Do you have a loved one or a friend who is battling with problematic alcohol use? It can be challenging to navigate such a delicate situation, as it often takes an emotional toll on both parties involved. However, setting healthy boundaries is essential for your well-being as well as theirs. In this blog post, we will explore effective strategies to establish boundaries while offering support and encouraging positive change.

Why Boundaries Matter
Before delving into how to set boundaries, it is crucial to understand why they are essential. Boundaries provide structure and clarity in relationships, ensuring that both individuals' needs are respected. When dealing with someone struggling with problematic alcohol use, boundaries help protect your own mental and emotional health, prevent enabling behaviors, and encourage responsibility and self-accountability for the person dealing with addiction.

Assess Your Own Boundaries
Take a moment to reflect on your own needs and limits. What behaviors are you comfortable with, and which ones cross the line? By clearly identifying your boundaries, you can communicate them effectively to the person struggling with alcohol use. Remember, setting boundaries is not about controlling or changing someone else; it is about asserting your own well-being.

Communicate Openly and Empathetically
Approaching the topic of boundaries requires open and honest communication. Speak from a place of empathy and compassion, expressing your concern for their well-being while also expressing your own needs. Use "I" statements to convey how their behavior affects you personally, rather than resorting to blame or accusations. This approach fosters a non-confrontational atmosphere, making it more likely for the person to be receptive to your boundaries.

Be Clear and Consistent
Clarity is key when setting boundaries. Clearly state your expectations and the consequences that may follow if those boundaries are crossed. It is essential to be consistent in upholding the boundaries you have set. This consistency helps build trust and reinforces the message that your boundaries are non-negotiable.

Offer Support without Negative Enabling
Supporting someone struggling with problematic alcohol use does not mean enabling their behavior. It is crucial to strike a balance between offering assistance and maintaining boundaries. You can provide emotional support, encourage them to seek professional help, or attend support groups together. However, it is equally important to avoid covering up or making excuses for their actions, as this can perpetuate the cycle of addiction.

Seek Professional Guidance
Remember, you do not have to face this challenge alone. Seeking guidance from professionals, such as therapists, counselors, coaches or support groups, can be invaluable in navigating this difficult situation. They can offer advice, strategies, and emotional support tailored to your specific circumstances.

Conclusion
Setting healthy boundaries with someone struggling with problematic alcohol use is a compassionate act that benefits both parties involved. By establishing clear boundaries, communicating openly and empathetically, and seeking professional guidance when necessary, you can contribute to a positive environment conducive to growth and change. Remember, you have the right to prioritize your own well-being while still offering support to those in need.

Need support and guidance? www.familyaddictionrecovery.net

Are you searching for family coaching/therapy options to aid in addiction recovery? Are you in need of parenting guidance while supporting a loved one who is recovering from addiction? Rebuilding family relationships after addiction can be challenging, but with the right strategies and support, it is possible to create a healthy and nurturing environment for everyone involved. In this blog post, we will explore various ways to support children, co-parent effectively, and find family guidance resources for drug addiction recovery.

Supporting Children of Parent in Recovery

When a parent is in recovery from addiction, it is crucial to provide support and guidance to their children. Open communication and age-appropriate discussions about addiction and recovery can help children understand the situation better. Reassure them that their feelings are valid and encourage them to express their emotions. Seeking professional guidance from therapists specializing in addiction can be beneficial in navigating this delicate process.

Rebuilding Family Relationships After Addiction

Recovery from addiction presents an opportunity to rebuild and strengthen family relationships. It requires patience, forgiveness, and a commitment to open and honest communication. Taking small steps to rebuild trust and demonstrating consistent positive change can contribute to healing wounds caused by addiction. Engaging in activities together, such as family outings or shared hobbies, can help create new positive memories and deepen bonds.

Co-Parenting with a Recovering Person

Co-parenting with a recovering drug person can be complex, but it is possible to establish a healthy co-parenting dynamic. Clear and respectful communication is paramount. Establish boundaries and expectations together, focusing on the best interests of the children. Consistency in parenting approaches and maintaining a stable and safe environment for the children are essential. Seeking guidance from family therapists who specialize in addiction recovery can provide valuable insights and strategies.

