Chat with us, powered by LiveChat
0 comments

How Long Do I Need Addiction Treatment?

One of the questions that people have when seeking treatment is how long do I need to do it?

 

I’m always trying to empower people by thinking deeply about their questions. If you put that question in perspective it’s more like: How long is it going to take for me to change? There isn’t an exact number of days that you can say.

 

Is 30 Days Enough?

 

There’s a model out there for 30-day treatment. What is that based on? Is that based on some science that people break addictions in 30 days? Absolutely not. It’s based on the way that insurance billing works. The 30-day treatment model may not provide the kind of change that people need. 

 

The standard answer these days is recovery takes around 90 days. I think that has more to do with the amount of time that people can afford to spend away from the system of their lives. Most people can’t just drop out of their lives for six months or nine months unless they’re young and maybe have good insurance. Or have strong support from the family. Or possibly getting resources from the county or the city. 

 

Our treatment program is 90 days. Still, the 90-day program is sort of a compromise. It’s trying to get people as much treatment as they can get realistically. In my mind, 30 days means maybe you’re starting to sleep good. Maybe you’re feeling safe. You’re beginning to approach recovery, but you’re nowhere near where you need to be to move on. By 90 days, you should have built a decent foundation…not a solid foundation, but a decent foundation. 

 

The Goal of Effective Treatment

 

A lot of TV programs, they portray good treatment. But the goal of treatment is not to do treatment well. The goal of treatment is to engage people in recovery so they can do their lives well. That’s the real trick. 

 

The immersive experience is upfront: experience with the recovery culture, knowledge and tools, understanding therapy, psychiatry, all the things you need. And then you really want to kind of move that person into life to build those peer and family support structures outside that they have forever. So that they can keep recovery sustainable. 

 

Ninety days in relatively contained care, as I see it: first 30 days real contained, second 30 days less contained, and much more freedom in the third 30 days. Then you’re back in your life but with a lot of support and resources to help you along the way.. 

 

That’s really good treatment and it works phenomenally well when the circumstances lineup to be able to do that.

 

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

We are Rooted in the Foundation of the  12-Steps and Believe in Long-Term Care

[/vc_column_text][/vc_column][/vc_row]

Read MoreRead More
Adam Mindel Interventionist with patient
0 comments

Interventions and Recovery: a Process

As I look back over the last several months of working with individuals and families towards recovery, I promise I am terribly understating when I describe interventions as a process versus an event. All interventions are a process, I promise you, and I promise you so is recovery. Firsthand, I reflect on my nearly 17-year journey of recovery and recognize the years I spent in my addiction leading up to my current sobriety as all part of the process that produced the recovery that I have today. 

Research shows that individuals must often go through a process of preparation before they are ready for permanent sobriety. The Transtheoretical Mode of Change by Prochaska & DiClemente is a model which describes sobriety as a movement from Denial to Contemplation to Preparation and ultimately Action and Maintenance. 

 

Two Predominant Methods to Move Individuals from Denial to Motivated States of Change

 

If the above is true, then realistically how do I utilize interventions to move individuals from states of denial to more motivated states of change? I suggest there are two predominant ways:

 

    1. Utilizing leverage to engage individuals in treatment, with ultimately, treatment itself as the vehicle which provides the process of resolving ambiguity and resistance to change 
    2. Meeting individuals “where they are at”, by finding levels of care that can begin to engage individuals in a process of change. 

 

Two important qualities required for an intervention 

 

First, let’s cover the basics in all models of interventions, most interventionist asses for two important qualities required for an intervention 

 

A. Influence – The capacity to have an effect on the character, development, or behavior of someone.

B. Leverage – The power to create consequences, or require behavioral change by an individual that is addicted.

 

I additionally assess for Attachment, which -is a deep and enduring emotional bond that connects one person to another across time and space (Ainsworth, 1973; Bowlby, 1969). Put simply, I like to know how much individuals care for and are connected to the friends and family that love them. Realistically individuals with high levels of sociopathy do not generally enter treatment without being compelled by the fear of consequences. At the same time, addiction and neurochemical changes will often resemble anti-social behavior.

 

Realistically individuals with high levels of sociopathy do not generally enter treatment without being compelled by the fear of consequences. Click To Tweet

 

Individuals often enter treatment due to tensions in interpersonal relationships.

