Maddy has experience working in various roles and settings with adults and adolescents. She graduated with a master’s degree in Counseling for Co-Occurring Disorders from Hazelden Betty Ford Graduate School of Addiction Studies. She is a Licensed Alcohol and Drug Counselor (LADC) and is currently under supervision while working toward Licensed Professional Clinical Counselor (LPCC) licensure.
Maddy is passionate about working with individuals ages 15+ who are experiencing trauma, addiction, anxiety and particularly enjoys working members of the LGBTQIA+ community. Maddy uses a person-centered lens and brings curiosity, empathy, compassion, and humor to her work. She creates a safe environment and builds strong therapeutic relationships. Cognitive Behavioral Therapy (CBT) and Mindful Self-Compassion (MSC) interventions are frequently used tools. Maddy is trained in Eye Movement Desensitization and Reprocessing (EMDR).
Outside of work, Maddy enjoys spending time with friends and family. She loves crossword puzzles, watching movies, and reading. Maddy enjoys rock climbing and tries to be outdoors as much as possible.
Welcoming in January: Student Therapist Jayme Hanson
Growing up Jayme’s parents struggled with mood disorders, depression, and substance abuse. Exposure to their wellness journeys embedded a deep interest in the workings of the human brain and nervous system along with the healing potential of therapy.
Jayme is a connector at her core, she aims to develop deep trust with her clients as they journey through the process of discovery and healing. She is passionate about adults struggling with relationship concerns, anxiety/depression, chronic illness, parenting, work stress, and racial trauma.
Before psychotherapy, Jayme held executive leadership roles within healthcare companies and co-founded a successful medical technology startup that improved treatment access for people living with chronic illnesses. She received her Bachelor's in Psychology from DePaul University and is in the process of obtaining a Master's in Clinical Mental Health from Northwestern University. Upon completion of her clinical rotation and graduation, she will pursue credentials as a Licensed Professional Counselor (LPCC).
Welcoming in September: Andrea Nelson, MA
We are excited to announce that Andrea Nelson, MA will be joining us September 11.
Andrea is graduating with a Master’s degree in Addiction Counseling from Hazelden Betty Ford Graduate School, with an emphasis on integrated recovery for co-occurring disorders. She will be working toward dual licensure as an alcohol and drug counselor and independent clinical licensure (LADC and LPCC). Andrea is passionate about helping people gain control of their lives, overcome challenges, and achieve their goals.
Welcoming at Birch Walk-In: Hannah Conaway, MSW, LGSW
Hannah (she/her) is a graduate social worker, currently working toward independent clinical licensure (LICSW). She has worked in community-based settings and private practice, serving a variety of client populations and needs. She has a passion for working with children, teens, adults, and families and is familiar working with a wide range of backgrounds and mental health diagnoses. She has experience helping clients through trauma, life stressors, life transitions, suicidal ideations, eating disorders, substance use, grief, and emotion regulation. Hannah particularly enjoys working with clients who present with ADHD, anxiety, depression, autism, OCD, and behavioral disorders.
Hannah uses Cognitive Behavior Therapy, Dialectical Behavior Therapy, Play Therapy, Person-Centered Approach, Trauma-Informed Therapy, and other approaches/interventions. She provides a calm, safe space for clients to be free of judgment, explore their thoughts and emotions.
Hannah obtained her Masters in Social Work from the University of Memphis in Memphis, Tennessee, along with a certificate in Clinical Social Work.
In her free time, she likes to spend time with family, go for a run, watch her favorite shows, listen to music, and explore the city.
JOINING US IN AUGUST: SONIA COBOS, MS
Sonia (she/her) is passionate about mental health and behavioral science and considers herself privileged to work in this field. Sonia recently completed a Master’s degree in rehabilitation and addiction counseling. Her training was focused on addiction and mental health counseling, including the special needs of individuals living with disability, congenital or acquired.
Sonia takes a holistic and goal-oriented Adlerian approach. Informed by this perspective, Sonia believes that the person’s wholeness or holistic nature is irreducible, therefore considering parts of the personality while ignoring others undermines the understanding of the individual. Sonia likes to apply contextual psychology, family system theory, cognitive behavioral therapy, and motivational interviewing in her practice.
