Lifespan Recovery Management LRM
Lifespan Recovery Management
By: Michael Weiner, Ph.D., MCAP
www.lifespanrecoverymanagement.com
Contact: 561 398-8696
The way that we have been treating people with addiction is not nearly as effective as we would like it to be. Isn’t it time to stop treating a chronic condition as though it was a series of acute episodes?
We’ve been treating people with addiction in short-term residential settings, frequently far away from home and family, and spending little time on what happens back in the real world.
Should the symptoms of addiction become active again we do the same thing over again. It’s the patient’s fault that the condition became active, probably didn’t go to enough meetings or use a sponsor well.
Every time this occurs shame accumulates.
I’ve developed“Lifespan Recovery Management (LRM) as a strategy that treats addiction close to home and over the course of time. “Close to home” means that families can participate and services that may be needed are easily accessible.
The process starts with an assessment. An assessment is needed to determine what is needed to get well. It’s a process that could start with managing withdrawal from substances and residential care. This is because the risk of continued use could be high.
There are also occasions when an assessment indicates that a less intense level of care, such as intensive outpatient, can be effective.
As symptoms become less severe and risks are lowered treatment becomes less intense. The perception that treatment is ongoing and lifelong is very important.
In general, people with substance use disorders do well while they are in treatment. So do people with diabetes and hypertension. When a person stops treating their chronic disease symptoms become active: blood sugar becomes unstable, blood pressures rise, substance use disorders become active.
“LRM” removes the stigma from treatment and recovery. It can be built upon a cognitive behavioral (SMART) or a “spiritual (12-step) approach to wellness. Cognitions and language are intertwined; each has an impact on the other. It follows that:
It is not possible to eliminate the stigma that exists around addiction, and apply a chronic care model, without changing the language that we use on a daily basis.
To bring about a chronic care model and to eliminate stigma we need to:
Change From/Change To:
Change From: Relapse / Change To: Recurrence
Change From: Relapse Prevention / Change To: Recovery Management
Change From: Aftercare/Primary Care
Change To: Continued Care/Ongoing Care/ Anything to indicate that all levels of care are equally important). Eliminate the term “primary care”
“I’ve been to treatment Once a person has engaged in treatment it is
“x” number of times” continuous. Abstinence dates may change.
“I’ve been to treatment 3 times,” means “I’ve
failed 3 times.”
“How many times have you been to treatment?”
means “how many times have you failed?”
Simply ask for a treatment history.
Remove labels.
A person is not just “an alcoholic’ or “an addict.” “My name is Michael, I’m an alcoholic” becomes “My name is Michael; I have a substance use disorder.” Or possibly, “an alcohol use disorder.” One would never say, “My name is Michael, I’m a cold.” One would say “I have a cold.”
Denial
“Ambivalence” is actually what a patient is feeling. Most patients have at least a glimmer that using is a problem. “Ambivalence” also gives a therapist something to work with.
Clean/Dirty
Anything other than “clean/dirty.” “Positive” or “Negative” might work. Does a diabetic’s blood ever come back “clean” or “dirty?”
The word “treatment” applies to the entire, continuous process, not just to residential.
We build upon “success,” not “failure.”
Change takes diligence, practice, and time. Let’s begin.
Ten Things to Know Before Choosing a Drug or Alcohol Treatment Program
With so many people entering drug treatment in the US today, it can often be a challenging a difficult process. How do you know when you are selecting the right program especially when you are going out of state and cannot tour the program that is not near your area? We have provided ten steps to ensure you or your loved one finds a program to meet your qualifications. Status shows that in fact, one in ten have had treatment for substance abuse rehabs five or more times before.
When families are searching online for an addiction treatment provider, it can be very hard in understanding what to look for, especially if this is your first time searching. We have created a basic knowledge and understanding what to search for and how to know if this is the right fit for you and financially affordable as well.
We have taken all of our expertise in providing you a brief 101 on what to ask and look for when it comes to finding substance abuse treatment options.
- Accreditation is very important.