 

With over 15 years of experience working with families and individual in treatment, I can unequivocally inform you that individuals with deep attachments to friends and family have better outcomes from interventions and addiction treatment. 

 

Having experience and understanding the quality of influence and leverage is vital to producing positive outcomes and creating the correct type of intervention. Quite frankly it is always easiest to intervene on loving individuals that care for their friends and family, and due to interdependent relationships, there are real consequences if the loved one does not enter treatment. For example, I recently intervened on a college student that had very close relationships with his parents and extended family. From the beginning, the initial assessment it was clear that this dutiful son would be entering treatment. In addition, he was dependent upon his parents to return to college. The intervention became high-level consultation, psychoeducation, and changing family dynamics while creating an accountable path back to university with the parent’s support post-treatment. 

 

Unfortunately, not all interventions are high in relational influence or attachment, and not all interventions have real leverage. Click To Tweet

 

I describe “real leverage” as actual consequence that an individual would experience if they choose to not enter treatment. These consequences may include the removal of financial support, parental or marital consequences.

“Adaptive models of interventions find ways to engage with individuals realistically in different stages of change” – Adam Mindel

 

Adaptive models of interventions find ways to engage with individuals realistically in different stages of change, different level of care, and often must create processes that allow individual to fail or provide them the dignity to try things “their way”, before accepting recommended courses of action.

 

For example, I recently Intervened on a successful businessman that was abusing both opiates and amphetamines. Though he loved his family, no individual in his family had any type of leverage, he was well able to finance/self-enable his own addiction. In addition, as a result of chronic amphetamine abuse, the client was dysregulated and unable to acquiesce to residential treatment, and insisted upon beginning outpatient treatment. An agreement was made between the client and his friends and family that included scheduled follow up meetings to track his progress in outpatient. Ultimately due to repeated relapses while attending outpatient treatment, the client became more intrinsically accepting in of entering residential treatment of his own accord versus external coercion. 

 

After the Intervention

Once in treatment a further process was created moving client through different levels of care which included residential treatment, sober living coupled with day treatment, intensive outpatient treatment, and ongoing continuing care which included week individual therapy for 6 months, psychiatric care, continued urine analysis monitoring, and of course the client’s agreement to attend self-help group throughout the recovery process.  The client to this day continues in his own process of recovery and growth…the process continues.

 

 

 

Schedule a 30-min consultation with Adam

 

Schedule Free ConsultationSchedule Free Consultation

 

We Believe in meeting individuals where they are and the power of  Long-Term Care

 

Read MoreRead More
0 comments

Are We Defining Treatment Success the Wrong Way?

Let’s face it, the media has an impact on our opinions and how we view the world. Unfortunately, seeing the world through the eyes of the media isn’t always…well, reality.

 

Take substance abuse treatment. Popular culture believes a person successfully completing treatment will stay away from drugs or alcohol for the rest of his or her life. As a result, life gets better. Sure this idea of success is ideal, but…

 

It’s not always that black and white.

 

Let’s say someone completes treatment and slips up some. Maybe they go out for a couple of drinks or have a weak moment with their drug of choice. But then they used what they learned in treatment to get back on track and not fall into the cycle of addiction.

 

Is this a success or failure?

 

Sure, there was relapse. But there was also a personal recovery taking place afterward. Ultimately, their quality of life did not suffer.

 

So treatment success may not fit into a neat little box of assumptions. Every individual comes to treatment with a unique set of circumstances. Is measuring success in a standard “popular” way counterproductive or even setting one up for failure?

 

Sometimes the right environment for the right amount of time can be the difference between success stories and failures. Recovery Integrity offers a long-term, all male program in Los Angeles. With a success rate of around 45%–much higher than the industry standard.

 

 

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

We are Rooted in the Foundation of the  12-Steps and Believe in Long-Term Care

[/vc_column_text][/vc_column][/vc_row]

Read MoreRead More
0 comments

The Reality of Treatment Success Rates

Coming to treatment has always been a hard threshold to cross – but more so now… Working in treatment for a long time, I’ve experienced greater consumer wariness.

 

People are more hesitatnt to send their loved ones to treatment and ppl who are looking for treatment are more hesitatant to come. I think one of the reasons is the discourse about addiction, treatment and recovery has hit the mainstream, and one of the things that has come out is that the success rate of treatment is like, 15% 🤷‍♂️

 

But why are success rates so low? Several reasons:

 

Poor treatment. Treatment that’s not set up well & doesn’t understand the various personalities of the population they’re working with and their underlying conditions and problems. Like a bad mechanic.

