Tag Archives: Alcoholism

Volume 29 Number 46
December 4, 2017
Alcoholism & Drug Abuse Weekly

The 12 Steps of Alcoholics Anonymous
The 12 Steps of Alcoholics Anonymous, part of the foundation of AA
Many people mistakenly define the 12 Steps as a treatment approach, which therefore somehow serves to exclude other strategies in working with patients with addictions. In reality, the Steps are more of a philosophy that can serve as a foundation around nearly every accepted treatment modality, which is why a wide range of programs are able to integrate the Steps into their patients’ experiences in treatment every day. “The 12 Steps are more of a point of view, which means you can believe all that and still do straight ahead [cognitive behavioral therapy],” Keith Humphreys, Ph.D., section director for mental health policy at Stanford University’s Department of Psychiatry and Behavioral Sciences, told ADAW.

“People think of the 12 Steps as a rigid set of procedures. It’s not,” Humphreys said. He is quick to remind, in fact, that one of the adages in the Big Book of Alcoholics Anonymous (AA) is that “the 12 Steps are but suggestions.” The 28-day residential programs that were the most fervent in structuring each week of treatment around a progression through the Steps may be fading in today’s market, but the treatment field’s belief in the power of the Steps certainly has not diminished. Twelve-Step Facilitation is a research-based practice in which programs seek to help patients establish lasting connections with recovery support resources in the community. This effort is based on the realization that when addressing a chronic disease, the meaningful and ongoing connections that patients can establish post-treatment may prove more important than what happens in the time-limited context of a primary treatment stay.

Looking through the 12-Step lens

This establishes a repetitive pattern, it reminds patients of the small actions they will need to take in order to stay in recovery every day.
– Cinde Stewart Freeman discussing a New Design for Living for individuals in Recovery

ADAW spoke with Cinde Stewart Freeman, chief clinical officer at Cumberland Heights in Nashville, Tennessee, who explained, “We use a variety of evidence-based practices that operate through the lens of a 12-Step-based philosophy.” Cumberland Heights patients’ exposure to the Steps is early and frequent, although Freeman says their very first experience with the Steps might actually occur unconsciously. A daily routine that includes morning meditation, periodic pauses to check in at intervals during the day, etc., is grounded in the Big Book’s Design for Daily Living. “This establishes a repetitive pattern,” Freeman said. “It reminds patients of the small actions they will need to take in order to stay in recovery every day.” In their orientation to treatment at Cumberland Heights, patients are introduced to the Steps, but not simply in terms of what the principles are. The practices that go with that, and the importance of the 12-Step fellowship, are emphasized from the start, Freeman said. Every patient who comes in receives a copy of either the AA Big Book or the basic text of Narcotics Anonymous, Freeman said. These are used in numerous ways over the course of treatment, which in many of the facility’s program lasts for around a month. The night staff in the residences are very familiar with the texts and will be able to use them in a practical fashion when everyday problems such as an uncomfortable phone conversation with a spouse or a spat with a roommate threaten to distract. “These things seem ginormous when someone is struggling with recovery, and they often make people want to leave [the facility],” Freeman said. Staff will be able to use specifics from the Big Book to show how these everyday concerns can be addressed. “In that way the books are treated not as literature, but as instruction manuals,” she said.

Meeting attendance

Attendance at 12-Step meetings also becomes an important component of a Cumberland Heights patient’s treatment stay. Freeman said an on-site AA meeting takes place at the facility every Friday, but the majority of the meetings patients attend while in treatment are located out in the community. “We try to get people to meetings at least three times a week,” Freeman said. “We want them to experience different meetings,” which will help familiarize them with the types of recovery support options that will be available to them posttreatment, she said.