I have found through the years, it is important to look for JCAHO, which is the Joint Commission on Accreditation of Healthcare Organizations. They recently just changed their name to just The Joint Commission. They have accredited over 21,000 healthcare organizations to ensure the highest quality of care standards. Another is CARF known as the Commission on Accreditation of Rehabilitation Facilities. These two are currently the reputable organizations holding facilities accountable in the services provided, this does not guarantee the rehab treatment center will provide quality care, but evaluates the drug rehab standards are compliant.
- Medical Stabilization Unit or Medical Detoxification
With the heavy arise for heroin-addicted patients or alcoholics, it is necessary to arrange medical stabilization. When looking at a drug addiction treatment provider, it is important to ask if they have a medical detox program. You can ask about their medical detox protocol and what medication will be used for stabilization. You also want to find out how long is the length of stay in detox will be. If the program does not have medical detoxification unit, then what is their approach or affiliates they use to ensure you will be medically stabilized.
- What is the entire length of stay in the drug or alcohol treatment program?
Treatment varies depending on the program. Some programs can be 28 days up to 90 days. It is important when searching programs to ask this question because insurance typically pays 30 days of treatment, but some programs offer 90 days step down with insurance. When verifying your insurance with a facility you need to know the length of stay and if they can transition down with the insurance to help offset cost associated. Also you should find out if it a 90 days program will there be additional fees incurred if you or your loved one stay longer and what is the self-pay rate for the additional months to stay in long-term treatment. If you have been to treatment in the past and having continued struggle with your recovery, its best to look into a long-term program to help you stay on the path to recovery. Studies show that a long-term program of 90 days can help benefits the success towards a lifestyle of recovery.
- Quality of Clinical Staff and Medical Professionals
Not all programs are a one size fits all type of facility. It is important to find out about their staffing and professionals helping treatment you or someone you care about. Usually, you can identify the clinical team on the company’s website to see who is involved with the program. This can help give you a better understand that the provider has the medical and/or clinical team necessary in helping you. Smaller programs will have fewer clinicians versus programs with over a 100 beds would have a larger staff, not to say any is less in care than the other, but a good point to look at when searching. Smaller programs can be more one on one then a bigger program that can cater towards individualized treatment tracks. It is all based on personal preference.
- How many individual sessions will I get per week?
Why you should ask everyone this question. Most programs offer one individual session a week, but some programs offer two individual sessions a week with an open door policy if they need additional support for the week they can take advantage for an additional session. Individual sessions give the individual seeking treatment the ability to work on personal one on one issue and learning new techniques to help support recovery and achieving goals. It’s a great added benefit in knowing that you will have that additional support versus once a week.
- Finding a Location
With thousands of options all across the world, it can be hard to decide on a facility that is going to meet your needs. Location can be important, for some who have never enjoyed the beaches, would not be receptive to a program in California or Florida, but maybe a treatment program in Utah in the wilderness. There is so many varieties to meet your needs from love of horses, to mountain climbing, to relaxing by the beach. You need the environment to be conducive to help you on the path. You may be staying longer than expected with aftercare in that area after treatment or you may be returning home and needing a support group for when you return. Location is an important part of taking a break from life to find healing in a sanctuary type of a place to feel comfortable to be receptive to treatment.
- Insurance Verification Process
When a facility verifies your insurance policy, it is a great train of thought to not just settle for the first program. Some programs will claim they accept insurance to only find out they do not and you get a bigger bill later. Or other programs will tell you, your insurance doesn’t work and you will have to pay $25,000 for you to come into the program. If this is the case, it is best to contact your insurance carrier to see which programs your insurance will accept. You can also go to Counseling Finder and search by your insurance to verify programs that can accept your insurance. There is always a way to find a program that will accept your insurance and not be trapped by a bait and switch where you are required to mortgage your home to pay for treatment. There is no cure for alcoholism or substance abuse addiction. We would never recommend that you mortgage or take loans you can’t afford to pay for treatment because there is no guarantee in recovery. It is up the individual seeking treatment to receive the tools to help and maintain once they leave treatment. This is the tough part, but there are great programs that are in or out of network with your insurance that can be able to help without coming out of pocket. Just keep in mind, if you do have a deductible you may be required those fees. Do the research.
