brain scans for addiction

Up and Coming Evidence-Based Treatment Practices

This article was written by Robert Galvin, a Primary Counselor at The Discovery Institute

The disease concept of addiction is verbalized frequently and I believe is central to treatment. However, there usually is a watered-down interpretation given to most clients and their loved ones.

It is certainly understood that the brain is highly impacted by substance use and brain health disorders. The brain is central to everything in our lives. It is responsible for our thoughts, feelings and ultimately for our personality and behaviors.

This is a simple concept, yet do we utilize all our options to help our clients heal their brain?

I argue that we don’t. It stands to reason that how well a person’s brain functions correlates to their well-being and functioning in all aspects of life. Most current mainstream substance use and brain health treatment options emphasize medicinal psychiatric treatments, medication assisted treatment (MAT) and therapeutic interventions, all of which can be effective.  

In most substance use or mental health treatment facilities, there are typically no biological tests utilized to confirm a mental health diagnosis or functioning of the brain. Wouldn’t it be great if we had a way to view issues with brain functioning in our clients?

While mental health inventories or criteria are used to diagnose disorders, they don’t always paint the whole picture. It is also not uncommon for diagnosis to be incorrect. According to research reported by National Depressive and Manic-Depressive Association (DMDA) approximately 69% of all first-time diagnoses of Bipolar Disorder are incorrect and more than one-third remained misdiagnosed for 10 years or more. This is certainly understandable as assessment and diagnosis in general is complex. A diagnosis in itself does not always explain the cause of the disorder. Clients can have a diagnosis for depression and there could be multiple reason such as grief, substance use, brain injury, chronic illness or pain, and other biological factors. Therefore, correct assessment is essential before implementing the correct intervention. This begs the question; how can we treat a disorder if we can’t always accurately identify the real cause? Imagine all the time and effort used to treat an incorrectly assessed problem, let alone the frustration and suffering a client will experience (i.e. bipolar diagnosis). 

I would like to encourage consumers, counselors, medical personnel, supervisors and anyone else involved with helping clients with substance use and brain health disorders to advocate for better evidenced based options. 

The trend toward finding solutions for treating individuals with substance use disorders has been proceeding in a seemingly urgent manner over the last few years in response to the opiate epidemic. Typically, over my 8-year career in substance use and mental health treatment, I have witnessed a consistent and sometimes considerable delay between the application of interventions and evidenced based research. The population suffering from substance use and brain health disorders all too often have poor outcomes as evidenced by recidivism rates and fatalities. Professionals and consumers have to contend with external influences which can cause significant barriers to treatment. One such barrier is limited funding and how it can all too often shorten the length of stay in treatment. However, we do have more control regarding the clinical interventions that we can implement to help our clients. There is a proven, but not often utilized intervention, that I believe could significantly change the trajectory of outcomes for our clients. I am speaking of the practices by Dr. Daniel Amen and SPECT scans. 

Dr. Amen is a well-known psychiatrist and brain disorder specialist who offers an alternative way to approach brain health. I believe so much in his research and interventions that I have enrolled for certification in brain health through his clinics.

Dr Amen introduced Single Photon Emission Computed Tomography (SPECT) scans as a means to visually display functioning of the brain. SPECT scans can tell us 3 things: areas of the brain that work well, areas that don’t work hard enough & areas of the brain that work too hard. 

He has been using SPECT scans for a least 4 decades and has developed simple strategies to heal the brain. His interventions are client centered treatments to help clients heal their brain and not only change their outcomes in recovery but also increase overall wellbeing. SPECT scans can be cost prohibitive among treatment facilities. However, professionals like myself can be certified in brain health. We would be able to accurately assess brain function issues without the use of SPECT scans at a significantly lower cost. The assessment process is very comprehensive and covers a variety of possible causes for brain health issues. The training also teaches client centered interventions that are realistic for clients to achieve. 

If you would like to learn more about Robert Galvin and his work at The Discovery Institute, please contact us today.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy

CBT (Cognitive Behavioral Therapy) was started in the 1950s. It has helped many people with mental disorders live a better life. People who do not have mental disorders but feel unhappy with their current way of life might also be positively affected by CBT. At the Discovery Institute of New Jersey, we incorporate CBT into our treatment programs. CBT is a short-term treatment that does not involve any medication, though it can be paired with medication if the client needs it.

What is CBT?

CBT combines the current theories on how people learn (behaviorism) under the theory that how you learn affects how you think and interpret events in your lives (cognition). Cognitive behavioral therapy focuses on an educational approach and goal setting. In CBT, individuals can set specific and individualized goals. For example, instead of setting a goal such as “stand up for yourself three times a day”, an individual may aim for something like “be more assertive”.  