Cumberland Heights patients routinely rank their experiences in community meetings favorably in patient satisfaction surveys. “They see what people are like out in real life,” Freeman said. “People there are talking about real problems. It lends a genuineness to things. It leaves patients thinking, ‘Maybe I can really do this.'” Ironically, some research has shown that patients who have the opportunity to attend in-facility support meetings have better outcomes, says John F. Kelly, Ph.D., associate professor of psychiatry in addiction medicine at Harvard Medical School. Both a program’s outreach into the community and its ability to provide resources in-house appear to have a significant impact, Kelly indicated. Kelly told ADAW that residential programs tend to be able to incorporate more components of the 12 Steps because they have more time with the patient. Outpatient programs still can have an impact by exposing
patients to the roles of 12-Step groups and sponsors. “Ideally you can have a warm handoff” to resources in the community, he said.

A good fit with therapy

Even for a program as steeped in the 12 Step philosophy as Cumberland Heights, “That’s not all we do,” Freeman said. She said her staff ‘People think of the Steps as a rigid set of procedures. It’s not.’ Keith Humphreys, Ph.D. colleagues probably have grown tired of hearing her say, “If all we do is what AA and NA did, we need to charge just a dollar.” Therefore, the organization has worked to understand how numerous treatment modalities can work through a 12 Step lens. Freeman said Cumberland Heights has worked with clinical experts at the Center for Dependency, Addiction & Rehabilitation (CeDAR) at the University of Colorado Hospital to incorporate a 12-Step-influenced model of dialectical behavior therapy. It also has tailored interventionist Judith Landau’s ARISE model to its 12 Step framework, helping patients to see the issues they are facing in a familial context. Around two-thirds of Cumberland Heights staff are in recovery, but the organization’s leaders want all employees to be literate in the Steps. The organization is establishing what leaders affectionately call a 12-Step “boot camp” for new employees, Freeman said. Humphreys believes that a 12 Step philosophy basically can fit with any research-supported treatment modality — with possibly one exception.

“We know there is a class of people who will wind up as moderate drinkers,” he said. “That doesn’t mesh with people’s understanding of the Steps.” Ironically, that is the case despite language in the Big Book that references some people ultimately being able to drink “like a gent,” or in moderation, he said.

Mayor Megan Barry joined Cumberland Heights executives and other dignitaries for opening event

NASHVILLE, TENN. – Aug. 9, 2016 – Nashville-based alcohol and drug treatment center Cumberland Heights today officially opened its new Music Row Intensive Outpatient Program (IOP) with an open house and ribbon cutting that included Mayor Megan Barry, musician John Hiatt and many other community leaders and supporters of Cumberland Heights.

IOPs offer alternatives to inpatient treatment for patients who seek daytime and evening counseling in order to continue with their schools or careers. IOPs offer flexible scheduling, group therapy, 12-Step meetings and specialized family therapy. The Music Row IOP is located at 1619  17th Ave. South.

“Cumberland Heights has a long history of working with members of the music industry, so it’s so great to finally be located here on Music Row,” said Cumberland Heights Chief Executive Officer Jay Crosson. “We are excited to be located so close the music, collegiate and Downtown Nashville communities, making this type of treatment as accessible as possible to those that might need it. Cumberland Heights is known for recovery, and Nashville is known for music, so this is a natural location for us.”

Nashville Mayor Megan Barry also spoke briefly at the opening event. “I want to thank the entire staff of Cumberland Heights for all the good work that they do for people who are overcoming addiction and regaining control of their lives,” said Mayor Barry.  “This facility is such an important component of how we go about building a warm and welcoming place and serving our community. Thanks to Cumberland Heights and the Boedecker Foundation for making all of this possible.”

George Boedecker, who originally came to Nashville years ago to “do music,” created the Boedecker Foundation that purchased and renovated the Music Row building for Cumberland Heights, making this new IOP possible.

“The mission of The Boedecker Foundation is to provide critical resources to nonprofit organizations that inspire positive change within diverse communities around the world,” said Boedecker. “It is such an honor and a privilege to be partnering with Cumberland Heights and their Intensive Outpatient Therapy Services at this location.  We look forward to a long-lasting and impactful relationship.”

Since its founding in 1966, Cumberland Heights has built a reputation for helping many music industry professionals recover life from drug and alcohol addiction. The Music Row IOP places a 12 step-based rehabilitative program nearer those who need it most and affords more flexible care for those who do not require the medical detoxification that requires inpatient care.