- Aftercare and Discharge Summary
When speaking with a facility, this is another great question to ask is about their aftercare program. Do they offer an aftercare program or will they make the recommendation for a step-down program in the area or transitioning home? Some programs will have a step down from inpatient treatment to outpatient with housing, and then transitional sober living. This varies from program to program depending on your needs. They can also provide you with resources upon your discharge summary and recommendations by the facility.
- Feeling Comfortable
Feeling comfortable with your choice is very important. After you have done all of the research and feeling great about your decision can help inspire you to be ready to do the work. There is no shortcut in receiving treatment, it is up to you to engage in the program, being present and involved to get the most out of your stay to help you towards a life of sobriety.
- What kind of results should you expect after Treatment?
There is no guarantee or magic pill that is going to cure you or even a book you read that will cure you of substance abuse. What treatment can help and teach you is that you can have a life without substance. Finding out why you started using in the first place and how to work on triggers along with prevention from abusing substances. It all matters on the work you do during treatment and the work you continue to do after treatment to have a successful life without drugs or alcohol.
With so much information online it has become often a difficult process in searching for a program that can help you or your loved one find the tools necessary to stay away from substance abuse. We created this guideline for people to understand that you do not have to accept the first offer or be pushed to a program that is not clinically appropriate. We at Counseling Finder have created a way for you to search verified providers that can help you find a treatment program for inpatient or outpatient depending on your needs. We also give you the flexibility to choose which area you will like to be in and to find all levels from inpatient to outpatient treatment, to finding counselors or therapists for continuum care after you have finished treatment. We believe that just because you finished treatment does not mean it is a cure, but a starting point to maintaining a life without substance. To start searching for a counselor visit www.counselingfinder.com or contact us at 800-517-2241 to learn more about your options.
Abuse Survivor
Therapy Approaches for Abuse Survivors
Abuse can affect virtually anybody, from all walks of life, both genders, and all ages. Abuse shows its ugly face in many forms as well from physical to emotional battery to sexual abuse and neglect. It has been estimated that as high as two-thirds of substance abuse clients in therapy have suffered some form of abuse during childhood; 80% of individuals that have been referred to mental health providers had backgrounds that included experiencing childhood abuse. Regardless of the situation, abuse survivors don’t need to live in fear and pain because there is help available. By finding out more about the various types of abuse and what can be done to prevent or stop it, you can make a huge difference in either your own or someone else’s life.
Abuse can leave psychological scars that are more difficult to heal than physical injuries. People who have gone through abusive experiences struggle with distressing emotions, terrifying memories and often a sensation of constantly being in danger, often feeling disconnected, numb and unable to trust. Distressing memories, depression, and anxiety end up causing intimacy problems and often lead to self-destructive behavior and anger issues. When abusive things happen, it can take a long time to get over the suffering and feel safe again. Fortunately, with the right treatment and support, you can speed up the recovery process and whether the abuse happened yesterday or years ago, it’s possible to heal and live a healthy, happy life.
In order to heal from psychological and emotional abuse, you first need to face and deal with the intolerable memories and feelings you’ve more than likely been avoiding, burying deep inside; if you don’t, they’ll crop up over and over again. Therapy can help abuse survivors express as well as process the difficult emotions that are associated with the abuse, develop compassion, learn self-care strategies that can help them manage emotions when they’re overwhelmed, and eventually learn to trust again. There are several therapeutic approaches that have been highly effective including everything from eye movement desensitization to narrative therapy and the use of mindfulness techniques like meditation. Equine assisted therapy has also been shown to have a substantial impact when it comes to treating both the physiological and psychological aspects of abuse related problems. Some of the benefits of Equine assisted therapy include the reduction in stress, better social interactions, improved self-esteem and patience, and self-empowerment.