Who Can Benefit From CBT?

Many people can find relief from many of their symptoms through CBT. Individuals who suffer from the following mental or behavioral health conditions:

Problems like substance abuse, personality disorders, and bulimia do not happen on their own. People who develop these disorders are often greatly affected by their past and/or present environments. This is one reason that CBT is available for families as a whole. Special CBT programs for couples also exist.

Cognitive behavioral therapy can also take place in a group setting, also known as group therapy. For people who struggle with social skills, a group setting provides hands-on practice of the concepts being taught while working on them under the supervision of a licensed professional. 

How Does CBT Work?

There are several distinct steps to CBT. At the beginning of each session, there is a mood check-up to gauge how the patient is feeling and what steps might need to be taken to help them before the session starts. CBT can feel very physically draining at times and can be emotionally uncomfortable at times. But, the process is necessary when it comes to recovery from addiction and its effects.

Step 1: Identifying problematic situations and conditions in your own life

This might seem unnecessary as some problem situations and conditions might seem obvious. But this step might also do things like uncover hidden triggers in a person’s life. Sometimes, people may not notice certain triggers and stressors in their lives. On the other hand, they may feel unable to accept the truth about these triggers. In other cases, individuals may be in denial over these issues.

For example, some people in early recovery can find odd things like listening to a song that they used to listen to while they abused substances makes them develop strong cravings. It might not make sense to the person at the time. But the therapist can help find the connection and help the patient make modifications. 

Step 2: Become aware of your thoughts, feelings, and beliefs about the problem(s)

In group therapy, you will explore this by talking to the group. In individual therapy, you will “self-talk” or talk about those thoughts, feelings, and beliefs, aloud to yourself in the presence of the therapist until you have a firm understanding of them.

Step 3: Identify negative or inaccurate thinking

Some thought patterns such as inaccurate thinking could affect a person. For someone with an avoidant personality disorder, thoughts that someone might criticize them are overwhelming. People in this phase of CBT might be asked to pay attention to their physical sensations, emotions, and behaviors when confronted with those situations. 

Step 4: Reshape negative or inaccurate thinking

This is one of the hardest steps for many individuals. The negative or inaccurate thoughts for many patients might have been developing over years or even decades. Many people in CBT go for long-standing problems. Someone with personality disorders, or even more traditionally treated problems like bipolar disorder or depression might go years before receiving treatment.

The Effectiveness of Cognitive Behavioral Therapy

The effects of CBT are long-lasting. If needed patients can go back to a CBT therapist for a “refresher” course. However, in an overwhelming number of instances the person can mindfully practice instead of using those skills that have become a habit. CBT is most effective when depression and anxiety are the main problem area. This does not mean that it is not effective or when used for other problem areas. 

Issues from disorders such as addiction that are directly related to the disorder like managing cravings are not the only areas that CBT improves. This therapeutic approach also seeks to improve the patient’s social skills to help them get and maintain a job and healthy relationships. Disorders like substance abuse disorder are not popularly known to affect the person in non-substance related areas. For example, someone deep into a heroin dependency might become so socially isolated that when they decide to stop abusing heroin, they feel like they are losing their ‘best friend’, the drug. They might need help to socially readjust to spending time with other people.

CBT can be used in combination with other therapies. Substance abuse clinics often combine CBT with more traditional talk therapy and other behavioral therapies to produce long term recovery journeys. Other less traditional therapies like music therapy and art therapy might also be involved. People with personality disorders often benefit from a variety of behavioral therapies such as Interpersonal Therapy (IPT) and Dialectical Behavioral Therapy (DBT).

What are Common CBT Goals?

As mentioned earlier, individuals in cognitive behavioral therapy can set goals. These goals are important components of the recovery process. Common CBT goals are including the following:

Setting more realistic goals and problem-solving skills

Individuals who are working to recover from substance abuse may often feel overwhelmed. It can be hard to transition from a life of continuous substance use to a life of abstinence from substance use. The very thought of it can be enough to keep individuals from succeeding. 

However, the journey to recovery can be much less overwhelming if people set reachable, achievable, and realistic goals. Therapy approaches like CBT can help people to do just that. 