 

Shady treatment that just isn’t trustworthy. Meaning their intention wasn’t to figure out how to help people recover. Their intention was to make money. That type of intention can be disasterous.

 

The nature of addiction and recovery. The nature of addiction is… it’s chronic. It is not a problem that can be solved with an event. It’s something that has to be worked with over time.

 

A good analogy to understand why treatment success rates are low is to think about something like the gym. My guess is you’re going to see like ten, fifteen percent success on those goals of fitness of people who signed up for memberships. Right?
.

Recovery is the same way. Recovery is similar to a muscle you have to exercise consistently. Lots of people will sign up for something that they won’t follow through with. It’s the really hard part of treatment and recovery.
.

It’s this mysterious question of the will, why some people have the will to change certain parts of their lives and other people don’t, and honestly it’s not a place where we have good answers.
.

Many times we just wait for people to be ready to change, but if you have a loved one or a spouse, or kid who is – shooting heroin – you really don’t feel like you have the luxury to wait around for them to change.
.

So people intervene, and people are in different stages of readiness for change, and there’s not an easy solution for that.

 

 

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

We are Rooted in the Foundation of the  12-Steps and Believe in Long-Term Care

[/vc_column_text][/vc_column][/vc_row]

Read MoreRead More
0 comments

Dogma in AA: Trusting in the Spirit of Reality

Dogma is not actually something I would want to get rid of within Alcoholics Anonymous.

 

I would also say dogma is not something that I want to get rid of in alcoholics anonymous. On some level, what it means to be a person in recovery, who’s engaged in traditional 12 steps is to have some sense of acceptance, that you are not in charge of the world.

 

And it’s sort of like trusting the spirit of reality and they call it God’s will, right. It’s a little bit more loaded of a term, I’ll just call it the spirit of reality. Meaning, I have to accept what is. Right?

 

I could fight it, but I’m going to lose, because – what is. And so if what is, is there are dogmatic personalities in alcoholics anonymous, who am I to fight that?

 

Am I in charge of how people should be in meetings? And the answer is no, I’d be a hypocrite. Right? Am I dogmatically against people who are dogmatic? Well, no.

 

There’s another reason why I wouldn’t get rid of dogma in alcoholics anonymous. It’s helped a lot of people. There’s a, sort of a spectrum of meetings, there are meetings, a late-night Hollywood meeting, it’s like a comedy show fiasco. It’s totally insane and foul and people yelling. A bunch of jesters all in one space acting out. There’s no order. It’s total chaos. Great Energy. I thought I sober was gonna be boring, this meeting is wild!

 

And then you have very rigid (you have to wear a tie) and other groups that have developed their own culture which is much stricter, much more dogmatic, much more rule-bound, and all are helpful for a lot of people.

 

That kind of container and that rule of structure and not having to question everything, and just being able to take direction feels really safe, and it feels good and it helps them build lives.

 

So there is dogma in the personalities in alcoholics anonymous. It’s not a bad thing, and if the traditional 12-step is something that’s going to help you, there are ways for you to belong that work for you.

 

 

 

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

We are Rooted in the Foundation of the  12-Steps and Believe in Long-Term Care

[/vc_column_text][/vc_column][/vc_row]

Read MoreRead More
0 comments

AA tries NOT to be dogmatic

Alcoholics Anonymous

Although somewhat known for dogma – actually has gone out of the way to NOT be dogmatic.

 

Everything is languaged from a place of suggestion as opposed to declarative statements for how you are supposed to be.

 

When you see it in the literature of Alcoholics Anonymous, you notice that these were people who were not only NOT particularly dogmatic, but they were also sensitive to the fact that people would be sensitive to dogma.

 

I am half African-American, and when I read the core text, the Big Book of Alcoholics Anonymous, I’m shocked that the word “negro” isn’t in there.

 

It’s 1936, pre-civil-rights-movement. It says nothing about who can come and who can’t…

 

So there is dogma in the 12-steps, it’s not my cup of tea, but it largely has to do with the personalities that exist in certain meetings within the fellowship.