Group therapy has been proven to be effective when it comes to social support that helps abuse survivors cope their feelings of guilt, shame, and alienation from others (common side effects of abuse). Group therapy provides a safe place to interact and connect with other individuals who have lived through similar experiences. For individuals who aren’t ready to deal with their feelings of vulnerability and fear in a group setting, working with a therapist one on one is the best option and it is a good starting point for treatment.
Academic Underachievement
Academic Underachievement
Most people, at some point in their lives, have academic problems, whether it’s elementary school, high school or college. The stress of experiencing academic underachievement can have a huge impact on self-esteem and, in younger students, particularly, lead to emotional withdrawal and/or acting out. The stress of academic problems can lead to even more stress and other situations that they have trouble dealing with, eventually interfering with their home lives, friendships which are so important, and work.
Academic underachievement doesn’t just affect children or young adults with learning disabilities; it can be attributed to intelligent or gifted students as well, who at times face problems with their studies because they’re bored with the material or are having some sort of emotional problem, perhaps having something to do with family conflicts or self-esteem issues. It could be a situation where, in relation to a sibling, one child excels in school and the other doesn’t and the parent put the academically successful child on a pedestal. Studies have shown that individuals who constantly struggle in an attempt to reach their full potential in some cases were dealing with learning disabilities like ADHD and Dyslexia.
Common Academic Underachievement Causes
- The student is dealing with bullying at school
- Disinterest in the class subjects
- Not enough attention from the teachers
- Having trouble understanding the topics of study
- Time management and procrastination issues
Be your Child’s Advocate
Keep the lines of communication (open and positive communication) with your child open regarding school, and offer advice or help if they ask for it. If your child is having trouble interacting with a teacher, dealing with a bully, or is falling behind in a class or classes, don’t be reluctant about intervening. The daily challenges of school life often seem trivial to adults who’ve been out of school for a long time, but for younger children and teens, a school can be everything. When their grades are poor, or school life, in general, goes badly, life for the student is miserable, so take your child’s concerns and sudden attitude changes seriously. Also, keep in mind that the school’s principal and teachers are there to help your child with their academics and to advocate, meet with the teachers and find out how, together, you can help your child succeed.
Counseling and Psychotherapy
Counseling can help relieve the stress that is in many cases is the cause of academic concerns, helping the student cope in a positive way. Psychotherapy, taking counseling a step further by helping determine the cause of the stresses or concerns which can both be related to the actual academics or other personal issues. Typical personal issues that can cause academic struggles include traumatic experiences like bullying, family or personal problems, financial problems and more. Psychotherapy addresses these kinds of underlying issues and helps to correct them. Academically related concerns can be addressed and helped to correct them. Academically related concerns can be addressed and helped by getting support from within the school system, including hiring a tutor or seeing the school counselor, advisor, or tutor.
Abandonment Issues
Dealing with Abandonment Issues
Dealing with feelings of abandonment is one of the most difficult problems to face, often leading to irrational levels of fear, depression, high levels of anxiety and mistrust. In many cases, people living in fear of abandonment and up living their lives trying to please everyone (an impossible task) and killing relationships because of feelings of jealousy based on mistrust. These issues have a huge impact on romantic relationships, friendships, careers and even how we interact with family, including our children, which can lead to a vicious cycle of abandonment, it may help to know you’re not alone, even if you currently feel that way.
Abandonment fears often stem from a traumatic loss during the childhood years like the loss of a parent through the divorce (made even worse by a parent that felt abandoned and brought the child into the turmoil) or death. These feelings can also stem from inadequate physical or emotional care. Even though some degree of the fear of abandonment is a normal part of life, when the fear is frequent, severe and impossible to console, it can cause significant problems, especially when it comes to developing healthy relationships.
People who have experienced abandonment are more likely end up with long-term psychological challenges because they live in fear of being abandoned again and feeling unloved. This is particularly hard on children when they don’t receive the emotional support they deserve from a parent, often due to the parent’s own psychological problems, sadly leading to a lack of the healthy self esteem typically seek out friends and partners who bolster those negative beliefs, leading to intimacy problems, co-dependence, anxiety, a feeling of unworthiness and more.