Goals should be attainable and realistic. They should also be specific and include solutions. For example, individuals in recovery may not benefit from setting a goal like “I won’t use alcohol to cope with stress anymore.” Although this is obviously a good plan, the approach may not be beneficial because it doesn’t include a solution. Instead, those in recovery should think along other lines: “I have used alcohol to cope with stress. But, from now on, I will talk and think through my emotions. I won’t ignore them or use alcohol to help me forget about them. Instead, I will speak with my therapist, think about the consequences of unhealthy coping methods, or convert my negative emotions and energy to positive ones.”

Learning to manage anxiety

Anxiety is often a trigger for substance abuse. But, cognitive behavioral therapy can help individuals to develop healthy coping alternatives. These coping methods can help individuals in many areas of their lives. For instance, individuals can learn to practice positive self-talk. They may be able to learn how to say things like, “Everything will be alright if this presentation is not perfect. I will still have the chance to get a good grade”. 

Determining which situations are often avoided and gradually approaching them

Sometimes, people turn to substance abuse instead of dealing with the difficult situations they encounter. Instead of dealing with those challenges, obstacles, and struggles, they may drink or use drugs

However, therapy works to help individuals to learn how to approach those challenges in a healthy way. 

Identifying and engaging in enjoyable activities such as hobbies, social activities, and exercise

Enjoyable activities help people enjoy their days and exercise releases endorphins that make people feel better. Adding hobbies, exercise, and social activities can help a person round out their day instead of becoming stuck in problem areas like a bad day at work for the rest of the day.

Identify negative thoughts

An example of a negative thought might be “I always look stupid when I ask questions”. Therapy can help you to keep track of your feelings, thoughts, and behaviors. This will you and your therapist identify different symptoms. This will make it easier to change your thoughts and behaviors. 

Find Help and Hope at Discovery Institute

If you are struggling with alcoholism or drug abuse, know that you are not alone. Many others are suffering from the same challenges. But, just as you are not alone in your struggle, you don’t have to be alone in your recovery. We are here to help you find freedom from substance abuse in your life.

Here at Discovery Institute, our staff is dedicated to helping individuals to fight the effects of alcoholism and drug abuse. We understand that each of our clients is different. So, we work to provide each individual with unique and specific care. 

You don’t have to continue struggling with substance dependence. You can break free from it. Recovery is only a phone call away. If you want to end substance abuse in your life, just reach out to us today.

Which Choice Is Better? How to Choose Between Inpatient vs Outpatient Rehab

If you’re reading this, you’ve made the choice to take a step toward recovering from addiction or you’re supporting a loved one in their recovery journey. Congratulations! These are accomplishments not everyone achieves, and you should certainly be proud of yourself.

Most people who suffer from addiction have tried many times without success by themselves. And many of them have found their attempts unsuccessful. Addiction a powerful illness that should be taken seriously. Just as you wouldn’t try to fight cancer by yourself, you shouldn’t expect to fight addiction without a professional either.

The challenge is in finding the right type of professional help you overcome addiction. There are several programs out there and it can be difficult to determine which one will be helpful for your situation. 

Two main types of treatment for addiction include outpatient and inpatient treatment programs. If you’re deciding between inpatient vs outpatient rehab, here’s what you need to know.

What is the Difference Between Outpatient and Inpatient Treatment?

When it comes to addiction treatment, it’s important to keep in mind the fact that each approach to treatment and offers different benefits. These different approaches to addiction treatment make it possible for people to find the type of program that best meets their needs. This is one of the reasons why so many people have been successful in ending addiction. 

Again, inpatient treatment and outpatient treatment are two types of programs that can help people to overcome substance abuse. There are a few main differences between these two kinds of treatment programs. 

Inpatient Treatment: Sometimes referred to as residential treatment, inpatient addiction rehab programs offer individuals treatment in an intensive setting. Normally, people who enroll in a residential program live at their rehab center for the duration of their treatment program.

This allows them access to 24/7 care and medical attention. It also provides a safe place, away from distractions. In these programs, individuals are less likely to have access to drugs or alcohol. So, those in residential or inpatient care can get the help they need without being influenced to use alcohol or drugs.

In inpatient programs, individuals attend therapy on a regular basis, may share living quarters with other peers, and participate in various activities throughout their stay. Those in treatment may attend various types of therapy, including individual and group therapy meetings.

Some of the types of therapy a person may receive while in an inpatient treatment facility might include the following:

  • Cognitive Behavioral Therapy (CBT)
  • Dialectical Behavioral Therapy (DBT)
  • Talk Therapy
  • Trauma Processing Therapy
  • Art Therapy
  • Focus Therapy
  • Processing Group

CBT works to help patients identify and improve negative, harmful thinking processes. This type of therapy is literally meant to bring attention to the processes and behaviors of the mind. Often, thoughts precede actions. So, if a person has harmful and unhealthy thoughts, it’s likely that he or she will engage in harmful and unhealthy activities or behaviors. But, through cognitive behavioral therapy, individuals can gain a deeper understanding of their negative thoughts and how to replace them with positive, healthy thoughts.

