Monthly Archives: June 2017

Behavioral Therapies Shown to Be Effective in Addressing Substance Abuse

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.

There are a variety of different behavior therapies that can help individuals dealing with addiction including:

Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine)

Cognitive-Behavioral Therapy (CBT) was 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.

Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana)

Research has demonstrated the effectiveness of treatment approaches using contingency management (CM) 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.

Voucher-Based Reinforcement  (VBR) augments other community-based treatments for adults who primarily abuse opioids (especially heroin) or stimulants (especially cocaine) or both. In VBR, the patient receives a voucher for every drug-free urine sample provided. The voucher has monetary value that can be exchanged for food items, movie passes, or other goods or services that are consistent with a drug-free lifestyle. The voucher values are low at first, but increase as the number of consecutive drug-free urine samples increases; positive urine samples reset the value of the vouchers to the initial low value. VBR has been shown to be effective in promoting abstinence from opioids and cocaine in patients undergoing methadone detoxification.

Prize Incentives CM applies similar principles as VBR but uses chances to win cash prizes instead of vouchers. Over the course of the program (at least 3 months, one or more times weekly), participants supplying drug-negative urine or breath tests draw from a bowl for the chance to win a prize worth between $1 and $100. Participants may also receive draws for attending counseling sessions and completing weekly goal-related activities. The number of draws starts at one and increases with consecutive negative drug tests and/or counseling sessions attended but resets to one with any drug-positive sample or unexcused absence. The practitioner community has raised concerns that this intervention could promote gambling—as it contains an element of chance—and that pathological gambling and substance use disorders can be comorbid. However, studies examining this concern found that Prize Incentives CM did not promote gambling behavior.

Community Reinforcement Approach Plus Vouchers (Alcohol, Cocaine, Opioids)

Community Reinforcement Approach (CRA) Plus Vouchers is an intensive 24-week outpatient therapy for treating people addicted to cocaine and alcohol. It uses a range of recreational, familial, social, and vocational reinforcers, along with material incentives, to make a non-drug-using lifestyle more rewarding than substance use. The treatment goals are twofold:

  • To maintain abstinence long enough for patients to learn new life skills to help sustain it; and
  • To reduce alcohol consumption for patients whose drinking is associated with cocaine use

Patients attend one or two individual counseling sessions each week, where they focus on improving family relations, learn a variety of skills to minimize drug use, receive vocational counseling, and develop new recreational activities and social networks. Those who also abuse alcohol receive clinic-monitored disulfiram (Antabuse) therapy. Patients submit urine samples two or three times each week and receive vouchers for cocaine-negative samples. As in VBR, the value of the vouchers increases with consecutive clean samples, and the vouchers may be exchanged for retail goods that are consistent with a drug-free lifestyle. Studies in both urban and rural areas have found that this approach facilitates patients’ engagement in treatment and successfully aids them in gaining substantial periods of cocaine abstinence.

A computer-based version of CRA Plus Vouchers called the Therapeutic Education System (TES) was found to be nearly as effective as treatment administered by a therapist in promoting abstinence from opioids and cocaine among opioid-dependent individuals in outpatient treatment. A version of CRA for adolescents addresses problem-solving, coping, and communication skills and encourages active participation in positive social and recreational activities.

Motivational Enhancement Therapy (Alcohol, Marijuana)

Motivational Enhancement Therapy (MET) is a counseling approach that helps individuals resolve their ambivalence about engaging in treatment and stopping their drug use. This approach aims to evoke rapid and internally motivated change, rather than guide the patient stepwise through the recovery process. This therapy consists of an initial assessment battery session, followed by two to four individual treatment sessions with a therapist. In the first treatment session, the therapist provides feedback to the initial assessment, stimulating discussion about personal substance use and eliciting self-motivational statements. Motivational interviewing principles are used to strengthen motivation and build a plan for change. Coping strategies for high-risk situations are suggested and discussed with the patient. In subsequent sessions, the therapist monitors change, reviews cessation strategies being used, and continues to encourage commitment to change or sustained abstinence. Patients sometimes are encouraged to bring a significant other to sessions.