Abandonment in Relation to Emotional and Physical Care
Common traumatic childhood events can e the death of a parent or the inability to feel safe because of a lack of adequate shelter or due to threatening circumstances such as physical, sexual or emotional abuse (which is very common). Emotional abuse is often caused by parents who ridicule their children or constrain their children’s emotional expression, holding them to unreasonable and impossible to live up to high standards. Sadly, for most people, childhood abandonment issues follow them to adulthood.
Therapy to Minimize Fear of Abandonment
The best way to deal with abandonment issues is to surround yourself with people that you trust, however, this is often easier said than done. It is a good idea to enlist the help of a professional counselor who will teach you how to develop healthy relationships with people you can trust. Skilled therapists will also help you address the experiences that have led to your feelings of abandonment. Working with a therapist, you’ll be able to learn how to separate fears of the past from the present, putting you in a position to achieve a cognitive transformation so that you can develop positive and realistic expectations in life.
The emotional healing begins when the person facing abandonment issues is able to recognize that their fears are grounded in the past and that they can develop the ability to reduce the way fear controls their emotionally charged responses to their relationships and life events.
With time and effective therapeutic approaches, people dealing with abandonment issues can learn to trust again and live the happy lives that they deserve.
Abortion Grief
Dealing with Abortion Grief By Taking a Therapeutic Approach
The most common feeling that strikes after having an abortion is the relief; sadly, it’s not always permanent. Granted, everyone’s unique, so feelings do vary from woman to woman. In some cases, a deep sadness and sense of loss sets in immediately following the abortion; some experience the emotion when they first come to the decision to have one. When both emotions (grief/relief) come into play, and they often do, you end up with a troubling cocktail of feelings that can be difficult to deal with.
Part of the healing process problem is the taboo’s that come with abortion, from religious beliefs to the opinions of some of our political leaders, those that don’t believe in a woman’s the freedom of choice. Even though abortion is legal in the United States and has been for years, the stigma attached to it hasn’t decreased very much, making some women who’ve had an abortion feel secretly tainted or marked, as if the act itself has blemished their character and that others would be disgusted if they knew about the abortion.
It’s important that women have a safe place to share their feelings about an abortion loss, away from religious and/or political debate. If you are in emotional or even spiritual pain following an abortion, there are several options and resources available that will help you along your journey to renewed psychological as well as spiritual well being.
Find a safe, nurturing place to talk, to cry and to share your feelings. There are people to talk to who will not only support whatever decision you make/have made regarding abortion and that will be there to listen and understand, not to judge. These people can be trusted friends and family members or compassionate, professional therapists who understand abortion grief and provide a safe, non-judgmental place to grieve and heal.
If you don’t have anyone in your life that you feel safe talking to about your abortion, then consider seeing a therapist or counselor, professionals that are trained to listen, and have helped others who have struggled with issues of guilt, grief, depression and low self-esteem. Talking to a therapist can actually prove to be more helpful than talking to someone you know.
The Therapeutic Approach
First and foremost, you’ll want to find an empathic and compassionate therapist or counselor you feel comfortable with. It’s important to feel that this professional cares about and respects you. The program and the individuals involved with it should be nonjudgmental, respectful, and knowledgeable. If, after 2 or 3 sessions, you don’t feel good about your therapist, you should look for someone else via online referrals or from the medical clinic where you had the abortion.
If you’re not certain whether a 1 on 1 approach or a group setting would be the best choice for you, consider trying both. You could start with a private consultation at first, get used to sharing your feelings and then try a group setting. The nice thing about group counseling is that it can be empowering to really see that you’re not alone, that other people are in the same emotional place you are.
Whether you seek the help of a therapist or a close friend you feel safe sharing with, it’s important that you realize that you aren’t alone and you don’t need to isolate yourself as you recover.