Often, people who are working to recover from addiction suffer from a relapse because of the triggers, stressful situations, and challenges they encounter. This is due to the fact that the individuals were used to coping with obstacles by turning to alcohol or drugs. So, in order to deal with challenges in recovery, people often resort to substance use. Dialectical behavioral therapy is designed to help individuals to develop coping skills that can help them to avoid relapse.

Many people who struggle with addiction have had traumatic experiences in the past. These occurrences often play a role in the development of substance abuse problems. So, those who are suffering from substance abuse may find it helpful to address the trauma in their lives as it may be an underlying cause of addiction. This is where trauma processing therapy comes in.

Talk therapy provides people with a secure space to speak about their challenges, struggles, needs, and desires. They can feel safe about talking through their feelings and emotions. During these therapy sessions, the patient speaks with a therapist and receives meaningful guidance and advise.

Art therapy uses artistic activities to help individuals get in touch with and work through their emotions and the challenges they’re facing in recovery. Focus therapy and processing groups both encourage individuals to speak with and listen to their peers, discussing their journeys through recovery from addiction.

Outpatient Treatment: This type of treatment is different from inpatient treatment in that individuals may continue to live at home or at a sober living home while getting treatment for substance abuse. Instead of spending 24 hours every day at their rehab center, people in outpatient treatment may only spend a few hours every day or a certain amount of hours every week at the rehab facility. For example, an individual may go to treatment 5 days out of the week rather than 7 days. 

Normally, people in outpatient programs still go to therapy sessions and attend group meetings. So, many of the therapy approaches that are included in inpatient programs are also included in outpatient programs. 

Through therapy, individuals in an outpatient program can gain relapse prevention skills and develop coping strategies in order to deal with stresses, triggers, and challenges in a healthy way. 

Therapy, especially in a group setting, can also help individuals to develop skills for interacting with others while in recovery. Communication skills are often lost while living with an addiction. But, those in recovery can regain healthy techniques for interpersonal communication and interaction.

Finally, therapy can boost self-esteem. Individuals in outpatient addiction rehab may sometimes struggle to “fit in” to their newfound lives of sobriety. But, while learning more about themselves and coming to an understanding of the effects of addiction in their lives, individuals can become more comfortable with themselves and who they are becoming!

Identifying the Benefits of Inpatient Rehab

During inpatient rehab, you live in a dedicated rehab facility for weeks or months. Your sobriety is your full-time job, so you spend much of your time in therapy or other sessions that will help your recovery. This environment offers several advantages.

Care for the Detox Period

When you first start your recovery, your body will go through withdrawal. It’s used to using your drug or drink of choice to function, and it falters when that crutch is gone.

The detox stage is a crucial part of your recovery because it’s difficult to avoid a relapse. It’s also important to have medical care during your withdrawal to watch for dangerous side effects. Medical professionals may be able to reduce your withdrawal symptoms too.

Inpatient rehab facilities have a way to handle your withdrawal safely. Some have dedicated detox care while others partner with a detox center where you’ll start your journey.

Less Temptation to Relapse

Whether you’ve been sober for a day or a decade, there is always some temptation to relapse. But, that temptation is far less intense when you’re surrounded by sober people.

During inpatient rehab, you’re in a complete environment of sobriety. The temptation is as low as it could be, so your chances of relapsing before you complete your program are low.

More Treatment for Underlying Issues

While in an inpatient program, you’re dedicating all of your time to your sobriety. This gives you more time to deal with the reasons you developed an addiction. Identifying and addressing the underlying causes of your addiction problem can help you and your therapists to determine the best way for you to work toward sobriety.

Most or all people have reasons they started using drugs or alcohol. It may be to numb old wounds that haven’t healed or to self-medicate mental health challenges.

In an inpatient program, you have the necessary time to get to the root of your addiction. By dealing with those underlying problems, your long-term chances for success are better.

Gaining Life Skills

In addition to learning about your own mental health, inpatient rehab gives you time to learn the skills you need for sober living.

Counselors can help you develop sober strategies for dealing with stress and pain. They can also help you take steps to get your career on track so you feel more fulfilled and less in need of a high.

Some Benefits of Outpatient Rehab

Inpatient rehab has plenty of advantages, but it isn’t for everyone. Outpatient rehab, in which you keep living at home but attend rehab therapy sessions, has its own benefits too.

