I have almost 30 years of training and experience in employing proven, successful treatment methods for the kinds of problems my patients present. These include behavior therapy, cognitive behavior therapy, and mindfulness therapy for substance use recovery. I also am trained and implement educational and counseling methods of the Prime for Life program, a prevention-oriented model to help people who have experienced potential crises from experiences with substance use.
Mindfulness-Based Treatment Methods
Mindfulness means maintaining a moment-by-moment awareness of our thoughts, feelings, bodily sensations, and surrounding environment, through a gentle, nurturing lens. Mindfulness also involves acceptance, meaning that we pay attention to our thoughts and feelings without judging them—without believing, for instance, that there’s a “right” or “wrong” way to think or feel in a given moment. When we practice mindfulness, our thoughts tune into what we’re sensing in the present moment rather than rehashing the past or imagining the future.
Though it has its roots in Buddhist meditation, a secular practice of mindfulness has entered the American mainstream in recent years, in part through the work of Jon Kabat-Zinn and his Mindfulness-Based Stress Reduction (MBSR) program, which he launched at the University of Massachusetts Medical School in 1979. Since that time, thousands of studies have documented the physical and mental health benefits of mindfulness in general and MBSR in particular, inspiring countless programs to adapt the MBSR model for schools, prisons, hospitals, veterans centers, and beyond.
The link between stress and addiction is well-known. Stress increases the likelihood of alcohol and drug use, and can precipitate relapses following treatment. Clinicians and researchers recognize the critical need to incorporate stress management techniques into inpatient and outpatient treatment. The goal is to assist clients to replace substance use with healthy coping skills when confronted with the inevitable stressors that threaten sobriety. Improved treatment retention and relapse prevention are desired outcomes of the challenging search for evidenced-based programs for recovering addicts.
The potential utility of mindfulness-based interventions for individuals in recovery from addictive disorders and for relapse prevention is compelling. As an example, experiential avoidance, or an individual’s unwillingness to remain in contact with unpleasant thoughts and experiences, has been implicated in substance abuse. Studies have shown that mindfulness meditation limits experiential avoidance by promoting nonjudgmental acceptance of moment-to-moment thoughts and by interrupting the tendency to respond using maladaptive behaviors such as substance use. Craving, too, may be ameliorated by mindfulness practice as one learns not to react automatically but respond with awareness.
Behavioral and Cognitive Behavioral Treatment Methods
Behavioral approaches help engage people in drug abuse treatment, provide incentives for them to remain abstinent, modify their attitudes and behaviors related to drug abuse, and increase their life skills to handle stressful circumstances and environmental cues that may trigger intense craving for drugs and prompt another cycle of compulsive abuse.
Contingency Management is a type of behavior therapy that uses reinforcements to encourage positive behaviors such as abstinence. Research has demonstrated the effectiveness of treatment approaches using contingency management principles, which involve giving patients tangible rewards to reinforce positive behaviors such as abstinence. Studies conducted in both methadone programs and psychosocial counseling treatment programs demonstrate that incentive-based interventions are highly effective in increasing treatment retention and promoting abstinence from drugs.
Cognitive Behavior Therapy developed as a method to prevent relapse when treating problem drinking, and later it was adapted for cocaine-addicted individuals. Cognitive-behavioral strategies are based on the theory that in the development of maladaptive behavioral patterns like substance abuse, learning processes play a critical role. Individuals in CBT learn to identify and correct problematic behaviors by applying a range of different skills that can be used to stop drug abuse and to address a range of other problems that often co-occur with it. A central element of CBT is anticipating likely problems and enhancing patients’ self-control by helping them develop effective coping strategies. Specific techniques include exploring the positive and negative consequences of continued drug use, self-monitoring to recognize cravings early and identify situations that might put one at risk for use, and developing strategies for coping with cravings and avoiding those high-risk situations. Research indicates that the skills individuals learn through cognitive-behavioral approaches remain after the completion of treatment. Current research focuses on how to produce even more powerful effects by combining CBT with medications for drug abuse and with other types of behavioral therapies. A computer-based CBT system has also been developed and has been shown to be effective in helping reduce drug use following standard drug abuse treatment.
Prime for Lifepproximately three out of every ten people in the United States make alcohol and/or drug choices that research shows are high risk. They experience the most problems, and this experience is tailored for them. This group includes, but is not limited to, people with a legal or policy violation on the road (impaired driving offenders), on the job, or at school. PRI partners with many state and local systems to provide court-required courses. Shorter variations of this evidence-based, motivational, risk-reduction program make Prime Fr Life an experience that virtually anyone can benefit from, even those who swear they’d “never touch the stuff!” Prime programs are most appropriate for about ages 13 and older.
Prime for Life is based on research and insights from more than 1,800 studies conducted over the last 75 years around the world. The Prime For Life experience is led by a certified instructor, and certification in any version of Prime For Life allows an instructor to deliver all versions of the program. Effectiveness also requires fidelity and we measure fidelity among instructors with our expert-designed quality assurance tool
Prime for Life encourages participants to examine their perception of personal risk; explore their progression toward substance dependence and assess where they might be on that progression; and guides preparation for personal change. Prime for Life utilizes both personal counseling and media-based educational interventions. Educational interventions reinforce principles and processes based essentially on cognitive behavioral principles. Counseling encourages empathic connections and collaboration, and may officer specific guidance regarding personal choices, management of resistance, support for change, and planning for success.