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How Our Occupational Therapists Help Trauma Patients

Most of us take for granted our ability to complete the most basic steps associated with self care and social engagement. We never really consider that brushing one’s teeth, taking a shower, or having even the briefest social interaction with a stranger may be an emotionally strenuous task for some individuals. Naturally, when a person suffering from post traumatic stress disorder (PTSD) tries to explain the difficulty they experience executing daily tasks, it is not uncommon for them to be met with objections or to have their issues dismissed and be told to simply “get over it.” This advice is in no way helpful to the firefighter who is triggered by the sound of their own children crying, after witnessing children dying in a fire while on the job. And this certainly does nothing to assist the war veteran who relives moments on the battlefield everytime they hear the sound of aircraft overhead. From the decades of research on PTSD, one thing is abundantly clear—avoidance is not a viable option. Enter occupational therapy.

What Is Occupational Therapy?

Occupational therapy is a form of treatment for individual suffering from addiction or mental health disorders that interfere with their ability to perform daily tasks associated with living a normal, healthy. Occupational therapy focuses on three main areas:

Occupational therapists will often try to restore a patient’s self-confidence by breaking down big tasks into smaller, more manageable subtasks for the patient. This approach prevents the patient from feeling overwhelmed and gives them a sense of achievement by proving a series of small wins that bring them incrementally closer to achieving a big goal.

Symptoms of Post-Traumatic Stress Disorder

The biggest commonality among first responders, veterans, and survivors of abuse with post-traumatic stress disorder (PTSD) is that it impairs their abilities to move forward after the traumatic event. PTSD symptoms create severe psychological limitations that promote self-destructive behaviors. Through repetition, these behaviors become habits that an individual will feel unable to control, much less stop. PTSD symptoms are usually grouped into four categories:

In his book, The Evil Hours: A Biography of Post-Traumatic Stress Disorder, David J. Morris describes the aftermath of trauma as follows:

Trauma destroys the fabric of time. In normal time you move from one moment to the next, sunrise to sunset, birth to death. After trauma, you may move in circles, find yourself being sucked backwards into an eddy or bouncing like a rubber ball from now to then to back again. … In the traumatic universe the basic laws of matter are suspended: ceiling fans can be helicopters, car exhaust can be mustard gas. 

Understanding Your Emotions Helps Manage Symptoms

Our emotions are an important part of our individual growth and development. They can help us with everything from situational awareness to establishing healthy relationships. Distinguishing between an appropriate emotional response and a dysfunctional one can be a challenge for individuals with post-traumatic stress disorder (PTSD). Our occupational therapists teach patients principles and skills to help them better understand their emotions:

The process of working with occupational therapists is both collaborative and goal oriented, making it easy for patients to track their progress.

The Wise Mind: Balancing Emotion and Reason

When we are in our emotional mind, our actions are predominately based on our emotions and how we are feeling. Our response to stress or triggering situations is extremely reactive as we abandon logic, fact, and reason when our emotional mind has taken over. An example of your emotional mind taking over is when you overreact to a situation because it triggers a negative memory of a similar situation; your fear that something similar to your memory may happen again drives your overreaction, even if it is actually extremely unlikely.

We would all like to believe that we operate from our reasonable mind, however this is not always the case. The reasonable mind is the part of us that is based solely on logic and rational information. It gathers and interprets empirical information from our observations and forms beliefs and opinions based on that information. If drives actions that are are cool, controlled, and strategic. The reasonable mind is very useful in crisis situations. Many military personnel and first responders can tell you, being able to access the reasonable mind when you need it can be the difference between life and death. The reasonable mind is excellent for planning and evaluating big life decisions, however, it is possible to overdo it and fail to recognize and consider the significance of our emotional signals. Overuse can create habits such as minimizing our feelings, and compartmentalizing events that could be pivotal to our development by diminishing our emotional connections to them. Such habits could lead to depression, burn out, or feeling numb.

The wise mind is the integration of the reasonable mind and the emotional mind. It is a functional blend of strategic thinking guided by healthy emotional awareness. It is the capacity to consider past experiences, current perceptions, and theoretical knowledge, to arrive at a constructive understanding of one’s present situation. Our occupational therapists teach our patients techniques to make the wise mind more easily accessible and available to help them manage their trauma symptoms.

Problem Solving: Barriers and Strategies

Problem solving can be difficult for the average person on any given day. It requires us to use all aspects of our mental capacity to analyze a particular set of circumstances and available choices, and then produce a solution. An ideal solution would not only satisfy our immediate need, but would also be consistent with our long-term goals. This process can be extremely difficult for individuals suffering from mental health or substance use disorders as they may not trust their own judgement and or accuracy in assessing a situation.

