Aftercare and Rehabiliation
Rehabilitation Centers, 12 Step Programs, Therapy
RDD Center is committed to your success and we cannot emphasize enough, the importance of aftercare. Some patients feel that 30 or 60 day rehabilitation centers would be of great benefit after the anesthesia detox treatment. Others find the 12 step program helpful and with this setting, can continue attending meetings for years if they would like. We feel it is important to also seek therapy in your own hometown because this is where you are, where your family is, this is where your familiar ground is, where your stress issues may be and this is where you will have to be strong and learn to say "no" when temptation and stress arises. Regular visits to a therapist in your area are more conducive and convenient and can be an on-going treatment without having to devote a lot of time away from home and work, etc. Therapists cannot prescribe medications and we feel it is good to try and remain drug free and work on more healthy ways to cope with stress, anxiety, etc. The attitude that "a pill" is needed for everything is possibly what got the person where they are today.
Cognitive Behavioral Therapy-CBT
It is best to find a therapist that is skilled and certified in CBT. You can visit the National Association of Cognitive-Behavioral Therapists website, specifically the CBT Referrals section to find a therapist in your area. CBT is a brief psychotherapeutic approach that hopes to change troubling behavior and dysfunctional emotions and cognitions through a 12-20 week goal oriented treatment. Relapse prevention may require more sessions and can be an enjoyable experience for most. The sessions start with formulating a plan that the patient is actively involved in and then comes the work of assisting the patient to reorganize dysfunctional thoughts and find ways to change behavior. This is typically done with a collaborative effort from both the patient and the therapist. This dual effort approach helps the patient gain some self control and helps with negative thinking about themselves, others and their future. Typically together they talk about expected outcomes, practice the skills learned and have active role playing during sessions. Ultimately, the goal of CBT is for the patient to gain the ability to think more positively and productively and to independently address cognitions and behaviors. This will encourage the patient to go forth in the right direction by pacing themselves and their thoughts, etc. Thoughts that are automatic are not eliminated but they are understood and restructured. Patients learn to go forward in a more positive direction and to focus on learning skills to improve their behavior and responses.
It is most important to help patients become aware of their actions, be able to gain meaning from their experiences, evaluate their responses and reactions to everyday life. Patients are encouraged to try new ways of reacting both cognitively and behaviorally. It is important to seek therapy from a therapist that sees events from their patient's perspective. The therapist should be warm and sympathetic and be able to quickly establish a good rapport through genuine concern and care for the patient.
Here are 13 "self help" books highly rated by therapists:
- Feeling Good: The New Mood Therapy Revised and Updated
- How to Stop Worrying (Overcoming Common Problems)
- Overcoming Anger and Irritability (Overcoming)
- Managing Anger
- Overcoming Anxiety (Overcoming)
- Overcoming Depression: A Step-by-Step Approach to Gaining Control Over Depression
- Overcoming Obsessive-Compulsive Disorder (Overcoming)
- The Relaxation & Stress Reduction Workbook
- 10 Days to Great Self-esteem
- Overcoming Low Self-esteem (Self-help)
- You'll Get Over It
- Overcoming Traumatic Stress (Overcoming Series)
Most can be purchased from amazon.com
The Benefits of Working Out
Adopting a regular exercise program is an important part of addiction treatment. Not only does it improve overall health, but exercising also can cut down stress and anxiety, which may have helped provoke the addiction in the first place. Exercise also stimulates the production of endorphins; the natural opiates.
Proper nutrition is always beneficial. We encourage fresh fruits and vegetables and protein intake should increase. Include smoothies, fish, chicken, eggs and limit red meat.
Probiotics/acidophilus are helpful for bowel health. Probiotics are live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut. They are also called "friendly bacteria" or "good bacteria." Probiotics are available to consumers mainly in the form of dietary supplements and foods.
Adopting a regular exercise program is an important part of addiction treatment. Not only does it improve overall health, but exercising also can cut down stress and anxiety, which may have helped provoke the addiction in the first place. Exercise also stimulates the production of endorphins; the natural opiates. Add... In a recent study "the effect you find using aerobic exercise alone in treating clinical depression is similar to what you find with antidepressant medications," according to Dr. Trivedi, one of the study authors. "The key is the intensity of the exercise and continuing it for 30 to 35 minutes per day."