Research on MET suggests that its effects depend on the type of drug used by participants and on the goal of the intervention. This approach has been used successfully with people addicted to alcohol to both improve their engagement in treatment and reduce their problem drinking. MET has also been used successfully with marijuana-dependent adults when combined with cognitive-behavioral therapy, constituting a more comprehensive treatment approach. The results of MET are mixed for people abusing other drugs (e.g., heroin, cocaine, nicotine) and for adolescents who tend to use multiple drugs. In general, MET seems to be more effective for engaging drug abusers in treatment than for producing changes in drug use.

The Matrix Model (Stimulants)

The Matrix Model provides a framework for engaging stimulant (e.g., methamphetamine and cocaine) abusers in treatment and helping them achieve abstinence. Patients learn about issues critical to addiction and relapse, receive direction and support from a trained therapist, and become familiar with self-help programs. Patients are monitored for drug use through urine testing.

The therapist functions simultaneously as a teacher and coach, fostering a positive, encouraging relationship with the patient and using that relationship to reinforce positive behavior change. The interaction between the therapist and the patient is authentic and direct but not confrontational or parental. Therapists are trained to conduct treatment sessions in a way that promotes the patient’s self-esteem, dignity, and self-worth. A positive relationship between patient and therapist is critical to patient retention.

Treatment materials draw heavily on other tested treatment approaches and, thus, include elements of relapse prevention, family and group therapies, drug education, and self-help participation. Detailed treatment manuals contain worksheets for individual sessions; other components include family education groups, early recovery skills groups, relapse prevention groups, combined sessions, urine tests, 12-step programs, relapse analysis, and social support groups.

A number of studies have demonstrated that participants treated using the Matrix Model show statistically significant reductions in drug and alcohol use, improvements in psychological indicators, and reduced risky sexual behaviors associated with HIV transmission.

12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates)

Twelve-step facilitation therapy is an active engagement strategy designed to increase the likelihood of a substance abuser becoming affiliated with and actively involved in 12-step self-help groups, thereby promoting abstinence. Three key ideas predominate (1) acceptance, which includes the realization that drug addiction is a chronic, progressive disease over which one has no control, that life has become unmanageable because of drugs, that willpower alone is insufficient to overcome the problem, and that abstinence is the only alternative; (2) surrender, which involves giving oneself over to a higher power, accepting the fellowship and support structure of other recovering addicted individuals, and following the recovery activities laid out by the 12-step program; and (3) active involvement in 12-step meetings and related activities. While the efficacy of 12-step programs (and 12-step facilitation) in treating alcohol dependence has been established, the research on its usefulness for other forms of substance abuse is more preliminary, but the treatment appears promising for helping drug abusers sustain recovery.

Family Behavior Therapy

Family Behavior Therapy (FBT), which has demonstrated positive results in both adults and adolescents, is aimed at addressing not only substance use problems but other co-occurring problems as well, such as conduct disorders, child mistreatment, depression, family conflict, and unemployment. FBT combines behavioral contracting with contingency management.

FBT involves the patient along with at least one significant other such as a cohabiting partner or a parent (in the case of minors). Therapists seek to engage families in applying the behavioral strategies taught in sessions and in acquiring new skills to improve the home environment. Patients are encouraged to develop behavioral goals for preventing substance use and HIV infection, which are anchored to a contingency management system. Substance-abusing parents are prompted to set goals related to effective parenting behaviors. During each session, the behavioral goals are reviewed, with rewards provided by significant others when goals are accomplished. Patients participate in treatment planning, choosing specific interventions from a menu of evidence-based treatment options. In a series of comparisons involving adolescents with and without conduct disorder, FBT was found to be more effective than supportive counseling.

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What Are Evidence Based Practices?

Evidence-based practices, also known as EBPs, are treatment interventions that have been proven effective by scientific studies. These treatments were tested under controlled circumstances and determined to truly help the patients they were designed to serve.