Barriers to Effective Problem Solving

The first step that our occupational therapists take with patients is to help them identify common barriers to solving problems quickly and effectively, including the following:

Strategies for Effective Problem Solving

Occupational therapist also teach patients a range of effective problem-solving strategies that can be used in different situations, including the following:

Subjective Unit of Distress Scale and Coping Strategies

It can be very difficult for those suffering from substance use and mental health disorders to clearly recognized and understand how they are feeling at any given time. Occupational therapists provide patients with tangible metrics to help them the recognize, isolate, and react appropriately to negative stimuli. The Subjective Unit of Distress Scale (SUDS) works as an emotional gauge, and is a crucial part of therapy. The SUDS protects patients from their more destructive emotions by teaching them practical ways to distract themselves from what they are feeling. The objective is to turn this distraction, which may be unusual to the patient in the beginning, into their habitual response to extreme stressors.  

Occupational Therapists Help Patients Get Back to Their Lives Faster and Better

Recovery from post-traumatic stress disorder is a difficult process that requires hard work and commitment from the patient. Occupational therapists help facilitate this process and allow patients to return to their normal lives more quickly, with effective coping skills, useful habits, practical knowledge, and effective problem-solving strategies.

Call Us for More Information

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

Integrated Treatment of Substance Use Disorders and Concurrent Post-Traumatic Stress Disorder (PTSD) Is The Most Effective Approach

Post-traumatic stress disorder (PTSD) can develop after an individual has been exposed to a traumatic event such as death, serious injury, or a threat of harm to themselves or to others. When exposed to such events, it is normal to feel intense fear, helplessness, and horror, but in most cases, these feelings are eventually resolved—but, unfortunately, not always. Some people experience long-lasting and intrusive symptoms such as disturbing flashbacks, heightened states of arousal, mood disturbances, and avoidance of memories about the event. These are the symptoms associated with PTSD.

Post-traumatic stress disorder (PTSD) is more common than you might think. An estimated 1-in-10 Canadians will experience PTSD at some point in their lives. Certain populations are at higher risk of developing PTSD because they are more likely to experience traumatic events. Members of the military are often seriously injured, witness the death or injury of others, and have their lives seriously threatened. Many veterans returning from Iraq and Afghanistan report being targets of enemy gunfire, knowing someone who was injured or killed, or even having to handle dead bodies. Such experiences can have a lasting effect on an individual’s mental and emotional well-being.

There appears to be a bi-directional causal relationship between developing post-traumatic stress disorder (PTSD) and developing a substance use disorder. People with PTSD experience persistent and disturbing psychological symptoms, which make them more likely to use alcohol or drugs as coping mechanisms. Conversely, people with substance use disorders are both more likely to experience traumatic events and less likely to be able to process them effectively.

Compared to either disorder alone, concurrent post-traumatic stress disorder (PTSD) and substance use disorders are associated with worse mental and physical functioning, and higher levels of psychological distress. When these two disorders are concurrent, the negative effects can be quite severe: they can impair a person’s ability to work, to maintain healthy relationships, and to maintain a positive outlook on life. As a result, people with concurrent PTSD and substance use disorders will often experience rapidly deteriorating physical and mental health, and should therefore get treatment as soon as possible.

There are several treatment options available for individuals with concurrent post-traumatic stress disorder (PTSD) and substance use disorders, including both medical therapy and psychotherapy. Historically, treatment focused on resolving the substance use disorder first, before proceeding to address the PTSD. However, the historical approach risks exacerbating a patient’s PTSD symptoms: when a patient with PTSD narrowly focuses on trying to resolve their substance use disorders, they are likely to be confronted with challenges and discomfort for which they are not yet adequately prepared. Today, however, most clinicians recognize that patients’ substance use is closely related to their PTSD symptoms. Hence, at EHN Canada, we believe that the most effective treatment approach is through integrated treatment programs that address both disorders together.

EHN Canada’s integrated treatment model acknowledges the fundamental interdependence between post-traumatic stress disorder (PTSD) and substance use disorders. Therefore, we address the two disorders at the same time, usually within the the same treatment program. Substance use disorders are conceptualized as tools—albeit highly dysfunctional ones—that people use to try to manage their PTSD symptoms. We educate patients and provide them with a new, healthier, and more effective set of tools, early on in their treatment programs. This reduces the likelihood that a patient’s PTSD will compromise their recovery from their substance use disorders. Our conviction that the integrated treatment model produces superior outcomes is also supported by patients’ attitudes: research has found that patients with concurrent PTSD and substance use disorders report an overwhelming preference for the integrated approach.

