In Epidemics, Hippocrates said, “Make a habit of two things–to help, or at least to do no harm.” How can we apply that idea to helping family and friends with addictions?
When we care about individuals who are trying to overcome addictions, we often face dilemmas in how best to help them. For instance, if I help someone by providing money for some critical need, am I supporting recovery by preventing some degree of “disaster”? Or am I just shielding the person from negative consequences that might motivate lasting behavior change? The latter, of course, is AKA the E word: Enabling. This article will identify some things to consider when you face that kind of decision.
What is support? I suggest that support, at its root, consists of two things: paying attention and active helping. I could pay attention to a friend who wants to quit smoking by listening to her talk about her cravings to smoke and how she copes with these cravings. I could actively help her by informing her of new tobacco cessation products (if she was unfamiliar with them). I could take her to a SMART Recovery® meeting (especially if she felt awkward going alone), or spend a non-smoking evening with her (when her other options were to be alone or be with smokers).
How to help your potential support system really be helpful
~Josh King, PsyD, Center for Motivation and Change
Many people start using substances (often as teens) as a way to engage socially. The reality is that almost all substances with abuse potential initially have a “social lubrication” effect (i.e., they are dis-inhibiting, relaxing, anxiety-reducing, buffers to self-criticism, enhancers of pleasure, etc). The problem? Further down the road (and sometimes right out of the gates), use patterns become much more solitary, withdrawn and isolated. Many have suffered through conflicts with family and friends and, by the time they seek treatment, feel disconnected from potential supporters of change. In addition, to break the destructive patterns that are in place when they seek treatment, they have to distance themselves from current friends who engage in the same behavior (party pals etc). The reality of “loss”…that is the loss of the relationship with the substance and with the people around it…and the awareness of distance from potentially supportive family and friends makes the early stages of change very hard to tolerate at times.
Research has shown time and again that having a robust support network can significantly reduce the odds of relapse Continue reading →
“How Science and Kindness Help People Change” with Jeffrey Foote, Ph.D., Center for Motivation and Change
“[We want to] change the conversation, from the language of stigma to the language of growth; from defects to strengths, from shame to pride and an open heart; from punishment and confrontation to an invitation to truly change. And to change that conversation, we rely on science and kindness.”
May 17, 2014 4:00pm ET : Jeffrey Foote, Ph.D., joins SMART Recovery to present: Beyond Addiction, How Science and Kindness Help People Change:
The Center for Motivation and Change’s (CMC) approach to helping families, including CRAFT;
CMC’s best new tools for families wishing to support a loved one’s recovery;
Beyond Addiction, by Jeffrey Foote, Ph.D., Carrie Wilkens, Ph.D., Nicole Kosanke, Ph.D., and Stephanie Higgs;
About the speaker: Dr. Foote is a nationally recognized clinical research scientist who has received extensive federal grant funding for his work on motivational treatment approaches. Dr. Foote has worked in the addiction treatment field as a clinician and researcher since the late 1980s, and has developed a unique motivational treatment approach that incorporates principles of group treatment as well as research-based principles of human behavior change.
In 2004, Dr. Foote opened the Center for Motivation and Change with his partner, Dr. Carrie Wilkens. CMC’s mission is to provide evidence-based treatments to help people change their substance use and compulsive behaviors while providing a warm and therapeutic atmosphere. CMC is built on the belief and optimism that people can change.
Previously, Dr. Foote was the Deputy Director of the Division of Alcohol Treatment and Research at Mt. Sinai Medical Center in NYC, as well as a Senior Research Associate at The National Center on Addiction and Substance Abuse at Columbia University (CASA) in NYC. Dr. Foote also served as Chief of the Smithers Addiction Treatment and Research Center as well as Director of Evaluation and Research between 1994 and 2001. Dr. Foote was also team Psychologist for the New York Mets. Continue reading →
A note on “enabling” vs. positive reinforcement
~Jeffrey Foote, PsyD, Center for Motivation and Change
“Caring about and staying connected in a helping way with someone dealing
with substances is not only helpful, it’s one of the most powerful motivators for change.”
