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Persons addicted to drugs often are among the most marginalized psychiatric patients, but are in need of the most support.1 Many of these patients have comorbid medical and psychiatric problems, including difficult-to-treat pathologies that may have developed because of a traumatic experience or an attachment disorder that dominates their emotional lives.2 These patients value clinicians who engage them in an open, nonjudgmental, and empathetic way.
Eliciting a patient’s reasons for change and introducing him (her) to a variety of peer-led recovery group options that complement and support psychotherapy and pharmacotherapy can be valuable. Although most clinicians are aware of the traditional 12-step group model that embraces spirituality, many might know less about other groups that can play an instrumental role in engaging patients and placing them on the path to recovery.
SMART (Self-Management and Recovery Training) Recovery5 is a nonprofit organization that does not employ the 12-step model; instead, it uses evidence-based, non-confrontational, motivational, behavioral, and cognitive approaches to achieve abstinence.
Women for Sobriety6 helps women achieve abstinence.
LifeRing Secular Recovery7 works on empowering the “sober self” through groups that de-emphasize drug and alcohol use in personal histories.
Rational Recovery8 uses the Addictive Voice Recognition Technique to empower people overcoming addictions. This technique trains individuals to recognize the “addictive voice.” It does not support the theory of continuous recovery, or even recovery groups, but enables the user to achieve sobriety independently. This program greatly limits interaction between people overcoming addiction and physicians and counselors—save for periods of serious withdrawal.
The Community Reinforcement Approach (CRA)9 is an evidence-based program that focuses primarily on environmental and social factors influencing sobriety. This behavioral approach emphasizes the role of contingencies that can encourage or discourage sobriety. CRA has been studied in outpatients—predominantly homeless persons—and inpatients, and in a range of abused substances.
Click here for another Pearl on familiarizing yourself with Alcoholics Anonymous dictums.
Disclosure
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
1. Kreek MJ. Extreme marginalization: addiction and other mental health disorders, stigma, and imprisonment. Ann N Y Acad Sci. 2011;1231:65-72.
2. Wu NS, Schairer LC, Dellor E, et al. Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders. Addict Behav. 2010;35(1):68-71.
3. Moderation Management. http://www.moderation.org. Accessed April 12, 2013.
4. Moderation Management. What is moderation management? http://www.moderation.org/whatisMM.shtml. Accessed August 6, 2013.
5. SMART (Self Management and Recovery Training) Recovery. http://www.smartrecovery.org. Accessed April 12, 2013.
6. Women for Sobriety. http://www.womenforsobriety.org. Accessed April 12, 2013.
7. LifeRing. http://lifering.org. Accessed April 12, 2013.
8. Rational Recovery. http://www.rational.org. Published October 25, 1995. Accessed April 12, 2013.
9. Miller WR, Meyers RJ, Hiller-Sturmhofel S. The community-reinforcement approach. http://pubs.niaaa.nih.gov/publications/arh23-2/116-121.pdf. Accessed August 6, 2013.
Persons addicted to drugs often are among the most marginalized psychiatric patients, but are in need of the most support.1 Many of these patients have comorbid medical and psychiatric problems, including difficult-to-treat pathologies that may have developed because of a traumatic experience or an attachment disorder that dominates their emotional lives.2 These patients value clinicians who engage them in an open, nonjudgmental, and empathetic way.
Eliciting a patient’s reasons for change and introducing him (her) to a variety of peer-led recovery group options that complement and support psychotherapy and pharmacotherapy can be valuable. Although most clinicians are aware of the traditional 12-step group model that embraces spirituality, many might know less about other groups that can play an instrumental role in engaging patients and placing them on the path to recovery.
SMART (Self-Management and Recovery Training) Recovery5 is a nonprofit organization that does not employ the 12-step model; instead, it uses evidence-based, non-confrontational, motivational, behavioral, and cognitive approaches to achieve abstinence.
Women for Sobriety6 helps women achieve abstinence.
LifeRing Secular Recovery7 works on empowering the “sober self” through groups that de-emphasize drug and alcohol use in personal histories.
Rational Recovery8 uses the Addictive Voice Recognition Technique to empower people overcoming addictions. This technique trains individuals to recognize the “addictive voice.” It does not support the theory of continuous recovery, or even recovery groups, but enables the user to achieve sobriety independently. This program greatly limits interaction between people overcoming addiction and physicians and counselors—save for periods of serious withdrawal.
