with me.” Or, “Hang in there; it will pass soon. Take slow, deep breaths. I’m here and I won’t let anything happen to you.”

Myth #8. Taking Benzos Successfully Cures Anxiety

Modern medicine has made huge advances; it seems like there’s a pill to cure everything these days. While doctors often prescribe benzodiazepines like Xanax, Valuim, Klonopin or Ativan to patients struggling with anxiety, these medications certainly don’t offer a cure.

You might take a pill and 30-minutes later you feel less anxious, but the feelings come back when the pill begins to wear off. Next thing you know, you’re reaching for another pill.

“Unfortunately, these patients are unlikely to successfully overcome their anxiety until they are no longer relying on benzodiazepines,” said Marla W. Deibler, a clinical psychologist and director of The Center for Emotional Health of Greater Philadelphia, LLC. “Benzodiazepines are habit-forming and reinforce the belief that you can’t cope with anxiety on your own, causing a reliance on external sources,” she said.

Myth #9. If Your Child Suffers From Anxiety, Force Her to do the Things She is Afraid of

When it comes to your child’s anxiety, there’s a huge difference between encouraging her to work through fears in a healthy way and simply forcing her to do the things she’s terrified of. Forcing her to do something she’s already afraid of will likely make her even more anxious. Instead of helping, it can heighten the anxiety she already has and make her less receptive to any kind of help or treatment in the future.

If your child has been diagnosed with an anxiety disorder, your job is to help her figure out which fears are rational and which ones aren’t. The pivotal key here is working with her; the process takes time and you’ll need to go at her pace. Behavioral therapies can also play a big role.

Snorting Percocet

snorting percocet

Percocet is a prescription opioid containing both oxycodone and acetaminophen. While it is an effective pain reliever, as a Schedule II controlled drug it has a high potential for abuse due to the oxycodone in it. Oxycodone is a semisynthetic opioid derived from an opiate alkaloid precursor. The opioid component of Percocet is capable of inducing euphoric and sedating effects, especially when misused.

Oxycodone has been shown to be powerfully addictive and has long been at the forefront of the prescription opioid epidemic. Those who chronically use (or misuse) this oxycodone-containing drug are at high risk of developing physiological dependence 1.

Acetaminophen—the other ingredient in Percocet—is a white, odorless powder with a slightly bitter taste. Although this pain reliever does not carry an inherent risk for abuse and dependence, the overuse of acetaminophen is associated with cases of liver damage. In the most severe cases, taking excess acetaminophen can lead to acute liver failure, which could result in the need for a liver transplant, or even death 1,2.

In 2015, 3.8 million people in the United States were current misusers of prescription painkillers 3.

Recreational abuse of Percocet can be carried out in a variety of ways. Depending on the method of ingestion, the drug reaches the bloodstream and, eventually, the brain at different rates—affecting the speed of onset and peak intensity of the high. Routes of administration include:

  • Oral ingestion.
  • Snorting crushed tablets.
  • Injection of drug after dissolution of tablets.

Snorting Percocet—or “percs” as they are referred to on the street—can induce the effects of the drug faster than swallowing it, increasing the risk of addiction.


Is Snorting Percocet Dangerous?

 Yes, abusing Percocet via any method of ingestion is dangerous. Percocet use should be carefully monitored by a physician when it is prescribed because it has the potential to be addictive even in those taking it as prescribed for pain.

When a user misuses the drug by snorting it, they may more quickly develop tolerance and physical dependence and, ultimately, may be at higher risk of becoming addicted. Again, addiction may develop faster in those abusing the drug in this way because snorting Percocet causes a user to experience a more intensely rewarding rush of euphoria as compared to oral ingestion.

Those who continue to misuse Percocet by snorting may also more easily overdose (for example, when trying to counteract the effects of a fast-mounting tolerance with increasingly higher doses) and may die. Even those who manage to avoid overdose may continue to face the serious physical and psychological consequences of chronic opioid abuse.