In the context of addiction evidence based treatment approaches are designed to address the complex aspect of substance abuse and addiction and its consequences for the individual, family, and society. Some of the approaches are used interchangeably to supplement or enhance treatment providing this way a better outcome for the patient.

Insurance companies often fund these studies to determine if an intervention is worth its cost. In general, if you enroll in a treatment program that advertises its interventions as “evidence-based,” you are more likely to have a successful outcome than if you enroll in one that is experimental or based on guesswork.

Below are a few of evidence-based therapies shown to be effective in addressing substance abuse  and addiction (effectiveness with particular drugs of abuse is denoted in parentheses).

  • Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine)
  • Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine)
  • Community Reinforcement Approach Plus Vouchers (Alcohol, Cocaine, Opioids)
  • Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine)
  • The Matrix Model (Stimulants)
  • 12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates)
  • Family Behavior Therapy
  • Behavioral Therapies


Rapid Resolution Therapy Training Conference in NY

It is PTSD Awareness Month and yesterday, Florida Center for Recovery (FCR) along with Long Island Center for Recovery (LICR) and The Kenneth Peters Center for Recovery (KPC) hosted the Rapid Resolution Therapy® (RRT) Training in New York. Doctor Jon Connelly, the founder, and developer or RRT, once more delivered an outstanding training to a crowd of 250 mental health professionals.

In the context of addiction, RRT has been a great therapeutic treatment for FCR clients in their recovery process. This is accomplished by resolving and clearing troubling memories and eliminating the negative emotional or behavioral influence of traumatic event(s). Once that is accomplished clients are integrated with our recovery community and attend our addiction treatment program.

For those of you who are not familiar with RRT (trauma therapy), please read our previous blog post: Rapid Resolution Therapy

Florida Center for Recovery’s environment is especially conducive for processing the intense, deeply-rooted emotions and distorted thinking associated with trauma resolution and PTSD treatment. Our focus is on the resolution of PTSD and helping addicts develop and utilize tools for maintaining a successful recovery process, as both are integral to the holistic healing process.

If you or your loved one is in need of addiction and trauma treatment, we are confident that the professional team and the programs we have in place will provide you or your loved one with the tools necessary to achieve lifelong sobriety.

rapid trauma resolution

Rapid Resolution Therapy (RRT)

Many people who suffer from substance addictions struggle with much more than just the physical ailments and consequences that come with their dependency and addiction. They also struggle mentally as well. In fact, many people suffering from addiction also struggle with mental health conditions. That mental health issue is what leads some people down the road to addiction. For others, their addictions have led to the development of their mental health conditions. For example, many people that suffer from trauma or PTSD start abusing substances to cope and thus, also develop substance addictions and vice versa. To overcome PTSD and an alcohol or drug addiction, one should look toward rapid trauma resolution, otherwise known as rapid resolution therapy (RRT). But what is rapid resolution therapy?

What Is Rapid Resolution Therapy?

Rapid Resolution Therapy (RRT), or rapid trauma resolution, is a type of therapeutic treatment that heals trauma. Developed by Dr. Jon Connelly, RRT is designed to help individuals permanently overcome the negative effects of trauma with a fast and relatively painless approach. 

Rapid resolution therapy often takes as few as 1 to 3 sessions. It also helps individuals get their lives back on track practically effortlessly.

RRT combines hypnosis, guided imagery, stories, and multilevel communication to eliminate the challenging effects of trauma. By quickly getting to the root of the problem, negative and troubling emotions, thoughts, and behaviors are quickly replaced with ones that are healthy and positive.

Rapid trauma resolution is beneficial for all types of trauma, whether it was a single incident or something that occurred repeatedly (e.g. ongoing sexual abuse). The trauma doesn’t have to be “huge” in order for rapid resolution therapy (RRT) to help.

rapid resolution therapy infographic

What Kinds of Conditions Can Rapid Trauma Resolution Help Treat?