Brain Scans and Brain Chemistry Analysis
We have heard of a few centers talking about the benefit of brain scans and brain chemistry analysis. A few anesthesia detox centers will mention these tests, but they do not perform these tests once the patient actually goes for treatment. We feel this is very misleading and gives a patient false hope that they can "fix their brain". These tests really have no medical credibility and have not been accepted in the medical community as anything more than theory. If such tests could pinpoint a physiological reason for a person's negative behavior and/or drug use it would be the biggest breakthrough in medical science in years and would readily be used as a defense in many courtrooms. For more information about this subject read our blog post "Addiction Isn't a Brain Disease". Drug use may cause a deficiency of certain chemicals that effect mood, energy, sleep, etc. but we feel that giving more drugs such as antidepressants, hormones or amphetamines is something we are not in agreement with. Use of these drugs may hinder the body's own ability to naturally repair itself and discourage the return of normal hormone production. Once the patient is detoxed from the opiates, patients will regain former health, natural chemistries, a more stable emotional state and proper hormone levels will return.
There is no 'magic pill' to correct a person's brain chemistries and all that is advised by centers that promote the controversial 'brain scans' are supplements. A good book that may be helpful: End Your Addiction Now: The Proven Nutritional Supplement Program That Can Set You Free can be purchased at bookstores or at amazon.com. Nutritional supplements believed to help correct imbalances certainly cannot hurt and can easily be purchased at your local health food store and are listed below:
- 5HTP (Tryptohan)
- An essential amino acid-believed to relieve migraine headaches, stress, depression and insomnia.
- A mineral that may help to improve emotions, feelings of irritability and insomnia.
- A mineral that some claim helps metabolize carbohydrates, amino acids and other minerals.
- Vitamin B-Complex
- B Vitamins are necessary for nerve functioning, supposedly helps develop neurotransmitters Gaba, Dopamine and Norepinephrine. May help with anxiety, depression, sadness and lack of energy.
- Precursor to testosterone, may help with improved mood, libido, energy levels and improving pain.
- Believed to help with fatigue, fibromyalgia, arthritis and may improve memory.
- May improve libido, memory and alertness. Believed to be an anti-depressant. May help replace Enkephalins which helps mood. Suppose to contribute to development of Dopamine and Norepinephrine. Could help to relieve pain.
- Believed to be necessary for the production of serotonin, dopamine, adrenalin and nor-adrenalin.
- May help liver to metabolize metabolites of Methadone, etc.
- A hormone released from the pineal gland at night for sleep and is also considered an antioxidant.
- An amino acid that may have a calming effect and help with anxiety.
- An amino acid and precursor to Neurotransmitter [pdf] (particularly dopamine and norepinephrine). Can use either alone or combined with Vitamin B6 to combat malaise.
- Omega 3 fatty acids (essential fatty acids)
- May help with fatigue, mood swings or depression.
- B12 (Sublingual)
- Plays a key role in the normal functioning of the brain and nervous system.
- Probiotics with FOS
- Can increase the natural healthy flora in the bowel and calms the bowel. Should be taken on empty stomach.
- Pancreatic Digestive Enzymes
- Helps with digestion of food contributing to bowel health and increasing vitamin absorption within the bowel. Can help with a bowel that is overactive after meals. Take with every meal.
- Ferrous Bisglycinate
- A form of iron that is easier to absorb with less side effects and is crucial for the distribution of oxygen and special detoxification processes in the liver.
- Vitamin D
- Vital for the proper functioning of our body. It regulates the calcium and phosphorus levels in the blood and helps to absorb these minerals from food.
- Capsaicin (the active chemical in red chili peppers)
- Has been shown to possibly stimulate endorphin release. Topical capsaicin cream, which can be purchased at a pharmacy, has been used as a treatment for certain types of chronic pain
- Amino Acids (some mentioned above)
- One of the most important functions of amino acids is to create neurotransmitters in your central nervous system. These transmitters help regulate mood and process the proteins that our bodies need to survive. In many cases, amino acids help depression.
There are over 20 amino acids that we need to live healthy lives, and a few of them have been shown to be helpful in treating depression. Some amino acids that may help depression are:
- A biochemical precursor to the neurotransmitter serotonin. Increased levels have been shown to help elevate mood
- L-Glutamic Acid and GABA
- It is believed that levels of certain types of GABA(gamma-amino butyric acid) can be a biomarker for people more susceptible to suicide during bouts of depression
- It is recommended for the treatment of certain types of manic depression and is an effective amino acid that helps depression
- When combined with other vitamins and minerals, tyrosine is used by many as an alternative taking to antidepressants, and it considered to be an amino acid that helps depression
- Converts to tyrosine in the body, creating norepinephrine, which is found in some antidepressants
- It is believed to increase cysteine levels in your body and to help relieve depression and elevate mood
- Considered to be a quick and extremely effective natural amino acid to help depression and is often used as alternative to harsh antidepressants
Unfortunately, few long-term clinical studies have been done to thoroughly document how amino acids help depression. However, small case studies have shown these and several others to be highly effective, natural alternative remedies for depression. www.nutritional-supplement-educational-centre.com
- 1 capsule 2 times a day. This supplement may help get relief from chronic back pain.