As an immigrant, Sonia is mindful of cultural influences as well as the trauma and generational trauma experienced by the immigrant and first and second generation Americans. She approaches multiculturalism as an enriching opportunity to expand our humanity and grow consciousness.
Sonia’s clinical training is patient centered and non-directive. Sonia’s research during graduate school was in neuroplasticity and the promotion of neurogenesis as part of the therapeutic approach for individuals with addictions and co-occurring mental illness.
Sonia enjoys working with individuals of all ages and backgrounds, and has special interest in helping those who experience addictions, domestic violence, developmental trauma, PTSD, grief and traumatic grief, and patients with long-term disability.
Announcing Men's Support Group: Swinging from Birches
We are pleased to announce the beginnings of a new support group, which will be facilitated by Birch Counseling provider Brian Rose, MA, LADC. This group is welcoming men who are facing questions about substance use as well as other pertinent life problems. The group will be held on Monday evenings, 5:00 - 6:30pm at our Hopkins location (904 Mainstreet, #200). If you are interested in becoming a member, please contact our front office at (866) 522-2472, ext. 0. They will be happy to schedule a pre-admission meeting with Brian, who will make sure you are a good fit for the group. This men’s group will be limited to a maximum of 8 active members.
Below is Brian Rose’s description of the group:
The pandemic has been tough. It has broken our connection with many sources of support and the routines that anchored us. This group’s purpose is to connect with other men for support to help answer questions about issues that have arisen in our lives, such as questions about substance use, interpersonal relationships, as well as anxiety and depression. While such issues may have predated the pandemic , the isolation of the lock-downs has made these concerns more visible and pressing for many.
Some of the topics discussed in this group will cover substance use, improving communication in our relationships, repairing connections with friends and family, coping with symptoms of anxiety and depression, and the facing lonliness that has increased with isolation. This will be a process group with a strong focus on learning to connect and trust others.
The group will meet Mondays, from 5:00pm to 6:30pm, in person.
Birches
Poem by Robert frost
When I see birches bend to left and right
Across the lines of straighter darker trees,
I like to think some boy's been swinging them.
But swinging doesn't bend them down to stay
As ice-storms do. Often you must have seen them
Loaded with ice a sunny winter morning
After a rain. They click upon themselves
As the breeze rises, and turn many-colored
As the stir cracks and crazes their enamel
Soon the sun's warmth makes them shed crystal shells
Shattering and avalanching on the snow-crust —
Such heaps of broken glass to sweep away
You'd think the inner dome of heaven had fallen.
They are dragged to the withered bracken by the load,
And they seem not to break; though once they are bowed
So low for long, they never right themselves:
You may see their trunks arching in the woods
Years afterwards, trailing their leaves on the ground
Like girls on hands and knees that throw their hair
Before them over their heads to dry in the sun.
But I was going to say when Truth broke in
With all her matter-of-fact about the ice-storm
I should prefer to have some boy bend them
As he went out and in to fetch the cows —
Some boy too far from town to learn baseball,
Whose only play was what he found himself,
Summer or winter, and could play alone.
One by one he subdued his father's trees
By riding them down over and over again
Until he took the stiffness out of them,
And not one but hung limp, not one was left
For him to conquer. He learned all there was
To learn about not launching out too soon
And so not carrying the tree away
Clear to the ground. He always kept his poise
To the top branches, climbing carefully
With the same pains you use to fill a cup
Up to the brim, and even above the brim.
Then he flung outward, feet first, with a swish,
Kicking his way down through the air to the ground.
So was I once myself a swinger of birches.
And so I dream of going back to be.
It's when I'm weary of considerations,
And life is too much like a pathless wood
Where your face burns and tickles with the cobwebs
Broken across it, and one eye is weeping
From a twig's having my lashed opened.
I'd like to get away from earth awhile
And then come back to it and begin over.
May no fate willfully misunderstand me
And half grant what I wish and snatch me away
Not to return. Earth's the right place for love:
I don't know where it's likely to go better.
I'd like to go by climbing a birch tree,
And climb black branches up a snow-white trunk
Toward heaven, till the tree could bear no more,
But dipped its top and set me down again.
That would be good both going and coming back.
One could do worse than be a swinger of birches.
Welcoming in September: Alison Campbell, MSW, LICSW
We are very excited to announce the newest addition to the Birch Counseling Team: Alison Campbell, MSW, LICSW!