Post-traumatic stress disorder (PTSD) and substance use disorders have a complex interrelationship. EHN Canada treatment programs teach patients how to recognize and manage their symptoms and triggers. We also help patients create solid recovery plans that serve to guide their long-term behaviour changes. EHN Canada’s individualized treatment programs also push each patient to discover their own unique strengths and skills. We encourage and support our patients to further develop these abilities to support their successful recoveries and recovery maintenance. Patients complete EHN Canada treatment programs having developed functional and adaptive coping strategies, as well as assertiveness and effective communication skills. They walk out our doors ready to face the world, full of optimism, and eager to get back to their relationships, families, friends, and careers.

Call Us For More Information About Our Programs

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

How Healthy Eating Can Help You With Addiction Recovery

Written by Munis Topcuoglu, Editor at EHN Canada.

Healthy eating helps you with addiction recovery by allowing your mind and body to work better and heal faster.  It helps you maintain your recovery by supporting your mind and body to function well consistently, thus maintaining your good health. Eating a healthy diet helps you with addiction recovery in a number of specific ways such as stabilizing your mood, improving your focus, increasing your energy, and making you better at resisting cravings for addictive substances and behaviors.  Conversely, nutrient deficiencies can make addiction recovery more difficult by making you more susceptible to depression, distraction, fatigue, and cravings. Substance use disorders can make you are especially vulnerable to nutrient deficiencies, for a number of behavioral and biological reasons—but healthy eating can help correct your nutrient deficiencies and greatly improve your odds of successfully achieving recovery and maintaining it long term.

Healthy Eating Means Getting the Right Nutrients and Calories in the Right Quantities

Your mind and body use up nutrients and energy constantly, so healthy eating requires that you get sufficient nutrients and energy regularly from the foods you eat.  Healthy eating means getting enough of all the nutrients you need to function well and be healthy, but not excessive amounts of any nutrients that would be enough to harm you.  Healthy eating also means getting enough calories (energy) that you need for performing healthy physical activity and maintaining a healthy body weight, but not so much that it would cause you to gain an unhealthy amount of body fat.

There are two main categories of nutrients, macro-nutrients and micro-nutrients.  Macro-nutrients are basic building blocks and energy sources for your body; you must get them in relatively large amounts, such as 10’s or 100’s of grams per day.  In comparison, micro-nutrients have specialized functions in your body; you need them in much smaller amounts, such as micrograms or milligrams per day.

Macro-nutrients

The three macronutrients are protein, fat, and carbohydrate.

Protein

Protein is used for building and repairing all the cells in your body.  It is especially important for muscle and connective tissue, but is also necessary for producing hormones and neurotransmitters.  Proteins are composed of amino acids. There are some amino acids that your body needs but cannot produce: these are called “essential amino acids.”

Fat

Fat is a preferred energy source, but is also essential for your nervous system, building cell membranes, and producing hormones.  There are some fats that your body needs but cannot produce: these are called “essential fatty acids.”

Carbohydrate

Carbohydrates are an optional energy source.  Appropriate carbohydrate intake depends on your physical activity levels and your genetics.  Excessive carbohydrate intake can disrupt your metabolism, cause you to gain unhealthy body fat, and lead to diabetes and cardiovascular disease.

Micro-nutrients

The two main groups of micro-nutrients are vitamins and minerals.  Vitamins are organic molecules and minerals are chemical elements.  Each vitamin and mineral has specialized roles within your body and they are all required in small amounts for your mind and body to function properly.  Your body cannot produce vitamins or minerals.

Essential nutrients and healthy foods

Essential nutrients are nutrients that your body requires to function properly but cannot produce, they are the following: essential amino acids, essential fatty acids, vitamins, and minerals.  Since your body cannot produce them, you must get them from the food you eat.

Healthy eating means getting all the essential nutrients that you need.  Therefore, healthy foods are foods that contain high amounts of essential nutrients; they are usually whole, unprocessed, and fresh.  In contrast, unhealthy foods contain low amounts of essential nutrients and are often refined, processed, and contain preservatives.

Addiction Makes It Difficult to Eat Healthy, Often Resulting in Nutrient Deficiencies

Addictive substances and behaviors can make healthy eating more difficult in a number of ways.  They can also prevent you from getting enough nutrients despite a normally healthy diet. When you don’t get enough of a particular essential nutrient in your body, you develop a nutrient deficiency.  Addictive substances can interfere with healthy eating and cause nutrient deficiencies in the following ways.