- 75-100 milligrams, 2 times per day may help to relieve Migraine headaches.
- Passion Flower
- May relieve anxiety, insomnia, fatigue and help with digestive problems. Drinking brewed passionflower tea may have calming effects
- Lemon Balm
- May help with insomnia and digestive problems . The oils of this herb may have calming effects and be sedative and an anti anxiety. Can be brewed into a tea.
- May help with muscle pain, insomnia, nausea, stomach pain, Inflammatory Bowel Syndrome and headaches. Can be consumed as a tea.
- Panax Ginseng
- May help to increase strength and energy and decrease stress and low libido. May work with the central nervous system to help with physical and emotional stress. Contains a non-caffeine stimulant.
- Mucuna Prureins
- May help with restless leg syndrome, depression and energy. Supposedly contains high levels of levadopa which is precursor to a neurotransmitter located in the pleasure center of the brain.
- Valerian Root Extract
- May help with insomnia, anxiety, headaches and muscle spasms. Thought to have a sedative effect.
Because of the potential for side effects and interactions with medications, dietary supplements and herbs should be taken only under the supervision of a knowledgeable health care provider.
Addiction Help Guide
Finally, here are some "Words of Wisdom" from a person who recovered from addiction and has been clean for over 8 years: Addiction Help Guide [pdf]
For some individuals to achieve success in overcoming addiction, they must first realize that their success is entirely up to them. They must realize that the addictive behavior does not bring gratification and fulfillment; it actually distances them further from the peace and comfort they seek. They must focus on how the addiction is affecting their life. Instead of looking around to find outward causes for their addiction - such as relationships, family, stress, chemical imbalances, health concerns - they must turn inward to discover the problem in their inner spiritual reality.
Spirituality is often described as a connection to yourself, others, and the society and world around you. To heal addiction, people must first begin by restructuring their spirituality to be of service to others, to focus on making good choices, and to take responsibility for their own actions. A stronger sense of spirituality helps people bring color and depth to their lives and inner reality - gradually replacing the temporary pleasure the addictive behavior may bring. A solid spiritual core cannot originate sobriety, but as spirituality is developed and strengthened, the resulting peace and connection to the world becomes crucial to ensuring a successful recovery.
Follow-up information for outpatient psychotherapy or counseling after you are discharged
Choosing the Right Therapist
As you go through the process of choosing the therapist that will best serve your needs, trying to first decipher the confusing array of academic degrees, licenses, and certifications used in the psychology profession can seem daunting, to say the least. You may come across literally dozens of designations, such as Ph.D., M.D., MA, Psy.D., M.F.C.C., or L.C.S.W.
Some will be "licensed", some "certified", and others will be "registered." They may also list a particular orientation like psychoanalytic, psychodynamic, cognitive/behavioral, gestalt, or solution-focused. Quite understandably, many people are confused about what all of these initials and titles mean. Wisdom, empathy, compassion and character are all attributes you'll want your therapist to have, but they aren't enough. Knowledge and good professional training are essential.
You will want a therapist who has acquired all of the following:
- Intensive academic study in a field of mental health
- A good, competent therapist starts with a master's or a doctorate in a field of mental health (e.g., MA, MS, MSW, PhD, PsyD, MD).
- Supervised clinical experience
- It is important to know whether or not the therapist you are considering choosing has completed an extensive psychotherapy training program ("clinical training"). This could have been part of their academic degree, or it could have been a separate postgraduate program. Psychotherapy cannot simply be learned out of a book or in a classroom. You want a therapist who has also benefited from supervised training.
- Certification or registration or licensure
- Following their successful training, the therapist is pronounced worthy by an authority to which they will then be accountable. This can be a government licensing board, or some other credentialing organization. Some of the more common designations you might see include: LCSW, CSW, MFT, LMFT, MFCC, AAPC, LPC, NCC, or NCPsyA. The type of credential is not as important as some may want you to believe.
Individuals often wonder if they would do better with a female or a male therapist. Trust your instincts to determine if the gender of the therapist is a significant issue for you. It could be that the nature of your particular problem, as well as your own preferences, will lead to a decision that is best suited to you. While the therapist's age and cultural background are certainly not determinates of their capacity for empathy or their skill at providing effective therapy, these may also be characteristics that you have either an intuitive or preferential response to. Choose what feels right for you personally.
As you evaluate a potential therapist, there are some specific questions to ask that can provide valuable insight into how good a match they are for you. You can ask for further details during the initial phone call to the therapist (usually the first phone call is quite brief and primarily focused on setting a first appointment), or during your first meeting.