 

 

  

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

We are Rooted in the Foundation of the  12-Steps as We Believe Fully in Long-Term Care

[/vc_column_text][/vc_column][/vc_row]

Read MoreRead More
0 comments

How to Deal with Dogma in Traditional 12-Step Recovery

The One major, legitimate critique of traditional 12-step recovery that I hear a lot (and agree with) Dogma.

 

Which is basically some authority prescribing rules or structure, usually rigid or fixed rules, to a system.

 

You find that in AA, and for some people that’s a big turn off

I don’t like that, I’m a questioner, a doubter, I’m curious… and it doesn’t work well with me or a lot of people.

 

So how do you deal with this? You can choose not to participate, but maybe 12-step or traditional recovery is a huge part of what is going to help you change.

 

What people need is some clarity. The program itself is actively not dogmatic. It’s not hierarchical, there is nobody in charge. In order to be dogmatic, really, there has to be someone prescribing the rules.

 

People project dogma because they experience dogmatic personalities in Alcoholics Anonymous, and that makes sense. Often dogma comes from pain and brokenness. In response to my difficulty, I might create a whole crazy rule structure to how I have to be… …and if I go too far down that road, I might create a whole crazy rule structure about how you have to be.

 

 

  

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

We are Rooted in the Foundation of the  12-Steps as We Believe Fully in Long-Term Care

[/vc_column_text][/vc_column][/vc_row]

Read MoreRead More
0 comments

The Rebel Side of Alcoholics Anonymous

What to expect in this episode:

 

  1. People suffering from addiction often feel very rebellious inside
  2. Alcoholics Anonymous is rebellious, it rejects traditional hierarchy & is free
  3. The most radical thing about AA is that it’s completely detached from the market

 

Alcoholics Anonymous is for Rebels 🤘

 

The other thing about Alcoholics Anonymous; addicts and alcoholics often feel rebellious inside.

 

There’s a rebel piece that grows inside of us during the teenage years and sometimes we have a hard time growing out of.

 

(…Maybe we shouldn’t grow out of it.)

 

I would say Alcoholics Anonymous is very rebellious. 

 

When I say its free, that’s a big deal, it also is completely disconnected from the market place. Its not only that it doesn’t cost any money to go there. There are non profits that you can go to that don’t cost money; but it actually has little to no relationship to the market place at all other than people putting a dollar in a basket to pay some cheap rent at a particular building. 

 

SO it is totally disconnected from our economic system, and I would invite anybody to name any other institution that’s completely disconnected from our market economy. I think that’s important. 

 

There are no commercials or advertising for it, somehow it’s just its own temple, or sacred space. It hasn’t been invaded by a lot of economic forces that we are all at the whim of. So I think there is something special about that. 

 

The other thing about AA is that it’s not hierarchical, not that there is no hierarchy, it just a very flat hierarchy.

 

There’s nobody in charge; when you go to a meeting, there is someone leading the meeting, that rotates every 6 months based on a democratic process usually, that people vote on. 

 

You might ask, “Who is in charge of these millions of people in Alcoholics Anonymous?” nobody knows, no one is in charge. It is people coming together to help each other in a way that has now worked for 80 years. It’s incredible to have that kind of flat hierarchy and it’s worked now through 3-4 generations of people.

 

That’s deep, religion is not like that, corporations are not like that, and my family is not even like that… well sometimes it’s like that… 

  

 

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

Our program follows the 12-Steps Foundation & Provides Long-Term Care

 

[/vc_column_text][/vc_column][/vc_row]

Read MoreRead More
0 comments

The Controversial Nature of Alcoholics Anonymous

What to expect in this episode:

 

  1. Where, specifically, is your resistance coming from?
  2. CBT & DBT are nice , but they are cost prohibitive
  3. The most radical thing about AA is that it’s FREE

 

The Controversial Nature of Alcoholics Anonymous

 

The resistance that people have to the 12 steps can be overcome.

 

What it takes is a person understanding specifically where your resistance is and walking you through it; allowing you to see it and understand it in a way that’s palatable for you. Showing you that in the beginning you can tolerate it and in time come to enjoy. 

 

I’m not into force or coercion, so a person has to say, “I am open to learning about this”. For a lot of people 12 step recovery is the biggest resource they’re going to have. There are quite a few things about 12 step that are really incredible and are not replicated anywhere else as of now, in terms of support for addicts and alcoholics. 