In addition to PTSD and the subsequent substance abuse disorder that might come with it, rapid trauma resolution can aid in helping to treat a wide variety of mental health conditions and traumas. Some of those conditions include:

  • Anxiety disorders
  • Mood disorders
  • Eating disorders
  • ADHD
  • Chronic pain and other serious medical conditions
  • OCD
  • Phobias
  • Abuse and rape victims

These are just some of the conditions that RRT has been proven to be effective in treating. If you are unsure if rapid resolution therapy is right for you, talk to a treatment professional.

What Can I Expect?

Rapid trauma resolution is a short-term treatment. Most individuals require between 1 and 3 sessions for lasting results. The first sessions will typically last up to two hours. Subsequent sessions are usually shorter, lasting 50 minutes to an hour. 

What Are the Important Components of Rapid Resolution Therapy?

There are several key elements of RRT that help to make it beneficial for clients who are striving to recover from trauma or dealing with other challenging issues. They include:

Picturing the Desired Outcome at the Beginning 

During rapid trauma resolution, your therapist will instruct you to imagine how you want to change as a result of treatment. For example, if things were better, how would you be feeling? How would you think about things differently than you do now? How would you react to situations in your life differently?

Hypnotic techniques and strategies will be implemented to help you clearly create this picture in your mind. You’ll not only be able to see how you want things to be, but also feel it deep within.

Staying Emotionally Connected to the Present Moment 

 Many people struggle with worrying or thinking about the future or dwelling on the past. During rapid trauma resolution, one of the most important elements is to help you feel safe enough to stay right in the present moment. Once that occurs, your therapist will help you identify the negative thoughts, emotions, and behaviors that have been keeping you stuck. This will enable you to resolve and release them so they no longer cause distress.

Your therapist will work with you to reprocess or reorganize a traumatic event without having to essentially relive it all over again. As you stay in the present emotionally, you can describe specific aspects of the event from a detached perspective. This allows you to feel safe, rather than re-traumatized all over again by the therapy itself (which is not uncommon in other types of trauma recovery work). Staying present plays an important role in allowing you to finally break from the impact of the trauma.

Changing Perspective with Stories, Symbolic Imagery, and Metaphors 

Your therapist will use stories and metaphors to help you look at yourself, the world, and the things you’ve experienced from a healthier and more affirming perspective. An example of a metaphor that symbolizes trauma recovery is that of a butterfly finally emerging from its chrysalis. Once released from the trappings of the cocoon (which is symbolic for the negative impact and “stuck” feelings following a trauma), it flies away, finally free at last. As you see yourself within these metaphors and stories, you are able to look at yourself in a more positive and self-affirming manner, thus making you feel resilient, strong, and free.

Shifting to Positive Emotions with Humor and Playfulness 

The use of humor and playfulness during rapid trauma resolution serves several purposes. For starters, it helps you lower your defenses so you’re more open to the process. It also helps reduce negative emotions typically related to trauma, such as anger, shame, and fear, that you likely felt at the beginning of treatment. 

This element of RRT will help you shift your initial emotional state from intense negative feelings to more positive ones. For example, if you’ve been struggling with a profound sense of sadness, playfulness and humor can help shift it to happiness and joy.

This aspect of treatment is especially refreshing for clients who have tried other types of therapy to deal with the impact of trauma such as cognitive-behavioral therapy (CBT) and dialectical behavioral therapy (DBT). 

It’s not uncommon to leave those sessions feeling emotionally drained, not to mention keenly aware of your internal pain, as you work through the deeply painful aspects of trauma. That’s not to say other treatment approaches aren’t beneficial or effective – many of them are – but few clients would ever perceive them as enjoyable and even fun, which is not uncommon with Rapid Resolution Therapy.

What Are Some of the Benefits of Rapid Resolution Therapy?