The Music Row IOP is Cumberland Heights’ tenth outpatient facility in Tennessee and the first in the central part of Nashville. The organization opened its first IOP in 1987.

Photos from the grand opening

Introdution by Jay Crosson, CEO of Cumberland Heights, and speech from Mayor Megan Barry

Introdution by Jay Crosson, CEO of Cumberland Heights, and speech from Mayor Megan Barry

About Cumberland Heights

Cumberland Heights’ mission is to transform lives, giving hope and healing to those affected by alcohol or drug addiction. As a non-profit organization, Cumberland Heights is committed to the approximately 2,500 men, women and adolescents it serves every year and the communities where its facilities are located. The organization has followed the teachings of the 12 Steps since its founding in 1966.

About the Boedecker Foundation

The Boedecker Foundation aspires to encourage positive outcomes through programs focused on education, health and wellness, youth development, along with family and community collaboration. At the central and innermost framework of The Boedecker Foundation’s endowments are partnerships and enduring relationships with organizations like Cumberland Heights, that have committed extensive resources to improve environmental circumstances, provide access to healthcare programs, and create opportunities for individuals, their families and communities in which they live. Through these guiding principles our Foundation has distributed over 28 million dollars to organizations in Tennessee and all across the nation.

# # #

Media Contact:
Amy A. Atkinson, APR
Amy Atkinson Communications
4117 Hillsboro Pike, Ste. 103308
Nashville, TN  37215
Cell: 615-305-8118
Email: Amy@AmyACommunications.com
www.AmyACommunications.com

Addiction doesn’t know zip codes, GPAs, or bank account balances.

Teen-Vogue-How-This-Teen-Beat-Alcoholism-at-17


Article: Teen Vogue: How This Teen Beat Alcoholism
Author:
Written: FEB 16, 2016 11:21AM EST

The first week of senior year for most high school students means seeing old friends, figuring out new class schedules, and feeling the excitement of doing every high school thing for the last time. For Regan*, then 17, it meant going to rehab.

 
The night before her parents pulled her out of school to admit her to a 30-day in-patient drug and alcohol treatment program, Regan had run away from home. With nowhere to go, hiding in a bush and covered in poison ivy, she made her way to a local fire station where she called her parents. The next day her life would change forever.

 
The Diagnostic and Statistical Manual of Mental Disorders (DSM) in its fifth edition as of 2013, refers to the disease of alcoholism as Alcohol Use Disorder or AUD. Individuals diagnosed with an AUD are placed along a disease continuum ranging from mild to severe.

 

Regan didn’t smoke crack or carry a gun. She didn’t bounce from school to school or sell drugs. She went to a high school for gifted students and lived in a private, upper-middle-class neighborhood. When she talks about her childhood, she describes it as “ideal” and “perfect.” None of this mattered though. Addiction doesn’t know zip codes, GPAs, or bank account balances.

 

“My mind was killing me. I couldn’t be happy when I was drunk or high. It wasn’t the same as it was those first times,” says Regan, who first started drinking when she was 14.

 

On the night she ran away, Regan had gotten in a fight with her parents. They’d found out about her older boyfriend, read through all the messages on her phone, taken her car keys and her bedroom doorknob. Realizing her attempt to run away wasn’t worth it, that none of it — the drinking, the drugs, the getting in trouble — was worth it, she gave up.

 

“This isn’t how my life is supposed to be. I’m in need of a change, no matter what that is,” Regan remembers thinking. “I couldn’t continue living the way I was. I was going to die.”

 

Tammy Stone, a licensed professional counselor at Cumberland Heights, a drug and alcohol rehabilitation center located outside Nashville, Tennessee, works with patients, many under the age of 21, and their families to help them better understand addiction.

 

For many young people, trouble with alcohol and drugs begins with a precipitating event: a parent’s divorce, a break up with a partner, rejection from a dream school, perhaps the death of a loved one.