While Percocet has a robust list of side effects (shown below), snorting it brings about an all-new set of health risks. Someone snorting this opioid substance may experience 4:

  • Respiratory depression.
  • Acute or severe bronchial asthma.
  • Hypersensitivity (i.e., severe allergic reaction) to oxycodone or acetaminophen.

Many people think that prescription drugs are safer than street drugs, but often this is not the case. These drugs are meant to be taken according to the prescription and can be just as dangerous as an illicit drug when abused.


Side Effects of Snorting Percocet

Percocet’s ability to bring about a euphoric high is similar to that of heroin, which helps to explain why it can be so addictive. The high, however, may be accompanied by numerous side effects that range from unpleasant to deadly.

Side effects of Percocet can include 1:

  • Confusion.
  • Anxiety.
  • Insomnia.
  • Blood pressure changes.
  • Heart rate changes.
  • Dizziness.
  • Increased sweating.

  • Itchy skin.
  • Fatigue.
  • Fever.
  • Constipation.
  • Nausea.
  • Vomiting.

As is the case with other opioids, using Percocet in combination with other substances can result in serious health implications for the user. In fact, when a person uses opioids with other depressant substances such as alcohol, tranquilizers, or other opioids, it can create an additive depressant effect and subject the user to serious respiratory depression, coma, and death 1.


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Can Snorting Percocet Cause an Overdose?

Yes. When a person takes too much Percocet they can overdose on the drug. A Percocet overdose poses serious risks, depending on the dose and the user’s tolerance. When a person snorts Percocet, it can overstimulate and overwhelm the brain. Symptoms of a Percocet overdose may include 1:

  • Muscle weakness.
  • Cold and clammy skin.
  • Small, non-reactive pupils.
  • Low blood pressure.
  • Significantly slowed heart rate.
  • Cardiac arrest.
  • Profound respiratory depression.
  • Coma.
  • Death.

Signs of liver damage from an overdose of acetaminophen include:

  • Nausea.
  • Vomiting.
  • Sweating.
  • Weakness.
  • Confusion.
  • Severe pain inright upper abdomen.
  • Yellowing of the skin or eyes.

If you believe that you or a loved one has overdosed on Percocet, call 911 immediately.


Signs That Someone is Addicted to Percocet

If your loved one is using Percocet and you’re wondering whether they are addicted, you may want to take some time to learn about what addiction is and how it impacts normal brain function. This can help you best support your loved one in their journey to recovery.

percocet overdose

Continued opioid use causes changes in the brain that makes quitting much more difficult than simply “saying no”. Physiological dependence develops and leads the user to continue seeking the drug in order to avoid withdrawal. As maladaptive patterns of drug seeking and using develop, the now-addicted individual will continue to compulsively abuse the drug, despite the fact that doing so results in demonstrable harm to a number of facets of life. As key areas of the brain change in the face of persistent drug use, otherwise normal and healthy sources of rewards (e.g., eating, drinking, socializing) decrease in priority for the user as the drug becomes the most effective way for the brain to experience these good feelings 1 . This is why many of the country’s researchers and addiction specialists view addiction as a process similar to many other chronic health issues—the brain is actually changed by substance use. In this manner, addiction does not reflect a “moral failing” but rather represents a chronic health condition that must be managed with treatment, often indefinitely.

As key areas of the brain change in the face of persistent drug use, otherwise normal and healthy sources of rewards decrease in priority for the user as the drug becomes the most effective way for the brain to experience these good feelings.

Addiction can bring continuous suffering to both the addicted individual and those that love them. Even in the face of mounting negative effects like worsening health, impaired social relationships, and trauma, the compulsion to seek the high from the drug often overwhelms all else. The difficulty of overcoming an addiction alone highlights the important of drug addiction treatment.

The following warning signs may indicate an addiction to Percocet 1:

  • Using Percocet in larger amounts than intended.
  • Using Percocet for longer than intended.
  • Spending a lot of time trying to buy, use, or recover from Percocet.
  • Wanting to stop using Percocet but not being able to.
  • Craving Percocet.
  • Lying or sneaking around to hide Percocet use.
  • Getting defensive when asked about Percocet use.
  • Visible nasal damage due to snorting.
  • Frequently appearing sedated or drowsy.
  • Showing the physical signs of use, including dilated pupils, sweating, or dizziness.