As we have touched on above, Rapid Resolution Therapy has many benefits for those who are suffering from both PTSD and a variety of mental health conditions. Some of the benefits of RRT include:

  • Fast recovery from the troubling impact of trauma, including traumatic experiences and memories that have been repressed
  • Improvements in self-esteem
  • Reduction in stress
  • Eliminate self-destructive behaviors
  • Loss of previously stubborn unwanted weight
  • Overcome bad habits once and for all
  • Increase in drive and motivation to get things done and reach goals
  • A decrease in negative emotions, such as grief, sadness, fear, distrust, and anger
  • Overcome debilitating and irrational fears (phobias)
  • Reduction in physical pain
  • Experience lasting change
  • A strong sense that you are in control of your life

Want To Know More About Rapid Resolution Therapy?

Having to deal with the repercussions of experiencing a traumatic event can oftentimes be scary and can make many people feel alienated and alone. This can then lead to the development of a substance abuse issue as the person who is suffering might turn to drugs and alcohol as a way to forget and feel better, even if it’s just temporary. What starts off as a temporary relief though can turn into a long-term substance abuse and addiction issue.

At Florida Center for Recovery, we understand that certain traumas and mental health conditions, such as PTSD oftentimes lead to the development of a substance abuse issue. That’s why we offer not just addiction treatment, but treatment for the mental side of things too, including Rapid Resolution Therapy. If you or someone you know is currently dealing with a mental health issue and could benefit from rapid trauma resolution, contact us today. We want everyone that walks through our doors to leave and lead a happy, healthy, and sober life.

June is Post Traumatic Stress Disorder (PTSD) Awareness Month

PTSD is a condition in which an individual experiences tremendous stress or anxiety after witnessing or being engaged in a traumatic event. Any physical or psychological trauma that leaves the individual feeling powerless and out of control may lead to PTSD. Some of the most common causes of the condition include:

  • Military combat
  • Violent assault
  • Natural disasters
  • Sexual assault
  • Childhood abuse

The symptoms of PTSD can be divided into three general categories:

1) re-experiencing the traumatic incident

2) avoiding experiences that evoke memories of the incident

3) symptoms of hyperarousal, such as irritability, anger, or extreme anxiety.

People who experience these symptoms for at least one month may be diagnosed with PTSD. Alcoholism and drug abuse fall into the category of avoidance symptoms, as the individual may use these chemicals to avoid memories or to numb fear.

When alcohol or drugs are used to manage PTSD symptoms, the symptoms of the disorder become more severe. 

Getting the right treatment to both the addiction and PTSD may make the difference between whether or not an individual is able to lead a satisfying, healthy life. At Florida Center for Recovery, individuals struggling with addiction and Post Traumatic Stress Disorder receives comprehensive treatment to address both issues. Our specialized trauma therapy is delivered exclusively by Dr. Jon Connelly, the founder, and developer of Rapid Resolution Therapy®. This therapeutic treatment approach often takes as few as 1 to 3 sessions and is utilized to treat all types of trauma – whether it was a single incident or something that occurred on an ongoing basis. RRT helps clients to permanently overcome the negative effects of trauma by eliminating the ongoing psychological suffering that stems from disturbing or painful experiences. Clients report that the best aspects of Rapid Resolution Therapy® are that treatment is painless and does not involve the re-experiencing of the traumatizing event(s).

In addition to RRT, our integrated treatment plan for PTSD and substance abuse include:

  • All-Inclusive Detox
  • Medical and Psychological Evaluation
  • Addiction Treatment Assessment
  • Group and Individual Psychotherapy
  • Gender-Specific Counseling
  • Grief / Loss Therapy
  • Family Therapy
  • Relapse Prevention
  • 12 Steps & SMART Recovery®
  • Addiction Educational Series
  • Holistic and Alternative Therapies
  • Recreational Activities
  • Aftercare Programming
  • Discharge Planning

Our professionals at Florida Center for Recovery understand the vulnerability of those clients who suffer from both PTSD and addiction. If you or someone you love is living with this difficult combination of conditions, call us for more information about our treatment plans.