If you are a partner, parent, or child of someone struggling with substance problems, and you live in America, you’ve probably heard this word “enabling” (possibly many, many times). And you’ve probably heard this described as central to your interactions in helping your loved one. Mostly, you have heard “DON’T DO IT”!, and if you are like most concerned family members, you feel vaguely guilty for doing something you’re not even sure you are doing (but you must be, right?). By way of quick review, “enabling” actually means doing positive things that will end up supporting continued negative behavior, such as providing your child with money so they won’t “go hungry” during the day, knowing they use it to buy pot, or going to talk to the teacher to make sure they don’t get a bad grade, even though their bad test score was due to drinking, or calling your husband’s work to explain he’s sick today, when he’s actually hung over. These are examples of doing something “nice” for your loved one that actually (from a behavioral reinforcement standpoint) might increase the frequency of the negative behavior, not decrease it. The logic: if they act badly, and nothing happens, or something good happens, this behavior is encouraged, even if what you are doing is “nice”. This IS enabling, and this is not helpful in changing behavior in a positive direction.
But everything nice is not enabling! And that’s the quicksand we have developed in our culture. Staying connected, rewarding positive behaviors with positivity, being caring and loving; these things are critical to positive change. So what’s the difference? Continue reading →
SMART Tools Help Families & Friends Cope with a Loved One’s Addiction ~Kathy Lang, SMART Recovery Online Facilitator
“People used to tell me I was enabling my adult son…..and, not helping my own sanity and/or serenity. With the SMART tools and the support of F&F, I’ve changed that, and am able to let him experience the consequences of the way he chooses to live his life. I have to admit, I was also exhausted, angry and resentful, as well…..and, that actually helped me ‘follow through’ and use the Tools and step back out of the way. I’m happy to say that I can see it working a lot of the time…….and I feel better! ~ LYL
“I am so thankful for this meeting! For the first time I feel like I am actively supported and have some tools to help me CHOOSE. ~Lira Z
These are comments made during Family & Friends (F&F) online meetings. Feedback from participants–parents, spouses, adult children, significant others of all kinds–confirm how SMART Recovery tools for F&F can help a concerned significant other (CSO) learn to more effectively manage their responses to the addiction of a loved one.
SMART F&F meeting facilitator Roxanne Allen says “SMART tools are the centerpiece of the Family & Friends program. Like all SMART meetings, our discussions are not problem-focused, they are solution-focused.”
‘TwoPutts’, one of the first F&F facilitators, says “Since we started the Family & Friends online meetings three years ago, I have watched them grow into a vital element of SMART Recovery. The information in the Family & Friends Handbook, particularly the tools, has proven to be successful in quickly assisting those who had previously found little help in facing their challenging situations.”
As a more recent online meeting facilitator, I discovered fairly quickly that the practical help that SMART tools provide is an important reason for the meetings’ success. Each meeting Continue reading →
Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening
Reviewed by Henry Steinberger, Ph.D.
To help people seeking sobriety for their loved ones, Get Your Loved One Sober offers a revolutionary program: The Community Reinforcement And Family Training (CRAFT) intervention. The subtitle, Alternatives to Nagging, Pleading, and Threatening more aptly describes what this book is about. Getting a loved one into treatment is not the first goal. Arranging for one’s own safety and finding a happier life independent of the drinker’s situation, takes priority. Getting a loved one to moderate, choose sobriety, or go into treatment, are offered as roads to a better relationship.
Still, CRAFT can boast phenomenal success getting people into treatment. An alternative to Al-Anon’s 12-Step tradition and “detachment” recommendations and the Johnson Institute’s confrontational interventions, the CRAFT program is based on non-confrontational behavioral principles like reinforcement. It gives the reader tools and instructions for changing their interactions with their loved ones, which in turn changes the loved one’s behavior. In repeated clinical trials, CRAFT proved twice as likely as the Johnson Intervention and six times as likely as Al-Anon to get loved ones into treatment.