Family Support Groups for Addiction Recovery

Finding a support system is crucial for both individuals in recovery and their families. Family support groups dedicated to addiction recovery can offer a safe space to share experiences, receive guidance, and connect with others facing similar challenges. These groups provide emotional support, practical advice, and a sense of community. Research local support groups or seek recommendations from addiction counselors and therapists in your area to find the most suitable options.

Talking to Children about a Parent's Addiction and Recovery

Open and age-appropriate communication is key when discussing a parent's addiction and recovery with children. Use language that they can understand and emphasize that addiction is wound that gets to be healed, a symptom of a deep pain. Reassure them that their parent's recovery is a positive step towards a healthier future. Encourage them to ask questions and express their feelings. Be prepared to provide ongoing support as they navigate their own emotions and concerns.

Navigating Family Conflict During Addiction Recovery

Addiction recovery can sometimes bring about family conflicts, often stemming from past hurts or strained relationships. It is crucial to address and resolve these conflicts in a constructive manner. Encourage open dialogue, active listening, and empathy. Seeking the guidance of a family therapist and/or coach can provide valuable tools and strategies to navigate conflicts, rebuild trust, and strengthen family bonds.

Parenting a Child After Addiction Treatment

Parenting a child after addiction treatment requires a delicate balance of providing structure, setting boundaries, and offering love and support. Consistency is key, as children thrive in stable environments. Establish routines, clear expectations, and healthy boundaries to create a sense of security. Seek guidance from addiction counselors or therapists who can offer specialized parenting advice tailored to your unique circumstances.

Family Therapy for Drug Addiction Recovery

Family counseling plays a crucial role in the recovery process. It provides a safe space for family members to address the impact of addiction, heal wounds, and develop effective communication and coping strategies. Qualified therapists who specialize in addiction recovery can guide families through this process, helping them rebuild trust, improve communication, and navigate the challenges that arise during drug addiction recovery. Family counseling sessions allow everyone involved to express their feelings, learn healthier ways of relating to one another, and develop a solid support system.

Finding Family Therapy for Addiction Recovery Near You

When seeking family therapy for addiction recovery, it's essential to find resources and professionals in your local area who specialize in this field. Conduct an online search or reach out to local mental health organizations, addiction treatment centers, or community clinics to inquire about family therapy services. They can provide you with information about therapists counselors and coaches who specialize in addiction recovery and offer family therapy sessions.

Conclusion
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Recovering from addiction and rebuilding family relationships is a journey that requires dedication, compassion, and professional support. By prioritizing open communication, seeking family counseling, and providing support to children, you can create a nurturing environment for everyone involved. Remember to practice patience and understanding, as healing takes time. With the right strategies and resources, you can navigate the challenges of addiction recovery, strengthen your family bonds, and create a brighter future together.

For complimentary guidance: www.sustainablerecovery.net

Introduction:
In the realm of parenting and family functioning, the impact of addiction can be profound. Families face unique challenges when a loved one is struggling with addiction, and unfortunately, the presence of stigma can further complicate matters. Stigma surrounding addiction and substance abuse can create barriers to seeking help, hinder family support, and perpetuate feelings of shame and isolation. In this blog post, we will delve into the role of stigma in parenting and family functioning for those facing addiction, shedding light on its effects and exploring ways to break free from its grasp.

The Damaging Effects of Stigma:
Stigma surrounding addiction often manifests in various ways, including societal judgment, stereotyping, and the marginalization of individuals and families. This can lead to feelings of shame, guilt, and fear of being judged or ostracized by others. The stigma associated with addiction can impact parenting and family functioning by:

1. Barriers to Seeking Help: Stigma can create significant barriers to accessing treatment and support services. The fear of being labeled or judged can prevent individuals and families from seeking the help they desperately need, prolonging the cycle of addiction and hindering the recovery process.
2. Impaired Family Support: Stigma can erode family support systems. Relatives may struggle with feelings of embarrassment or may not understand addiction as a disease, leading to strained relationships and limited emotional support for the individual in recovery.
3. Internalized Shame and Isolation: Stigma can contribute to internalized shame and isolation within families. Parents may blame themselves for their loved one's addiction, fostering feelings of guilt and inadequacy. The secrecy and silence surrounding addiction due to stigma can isolate families, preventing them from reaching out for support and sharing their experiences.
   