Alison enjoys working with both adult individuals and couples across the lifespan from all walks of life. She uses a holistic, mind-body perspective and recognizes that a wide range of past and present influences effect both our individual well being and our relationships. With a collaborative, kind and practical approach, Alison helps people explore patterns that may not be serving them and offers guidance and tools for better coping, balance and resiliency so that they can feel more empowered to make the changes they desire. She uses a strengths based, person centered approach with evidence based practices informed by a blend of frameworks. She has had extensive training in mindfulness and somatic practices.
Alison has experience addressing depression, anxiety, stress reduction, trauma, health issues, substance use, relationship difficulties, grief and loss and personal growth. She has lived on both coasts of the US and has worked with people in a variety of settings including low-come housing, correctional facilities, long term care facilities and hospice and community counseling centers. She received her Master’s degree in Social Work from Washington University in St Louis.
Alison has two children, enjoys good books, good cooking, meeting new people and being in the outdoors. She is also a certified yoga teacher.
Spotlight with Brian Borre: Metacognitive Therapy
Before we get into theory, or how this approach might apply to you, let’s take a detour into language. When used as a prefix in the English language, “meta-”, stemming from the Greek for “after” or “beyond”, means something that goes beyond, to be all-encompassing, or become transcendent. When “Meta” and “Cognitive” are put together, the result essentially means “thinking about thinking.” For example, have you ever had an experience where you’re certain you know the name of something--a person, product, or place--but you can’t recall it? This “tip of the tongue” experience is just one example of how metacognitions work to inform our everyday lives--we’re thinking about how we’re thinking. While most of our meta-processes aren’t so conscious, our metacognitions are in the background actively controlling and influencing our conscious experience of the world,
Metacognitive Therapy (MCT) focuses on targeting and modifying our deeply held beliefs--the thinking about our thinking--that fosters states of perpetual worry, rumination, and/or fixation. For example, if you say to yourself, “worrying about this keeps me safe,” or “I have no control over my thoughts,” you are both observing your own thinkingand having thoughts about thinking. The goal of MCT is simple: identify, challenge, and reduce what they dub, “Cognitive-Attentional Syndrome” (CAS). CAS is an umbrella term that refers to the kinds of beliefs that imply: we need worry, are incapable of stopping worry, and would be better off if we hyperfocus on tackling each individual worry.
You might be thinking to yourself, “Birch Counseling, this is starting to sound a lot like CBT,” (Cognitive Behavioral Therapy). The truth is, you aren’t exactly wrong. In CBT, we are dealing with our thoughts. For example, if we were to use CBT to challenge our social anxiety, we might ask ourselves, “how likely will this outcome be, and will it be as bad as we’re thinking it will be?” Essentially, we identify an irrational thought and we challenge it with a more realistic lens.
In comparison, with MCT, we are dealing with how we think about our thinking. We don’t give a lot of attention to the individual thoughts. Instead, we challenge the thinking around the thoughts themselves by asking ourselves, “should I spend my time worrying if the worry doesn’t make it less likely to happen? And if I already worried about it and made a decision, why am I re-worrying about this when I don’t have any new information?” This process, which encourages us to refuse to engage with unhelpful thinking, is called “Detached Mindfulness.” It works because it isn’t avoidance--it challenges people to view their worry and irrational beliefs as something that is outside of their core, observe the thoughts, stay non-reactive to them, and choose to respond without the preoccupation with worry about worried thinking.
Why does Brian like it? Besides being a philosophical guy interested in all things “meta” (emotions, beliefs, and communication), Brian saw that CBT wasn’t always helpful with anxious, depressed, or addiction-driven thinking. From his perspective, it can be equally harmful to hyper-focus on our worry if we feel utterly incapable of controlling or changing it. He thinks about it like “giving in to a screaming toddler you know is just seeking attention because they want something from you, and you don’t know how to handle the upset anymore. Ultimately, it doesn’t help you, or them, to keep caving in or feeling totally helpless to stop it.” Instead, you can learn how to provide the tantruming child in your brain--the anxiety, depression, or addiction monster’s voice--the reassurance that you know what’s best, have a plan, can essentially “pivot” yourself out of the situation, or rebound if you make a mistake. It deflates the tantrum in your brain. And that’s a powerful tool.