Reducing your appetite

When your appetite is reduced and you regularly eat less food, you might not get enough nutrients and energy even if the foods you eat are normally healthy foods.

Increasing cravings for unhealthy foods

When you have cravings and eat a lot of unhealthy foods, it can be difficult to get all the nutrients you need, since unhealthy foods contain low amounts of essential nutrients.

Reducing how well you absorb nutrients

Getting enough nutrients requires that you absorb the nutrients from food in your digestive system.  Since some addictive substances can reduce your ability to absorb nutrients, you might not get enough nutrients even if you have a normally healthy diet.

Depleting nutrients in your body

Getting enough nutrients means that the amount of each nutrient you get equals the amount your body uses up.  Some addictive substances can cause your body to use up nutrients in much larger quantities than normal, or they can destroy nutrients in your body.  When either of these happens, you might not get enough nutrients even if you have a normally healthy diet.

Reduce your motivation to eat healthy

Staying motivated to eat healthy requires maintaining the belief that healthy eating will produce positive outcomes for you.  It also requires the confidence that you will succeed at healthy eating long enough to experience those positive outcomes. Addiction can make it more difficult to maintain a positive outlook on the future and can also negatively affect your confidence.

Take your attention and energy away from your goal of healthy eating

Especially when you first start, healthy eating requires that you pay careful attention to choosing the foods you eat.  Shopping for and preparing healthy foods also usually requires more time and energy compared to unhealthy foods. Addictions can be distracting and take your attention away from healthy eating.  They can also get in the way of healthy eating by draining your time and energy.

Nutrient deficiencies and too few calories

As described above, recovering addicts often do not eat healthy and do not get enough nutrients and calories.  If you are a recovering addict, you may have nutrient deficiencies that are harming your mind and body in ways that make getting sober and staying sober much harder.  A caloric deficit (eating too few calories) can also make getting and staying sober much harder.

Healthy Eating Makes Addiction Recovery Easier—Nutrient Deficiencies Make It Harder

There are a number of factors that are essential for addiction recovery and recovery maintenance.  These factors are positively affected by healthy eating and negatively affected by nutrient deficiencies.

Mood and confidence

A positive outlook and confidence in your ability to overcome challenges makes it easier to accomplish difficult tasks.  Healthy eating can help maintain a stable positive mood whereas nutrient deficiencies can make you more vulnerable to anxiety and depression.  For example, research has shown a relationship between folic acid (vitamin B9) deficiency and depressed mood, and also a relationship between thiamine (vitamin B1) deficiency and decreased self-confidence (Ottley, 2000).

Focus and awareness

Focusing on achieving your goals combined with maintaining awareness of yourself and your environment are very useful practices.  Healthy eating can improve your ability to focus and maintain awareness whereas nutrient deficiencies can make you more vulnerable to distractions.  An example is magnesium deficiency, occurring especially frequently in recovering addicts, which has symptoms including confusion and insomnia (Flink, 1985).

Motivation, drive, and energy

Consistent motivation, drive, and energy are necessary for problem solving and overcoming obstacles.  Healthy eating can help maintain high levels of motivation, drive, and energy whereas nutrient deficiencies can cause you to experience more ups and downs that jeopardize your success.  A well-known example is iron deficiency which can cause apathy and abnormal fatigue (Ottley, 2000).

Experience of cravings and ability to resist them

Feeling cravings less intensely and being able to resist them are both critically important.  Healthy eating can make your cravings for addictive substances and behaviors less intense, it can also strengthen your willpower to resist them.  Conversely, nutrient deficiencies can make your cravings more intense and weaken your willpower. One example is a study which showed that alcoholics treated with a traditional therapy combined with nutritional therapy had less alcohol cravings and were more successful at abstaining compared to alcoholics treated with only traditional therapy (Biery et al., 1991).

Too Much of Certain Macro-Nutrients Can Also Make Recovery and Maintenance Harder

Certain macro-nutrients consumed in excess can harm you and make addiction recovery and recovery maintenance more difficult, a few examples follow.  

Carbohydrate: Sugars

Too much sugars (simple carbohydrates) can cause you to have unstable energy levels, intensified cravings, and lower willpower.  Sugar is a reinforcing substance which has demonstrated cross-sensitization with other addictive substances such as amphetamine and alcohol in rodent models (Hoebel et al., 2009).

Fat: ratio of Omega-6 to Omega-3

Researchers believe that a high ratio of omega-6 to omega-3 (two fatty acids) can increase systemic inflammation which contributes to the development of chronic conditions such as arthritis and cardiovascular disease (Patterson et al., 2012) and also depression (Berk et al., 2013).