Basic questions to ask that will help you decide if a therapist is right for you include:
- "What expertise do they have with my type of problem?"
- Although the therapist doesn't necessarily need to have had experience in helping with your exact problem, she or he should be at least familiar with your type of situation and be prepared to tell you how they've helped others in similar circumstances.
- "What do they think is usually the cause of most people's problems?"
- There are many ways to approach people's problems. Depending on their personal background, training, and preferences, therapists attribute problems to different sources. Some look to childhood events, some to the interrelationship of family members, others to faulty thinking, bad habits, or societal and cultural influences. Make sure your therapist's beliefs are at least somewhat in sync with your own views.
- "What is their fee?"
- If you have no mental health Insurance coverage, or you must pay a portion of the fee out of pocket, determine if you are able to comfortably afford the therapist's fee. During the first session, you and the therapist will determine an approximate length of therapy necessary to help with your particular Issues and goals which will provide you with a "ballpark" figure for the total cost of therapy. If you have severe financial concerns, there are practitioners and clinics that have a sliding fee scale. Additional resources might be a community mental health center, a social service agency or a university psychological clinic (for the community, not the students) associated with a psychology graduate training program.
When you feel confident that a particular therapist's overall criteria meet your needs, you're ready for the first phone call. Although you might be feeling nervous during this initial conversation with the therapist, it can still offer an opportunity to evaluate how clearly you are able to communicate with one another and how the rapport feels. Remember, you are the one doing the choosing.
During your first meeting with the therapist, pay attention to how you feel in their presence and in the therapeutic setting they've created. Note how "listened to" you feel and how their style of responding to you and sharing Information makes you feel. Although making yourself vulnerable to another human being is always anxiety provoking, observe how you feel as the session progresses, including changes in your level of ease and shift in the depth of information you reveal.
It's important to remember that therapy is a much, much richer experience than just problem-solving. The foundation of good therapy is the relationship you and the therapist build together. Because this relationship is going to be so crucial to the effectiveness of your therapy, it is essential you find someone with whom you feel a comfortable connection, someone who makes you feel understood and accepted, a therapist who creates and maintains an environment within which you can feel safe to explore even the most deeply felt sources of pain or conflict.
Understanding Therapists' Professional Degrees
As you may already know there are many types of mental health professionals, each with specific educational backgrounds, training, licensure, philosophies, and techniques.
Therapists' academic degrees include:
- Ph.D.: Doctor of Philosophy degree in psychology
- A Ph.D. in clinical or counseling psychology qualifies the professional to become a practitioner or a researcher. Psychologists with a Ph.D. will frequently work in a clinical practice or and/or an academic setting. Ph.D.'s are trained in psychological assessment and diagnostic treatment of the full range of psychological disorders. Clinical psychologists are in school from 5 to 7 years, take many courses in personality, therapy, take supervised practices in therapies, have at least a year of supervised Internship before graduating and at least two years further supervised work post-graduation.
- M.D.: Psychiatrist — Doctor of Medicine
- Psychiatrists are medical doctors who undergo four years of clinical residency in psychiatry after receiving their medical degree and become trained In the biology, medical aspects, assessment, and diagnostic treatment of the full range of psychological disorders. As M.D.'s, psychiatrists can prescribe medications. Most often psychiatrists focus on psycho-pharmacological treatment - they primarily prescribe medications to help in controlling psychological disorders.
- M.S. W.: Master of Social Work (Also M.S.. M.S.S. W., MA. or A.M. in Social Work)
- Social Workers apply social work theory, knowledge, methods and ethics to restore or enhance the functioning (social, psychosocial, or biopsychosocial) of individuals, couples, families, and groups, as well as organizations and communities. Social workers are educated and trained to consider their clients within a social context and, in particular, to be attentive to diversity and the ways in which cultural influences affect individuals and families.
- MA. or M.S.: Master of Arts (Science) degree in psychology
- An M.A. degree is essentially a counseling degree with an emphasis on clinical experience and psychotherapy. Therapists with an MA or M.S. in psychology have a background in the assessment, diagnosis, and treatment of mental disorders and emotional issues.
Resources for Referrals In Your Area
- American Psychological Association (psychology help center)
- Your state's psychological association (i.e. ____ psychological association)
- Psychology Today Referrals
- National Association for Addiction Professionals
- Psychology Central: Referrals
- Narcotics Anonymous - NA is an informal society of recovering drug users. Members share their successes and challenges in overcoming active addiction and living drug-free productive lives.
- Alcoholics Anonymous
- Dual Recovery Anonymous
Also: Smart Recovery, Rational Recovery, Celebrate Recovery