If you think Brian might be a fit for you, or have any additional questions about metacognitive therapy, please feel free to reach out to our team at BizOffice@birchcounseling.com.
References:
Going Out On A Limb With Brian Borre, MA, LMFT, LADC
In another life, Brian would have been any college student’s dream Philosophy or Creative Writing professor because he makes you think without feeling judged. He doesn’t pepper you with questions, or reflexively challenge your answers for the sake of being contrarian. And while you can tell that there is always something percolating just beneath the surface, it never feels like he’s holding something back from you, creating a power imbalance, or checked-out in the moment. He’s just effortlessly curious, compassionate, and clear about his boundaries: he won’t work harder than you do.
Perhaps part of what makes Brian a refreshing therapist to Minnesotans is that he’s not from here; being a Chicago native, he can observe the “Minnesota Nice” practices of passivity, but he’s not limited to them. He’s not afraid to sit in silence, push on a button, or meet clients where they are at--it all just depends on what the client’s needs are. While he identifies as more of a “generalist,” or someone who sees a variety of client populations, Brian likes to work with blended families, young professionals, and couples because of his own personal experiences. When it’s appropriate, Brian has found it can really help to have someone who has been through some of those experiences help validate your feelings, normalize what’s happening, and help figure out what comes next.
One thing you might find surprising about Brian: His first professional venture had nothing to do with therapy! While he always felt a calling towards private practice, and his undergraduate major focused on Psychology and Sociology, Brian took a several-year detour into the Culinary Arts! Brian worked in professional kitchens near Yosemite National Park and “really loved it.” What’s really surprising about this tidbit isn’t even the professional pivot, it’s the fact that he identifies as a “professional chef who now doesn’t cook.” He’s clear he’s diplomatic about shared household labor, but in terms of creative expression and self-care, he’d rather spend his time watching or reading Science Fiction, having adventures with his kids, or playing guitar.
On coping with the pandemic: Brian admits that his coping with the pandemic has shifted as the world starts to open up again. Early on, his coping came from fitness, work, reading, and nature; things that would help him to ground or find some semblance of normalcy. Now that we’re able to explore more, he finds himself coping with the uncertainty by noticing the “absolute, purest joy” that his children are experiencing. Even if vicarious, the “wonder they have and excitement for everything they’re doing, it’s like watching them discover it all for the first time,” which helps him hold on to gratitude, wonder, and simplicity, even in the most uncertain or ambiguous of times.
Walk-Up Song: Brian’s ideal walk-up song, “would be something like a mash-up between The Sex Pistols and Beethoven,” which we think is pretty indicative of his style: a balance between classical approaches and total anarchy. Since that song doesn’t technically exist yet (and Brian’s musical skills are limited to the guitar), the closest thing he could think of was London Punkharmonic Orchestra’s cover of “Pretty Vacant” (originally by The Sex Pistols). While we were skeptical at first, we might be able to add this to our waiting room playlist…
Professional pet-peeve: Brian is “other professionals who stop learning or continue to learn in a singular way.” From Brian’s perspective, having an interest as a clinician in anything ranging from music to Mythology, Stoicism to sports, nature or technology, literally whatever you choose to learn about, can inform how we experience our lives and others. Brian believes that a narrow focus or general lack of curiosity can contribute to the greatest of professional offenses: shaming and invalidating clients.
Favorite tool in the Therapist Toolbox: By this point in the blog, you’re probably not going to be surprised that Brian is anti-assessment and scales. To be fair, he does believe in referring to psych testing, understands the value of tracking relevant data, and ongoing anecdotal assessments. He just doesn’t believe in universal measures of unique situations, or snapshots in time meant to reflect something grander. In his experience, some of the most standardized tools can bring about shame for clients because they “didn’t make progress fast enough, or felt like they had a better week but their depression assessment is high today,” and it can cause undue harm. Instead, Brian often uses an ecological approach to help clients reflect on what is going on in their life at any given moment, on a bunch of different levels. If you’ve never had one, it can sort of look like a target with each ring reflecting a different domain of our life. This way, “we’re checking the health of their system as it is today--not just focusing on all the bad at work or home, it’s bringing it back into a larger context and perspective so there’s more balance and insight.”
