American Healthcare and Addiction Treatment by Tom Horvath, Ph.D., ABPP With the passage of “Trumpcare” in the House we have renewed our national focus on healthcare legislation. Rather than address the specifics of this bill, let’s step back and consider two often over-looked “big picture” factors when it comes to American healthcare and addiction treatment. 1) What is the role of government in healthcare? Although in the US we like to think of ourselves as “the best,” in healthcare we are best perhaps in only one way. The very best medical care in the world is available here, if you have the money to pay for it. The Mayo Clinic, Cleveland Clinic, Massachusetts General, Johns Hopkins, UCLA, and other renowned facilities attract wealthy patients from around the world. These cente...

How to Pick a Good Therapist by Thaddeus Camlin, Psy.D. One of my favorite professors often espoused that, “when it comes to therapists, the competition is at the level of mediocrity.”  Finding the right therapist can be quite an undertaking.  In the world of therapists there are countless therapeutic modalities, certifications, qualifications, and credentials.  This article hopes to help one navigate the multitudinous therapeutic acronyms, degrees, and services out there to find the right fit for you. Read on for information on how to pick a good therapist. The world of addiction and recovery presents some unique challenges to finding a good therapist.  Three primary types of providers make up the options for therapists when it comes to addiction: certified drug and alcohol coun...

Alcohol, Drugs, and Health: Highlights from The Surgeon General's Report Tom Horvath, Ph.D., and Thaddeus Camlin, Psy.D. Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs and Health, released in November, has received considerable attention. The massive effort involved in creating this document is in itself worthy of respect. The opening pages list seven science editors, three managing editors, five contributing editors, 21 contributing authors, one science writer, 117 reviewers, and 10 other contributors (these individuals apparently being mostly involved in production). The professionals involved include many of the most important individuals in the fields of addiction and recovery. You may have heard the expression that a camel is a horse that was des...

by Thaddeus Camlin, Psy.D. The Surgeon General's Report and the US Prescription Drug Epidemic Trusted Physician or Neighborhood Drug Dealer? It is no secret that the United States has a serious problem when it comes to prescription drugs.  Heroin’s renaissance is puzzling to many, but the trail of evidence leads back to our own medical community.  This week’s article explores the current prescription drug epidemic in light of the recent Surgeon General’s report. The Surgeon General’s Facing Addiction in America report includes startling statistics that paint a grave picture of the current epidemic in the United States.  Opioids alone account for nearly 300 million prescriptions every year and have accordingly taken the crown for most prescribed medications in the U.S.  The addicti...

David H. Jacobs, Ph.D. 1945-2016 In Memoriam Our brilliant and beloved colleague, David Jacobs, died last month. He had been with Practical Recovery since 2003. David was a therapist’s therapist. In our era most therapists rush to learn the latest evidence-based techniques. David was not opposed to new ideas, but his focus was on continually refining the basics of the psychotherapeutic art: listening well, responding authentically, developing a relationship that is simultaneously a working relationship and to some extent a personal one, all in service of fundamental change, perhaps in both parties. I believe that all of us at Practical Recovery benefited from our collaboration with this therapeutic sage. We will miss him deeply.   With the permission of his wife the home...

by Tom Horvath, Ph.D., ABPP How can the United States improve addiction treatment? The ultimate goal of support for overcoming problematic addictive behavior is to improve individual health and well-being while reducing societal costs associated with the behavior.  Several countries (e.g., Portugal, Switzerland, the Netherlands) are much more effective than the US in providing this support, which can include professional services (treatment) as well as a variety of non-professional and informal support. Calling for Change in US Addiction Treatment In the US a rational, medical and psychological approach would improve a system that has been overly influenced by the punitive aspects of drug prohibition and the diversity-suppressing dominance of the 12-step spiritual approach (which ha...

by Tom Horvath, PhD, ABPP Why individual sessions in addiction treatment are important One of the most frequent complaints I hear from clients who have attended other treatment facilities is “I almost never had an individual session.” Why are frequent individual sessions unusual in US addiction treatment, and why are they important? Groups led by drug and alcohol counselors save money A business reason to provide treatment primarily in groups is to lower costs. All businesses want to save on labor costs. In many cases groups are oriented around a well-established curriculum, designed to help clients “get the program.” Getting the program typically involves accepting the perspective that “I have a disease, I need to go to meetings for the rest of my life, I can never drink again, my ...

by Tom Horvath, Ph.D., ABPP Practical Recovery’s IIOP The Individualized Intensive Outpatient Program To be clear: An Individualized Intensive Outpatient Program (IIOP) is not an Intensive Outpatient Program (IOP). An IOP is a group that typically meets three hours per day, three days per week. In addition, there may be one individual session per week. The IOP is the backbone of many outpatient addiction treatment approaches, and indeed, Practical Recovery offers one (which includes one individual session per week). One of the advantages of an IOP is that insurance companies are familiar with it, and tend to reimburse this service at a reasonable level. Nearly 20 years ago Practical Recovery introduced the concept of the Individualized Intensive Outpatient Program. This year we ar...

It can be challenging to stay sober when you're coping with tragedy. This last year has been full of grief, tragedy, and challenge. We continue to grieve together and are finding that many people are experiencing anger, sadness, confusion, grief and anxiety.  With a surge of emotions that arise in response to tragic events, it is understandable that some of us may experience temptations to return to our addictive behaviors in order to cope with stress and loss.  It is important to understand that this is a normal reaction and a part of recovery. It is also important to know that while the urge may be there, we do not need to give in. Now is the time to call on those new coping tools we've been working on! Some common reactions to tragic events: Increased fear, anxiety and worry i...

Have you noticed the stigma that exists when it comes to men and addiction? It is no secret that the stigma of males in relation to addiction exists in our society today. While it’s widely understood that this is a complex issue, it’s often oversimplified and overlooked.  The stigma may include anything from negative attitudes towards those who may be overindulging in addictive substances or behaviors, to critical beliefs about who specifically is affected by addiction.  The idea that men who are affected by addiction are weak, deserving of their fate and less worthy of care is so inextricably tied to our current societal views that it’s challenging to attempt the separation of addiction from shame and guilt. Most of us who are struggling with addictive behaviors find that the stigm...