   

Breaking Free from Stigma:
Overcoming stigma is crucial for creating an environment that promotes healing, understanding, and support. Here are strategies to help break free from the grip of stigma:

1. Education and Awareness: Educating yourself and others about addiction as a complex disease can help dispel misconceptions and reduce stigma. Sharing accurate information and personal stories can increase empathy and understanding within your family and community.
2. Open Communication: Encouraging open and honest communication within your family can foster understanding and reduce the shame associated with addiction. Create a safe space where family members can share their thoughts, emotions, and concerns without fear of judgment or blame.
3. Seeking Support: Engaging in support networks, such as counseling, support groups, or online communities, can provide valuable assistance and connection. These spaces offer a non-judgmental environment where families can share their experiences, seek guidance, and find solace.
4. Advocacy and Community Involvement: Getting involved in advocacy efforts and community initiatives can help combat stigma on a broader scale. By sharing your experiences and supporting initiatives aimed at reducing stigma, you can contribute to creating a more compassionate and supportive society.

​Conclusion:
Stigma surrounding addiction can have a detrimental impact on parenting and family functioning for those struggling with addiction. By understanding the damaging effects of stigma and taking steps to break free from its grip, families can create an environment of support, empathy, and healing. Through education, open communication, seeking support, and advocating for change, we can work together to dismantle the barriers of stigma and foster healthier, more resilient families in the face of addiction.

Addiction as a Learning Disorder: A Closer Look 
​Introduction:
Addiction is a complex and multifaceted condition that can have serious consequences for individuals and systems, like the family. While commonly seen as a behavioral issue, emerging research suggests that addiction may also be a form of learning disorder. In this article, we delve into the intricacies of addiction as a learning disorder, exploring its definition, impact, and intriguing connection between the two.

The Science Behind Addiction
Rewiring the BrainUnderstanding the Brain’s Reward System:
At the core of addiction lies the brain’s reward system. When a pleasurable experience occurs, the brain releases dopamine, a neurotransmitter associated with pleasure and reward. Like falling in love. In the context of addiction, substances or behaviors can hijack this reward system, leading to an increased release of dopamine. This rewiring of the brain’s reward pathways can result in a heightened sense of pleasure, leading individuals to seek out the substance or behavior repeatedly. Think, “I’d do anything for love”.

Additionally, conditioning plays a crucial role in addiction. Through associative learning, individuals may develop strong associations between certain stimuli, such as places or people, and the pleasurable effects of the substance or behavior. This conditioning can create powerful cravings and urges, making it challenging to break free from the cycle of addiction.

Common Factors in Addiction and Learning Disorders
Genetics: Unraveling the Role of DNA:
Addiction and learning disorders often share common factors that contribute to their development. Genetics can play a role in both conditions, with certain genetic variations increasing susceptibility. However, it is important to note that genes alone do not determine the outcome. Environmental factors, such as upbringing, social influences, and trauma, also shape an individual’s risk for addiction and learning disorders.

Moreover, mental health conditions, such as anxiety, and depression are closely intertwined with addiction and learning disorders. These conditions can contribute to difficulties with impulse control, decision-making, and emotional regulation, further exacerbating the risk of developing an addiction.

Treating Addiction as a Learning Disorder: Strategies and Approaches
Therapy Approaches: Breaking the Cycle:
To address addiction as a learning disorder, comprehensive treatment approaches are crucial. Therapy plays a pivotal role in breaking the cycle of addiction. Cognitive Behavioral Therapy (CBT), for example, helps individuals identify and reframe negative thoughts and behaviors associated with addiction. By rewiring cognitive patterns, individuals can develop healthier coping mechanisms and learn alternative ways of managing cravings and triggers.

Medication-assisted treatment is another valuable approach. Certain medications, such as methadone or buprenorphine, can help reduce cravings and withdrawal symptoms, supporting individuals in their recovery journey. Combined with therapy and holistic support, medication-assisted treatment offers a multifaceted approach to address the complex nature of addiction as a learning disorder.