Protein: (Any)

Some addictive substances cause kidney damage.  If you have kidney damage, there is evidence which suggests that excessive protein consumption can make it worse (Levey et al., 1996).

For Best Results Make Healthy Eating a Part of Your Addiction Recovery Plan

Healthy eating will ensure that the food you eat is helping your addiction recovery and not holding you back.  It will ensure that the food you eat is protecting you from relapse and not increasing your risk.

Healthy eating is challenging for anyone and to succeed you need a clear plan for how you will start eating a healthier diet and for how you will develop habits to keep eating healthy for the rest of your life.  The following list is a good starting point:

However, each individual’s nutritional requirements are different, due to a wide range of factors.  Professional consultation can help you design a personalized plan for your own specific needs and develop a deeper understanding of your unique nutritional requirements.

EHN Canada Facilities Can Help You Eat Healthy, Achieve Recovery, and Maintain It

The comprehensive drug rehab and other treatment programs at EHN Canada facilities include nutrition planning through consultation with our staff dietitians.  Our nutrition planning aims to get you eating healthy with the following objectives for successful long-term addiction recovery:

Please Call Us for More Information

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

Online Treatment and Support

If you’d like to learn more about our online treatment and support options, please call us at 1-800-387-6198 or visit onthewagon.ca.

Further Reading About How Specific Nutrients Can Help Addiction Recovery and Recovery Maintenance

Protein Part 1

Protein Part 2

Fat

Carbohydrate

Sugar (video)

Vitamins & Minerals

References

Berk, M., Williams, L. J., Jacka, F. N., O’Neil, A., Pasco, J. A., Moylan, S., … & Maes, M.
(2013). So depression is an inflammatory disease, but where does the inflammation come from?. BMC medicine, 11(1), 200.

Biery, J. R., Williford, J. J., & McMullen, E. A. (1991). Alcohol craving in rehabilitation: assessment of nutrition therapy. Journal of the American Dietetic Association, 91(4), 463-466.

Flink, E. B. (1985). Magnesium deficiency in human subjects—a personal historical perspective. Journal of the American College of Nutrition, 4(1), 17-31.

Hoebel, B. G., Avena, N. M., Bocarsly, M. E., & Rada, P. (2009). Natural addiction: A behavioral and circuit model based on sugar addiction in rats. Journal of Addiction Medicine, 3, 33-41.  

Levey, A. S., Adler, S., Caggiula, A. W., England, B. K., Greene, T., Hunsicker, L. G., … & Teschan, P. E. (1996). Effects of dietary protein restriction on the progression of moderate renal disease in the modification of diet in renal disease study: modification of diet in renal disease study group. Journal of the American Society of Nephrology, 7(12), 2616-2626.

Ottley, C. (2000). Food and mood. Nursing Standard (through 2013), 15(2), 46.

Patterson, E., Wall, R., Fitzgerald, G. F., Ross, R. P., & Stanton, C. (2012). Health implications of high dietary omega-6 polyunsaturated fatty acids. Journal of nutrition and metabolism, 2012.x

Will AA’s 12-Steps Work For Me?

Written By: Brent Lloyd, BSW, MA, Clinical Manager, EHN Calgary Outpatient Clinic

A Touch of Controversy

Questions about the effectiveness of the 12-Step Alcoholics Anonymous and whether it’s a bonifide approach to addressing recovery from addiction still remain. These questions can create uncertainty about whether or not the 12-Steps program is right for you or if it will work.

Authors, such as Dr. Lance Dodes who published a few years ago, “The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry” used key studies to support his opinion that AA didn’t work.

In the last couple of years, new research studies demonstrate that the 12-Steps do work and help people remain in recovery. A study published this year in the Journal of Health and Human Services Administration looked at the effectiveness of the 12-Steps in helping someone remain abstinent after they’d been through a substance abuse treatment program at the one year mark and five year mark. The results found that “12-Steps or self-help program have a higher success than cases not in a program for the 1-year follow up… Comparing the percentages we can conclude that the probability that an individual relapses is smaller for those who are part of the 12-Step program.”[1]

My Point of View

Before we get started, let’s first look at how open and willing we are to look at both pros and cons of Alcoholics Anonymous. Easier said than done. I believe we all have biases and that does not have to be a negative thing as long as we are willing to be honest about how and why we came about these biases.

For instance, I have met and had the privilege of hearing how scores of people in recovery from addiction whom now speak highly of AA, but at the beginning were angry, defiant and skeptical about this approach. I was one of them.