The Community Reinforcement Approach (CRA)9 is an evidence-based program that focuses primarily on environmental and social factors influencing sobriety. This behavioral approach emphasizes the role of contingencies that can encourage or discourage sobriety. CRA has been studied in outpatients—predominantly homeless persons—and inpatients, and in a range of abused substances.
Click here for another Pearl on familiarizing yourself with Alcoholics Anonymous dictums.
Disclosure
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
Persons addicted to drugs often are among the most marginalized psychiatric patients, but are in need of the most support.1 Many of these patients have comorbid medical and psychiatric problems, including difficult-to-treat pathologies that may have developed because of a traumatic experience or an attachment disorder that dominates their emotional lives.2 These patients value clinicians who engage them in an open, nonjudgmental, and empathetic way.
Eliciting a patient’s reasons for change and introducing him (her) to a variety of peer-led recovery group options that complement and support psychotherapy and pharmacotherapy can be valuable. Although most clinicians are aware of the traditional 12-step group model that embraces spirituality, many might know less about other groups that can play an instrumental role in engaging patients and placing them on the path to recovery.
SMART (Self-Management and Recovery Training) Recovery5 is a nonprofit organization that does not employ the 12-step model; instead, it uses evidence-based, non-confrontational, motivational, behavioral, and cognitive approaches to achieve abstinence.
Women for Sobriety6 helps women achieve abstinence.
LifeRing Secular Recovery7 works on empowering the “sober self” through groups that de-emphasize drug and alcohol use in personal histories.
Rational Recovery8 uses the Addictive Voice Recognition Technique to empower people overcoming addictions. This technique trains individuals to recognize the “addictive voice.” It does not support the theory of continuous recovery, or even recovery groups, but enables the user to achieve sobriety independently. This program greatly limits interaction between people overcoming addiction and physicians and counselors—save for periods of serious withdrawal.
The Community Reinforcement Approach (CRA)9 is an evidence-based program that focuses primarily on environmental and social factors influencing sobriety. This behavioral approach emphasizes the role of contingencies that can encourage or discourage sobriety. CRA has been studied in outpatients—predominantly homeless persons—and inpatients, and in a range of abused substances.
Click here for another Pearl on familiarizing yourself with Alcoholics Anonymous dictums.
Disclosure
The authors report no financial relationships with any company whose products are mentioned in this article or with manufacturers of competing products.
1. Kreek MJ. Extreme marginalization: addiction and other mental health disorders, stigma, and imprisonment. Ann N Y Acad Sci. 2011;1231:65-72.
2. Wu NS, Schairer LC, Dellor E, et al. Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders. Addict Behav. 2010;35(1):68-71.
3. Moderation Management. http://www.moderation.org. Accessed April 12, 2013.
4. Moderation Management. What is moderation management? http://www.moderation.org/whatisMM.shtml. Accessed August 6, 2013.
5. SMART (Self Management and Recovery Training) Recovery. http://www.smartrecovery.org. Accessed April 12, 2013.
6. Women for Sobriety. http://www.womenforsobriety.org. Accessed April 12, 2013.
7. LifeRing. http://lifering.org. Accessed April 12, 2013.
8. Rational Recovery. http://www.rational.org. Published October 25, 1995. Accessed April 12, 2013.
9. Miller WR, Meyers RJ, Hiller-Sturmhofel S. The community-reinforcement approach. http://pubs.niaaa.nih.gov/publications/arh23-2/116-121.pdf. Accessed August 6, 2013.
1. Kreek MJ. Extreme marginalization: addiction and other mental health disorders, stigma, and imprisonment. Ann N Y Acad Sci. 2011;1231:65-72.
2. Wu NS, Schairer LC, Dellor E, et al. Childhood trauma and health outcomes in adults with comorbid substance abuse and mental health disorders. Addict Behav. 2010;35(1):68-71.
3. Moderation Management. http://www.moderation.org. Accessed April 12, 2013.
4. Moderation Management. What is moderation management? http://www.moderation.org/whatisMM.shtml. Accessed August 6, 2013.
5. SMART (Self Management and Recovery Training) Recovery. http://www.smartrecovery.org. Accessed April 12, 2013.
6. Women for Sobriety. http://www.womenforsobriety.org. Accessed April 12, 2013.
7. LifeRing. http://lifering.org. Accessed April 12, 2013.
8. Rational Recovery. http://www.rational.org. Published October 25, 1995. Accessed April 12, 2013.
9. Miller WR, Meyers RJ, Hiller-Sturmhofel S. The community-reinforcement approach. http://pubs.niaaa.nih.gov/publications/arh23-2/116-121.pdf. Accessed August 6, 2013.