Psychedelic therapy is an emerging treatment approach that shows promising results in addressing addiction and various mental health conditions. This therapeutic approach involves the controlled and supervised use of psychedelic substances, such as psilocybin or MDMA, in conjunction with psychotherapy. The psychedelic experience induced by these substances can lead to profound shifts in consciousness, introspection, and emotional processing. Research suggests that psychedelic therapy can help individuals with addiction by facilitating transformative experiences, enhancing self-awareness, and promoting a sense of connectedness. It has shown particular efficacy in treating conditions such as depression, post-traumatic stress disorder (PTSD), and anxiety disorders. By assisting individuals in exploring their inner thoughts, emotions, and patterns of behavior, psychedelic therapy offers a unique opportunity for personal growth, healing, and overcoming addiction. However, it is important to note that psychedelic therapy should only be conducted under the guidance of trained professionals in a safe and controlled setting.

Addiction and Learning Disorders: Addressing the Stigma
Challenging Misconceptions:
Addiction and learning disorders often face stigmatization and misunderstanding in society. It is crucial to challenge misconceptions surrounding these conditions and foster a more compassionate and informed approach.

Understanding the interplay of biology, environment, and choice is essential in combating stigma. While biological factors can predispose individuals to addiction and learning disorders, environmental influences and personal choices also play a significant role. Recognizing that addiction is not solely a matter of weak willpower or moral failing helps break down the barriers of judgment and opens the door to empathy and support.

Promoting empathy and support for individuals facing addiction and learning disorders is vital for their recovery. By fostering an environment of understanding, compassion, and non-judgment, we can encourage individuals to seek help without fear of shame or discrimination. This support can come from family, friends, communities, and healthcare professionals who play a crucial role in providing resources, education, and treatment options.

Conclusion: A New Perspective on Addiction
Remembering the Learning Disorder Aspect:
Recognizing addiction as a learning disorder offers a new perspective that can guide us toward more effective prevention and treatment strategies. Early intervention and education are paramount in addressing addiction as a learning disorder. By providing comprehensive education on the nature of addiction, promoting healthy coping mechanisms, and addressing risk factors, we can empower individuals to make informed choices and reduce the likelihood of developing addictive behaviors.

Enhancing treatment approaches is also crucial for fostering lasting recovery. Continued research and innovation in therapies, medications, and support systems can provide individuals with the tools and resources they need to overcome addiction as a learning disorder. By integrating multidisciplinary approaches that address the biological, psychological, and social aspects of addiction, we can maximize the chances of successful long-term recovery.

By understanding addiction as a learning disorder and challenging stigma, we pave the way for a more compassionate and effective approach to prevention, intervention, and treatment. Together, let us strive to create a society that embraces empathy, education, and support for individuals navigating the complexities of addiction and learning disorders.
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If you or someone you know is struggling with the experience of addiction, or mental and/or emotional health challenges, please reach out: www.sustainablerecovery.net

As a family coach with 20 years of experience, I have worked with many families dealing with addiction. It can be a complex and challenging issue that affects not only the individual, but also their loved ones. As a coach, my goal is to help families develop the tools and strategies they need to support their loved one's process and heal as a family. In this blog post, I will outline a coaching curriculum for families dealing with addiction.

Understanding addiction 
​The first step in the coaching process is to help the family understand addiction. Addiction, properly understood, is neither a disease to be cured—though it has aspects of a disease—nor a problem to be eliminated. On the contrary, addiction is the individual’s attempt to solve a quandary. Before we can address addiction, this simple fact must be understood.

As a coach, I work with families to help them understand the signs and symptoms of addiction, as well as the risks and consequences of continuing to use substances. This may include discussing the physical and psychological effects of addiction, as well as the impact it can have on relationships, work, and overall quality of life.

Communication skills 
Addiction can put a strain on relationships and communication within a family. As a coach, I work with families to help them develop effective communication skills. This may include active listening, setting boundaries, and expressing emotions in a healthy way.

​It is important for families to communicate openly and honestly about their feelings and concerns, while also respecting each other's boundaries. Effective communication can help families build stronger, healthier relationships and support their loved one's recovery.

Coping skills 
Dealing with a loved one's addiction can be emotionally and mentally draining. As a coach, I work with families to help them develop coping skills to manage their own emotions and stress. This may include practicing self-care, finding healthy ways to cope with difficult emotions, and seeking professional support when needed.

It is important for families to take care of themselves, both physically and emotionally, in order to be able to support their loved one's recovery. Developing coping skills can help families manage stress and build resilience in the face of challenging circumstances.

Support and self-care 
Support is crucial for families dealing with addiction. As a coach, I work with families to help them build a supportive network of friends and family, as well as find resources for professional support, such as therapy or support groups.