I have found that when wanting to get high our drunk I would go to any lengths to make this happen. I learned that I needed to be earnestly willing to put in at least half that energy. That’s where AA became the chief reason that helped not only solve the drinking problem I had, but my emotional, health, spiritual, physical and emotional.

Essentially, you need to participate on a regular basis and “work” the 12-Step program if you want to see results. Recently, in Drug and Alcohol Dependence, a study looked at the recovery benefits of the “therapeutic alliance” among 12-Step mutual-help organization attendees and their sponsors. The results from this study showed that almost 69% of participants that had a sponsor, remained in contact with them and had a strong sponsor alliance were “significantly associated with greater 12-Step participation and abstinence, on average, during follow-up. Interaction results revealed that more sponsor contact was associated with increasingly higher 12-Step participation whereas stronger sponsor alliance was associated with increasingly greater abstinence.” [2]

Let me be clear. AA is not a cure all. Those words are from the AA big book. I would humbly ask any person struggling with addiction to look at all options, many people who have recovered via the AA route will tell you themselves that they had tried many approaches before going through the doors of an AA meeting.

You Be The Judge

In conclusion, only you can answer the question is AA right for me. However, before you rule it out as an option, please give it an earnest evaluation. Recovery is not for the faint of heart and walking through any recovery program requires one to look within. Not an easy task when we put down our mood altering chemicals. I am bias- yes. However, 19 years of ongoing recovery has inspired me to remember where and why I am sober.  I would not be where I am today without this life changing fellowship of AA.

Regards, Brent Lloyd, BSW, MA, Clinical Manager, EHN Calgary Outpatient Clinic

Brent_Calgary_300pxBrent is a registered social worker with a degree from the University of Victoria and a Master of Arts in Leadership from Royal Roads University. With several years of experience as a counsellor in both inpatient and outpatient settings, Brent is passionate about guiding and assisting individuals and their loved ones through the struggles of addiction.

 

 

 

Bellwood is Accredited With Exemplary Standing by Accreditation Canada

Accreditation LogoBellwood is pleased to share with you the exciting news that we recently completed our accreditation process and have received the highest level of certification from Accreditation Canada: Accreditation with Exemplary Standing. This award level is a repeat of our 2012 achievement and reflects our continuing commitment to quality and services to our clients.

Bellwood May 2016 Staff Photo Accreditation

As part of the accreditation process, Bellwood was evaluated on 417 safety and quality standards, and met each one of these standards.  Quality dimensions included:

 

Bellwood is committed to providing excellent care and service to our clients, their families, and our community partners.  Our commitment to quality is long-standing, and is reflected through our membership in the Edgewood Health Network, Canada’s first truly national organization for addiction treatment services.

We will strive to continue to deliver high quality care and services to individuals and families dealing with addictions, substance abuse, eating disorders, concurrent trauma issues, and other related problems, and are excited to announcement that we will be re-locating to a newly renovated, state of the art facility in the Fall of this year.

For more information about Bellwood’s accreditation or re-location, please contact us at 416-495-0926/800-387-6198, or [email protected].

Challenging Those Addiction Symptoms That Can Linger After You Stop Drinking

photo-1463062511209-f7aa591fa72f“This is WHO I AM! Why are you trying to change me? I stopped drinking!” Sound familiar? Statements like these are examples of what people might say who’ve stopped drinking but continue to behave as if they were still drinking or using. You see, becoming sober is just one part of addiction recovery. This behaviour is commonly referred to as untreated sobriety.

It’s important to recognize this behaviour because it usually presents itself as anger and resentment. These emotions are triggering for your recovery. The anger and resentment are usually a result of not being able to accept that you can no longer use substances to feel better. In essence, what you may be experiencing is grief over the loss of your drug of choice.

We spoke to Kim Holmgren, Addiction Counsellor at Bellwood Health Services to discuss what “dry drunk syndrome” looks like. Kim Holmgren teaches a session on untreated sobriety every few weeks at Bellwood to clients and has been with Bellwood’s clinical team for over three years. Kim Holmgren states, “Although a person may not have used or acted out in years they may still have never had a sober day. So not using or acting out is definitely a part of addiction recovery, but in itself, it is not recovery.” Moving from a stage of loss to acceptance can make all the difference of how you feel. If you’re having a difficult time accepting the loss of drugs or alcohol, this can keep you stuck in a nasty state of bitterness.