If you have any questions about Brian, his approach, or think he might be a fit for you, please reach out to us at bizoffice@birchcounseling.com or get in touch through the “Contact Us” tab on our website. Otherwise, stay tuned for our next blog post where we put the spotlight on how Brian’s “Meta” thinking translates into Metacognitive Therapy with clients!
Welcoming in May: Brian Rose, MA, LADC
Brian worked as a professional bicycle mechanic for 29 years. This allowed him to travel around the country and connect with people from all over. He enjoys spending time on the bike, meeting people and trying to learn to fly a drone.
After working in the bicycle industry for so long he found himself working for a non-profit that focused on underserved communities. He envisioned doing more for people and decided to change careers. His own journey with mental health and recovery lead him down the path to becoming a counselor. He earned his master’s degree in Addiction counseling and advanced practice from Hazelden Betty Ford Graduate School. He received a Bachelor’s in Psychology with a religious studies minor (focused on Islam) from Hamline University.
Brian believes that his clients are the experts in their own lives. He brings an existential approach to therapy that focuses on meaning, purpose and personal identity. Brian feels his role in the therapeutic relationship is to create an environment where a sense of safety and acceptance allow for openness and collaboration. Brian enjoys working with clients on topics around culture, identity and helping find where they meet.
What Trauma Looks Likes →
In this powerful short film from producers Nathanael Matanick and Christina Matanick, we witness the impact of domestic violence on a young girl. The consequences of her caregivers’ violence are far-reaching. The girl's world is shattered, her family breaks apart, and her life is turned up-side-down.
This is trauma.
This film shows graphically how trauma fragments the world outside. But it also depicts how the world within is injured. Trauma undermines self-esteem and erodes trust, setting the stage for difficulties ahead.
As difficult as it is to watch, the film illuminates the core elements of trauma. It offers a starting place for understanding, repair, and hope.
Understanding and Protecting Your Family from Dark Web Opioid Purchases
The number of people who have died from heroin and opioids in the United States has more than quadrupled since 1999, according to numbers from the CDC. Drug overdose is now a greater cause of death than car accidents.
Although many people unfortunately develop an opioid addiction through the use of prescription pain relievers, prescription abuse is no longer the easiest way to gain access to these drugs. The Internet has become a major player in the opioid industry, with purchases made on the so-called “dark web”—the part of the Internet that exists on encrypted networks and requires special software to access. Since traffic on the dark web is difficult to trace, it is a prime venue for illicit commerce.
Exacerbating this problem is a particular synthetic opioid—fentanyl—which is extremely potent. Because only a tiny amount is enough to get an adult high and only a few flakes of it are enough to cause an overdose, large quantities of it can be transported in a standard first-class envelope. Dealers in China have been known to deliver the drug through the US Mail by routing it through Hong Kong. The dark web is making it easier than ever for dangerous opioids to reach the streets in the United States.
The opioid epidemic is a major public health problem that will require the best efforts of law enforcement, legislators, and local communities to solve. Parents and families may not be able to immediately stop illegal drugs from reaching the streets, but they can teach common sense practices to their children to help protect them. Although the dangers are different, the solutions are largely the same—the chief of which is clear communication between parents and children.
Communicate with your children about the dangers of drug use. And remember that communication is a two-way street: be willing to listen to your children’s experiences of peer pressure, and provide a safe space for them to share their experiences with you—without fear of punishment. Having a strong relationship with your child and encouraging strong and healthy relationships with responsible peers is one of the best ways to prevent high-risk behaviors like experimenting with illicit drugs.
Communicate, too, about the risks of the Internet. In our digital age, it is not unheard of for a curious teenager to explore the dark web and the “deep web”—the part of the Internet not indexed by standard search engines, which houses the dark web. Help your child understand the legal and ethical implications of Internet use, and instill in them a healthy fear of products and services that they may find on the web. Be sure you know what your child is doing on the Internet, and find a positive outlet for their interests—like a coding class.
Seeking Help for Opioid Addictions
Opioid addictions to drugs like heroin are on the rise.
Opioid addiction and deaths are on the rise. In 2016, 20,101 died from opioid overdoses. Movies like “Trainspotting” and now “Trainspotting 2” have brought some of the realities and problems of opioid use to the public eye, but perhaps glorify it unintentionally.