It is important for families to seek out support from others who have been through similar experiences. This can help them feel less alone and provide them with valuable insights and resources for supporting their loved one's recovery. In addition, families should prioritize self-care activities that help them relax, recharge, and take care of their own needs.

Setting goals 
Recovery from addiction is a process, and it is important for families to set goals for themselves and their loved one. As a coach, I work with families to help them set achievable goals, such as reducing substance use or improving communication within the family.

Setting goals can help families stay focused and motivated, as well as provide a sense of accomplishment as they make progress towards recovery. Goals should be specific, measurable, and achievable, and should be reviewed regularly to ensure that they are still relevant and attainable.

Resumption of Use prevention 
Resuming use is a common part of the recovery process, and it is important for families to have a plan in place to prevent relapse and support their loved one in maintaining sobriety. As a coach, I work with families to develop a relapse prevention plan and identify triggers for relapse.

A prevention plan should include strategies for managing stress, avoiding triggers, and seeking professional support when needed. It is important for families to understand that resumption of use does not mean failure, and that it is a common part of the recovery process. Families should be prepared to provide emotional support and help their loved one get back on track if more use occurs.

Celebrating successes 
Recovery from addiction is a challenging and ongoing process, but it is important for families to celebrate their successes along the way. As a coach, I work with families to acknowledge and celebrate their achievements, no matter how small.

This may include celebrating milestones such as days or weeks of sobriety, as well as recognizing improvements in communication or other areas of family life. Celebrating successes can help families stay motivated and build confidence as they continue on the path to recovery.

Conclusion
In conclusion, dealing with addiction is a difficult journey that can have a profound impact on families. As a family coach, I believe that it is important for families to have the tools and strategies they need to support their loved one's recovery and heal as a family.
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The coaching curriculum I have outlined in this blog post includes understanding addiction, communication skills, coping skills, support and self-care, setting goals, relapse prevention, and celebrating successes. By working together and implementing these strategies, families can support their loved one's recovery and strengthen their relationships with each other. Remember, recovery is a process, and it is never too late to start the journey towards healing and recovery.

Introduction:
Addiction is complex so it can affect not only the individual, but also their loved ones. The impact of addiction on family relationships can be devastating, leading to broken trust, communication breakdowns, and strained family dynamics. However, with the right support and resources, families can work towards healing and rebuilding their relationships. In this post, we'll explore the importance of family support in addiction recovery, and provide strategies and resources for parents.

Supporting Your Loved One in Addiction Recovery: Supporting a loved one in addiction recovery can be challenging, but it's an essential component of the recovery process. Understanding addiction and its impact on family relationships is key to providing effective support. It's also important for families to seek resources and support for themselves, such as family therapy and counseling, to help them work through the emotions and stress of addiction.

Self-Care for Parents of Addicts: Parents often neglect their own self-care in the process of supporting their loved one's recovery. However, prioritizing self-care is crucial in maintaining physical and emotional well-being. This can include practicing mindfulness, engaging in physical activity, and seeking support from friends and family. Resources such as support groups and online forums can also be helpful for parents seeking self-care and support.

Navigating the Challenges of Parenting a Child with Addiction: Parenting a child with addiction can be a challenging and emotional experience. It's important for parents to understand addiction and its impact on children, and to seek resources and support to help their child in recovery. Strategies such as setting boundaries and clear communication, as well as seeking therapy and counseling, can be effective in supporting a child with addiction.

Addressing the Stigma of Addiction and Seeking Support: The stigma of addiction can prevent families from seeking the support they need. However, addressing the stigma and seeking support is crucial in addiction recovery. Families can seek support and advocacy through organizations such as the National Council on Alcoholism and Drug Dependence (NCADD) and the Substance Abuse and Mental Health Services Administration (SAMHSA). Resources such as hotlines and online forums can also provide support and information for families affected by addiction.
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Conclusion: Family support is essential in addiction recovery, and parents play a vital role in providing that support. By prioritizing self-care and seeking resources and support, parents can effectively support their loved ones in recovery. Remember, there are resources and support available for families affected by addiction, and seeking help is the first step towards healing and recovery.