 

The first thing I would say that is really radical about the 12 step program is that it’s FREE. I hear a lot of critique from psychologists and psychiatrists, and honestly I don’t like it, about the 12 step program. That it’s not sophisticated enough, it’s a religion; the same critique that clients have, they parrot those (opinions) back in NPR. 

 

So I will ask, “What is your solution then, for addicts and alcoholics”? They will say CBT, which is particular therapeutic modality or DBT (another therapeutic modality), or psychiatry, etc. 

 

That’s great, but what about the hundred million people who can’t afford to go see a therapist 3 times a week, at $120-$180 per hour in LA. What about the million people who can’t afford $400 per hour to see a psychiatrist monthly? What about those folks? What is going to be their consistent support? SO they critique it, but they don’t have another good solution in the end.

 

If you were to ask me, “How many people do you know in recovery”? I’d say, “I know about 2500 people in recovery”. If they said, “how many of those people had a 12 step experience as a foundation for their recovery”? I’d say, “Probably about 2475”. 

 

Now that’s not evidence that this is the only way to do it, or the only way that works, it’s the most available way to do it, so that makes sense. However, if you were to say, “Yeshaia, how many times have you seen people use an alternate route to recover successfully”? My answer would be 330-40, or something like that. 

  

 

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

We are Rooted in the Foundation of the  12-Steps as We Believe Fully in Long-Term Care

 

 

Read MoreRead More
0 comments

Is Recovery Abstinence?

What to expect in this episode:

 

  1. Is recovery (just) abstinence?
  2. You won’t be protected from relapse unless you learn to change and grow through the underlying issues
  3. The fastest way to learn, grow, and change is to be in an immersive environment. That’s why the recovery community is so important.

 

Is Recovery Abstinence?

 

The fundamental question is: What is Recovery?

 

People don’t ask it because they think they know the answer, but answering that question wrong leads to heartache and tragedy for millions of families.

Recovery is not abstinence. It’s not NOT using the substance you were addicted to. If recovery was just abstinence, it would be like taking a picture of a person 3 weeks a month after they were actively using and that person if you look at them is the exact same person they were when they were using, minus the substances.

Well, that person is going to use again. WHY? Because they are the exact same person they were when they were using. As soon as you remove whatever the block is, whether its environment, commitment, things going well, anything really, they’re going to respond and behave in the same way they did before because they haven’t changed.

The way to understand recovery is to understand that it is abstinence PLUS. Not using the substance I am addicted to and perhaps even all substances PLUS learning, changing and growing. It’s the learning, changing and growing that protects me from relapse. I no longer have the same thoughts, feelings and responses that I did before; therefore I can navigate life, environment, relationships, success, lack of success, and all the stuff that comes along in life in new ways because I am continually growing. The real work of recovery is about that growth.

A deep question is: How do I do that? How do I engage in recovery and learn, change and grow?

Anybody who knows me knows that I do not think that therapy is the fastest or the most direct path to change. It’s a part of the puzzle but not the whole puzzle. I’m not a fundamentalist, I like the 12 steps program a lot, but I’m quite open-minded about how transformation happens.

I will say that an immersive experience is the fastest way to learn and grow. An easy analogy would be like learning a language. If I want to learn Spanish (I’m in California so it makes sense), how much studying am I going to have to do from a book to be able to speak Spanish? I personally took about 9 classes and I can order a burrito, taco, say hello, say goodbye, but if you drop me in the middle of Mexico I will not be able to ask how to leave.

 

If you drop me in Mexico and I have to live there for 3, 4, 5, 6 months, a year… through necessity I am going to immerse myself in the culture and with those people and then I am going to have to learn the language to get by, unless I actively stop myself.

I think recovery actually happens the same way, it’s learning through culture. It’s why I’m a huge fan of recovery support systems; it’s why I’m a big backer of treatment communities, group treatment. There’s something about being immersed in the culture of recovery where people are speaking the same language and we are picking up on all kinds of stimulus, not just one person working on themselves, which allows us to change and grow faster.

 

 

 

Schedule a 30-min consultation with Yeshaia 

 

Schedule Free ConsultationSchedule Free Consultation

 

We Can Help You or Your Loved One Move Beyond Abstinence into True Freedom from Addiction

 

 

Read MoreRead More