For whatever reasons are causing this trend, opioid overdoses on drugs like heroin continue to be one the rise. But, how does a doctor or a friend help someone with these addictions or even in the throws of an overdose?
A Safe and Tested Solution
A medication called Naloxone has been used since 1961 by paramedics and first responders in 28 states to reverse the effects ofdrug overdoses. Naloxone is administered either through the nose (intranasal), as an intramuscular injection, or intravenously.
In the United States, naloxone is classified as a prescription medication, but is not a controlled substance. While it is legal to prescribe naloxone in every state, dispensing the drug by medical professionals (including physicians or other licensed prescribers) at the point of service is subject to rules that vary by jurisdiction.
Obtaining Naxolone
In most states, you can purchase naloxone from a pharmacist directly without getting a prescription from a doctor. In Australia, as of February 1, 2016, naloxone is now available over-the-counter (OTC) in pharmacies without a prescription. It comes in single use filled syringe similar to law enforcement kits. In Canada, naloxone single-use syringe kits are distributed and available at various clinics and emergency rooms.
Avoiding Long-Term Complications
The sooner an opioid overdose is treated, the better, because it’s not just death that is the worry, but permanent brain damage and other injuries related to overdose. Even if you are not sure if someone is suffering an opioid overdose, Naloxone has been found to be safe and would have no effect on anyone without opioids in their system. The benefits of increasing availability of naloxone outweigh the risks.
If you or someone you know has an opioid problem, get help as soon as possible in order to save their life.
The Connection Between Facebook and Depression
We live in a world of social media addiction and a virtual world that isn’t real. We’re online constantly: at home, work, the bus, school, and simply whenever we have down time. We’re barraged by what people choose to share — the best of themselves, and what they want you to believe about their lives.
No doubt about it, there are psychological effects of this new digital age that are only just being uncovered.
Depression and Social Media
Recently, researchers at the University of Pittsburgh School of Medicine conducted a study about the effects of social media habits on the moods of users.
This research found that the more time young adults use social media, the more likely they feel depressed.
According to their study, participants used social media 61 minutes per day and visited various social media accounts 30 times per week on average and more than a quarter of them were classified as having “high” indicators of depression.
How could Social Media cause Depression?
What we present on social media isn’t necessarily the truth of our lives. Rather, most are aware it's a thin veneer of a highly edited, idealized and exaggerated version of who we'd like to be. Still, it tends to bring out feelings of envy, a sense that others are happier than we are or living a more successful life.
Despite recognizing the shallowness of social media content, many still feel stuck in constant participation, then end up feeling empty, lost in meaningless exchanges that feel like a waste of time.
Spending significant time online exposes social media participants to cyber-bullying, invites gossip and judgment from others. While many who struggle with depression may use social media to fill a void, exposure also can strengthen depression, and so create a vicious cycle.
What can I do?
Set limits on how often you are on social media. Seek out offline interactions with friends and family. If you can, stop using a smart phone — the tendency to check updates and alerts is ever-present, and often they are not important.
If you find that you are unable to control your online behavior, seek professional help to break the compulsive cycle.
You are NOT your problems.
It takes a lot of courage to ask for help. And, it usually takes a lot of time to muster up that courage.
But, by the time you ask, you’ve most likely internalized your problems.
Internalizing problems over a long period of time can lead to ‘absorbing’ the problems into our identity, meaning you begin to define yourself by the problems. This not only exacerbates your problems, but it also becomes a malicious adversary in our lives.
When you realize this, it’s time to begin to view problems as being ‘other’ and therefore able to be influenced, challenged, changed, even eradicated.
Therapy can help challenge any preexisting internalization of the problem. That is to say, therapy can be understood, in part, as a process by which the individual can begin to be separated from his/her problematic symptoms.
No matter how educated we may be and intellectually or emotionally sophisticated; in the quiet moments when our problem presents as overwhelming how long until some version of the internal message ‘what is wrong with me?’ enters into our consciousness.
We live in a society that relentlessly facilitates the internalization of our problems; intertwined into the habitual fabric of our lives. Some of us grow up in homes where shameful messages were ever present. ‘Something is wrong’ so often became ‘something is wrong with me’. If our problematic symptoms are indivisible from ourselves then we are condemned to being ‘less than’, ‘broken’, being ‘apart from’.