Getting Help for Percocet Addiction

 Percocet addiction can be treated with the help of evidence-based practices, including behavioral therapy and medication.

Options for Percocet addiction treatment may include 5:

help for percocet addiction

  • Inpatient residential treatment: Residential treatment is an intensive approach to treating your addiction, allowing you to live and receive treatment at the facility. You will live among others who are also recovering from addiction and progressing through a similar recovery journey as you. Treatment programs typically last between 30 to 90 days (longer, if required) and, depending on the program, may offer specific services tailored to your needs.
  • Outpatient treatment: In outpatient treatment, you can live at home while you address your addiction. This may be an ideal option if you have responsibilities at home that would make it especially difficult to complete a residential treatment program.

Therapies which may be used in either an inpatient or outpatient environment may include:

  • Contingency management (CM): CM is a voucher-based system that rewards you for being drug-free. You earn “points” throughout treatment, which you can then exchange for rewards.
  • Cognitive behavioral therapy (CBT).This is an increasingly common therapy used to address opioid addictions. CBT is designed to prevent relapse and teach you how to identify unhealthy behaviors and destructive thinking patterns so that you can correct and manage them.

Your doctor may also recommend medication as part of your treatment program. If this is the case, you may be prescribed stabilizing medications such as buprenorphine or Suboxone, which can help you relieve cravings and manage unpleasant withdrawal symptoms. An approach to opioid addiction recovery that has shown success for many individuals is the use of both medication and therapy (not simply one or the other). This approach which combines both methods of care is referred to as medication-assisted treatment.

Withdrawal from opiates is uncomfortable but not life-threatening. If you have developed a physical dependence to Percocet, you will experience withdrawal symptoms after you discontinue your drug use. The severity of your symptoms during withdrawal will depend on your degree of physical dependence. Opioid withdrawal is characterized by some or all of the following symptoms 1.

  • Flu-like symptoms (muscle aches, chills, sweating, diarrhea, nausea, vomiting).
  • Abdominal cramps.
  • Anorexia.
  • Yawning.
  • Teary eyes.
  • Pain in the joints.
  • Increased blood pressure.
  • Anxiety.
  • Irritability.
  • Insomnia.
  • Restlessness.

Detox programs can help you to manage these symptoms so that you can get through them without relapsing and begin your recovery from Percocet in earnest.

If you are snorting Percocet and you need help to stop, call 1-888-744-0069 for more information about your rehabilitation options. You can speak with one of our rehab support specialists confidentially about the best way to begin your recovery today.


References:

  1. Food and Drug Administration. (2006). Percocet.
  2. Fontana, R. J. (2008). Acute liver failure including acetaminophen overdose. Medical Clinics of North America92(4), 761-794.
  3. Center for Behavioral Health Statistics and Quality. (2016). Key substance use and mental health indicators in the United States: Results from the 2015 National Survey on Drug Use and Health (HHS Publication No. SMA 16-4984, NSDUH Series H-51).
  4. Peyrière, H., Léglise, Y., Rousseau, A., Cartier, C., Gibaja, V., & Galland, P. (2013). Necrosis of the intranasal structures and soft palate as a result of heroin snorting: a case series. Substance abuse34(4), 409-414.
  5. National Institute on Drug Abuse. (2014). What are the treatments for heroin addiction.

17 Ways to Get Sober You Probably Didn’t Know About (#8 is Controversial)

The 12 steps of Alcoholics Anonymous are so dominant in addiction recovery culture that it can be easy to forget there are other ways to get sober.

If AA or NA works for you, that’s wonderful. If not, there are plenty of alternative tools and methods you could try.

1. Moderation Management

Moderation Management is aimed at people in the early stages of an unhealthy relationship with alcohol: “problem drinkers” rather than “alcoholics.” It’s a behavioral change program and network of support groups for people looking to make positive lifestyle changes, and as the name suggests, it’s a moderation- rather than abstinence-based program.

