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In recent years, there have been growing calls to shift the organizing center of the addiction and mental health fields from pathology and intervention paradigms to a recovery paradigm and to begin this evolution with a recovery-focused research agenda. One of the pioneers who has most influenced this interest in resilience and recovery is Dr. Stephanie Brown. I consider her developmental models of personal and family recovery as among the most important in the modern era of addiction treatment. The implications of some research are so profound and far-reaching that it takes decades to fully appreciate their import. I think we as a professional field will be mining the implications of Stephanie Brown’s work for decades to come. In this very personal interview conducted in late 2010, Dr. Brown talks about her life, her work, and her legacy.
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Personal success or failure at rehab hinges on attitude and accountability. A report from Canada.
I went to rehab with a notebook. I was there, I told myself, because I was doing research for a book about a woman who’s an addict and who had to go to rehab because her relapse was affecting her family life—specifically her ability to parent an infant. The program was a three-week deal and it was a two-hour drive from my home in Toronto, Ontario. My husband drove me there, grimly, as if I wasn’t really going for research but rather because I needed help.
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Dr. Tannenbaum's book, The Addiction Conspiracy, allows the community a better understanding of how drugs and alcohol affect the brain and the use of medications in the treatment of addiction.
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Alcohol abuse is one of the most insidious, destructive and self-defeating habits that millions of people struggle with. Many thoughtful, kind, intelligent and good people get caught in the web of alcohol abuse and dependency. You don't have to be an "alcoholic" to have a drinking problem -- but you need to examine honestly whether drinking has led to problems for you and the people in your life.
No one sits down on Tuesday afternoon at 3:30 and says, "I think I'll become an alcoholic." No one wants that as a life problem. But it happens, and it's hard to break free from it.
Many physicians and therapists are reluctant to address the issue straight on. They may not want to offend their patients, they may fear losing the patient's business. Or they may simply not recognize how serious the problem is. But many people with anxiety and depression misuse alcohol -- some become dependent on it. Many use alcohol to cope with situations that make them anxious ("I'm going to a party so I will need a few drinks to loosen up"). But there is no problem that you have that alcohol abuse won't make worse. Whether it's your marriage, your relationship with your kids, your job, your health, your mood or your ability to get anything done -- alcohol abuse will make things worse.
Thinking Yourself into Drinking:
I'd like to discuss in this article the way you "think yourself into drinking" -- what I call "drinking thinking." I would suggest that you have two heads -- the head that wants to drink and the head that is rational that wants to be in more control. In this case, two heads are not better than one.
I've been listening to people for years who overdrink. They always have excellent reasons for drinking more -- convincing themselves that they are in control. Let's take a look -- and ask yourself if you or a loved one is a familiar voice here.
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Do you have a substance-using loved one who refuses treatment? The CRAFT program may help. CRAFT - Community Reinforcement and Family Training - teaches the use of healthy rewards to encourage positive behaviors. Plus, it focuses on helping both the substance user and the family.
The CRAFT goals are to teach you how to encourage your substance user to reduce use and enter treatment. The other goal is to help you enhance your own quality of life. This non-confrontational approach teaches you how to figure out the best times and strategies to make small but powerful changes. And it will show you how to do so in a fashion that reduces relationship conflict.
Experts have based CRAFT on solid science. People from many walks of life have used it successfully to help their loved ones and themselves. Whether you are the parent, spouse, romantic partner, adult child or friend of the substance user, research tells us that you too can succeed with this program. The methods are effective and easy to learn . CRAFT allows family members to feel good about their efforts on behalf of their loved ones.
When a CRAFT Program is Not Available in Your CommunityCRAFT can easily be learned on your own. The 2004 book, Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening by Robert J. Meyers and Brenda L. Wolfe, was written to bring CRAFT right into your home. It helps you change the way you think about your situation and teaches you how to help your loved one learn to enjoy a sober lifestyle. The authors also help you rethink your own lifestyle to make it safer and saner regardless of what your loved one does. If you are also working with a therapist, we recommend that you alert your counselor to the CRAFT manual for therapists, Motivating Substance Abusers to Enter Treatment: Working with Family Members.
FIVE THINGS TO KNOW ABOUT CRAFT1. CRAFT is a motivational model of help based on research that consistently finds motivational treatments to be superior to confrontational ones.
2. More than two-thirds of family members who use CRAFT successfully engage their substance using loved ones in treatment.
3. Evidence suggests that substance users who are pushed into treatment by a traditional confrontational intervention are more likely to relapse than clients who are encouraged into treatment with less confrontational means.
4. Family members who use CRAFT experience greater improvements in their emotional and physical health than do those who use confrontational methods to try to help their loved ones.
5. People who use CRAFT are more likely to see the process through to success than those who use confrontational methods.
FIVE MYTHS ABOUT CRAFT1. CRAFT's system of offering and withdrawing "rewards" such as your affection and attention is just another way of enabling someone who is using substances. And enabling is bad.
2. No one enters treatment until they "hit bottom" so using CRAFT while your loved one is still functioning is a waste of time.
3. Most substance users overdo it all the time so it is impossible to do anything to lessen the severity of their use.
4. If you love someone, it is cruel to allow him or her to sleep in vomit or endure public humiliation when you have the power to fix those things.
5. Once your loved one agrees to stop using or enter treatment, your job is done.
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Timothy Harrington is passionate about sharing information with people on ways to strengthen the link between treatment and long-term recovery.