But this is not true.
- You are NOT your symptoms.
- You are NOT your problems.
- You are NOT your thoughts.
- You are NOT your problems.
Through Narrative Therapy, we can help you externalize the problems and affirm that you are not the problem, rather the problem is the problem.
We are here to help.
Families Impacted by Addiction: An Underserved Population
If you have any connection to the recovery community you most likely have heard the adage: “addiction is a family disease”. This idea is the rationale behind treatment centers having Family Programs for the loved ones of an addict/alcoholic in treatment. There are many wonderful treatment centers offering family programs, staffed by talented counselors, to coincide with their loved one’s treatment program. Unfortunately, most family programs are limited to a “family day” (once weekly for an hour or two, occasionally offered a couple days in total), rarely -if ever- with ongoing professional family therapy. Given this lack of emphasis, recommended continuing care from a family program is the singular advice: "go to Al-anon". This is inadequate. Which is not to say that 12-Step programs for family members and loved ones do not play a crucial role in coping with the addiction/alcoholism in their family life. Al-anon and Al-ateen, similar to Alcoholics Anonymous and Narcotics Anonymous, continue to be the foundation of countless people’s recovery from drugs and alcohol. Yet, I implore you to challenge old ways of thinking.
If we actually believe addiction is a family disease (and most addiction experts emphatically agree that it is), the question arises: are family members receiving enough clinical support? Now, let’s contrast the ongoing care generally recommended to patients discharged from an inpatient treatment program. A continuing care recommendation for the recovering addict/ alcoholic often has an outpatient treatment component where they might participate in Day Treatment (an outpatient treatment program, typically meeting 6-7 hours per day (during business hours), 4-5 times weekly for about one month). Followed by Intensive Outpatient Treatment (“IOP” often meeting 2-3 hours per day, 3-4 times weekly for a couple months or more). Additionally, the outpatient recommendation can include a move to a sober house, recovery case management, ongoing work with a mental health professional, and most often active engagement in a 12-Step program. In the context of time investment, it really does equate to a full time job for some and a part-time job for the rest. Totaling some form of treatment for an average of six months, with decreasing levels of care and time investment, has arguably become the minimum continuing care recommendation with those struggling with severe substance use disorders. Let me be clear about the recommended investment that addiction professionals and treatment centers usually suggest to the recovering addict/alcoholic: it is a good thing. A very good thing. It is saving lives. My concern is the lack of referrals and resources provided to family members following their loved one’s treatment program. There are, of course, exceptions where addiction professionals are coordinating services for family members in need of support with mental health professionals experienced with family therapy. Al-anon, while infinitely important to those who engage it, is not treatment or therapy. I would be curious to see a research study tracking the percentage of people attending a family program at a treatment center, subsequently going on to participate in a 12-Step Program (such as Al-anon), for more than one meeting. While only anecdotal, I would argue it being far less than the actual need.
One possible response to the shockingly under-served population is the obvious: connect family members, in need of support, with family therapists.
I clearly cannot be the first person submitting this notion. The fact that coordinating resources for families is not a standard part of best practice policies within the addiction treatment field is quite perplexing. I am open to any coherent explanation as to why families are routinely not connected with experienced therapists in family therapy, as well as being provided with other necessary resources.
Having asked many professionals in the field, I have yet to find one. When addiction is in the household, often many other issues are close at hand including depression, anxiety, legal issues, poor boundaries, unhealthy communication, abuse, trauma, and grief. Antiquated arguments such as “family members need to work their own recovery programs separately” or “the addict/alcoholic needs to establish his/her own recovery before they can focus on their relationships” only serve to contradict the original assertion that addiction is a family disease. The systemic nature of relationships and family dynamics dictates that something so transformative as recovery does not, and cannot, exist in a vacuum. Change is hard. Healthy change is stressful and puts strain on relationships.
Having clear and healthy boundaries between family members’ recovery programs is definitely a positive thing, but we should not lose sight of how addiction has a ripple effect of discord permeating all intimate relationships.
Family therapy can help support and facilitate navigation on the often arduous path of recovery. Generally speaking I commend and support the ever evolving and improving field of addiction treatment. But would be remiss without encouraging an expanded vision of adequately supporting family members still suffering in the wake from addiction. Accountability, structure, and support are needed by all.