It has its own steps—nine of them—which the organization says can help followers to achieve balance and moderation in all aspects of their lives. The organization is upfront about the fact that 30 percent of its members go on to abstinence-based programs, if moderation didn’t work for them. If you’re worried but haven’t yet reached your bottom, it could be worth checking them out.

2. Smart Recovery

The SMART in SMART Recovery stands for Self Management and Recovery Training. It’s a worldwide support network and arguably the leading alternative to AA. It espouses a four-point program based on abstinence, the ultimate goal of which is to help followers to lead more balanced lives. SMART Recovery is all about empowerment; it diverges from AA on its first step—that “powerless over alcohol” thing—and makes use of techniques from motivational interviewing and cognitive behavioral therapy. Secularity and non-confrontation are central to its ethos, and the organization says it’s perfectly acceptable to use SMART alongside other sobriety aids, even including 12-step societies.

3. Ibogaine

Ibogaine is a psychedelic substance that’s illegal in the U.S., though in other countries it’s used to treat addiction to opiates, alcohol, and other drugs. It’s thought to work by dampening the brain’s “reward pathway,” and can be particularly effective in lessening the effects of withdrawal, though its illegal status in the U.S. means there’s limited research on its functioning and effects.

4. Emotional Freedom Technique (EFT)

Also known as “tapping,” this technique involves just that: tapping on a series of pressure points while talking your way through whatever challenge you’re facing—for example, an addictive urge. EFT combines Eastern acupressure knowledge with the techniques of Western psychotherapy. Beyond responding to urges, tapping can also address the root causes of addiction.

5. Online Support Groups

For addicts, meetings in church basements used to be the only surefire way to find people who knew what you were going through. But today there are hundreds of people sharing their stories just a few clicks away. Search Google for “sober blogger” and thousands of entries will come up; there’s a little sober community of writers, readers, and commenters around each of these blogs. This is a great way to find fellowship and accountability if you don’t like the sound of face-to-face interaction. And if you need a little more accountability than that, try the hundred-day sober challenge at TiredofThinkingAboutDrinking.wordpress.com. Comes with its own free penpal!

6. Neurofeedback

Neurofeedback allows you to see your own brain waves on a computer screen, in real-time, and thus learn to alter certain brain rhythms through continuous feedback. It’s traditionally been used for sufferers of PTSD, though in recent years it’s been incorporated into a few rehab centers and a growing number of psychological clinics. Neurofeedback is still relatively new and the research on its effects are mixed, although accumulating evidence supports its effectiveness in conditions like insomnia, anxiety, and depression.

7. LifeRing

LifeRing is another abstinence-based support network with face-to-face meetings in the U.S., Canada, and Europe, in addition to online support for those who live elsewhere. It’s secular and built on peer-to-peer support: recovering addicts offer fellowship and personal strategies for staying sober and living a rewarding life in recovery. The focus is on the individual’s current life, rather than past difficulties. Members of LifeRing are free to attend other support groups.

8. Hallucinogens

It’s an unorthodox method, but some researchers (and enthusiasts) claim that hallucinogens can be effective in treating addiction. The above-mentioned Ibogaine is one such example; also worth mentioning are magic mushrooms and ayahuasca, a healing brew traditionally used by indigenous peoples in the Amazon. The research is ongoing and controversial, but the thinking is that hallucinogens can affect the brain cell receptors that control addiction because they’re similar to the brain’s natural neurotransmitters. On a less scientific level, the healing or even holy experiences people report after a good trip are thought to have lasting effects on mood.

>On a less scientific level, the healing or even holy experiences people report after a good trip are thought to have lasting effects on mood.

9. HAMS

HAMS stands for Harm Reduction, Abstinence, and Moderation Support. As the name suggests, the organization doesn’t dictate either abstinence or moderation, it simply encourages people to be safe and responsible in their attitudes to alcohol. It does this through a book, online community resources, live meetings, and its “17 elements”—recommendations that can be completed in any order, none of which is compulsory. Elements include charting your drinking behavior and learning to have fun without booze.