Introduction:
Addiction can take a toll not only on the individual, but also on their family members. The impact of addiction on family relationships can be devastating, leading to broken trust, communication breakdowns, and strained family dynamics. However, with the right support and resources, families can rebuild their relationships and work towards a healthier, happier future. In this post, we'll explore the importance of parenting and family functioning for addiction recovery, and provide strategies and resources for families affected by addiction.

Supporting the Family in Addiction Recovery:
Addiction can cause a significant amount of stress and trauma for family members, leading to feelings of anger, fear, and hopelessness. It's important for families to have access to resources and support to help them cope with these emotions and work towards rebuilding trust and communication. Family coaching therapy and counseling can be an effective option for families to work through their issues and learn healthy communication and coping skills.

Parenting During Addiction Recovery:
Parenting while in recovery can be challenging, but it's important for parents to prioritize their recovery while also being present and supportive for their children. Parents in recovery can benefit from resources and support specifically tailored to their needs, such as parent support groups and online forums. It's also important for parents to have a solid support system in place, including family members, friends, and addiction professionals.

Talking to Children About Addiction and Recovery:
Communicating with children about addiction and recovery can be difficult, but it's important to do so in an age-appropriate and honest manner. Children may have a range of emotions and concerns, including fear, anger, and confusion. It's important for parents to be open and honest about their addiction and recovery, while also providing support and resources for their children. Resources such as children's books and online forums can be helpful for children of addicts.

Co-Parenting with a Recovering Person:
​Co-parenting can be challenging in any situation, but it can be especially difficult when one parent is in recovery. It's important for co-parents to work together to provide a supportive and stable environment for their children. This may involve setting boundaries and clear communication, as well as being open to seeking outside resources and support.

Conclusion:
Addiction can have a significant impact on family relationships, but it's important to remember that families can work towards healing and rebuilding their relationships. By prioritizing parenting and family functioning during addiction recovery, families can create a supportive and healthy environment for their loved ones. Remember, there are resources and support available for families affected by addiction, and seeking help is the first step towards healing and recovery. 

Introduction: Habits are hard to break, and bad habits like smoking, drinking, sedentary lifestyle, and overeating are making our population sick. While doctors are trained to diagnose and treat, they aren't trained to help people change their behavior. This is where recovery support specialists come in.
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What Are Recovery Support Specialists? Recovery support specialists are healthcare para-professionals who help people change their lifestyles using a tailored approach and the tools of compassion, motivation, and self-efficacy building. They're not trained in medicine, but they're trained to fill the gap in the healthcare system by working with patients in the days and weeks between appointments or post inpatient treatment.

The Role of Recovery Support Specialists: According to Timothy Harrington, Chief Empowerment Officer of Sustainable Recovery, recovery support specialists require a large skill set to be effective. For people transitioning from other medical disciplines, it requires a deprogramming from the role of expert advisor to that of health facilitator. Unlike physicians, who serve as advisors, defining agendas, and treating disease, recovery support specialists serve as partners, eliciting patient's agendas and co-discovering solutions.

Outcomes Achieved by Recovery Support Specialists: Recovery support specialists have achieved good outcomes in programs for smoking cessation, weight loss, and diabetes management. Corporate America is also catching on, with some of the nation's biggest employers such as Johnson & Johnson hiring health coaches for their workforce to cut down on medical expenses and lost productivity.

Challenges Faced by Recovery Support Specialists: Despite these gains, the practice hasn't quite hit the mainstream and in most cases it is not covered by health insurance. One reason for this is that the field is still highly fragmented in terms of certification and education. Unlike seeing a board-certified physician, when you work with a recovery support specialist, you don't always know what you are going to get.

Standardizing the Field of Recovery Support Specialists: In order to standardize the emerging field of recovery support specialists, Timothy Harrington, is hopeful that soon there will be, at a national level, uniform educational standards, core competencies, and more research demonstrating cost savings. According to Harrington, part of the need is for us to come up with a cohesive definition and clarification of credentials to be able to hold our own in this ground where there is a lot of confusion.
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The Future of Recovery Support Specialists: When asked if health coaching was an outsider movement, Timothy Harrington asserted that in the future recovery support specialists will have a place in the conventional primary care system, especially if there is an overhaul of the pay-per-service reimbursement model. Who will fix healthcare? The answer to this is still unclear, but recovery support specialists are certainly priming themselves to be an important part of the solution.