Lower Cost

It should be no surprise that the more intensive experience of inpatient rehab is more expensive. Outpatient rehab is often more affordable for those who are seeking help in ending addiction.

If you choose to go with an outpatient program, you won’t be paying for housing and food at the facility. You also won’t have to pay for as many hours of therapy. Outpatient rehab can be a great option for people who can’t afford inpatient treatment.

Life Doesn’t Get Put on Hold

During inpatient rehab, you leave your normal life behind and your sobriety becomes your life for several weeks or months. For people who have families to support, this isn’t always an option.

With outpatient treatment, you can continue to work, care for your family, and fulfill other responsibilities while getting treatment. You also don’t have to worry about whether or not your job will be waiting for you when you return from rehab.

No “Rehab Bubble”

As we mentioned above, during inpatient rehab, it’s like you’re draped in sobriety. There is little temptation because you’re in a different environment than the one in which you used to use drugs or alcohol.

The problem is that this makes for a hard transition when you leave rehab. You don’t know how to soberly deal with that old environment. This is why so many people enter sober living homes after inpatient rehab.

With outpatient rehab, you learn how to be sober while balancing family, work, and responsibilities from the start. You don’t have the sudden dropoff of support that can make other people prone to relapsing.

Easier Entry

Some people mistakenly think inpatient rehab is the only real option. They know how expensive it is and they’re afraid of leaving their families and lives behind. As a result, they don’t seek any treatment at all.

Outpatient rehab is a way to bridge that gap. It isn’t as daunting as inpatient rehab because you can continue to be you, but a sober you.

Inpatient vs Outpatient Rehab: The Bottom Line

When it comes down to it, there’s no one right answer in regards to choosing between inpatient vs outpatient rehab. This is because it’s best to take each individual’s needs into account when selecting an approach to addiction treatment. Every person is unique, and different choices work for different people.

With that being said, if you’re looking for the right choice for your treatment or the treatment of a loved one, you need to weigh your options and find the option that feels right for you. Professionals can help you to navigate through your choices and determine the best kind of program for your journey to an addiction-free life. 

It’s commonly believed that outpatient treatment is much less intensive than inpatient rehab and is, therefore, less effective. But, the truth of the matter is that, although there is often less possibility for relapse for those in residential treatment, it doesn’t mean it’s the only way to get sober.

Whether you choose inpatient or outpatient treatment, remember that your rehab center can’t do all the work for you. Recovery requires dedication and commitment. So, while in your treatment program, it’s important for you to keep focused on the goal of becoming free from substance abuse. In order to get that freedom, you may need to deal with some challenging situations and address some serious matters in your life. But, it will all be worth it when you’re finally living on the other side of addiction!

Recovery is an accomplishment in which you have to play an active role. It may be helpful if you take other steps, such as bringing your family into family therapy and avoiding the people and settings that encourage you to relapse.

If you’re ready to get started on the journey to recovery and regain control of your life, we here at Discovery Institute can help! You can simply contact our drug and alcohol rehab for more information about our treatment options and how we can work with you in order to help you find your way to a new and better life!

References:

https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction

https://www.addictioncenter.com/treatment/inpatient-outpatient-rehab/

what is an enabler

What Is an Enabler in a Drug Addiction and How Can You Identify Them?

Addiction affects everyone in the user’s life. With 1 in 8 American adults suffering from addiction, that’s 12.5% of families also suffering.

Contrary to what many people believe, drug and alcohol dependence do not only affect the individual who is using alcohol or drugs. It also affects everyone in the individual’s life. With 1 in 8 American adults suffering from addiction, that’s 12.5% of families also suffering. Over 70,000 Americans died from drug overdose in 2017. No doubt, their families are still feeling the pain of these losses.

It’s likely that most of the families of these struggling individuals want to help. But, this isn’t always an easy task. Unfortunately, loving an individual who suffers from addiction comes with the temptation to enable them.

If you know someone who is struggling with addiction, you probably want to show your loved one that you care and won’t abandon them. Of course, this is absolutely normal and certainly commendable. But, this desire to always ensure that your loved one knows you’re there can cause you to relax your boundaries and limits. As a result, you could be doing more harm than good. Instead of helping your friend or family member, you could be enabling this individual.

Wondering what is an enabler, anyways? Keep reading to find out if you’re enabling your loved one’s addiction and how to stop.

What is an Enabler?