Kim Holmgren shared with us a list of symptoms or some things you might say when you have untreated sobriety:

  1. Low self-esteem
  2. Can’t live in the moment.
  3. “I don’t like myself.”
  4. “What do they think of me?”
  5. “Am I good enough?”
  6. “Nobody understands me.”
  7. “You don’t get it.”
  8. Tomorrow I’ll smarten up.
  9. I don’t fit in.
  10. Maybe I can control it?
  11. One isn’t going to hurt…or is it?
  12. But it is different now.
  13. I feel so much better
  14. I don’t feel any better.
  15. I still feel crappy.
  16. “I’ll stay off the hard stuff!”
  17. Why does everything always happen to me?
  18. I never get a break.
  19. If they don’t trust me, why am I doing this?
  20. It’s not going to help if I call someone.
  21. I’m different.
  22. I don’t care.
  23. It’s MY LIFE!

Kim Holmgren states that all these symptoms or sayings are often said by individuals by people who aren’t in recovery too, but the difference is that this type of thinking and behaviour is dangerous for a person who is in recovery. “Those who quit using or acting out and are still angry about it usually wind up living miserable lives and usually make everyone around them feel miserable too. Family members or members from a support group are often the first to notice this behaviour. Some people might argue that their loved one or friend is trying to change who they are despite the obvious. Why pay attention to this? Resentment and anger are one of the worst enemies for a person in recovery! Remember, these individuals are not addicted to the substances. The substances are just a solution. If this behaviour isn’t handled properly, it can come back after long periods of sobriety and is usually the first sign of a relapse waiting to happen.”

Recovery Vs. Abstinence/ Not Acting Out

What does recovery look like versus untreated sobriety? Kim Holmgren explains, “Recovery involves working on all of the problems and issues that led you to use in the first place. It requires major lifestyle changes and developing a support group system. You need to work on yourself and fix what was broken. Plain abstinence does not do any of the things previously mentioned.”

Kim Holmgren does mention in a previous blog post that its not always the person’s fault they weren’t able to accept and move forward in their recovery. “Sometimes people have underlying mental health illnesses that haven’t been addressed yet. Other times, it can be environmental stressors and triggers that are overwhelming for someone who is in early recovery.”

Next Steps

According to Kim Holmgren, one of first things you can do to stop this behaviour and move towards acceptance is to get a sponsor, “Get a sponsor and to talk to them. Ask yourself, where are the anger and the resentment coming from? Acceptance is the first step.” Kim Holmgren also suggested to look at Dr. Steven Melemis, PhD, MD’ five rules of recovery published in his book, I Want To Change My Life: How to Overcome Anxiety, Depression and Addiction:

  1. Change your life. You recover by creating a new life where it is easier to NOT use.
  2. Be completely honest. Addiction requires lying. From this day forward, you have to be completely honest, especially with yourself and your recovery circle. As you get more comfortable, the circle can widen. Honesty is always preferable, except where it may harm others.
  3. Ask for help. That includes doctors, therapists, addiction counsellors and people in recovery. Anywhere that will help your recovery.
  4. Practice self-care. Mind-body relaxation is not an optional part of recovery, it is essential. The practice of self-care during mind-body relaxation translates into self-care in the rest of life.
  5. Don’t bend the rules. Don’t look for loopholes in your recovery (quick fix). No change is no change.

If you need to speak to someone about the challenges you are facing in your recovery, please call us at 1-800-387-6198. It’s important that you start to be honest with yourself and ask for help.

Should My Addiction Treatment Program Be Gender-Specific?

‘Should my addiction treatment program be gender-specific?’  It’s one of the questions you might ask if you’re looking at addiction treatment programs or support options for substance use disorder. As addiction treatment providers, we always want to offer the best treatment programs for our clients’ recovery. It’s important that we look at what works and what we can do better.

Research published in the Journal of Substance Abuse Treatment states that “greater effectiveness has been demonstrated by treatment programs that address problems and issues common among substance-abusing women, such as childcare issues, services for pregnant or postpartum women, or histories of trauma and/ or domestic violence.”[1] While research in the Journal of Psychoactive Drugs concludes that appropriate methodologies need to be developed to properly analyze the effectiveness of gender-responsive treatment.[2] So, the question remains: Will it make a difference if my addiction treatment program or substance abuse support program is gender-specific?

What Does Gender-Specific Treatment Look Like?

Gender-specific treatment programs are created to treat only males or females in a specific program. Some reasons why centres state that they use this style is to remove distractions from the opposite sex, it allows patients to feel more comfortable discussing certain issues and experiences. Essentially, the treatment program allows males or females to focus on certain factors or experiences that they share during their treatment program.