It has become fashionable by commentators in the addictions arena to point to research studies confirming three linked findings:  1) the course of alcohol and other drug (AOD) problems are highly variable rather than inevitably progressive, 2) the majority of people experiencing substance use disorders and broader patterns of AOD-related problems resolve these challenges without specialized professional care or mutual aid assistance, and 3) the majority of such resolutions occur through deceleration of the frequency and intensity of use rather than through complete and sustained abstinence.  Those findings, drawn from studies of community populations, have been used to buttress attacks on addiction treatment, Alcoholics Anonymous and other abstinence-based mutual aid organizations, the conceptualization of addiction as a disease, and the characterization of addiction as a "chronic" disorder.  There is within these critiques an implied underlying tone of moral indictment:  "If such large numbers of people resolve AOD problems without the need for abstinence and professional assistance, then why can't you?"  The tone of moral superiority in which this question is posed suggests that such problems could be resolved if one would just "Suck it up and deal with it!"

The idea that some people can resolve alcohol problems on their own via an exertion of will is not a new one and is outlined clearly in the basic text of A.A.--authored before most contemporary critics were born.  Such self-will and moderated approaches had not worked for early AA members, but AA made no effort to deny that option to others.  In fact, AA took quite the opposite position. 

             Then we have a certain type of hard drinker. He may have the habit badly enough to gradually impair him physically and mentally. It may cause him to di a few years before his time. If a sufficiently strong reason-ill health, falling in love, change of environment, or the warning of a doctor-becomes operative, this man can also stop or moderate, although he may find it difficult and troublesome and may even need medical attention.  (Alcoholics Anonymous, 1939, p. 31)

             If anyone, who is showing inability to control his drinking, can do the right-about-face and drink like a gentleman, our hats are off to him. Heaven knows we have tried hard enough and long enough to drink like other people!  (Alcoholics Anonymous, 1939, p. 42)

AA literature makes no claim that the collective experience of AA members constitutes a universal truth applicable to the broader universe of all alcohol problems. By distinguishing themselves ("real alcoholics") from problem drinkers, early AA members defined their own recoveries in terms of abstinence and mutual support because that is what had been successful in their experience. 

So if there are potentially two worlds of AOD problems reflected in the divergent conclusions of epidemiologists and clinicians, what separates those who naturally mature out of AOD problems without professional or peer support and those for whom AOD problems become prolonged, life-threatening medical disorders?  Having closely observed both patterns for nearly half a century, I believe there exists a "clinical cluster" that predictively distinguishes those whose AOD problems are most likely to become the most severe, complex and enduring and that are less amenable to natural recovery and moderated resolution.  This cluster includes the following elements:

* Family history of AOD-related problems

* Early age of onset of AOD use

* Euphoric recall of first AOD use

* Atypically high or low drug tolerance from onset of use

* Historical or developmental trauma:  cumulative adverse experiences with traumagenic factors (e.g., early onset, long duration, multiple perpetrators, perpetrators from within family or social network, disbelief or blame following disclosure)--without neutralizing healing opportunities

* Adjustment problems in adolescence that contribute to adult transition problems, e.g., instability in education, employment, housing, and intimate and social       relationships 

* Multiple drug use

* High risk methods of drug ingestion (e.g., injection)

* Co-occurring physical/psychiatric challenges

* Enmeshment in excessive AOD-using family and social environments, and

* Low levels of recovery capital (internal and external assets that can be mobilized to initiate and sustain recovery).

Each of these factors constitutes a risk factor for the development of severe and prolonged AOD problems, but such risks are dramatically amplified when combined.  Not everyone sharing such risk factors will develop severe and chronic addiction, and some lacking such factors will still experience prolonged addictions.  Some in the former group will also resolve their AOD-related problems without professional or formal peer assistance.  But addiction is a disorder of odds, and one's odds of escaping addiction and achieving recovery without help from others decline in tandem with the accumulation of risk factors and the absence of factors that protect and promote resiliency. 

In my professional experience, the prospects of natural recovery and problem resolution via moderation decline in tandem with the increased number and intensity of the above factors.  The "apples and oranges" comparison problems can be minimized, if not transcended, if we realize that findings from studies of the resolution of AOD problems among persons without these risk factors cannot be indiscriminately applied to those who possess such characteristics, and vice versa! 


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