Those who are dependent on drugs and alcohol become controlled by their addiction. It changes their sense of right and wrong. It also changes or eliminates an individual’s boundaries. People who suffer from addiction may try to use drugs under your roof and expect you to turn a blind eye. They may ask you to lend them money for their habit. They may expect you to lie for them.

When you engage in enabling behaviors like these, you endorse their substance use. Most likely, you do not intend to do this. However, these behaviors prevent you from being helpful to your loved one. In a sense, you’re essentially telling them to keep using because you’ll take care of them regardless.

Why is Enabling Harmful?

Enabling an individual who suffers from substance dependence can prevent the person from seeking help. This behavior is very harmful to the user’s health and wellness, as well as your own. If the person does not see the truth about his or her substance use disorder, it’s unlikely that the individual will be interested in getting treatment. Also, if you continue to enable your loved one, you will likely experience emotional, mental, and physical fatigue. It can be both difficult and dangerous to keep up with enabling behaviors.

But, for many people, it’s hard to know how to avoid enabling their loved ones. Figuring out how to be there for your loved one without encouraging or facilitating substance misuse can be very challenging. But, the truth of the matter is that you can love and care for them without enabling their substance use. However, before we discuss the ways in which you can do this, let’s talk about some common enabling behaviors. Perhaps you will identify some of them in your own life. If so, know that you do not have to be ashamed. Instead, use this knowledge to help you make healthy and helpful changes! 

Types of Enabling Behaviors

You may still be unsure if what you’re doing is enabling your loved one. It can sometimes be hard to identify enabling behaviors, especially when you’re behaving out of love or even pity. But, it is definitely important to be able to recognize the actions in your life that may actually be enabling your loved one’s substance dependence.

There are five common enabling behaviors to look out for and how you can avoid them.

1. Providing Shelter to Use In

Is your loved one allowed to use drugs or drink alcohol in your house? If your loved one lives with you, make your house a sober-zone. Don’t buy drugs or alcohol. Lock up your prescription drugs.

Make it a firm rule that they cannot use in their bedroom, or anywhere on your property. Yes, that means they’ll likely go elsewhere to use. This may be hard for you, but it’s a crucial first step.

Your home needs to be a safe space for them to come back to. Allowing them to drink or use drugs there is enabling their use. It is also making your home a place where the individual feels secure enough to use, which can prevent you from being able to help the person end substance dependence.

2. Lying for Them

Do you make up an excuse for why they can’t come to Christmas dinner? Do you tell their job that they’re feeling ill when they don’t show up for work? Do you tell yourself that it’s only one more hit and they’ll stop?

Lying for them or “covering” for them is enabling them to continue using. You’re making it possible for them to use without consequences.

What happens if you tell the rest of their family the truth? Consequences will occur that could potentially help them. They might lose their job, but that might be what needs to happen.

Tell your loved one that you will not lie for them anymore. Make them answer or lie for themselves; they must take ownership of their addiction. This encourages accountability in the struggling individual’s life. It also gives you freedom from the stress that comes with constantly having to make excuses.

3. Financially Supporting Their Habit

This is a common one for the parents of those who are suffering from addiction. Your son or daughter asks you for $20 for the fifth time this week. He or she promises to pay you back but never actually gives you any money. It’s highly probable that your child is using your money to buy alcohol or drugs. Supporting an addiction can be very expensive and it’s not uncommon for people to experience financial challenges. So, individuals who suffer from addiction often turn to loved ones for money.

Withdrawal symptoms can be very intense. They occur after the effects of drugs or alcohol begin to wear off. These symptoms can include headaches, irritability, tremors, delirium, nausea, vomiting, and much more. Withdrawal symptoms are what cause people to return to substance use. But, if an individual doesn’t have the funds necessary to purchase more drugs or alcohol, he or she will have to ask a family member or friend. This is where you might come in. 

It can be extremely difficult to see your loved one suffer from these symptoms. But, it’s important to realize that you don’t want to fund their habit for life. Their substance use could cut their life short. So, it’s necessary to nip this in the bud. Tell your loved one that you will not be providing any more money. They cannot take advantage of your love anymore.

4. Using Empty Threats

You might not think you’re an enabler because you kick them out when they use. Maybe you stopped paying their phone bill. But only for one month. After that, you might have felt bad and decided to help out again.

Empty threats are consequences that don’t last or don’t even happen. They tell the suffering individual not to worry about your threats because they most likely aren’t real.

It’s time to stick to your guns and set boundaries. If you stop paying their phone bill, don’t resume until they’ve gotten help. If you threaten to kick them out if they use drugs or drink alcohol in your house, enforce it. The trick is not to make threats that you cannot enforce. Think about real consequences you can set and stick to.