 

“If they [the patients] don’t have the coping skills or support to work through the event, they might turn to alcohol and drugs to cope,” says Stone. When this happens, the feelings associated with the precipitating event — disappointment, fear, confusion, sadness, anger — are all still there; they never went anywhere.

 

There isn’t always a precipitating event. Regan describes a general feeling of otherness, a feeling like she didn’t quite fit the mold of her peers or like she was missing the life manual everyone else seemed to have.

 

“If you’re experiencing negative consequences in at least three life areas as a result of a particular behavior, like drinking, you have a problem,” she advises. Failing or dropping grades, conflict in peer groups, getting arrested or cited for illegal activity, even losing interest in activities that once brought joy — these events begin to add up to something that looks like more than just the consequences of experimentation.

 

While there are more women in the public spotlight today sharing about their experiences with alcohol and drug abuse (Eva Mendes, Adwoa Aboah, Kelly Osbourne, Kat Von D), there is still a considerable social stigma women face when confronting addiction.

 

“There’s more of a social degradation, so women tend to hide it,” says Stone, adding that for young women, this is compounded by parents who enable, hide, or deny their child’s behavior.

 

“Parents want to protect them from that [the social stigma]. They have a hard time admitting ‘my daughter is an alcoholic,’ so they’ll bail them out of trouble, send them to different colleges, hire lawyers to get them out of legal trouble,” says Stone, “And what that does is send girls a message that, ‘OK, I can’t have this problem. My family is not accepting of me having this problem.'” Shame and denial bury the problem deeper.

 

Alcohol and drug abuse is also linked to sexual assault. A 2015 study conducted by The Washington Post and the Henry J. Kaiser Family Foundation revealed one in five college-aged women have been victims of sexual assault. The report stated, “Most notably, two-thirds of victims say they had been drinking alcohol just before the incidents.”

 

At Cumberland Heights, Stone estimates, conservatively, at least 80% of the female patients have some kind of sexual trauma in their history. “A lot of times, alcoholism doesn’t come to light until they suffer their first sexual assault. That’s if they’ll talk about it.” The shame that so often accompanies a sexual assault then gets tangled up with the shame and denial of addiction. One begins to feed the other and a way out can seem impossible to find.

 

On the way to treatment, Regan remembers thinking she didn’t have a problem with drugs or alcohol, that it was something else altogether. “That’s what I thought treatment was, addressing your problems with drugs and alcohol. But then I realized when I got there that no, those actually aren’t the problems; they’re symptoms.”

 

Just shy of 18, Regan was the oldest in her adolescent program in treatment. Initially, all she could hear was how different she was from everyone else. Over the days and weeks though, she began to realize how similar everyone’s stories were. Regan could replace alcohol for someone else’s heroin or crack, and the feelings were all the same: different, uncomfortable, ashamed, tired, defeated. In treatment, she worked with counselors and case managers to address underlying issues that led to self-medicating with alcohol and drugs.

 

Regan describes struggling early in sobriety with the awkwardness of experiencing life in a sober body: meeting new people, going to events sober, changing old habits and behaviors. The benefits, however, of the sober life quickly outweighed the chaos and instability of the drinking life. No more waking up next to people whose names she couldn’t remember, no more hangovers or blackouts, no more wasting time chasing alcohol and drugs. More than that, sobriety came to mean finding out what she liked to do for fun, uncovering (and appreciating) their authentic selves, and being present for their lives in a way she had never been before.

 

Stone stresses the importance of finding a supportive community, one that understands not only that you don’t drink, but that you can’t drink. That community may look vastly different from what it used to look like before sobriety; in many ways, that’s the point. Many individuals struggle to maintain sobriety when they fall back in with old friends and old habits, ones that don’t support sober living.

 

Through AA, which also has a young people’s program called Young People in Alcoholics Anonymous (icYPAA), and her meditation group, Regan found other people her age trying to do exactly what she was trying to do: stay sober one day at a time.

 

“Young people in recovery care for each other,” Regan explains, “They need each other. They need to see that other people can do it so they can do it.”

 

* Names changed or last names withheld to protect individuals’ anonymity.

 


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