10. Thamkrabok Monastery

Thailand’s Thamkrabok Monastery has been called “the toughest drug rehabilitation regime in the world.” It doesn’t accept re-entry—one strike and you’re out. The program is based on a Sajja, or sacred vow, not to use intoxicating substances, along with a herbal medicinal treatment that offers what’s worryingly referred to as “very real and very rapid detoxification.” There’s no cost for treatment, but you have to pay for your own food, drink, and cigarettes. Treatment usually lasts between ten and twenty-eight days.

11. NAD

NAD’s full name is Nicotinamide adenine dinucleotide. It’s a coenzyme that plays an important part in the body’s production of energy, and when injected at high doses it’s thought to reduce cravings and withdrawal symptoms. It’s been found to help with rapid detox from substances including opiates, alcohol, cocaine, methadone and benzos.

12. Meditation

In the last few years, mindfulness has emerged as a hot ticket in mental health care, and a fact long known by followers of Eastern spirituality has become common knowledge: meditation is remarkably effective at treating an enormous range of mental health problems, including substance abuse.

Plenty of studies have shown that a regular meditation practice can be just as effective as a traditional relapse-prevention program, if not more so. Here’s one particularly pleasing bit of science: neuroscientists have found that after just five 20-minute sessions of mindfulness meditation, people had increased blood flow to the anterior cingulate cortex, an area of the brain that’s crucial in self control. The same study showed that the same area of the brain had physically changed after 11 hours of meditation practice.

…neuroscientists have found that after just five 20-minute sessions of mindfulness meditation, people had increased blood flow to the anterior cingulate cortex, an area of the brain that’s crucial in self control.

13. Rational Recovery

Rational Recovery is an abstinence-based program based on a method called AVRT—the Addictive Voice Recognition Technique. There are no groups or support centers; the organization holds that these are unnecessary and actually encourage relapse. This method is all about isolating your Beast—the internal voice that makes you want to drink or use drugs—and vanquishing it, alone. The method’s simple but smart ideology has you taking joy in the pain of quitting as evidence of the death of your Beast.

14. Women For Sobriety

Women for Sobriety is another sobriety support group and program. Its “New Life” program is founded on thirteen affirmations based on the principles of positivity and responsibility for one’s own life—things like, “Enthusiasm is my daily exercise,” and “I am responsible for myself and for my actions.” The efficacy of the program relies on followers spending time with these thirteen affirmations every morning, and selecting one as their focus each day. Support is available in self-help groups across the U.S. and abroad, as well as in an online forum.

15. Topamax

Topamax is an anticonvulsant drug traditionally used to prevent seizures and migraine headaches. It’s not yet federally approved as an addiction treatment, but studies show that it can partially reverse the damage done to neurotransmitters by extended alcohol abuse, rebalancing the brain chemistry and so lessening cravings for alcohol.

16. Refuge Recovery

Refuge Recovery is a Buddhist path to addiction recovery, spearheaded by Buddhist teacher Noah Levine as an alternative to 12-step programs. It’s built around Buddhism’s Four Noble Truths and Eightfold Path, and draws on Levine’s own struggle with addiction. Levine proposes that Buddhism is ideally suited to target addiction, since transcending suffering and “nonattachment” are at its core. Levine published the book Refuge Recovery in 2014, and since then groups and meetings have been popping up all over the U.S. as well as in Canada, Denmark, Finland, and the UK. There are also online and phone-in meetings for those who can’t make it to any of the physical locations.

Levine proposes that Buddhism is ideally suited to target addiction, since transcending suffering and “nonattachment” are at its core.

17. Neuro-Linguistic Programming

Neuro-linguistic programming (NLP) was developed in the 1970s. It focuses on the interplay of an individual’s physical, linguistic, and cognitive behavior, and aims to help people to understand the way their brain works and so change negative thoughts, beliefs, and behaviors. Benefits include an increased understanding of self and others and better communication, and addiction therapy is just one of many suggested uses. Proponents of NLP argue that the best way to treat an addiction is to change the way the sufferer thinks—and NLP claims to do just that.

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