5. Fulfilling Their Responsibilities

You don’t have to pick up their slack in your household. In many marriages, the sober spouse often takes over the other’s duties. That could mean you start working an extra job to pay their half of the bills. You take care of the kids and the property. Your “me-time” is virtually non-existent.

This isn’t fair to you and it’s enabling your loved one. By fulfilling his or her responsibilities, you’re encouraging the individual to spend their time using drugs or alcohol. If you have children, it can be severely damaging to grow up with an individual struggling with addiction in the house.

How to Stop Enabling

Give your loved one a heads up that things will be changing in your household. Tell the person that you’re planning on setting new boundaries and enforcing them. This gives the individual time to decide if they want to get help now or deal with the consequences.

Focus on creating a positive, safe environment. Consequences are there because you love the person who is suffering from addiction, not because you want to punish this individual.

It may also help if you get your entire family on board with your plan. If there’s one weak link, they’ll get taken advantage of. Your loved one isn’t a bad person; they have a disease that causes harmful behavior. But, you can help by avoiding enabling behaviors.

Help is Always Available

If you’re wondering, “what is an enabler?” use the list above. These are the most common enabling behaviors you could be doing. If you find that some of these behaviors are present in your life, now is the time to make a change.

You don’t have to navigate this alone. Start meeting with a counselor or therapist to help you get through this. Your own personal wellness is as important as your loved ones.

Here at Discovery Institute, we offer family counseling and individual therapy. Consider going together as a family. We also have effective and compassionate treatment programs for adults and young adults. 

You are not alone in your struggles. Many others are dealing with the challenges that come with loving someone who suffers from addiction. But, regardless of the difficulties, you’re facing, know that we are here to help you. Reach out today to get your family the help it deserves.

contingency management therapy

Contingency Management Therapy (CMT) Explained

Contingency management behavioral therapy is attractive in many ways, but some say that it is too logistically problematic to be a really useful form of treatment. Contingency management therapy (CMT) is a process built around a reward system that can involve both negative and positive consequences for an addict to consider when they make behavioral decisions. The strategy is based around the notion that positive reinforcement is indeed a better way to rewire behavior.

Kathleen M Carroll in her article Behavioral Therapies for Drug Abuse in The American Journal of Psychiatry says the following about contingency management therapy: “Contingency management, in which patients receive incentives or rewards for meeting specific behavioral goals (e.g., verified abstinence), has particularly strong, consistent, and robust empirical support across a range of types of drug use”  (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633201/). Carroll goes on to say that contingency management therapy is modeled on the principles of behavioral pharmacology and operant conditioning – positive conditioning leading to positive results.

The CMT strategy is successful because its method is to leverage the habit-forming part of the addict’s brain. It is alluring to the reward system in the user’s central nervous system, which is the section of the human brain known to be used and abused by some of the most deadly forms of substance addiction out there. Opioids are drugs that play on the reward receptors in the brain. Turning addiction’s own strategy against itself by aiming all of its focus at the reward center of the brain can result in some impressive end results.

Even though CMT has a good record as far as producing real and positive results, and in many of the cases the success was quite sustainable for those looking to live a life of clean and sober. In spite of this fact, however, many detox and rehab facilities in New Jersey do not make use of CMT due to its substantial cost. Being able to afford the testing for consistent drug checks and funding for the actual rewards themselves, for most treatment centers results in the baseline functioning of the CMT program becoming impossible in the long run. A person seeking out treatment should always be sure to research each specific treatment facility that they plan on attending and the various programs that the facility offers as different facilities offer different therapies.

Top Rated Drug Rehab Centers in NJ Offer Behavioral Therapy

Regardless of if you think contingency management therapy is a kind of therapy that would work for you, behavioral therapy, more broadly, is the cornerstone of most rehab programs. There are many forms of behavioral therapy. Most commonly programs use cognitive behavioral therapy.

What is Contingency Management Therapy: The Details of CMT

There are many types of therapy approaches that can help those who are working to overcome substance abuse. Behavioral therapies work to help individuals develop healthier ways to deal with their cognitive and behavioral behavior.

Sometimes, addiction can be encouraged by the negative thought processes individuals harbor. But, behavioral therapies work to replace those negative and harmful patterns with healthy ones.

Contingency management therapy, sometimes called CMT or motivational incentives, uses a very scientific and psychological process to help condition individuals to develop healthy behavioral patterns.

How Does Contingency Management Therapy Work?

Now that we’ve briefly discussed what contingency management therapy is, it may be helpful to define the actual terms which are used to title this therapy. The word “contingent” is defined as something that depends on or is conditioned by something else. In other words, the event might only happen if other desired actions take place.

In this case, certain rewards can positively affect the individual in recovery as long as he or she performs certain behaviors.“Management” is the way in which therapists work to help arrange and regulate those specific rewards.

So, how do these definitions play into the actual process of CMT? Well, first, it’s important to realize that addiction is a result of positive reinforcement. (Remember, the term “positive” doesn’t necessarily mean that it’s good. Instead, it refers to the way it makes the individual feel.) People who use drugs or alcohol often become dependent on these substances because they produce pleasurable effects.

Of course, although these effects feel good, they don’t lead to good results. In an attempt to continue receiving the rewards, individuals continue to engage in the behaviors that resulted in those rewards; they continue using drugs or alcohol.

This is considered to be an unconditioned reinforcement. Individuals don’t necessarily have to be taught or conditioned to respond in this way when they use alcohol or drugs. This unconditioned positive reinforcer is basically the main reason addiction develops.

So, when it comes to ending addiction, contingency management therapy works too, in a sense, do the opposite of unconditioned positive reinforcement. This type of therapy is based mainly on what we call operant conditioning. In short, this is an approach that rewards positive behaviors.

Positive reinforcement is an element that’s critical to contingency management therapy. But, it is used in combination with contingency management.

The body has a natural reward system, which produces both positive and negative results. In the case of substance use, the body’s reward system makes it difficult for individuals to avoid addiction since drug or alcohol use produces rewards like euphoria and temporary stress-relief.

Fortunately, behavioral therapy approaches understand that the body’s reward system has the ability to encourage individuals to perform healthier behaviors. CMT introducers positive reinforcement in the form of outward rewards, which, in turn, release the natural rewards within the body.

More simply put, individuals who go through CMT are rewarded for performing desired behaviors and gain the opportunity to enjoy the results of their good choices! For example, people who pass drug or urine tests may receive a special reward from the medical professionals in their treatment program, such as prizes or some other sort of acknowledgment.

People who are in recovery may sometimes struggle to avoid using drugs or alcohol. After all, their bodies have grown dependent on the substances they were abusing. It’s never easy to end the dependence and it certainly takes a lot of time and patience.

The ultimate reward after treatment is total freedom from the bondage of substance abuse and addiction. This is one of the most amazing feats a person can accomplish. But, getting to that point can be very difficult for those who are trying to overcome addiction. And, while going through the challenges of recovery, it can be hard to keep that end goal and reward in mind.

It can also be hard to think about the ultimate goal when it feels so far away. So, during the treatment process, it can be helpful to have what you might call “mini goals”, rewarding efforts that lead up to the main reward of sobriety and freedom from drug use. Motivational incentives and positive reinforcements help to give individuals those “mini goals” to accomplish along the way.

There are two main types of contingency management therapy reinforcement and incentive methods:

Voucher-Based Reinforcement – This kind of positive reinforcement, often called VBR, helps to encourage individuals to remain free from drug use. For every urine test that comes back showing no sign of drug use, individuals in treatment get a voucher. These vouchers have monetary value and can be redeemed for various things. Individuals can use them to purchase food items, passes to the movies, clothing, electronic items, and many other services or goods!

As individuals continue to pass drug tests and avoid substance abuse, they receive rewards in the form of vouchers, which they can use to acquire items they want to buy and engage in fun, sober activities!

Prize Incentives – When individuals in treatment avoid substance use and are able to provide breathalizer and urine tests that show up negative for drugs or alcohol, prize incentive reinforcement gives them the opportunity to draw a prize out of a container. Sometimes, prizes may be cash (from $1 to $100+). Or, they may be cards with words of encouragement.

This approach to positive reinforcement has been a source of concern for some. Many have felt that the prize incentive method may encourage gambling because it has an element of chance. But, studies have shown that this isn’t the case.

Getting Treatment and Therapy at Discovery Insititute

If you have been dealing with an addiction problem, it’s not too late to change the course of your life! You may feel hopeless or helpless, but you can overcome substance abuse once and for all. There will be challenges along the road to recovery. But, with the right team by your side, you will gain the freedom you deserve!

You don’t have to let guilt, shame, or fear hold you back anymore. Take a step toward recovery by contacting us here at Discovery Institute today. Just call (844) 478-6563 to learn more about the detox programs, therapies, and treatment approaches we offer here!

References:

https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-0

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3083448/

https://www.health.harvard.edu/newsletter_article/Contingency_management