Socioeconomic factors related to their male and female genders have an effect on treatment completion rates and duration.[3] It seems women are more vulnerable to stigma than men when seeking treatment because of socioeconomic factors such as being a parent of young children. Women’s addictions are often associated with violence and sexual abuse and/ or risky sexual behaviour. On the other hand men’s addictions are usually associated with legal problems.

What the Edgewood Health Network Offers

Bill Caldwell, Extended Care Supervisor & Chemical Dependency Counsellor at the Edgewood Treatment Centre shares why and how Edgewood provides a co-ed or mixed-gender program for clients. “The decision to make Edgewood a coed program was made very early in the planning stages and is one of the things that makes us a little bit different than many of the other treatment providers. We do this for a variety of reasons, not least of which is the decision that addiction does not discriminate between genders, so neither do we. It also affords some options for therapy and growth that otherwise might not be available. As an example many of our patients have never learned how to have healthy platonic relationships with the opposite sex, and now have a chance to do that in a supportive setting.”

Bill Caldwell shares that there are challenges that come with a mixed gender addiction treatment program. “Coed treatment comes with its own set of challenges. Inappropriate relationships are the obvious shortfall: when we first opened our extended care program. We found quickly that some distance between the male and female residences was a very good idea, especially at night. It also creates some interesting dichotomies: while we do want to encourage our patients to learn more about healthy interactions, we also know that there is a different connection that happens when seeking support and assistance from same-sex peers.”

Finding a Healthy Balance

So the question now is what’s the best choice for treatment? Bill Caldwell believes a balanced approach works best. “We have found that combining the best of both worlds seems to be the winning approach, and we accomplish this by running a variety of gender specific groups alongside our coed programming and groups. These include groups focusing on sexual addiction, trauma, and general men’s/women’s group therapy, but it can also mean that we adapt existing groups to tailor to the needs of the patients. Sometimes we have men or women tell their patient story just to peers of the same gender, especially if their story includes details that would best be supported by same-sex groups.”

According to Bill Caldwell, Edgewood’s balanced approach creates the best possibilities for our clients to recover from drug and alcohol addictions and sexual compulsive behaviour, “There has been a lot of research done about the similarities and differences between men and women in treatment and recovery and the corresponding importance of respecting those similarities and differences. We believe that we have struck a balance that works very well for our patient’s growth and healing, and we will continue to develop new ways of individualizing our treatment process to create the best possible outcomes.”

At the Edgewood Health Network, we support customized treatment and evidence-based research. It’s important to us that you have all the information to make an educated decision about what program to choose. Whether you prefer a mixed program or gender-specific, the Edgewood Health Network has a range of options for you to choose from across Canada. To learn more about our programs visit our website or call us 1-800-683-0111.

Sources:
Brady, K. T., & Randall, C. L. (1999). Gender differences in substance use disorders. Psychiatr Clin North Am, 22(2), 241-252.
Fattore, L., Melis, M., Fadda, P., & Fratta, W. (2014). Sex differences in addictive disorders. Front Neuroendocrinol, 35(3), 272-284. doi: 10.1016/j.yfrne.2014.04.003
[1] Prendergast, M. L., Messina, N. P., Hall, E. A., & Warda, U. S. (2011). The relative effectiveness of women-only and mixed-gender treatment for substance-abusing women. Journal of Substance Abuse Treatment, 40(4), 336-348. doi:10.1016/j.jsat.2010.12.001

[2] Grella, C. E. (2008). From generic to gender-responsive treatment: Changes in social policies, treatment services, and outcomes of women in substance abuse treatment. Journal of Psychoactive Drugs, 40(sup5), 327-343. doi:10.1080/02791072.2008.10400661

[3] Grella, C. E. (2008). From generic to gender-responsive treatment: Changes in social policies, treatment services, and outcomes of women in substance abuse treatment. Journal of Psychoactive Drugs, 40(sup5), 327-343. doi:10.1080/02791072.2008.10400661

A Healing Path for All: The Importance of a Family Aftercare Program

family sitting in a fieldAddiction is a family disease. It doesn’t affect just one person in the family; it affects everyone in the family. You’ve probably heard this statement many times or perhaps you’ve never thought of addiction in this way. Well, it’s very true and although the other family members are not addicted they still experience pain, loss, and turmoil.

Addiction has a way of creating tension and conflict that leads to problems for family members about how to cope with the person’s addiction and the effects on the family unit.[1] An American study was conducted on over 25,000 family members of someone with substance use disorder (SUD), matched to family members of someone with diabetes, asthma or a control group of family members where there was no SUD  nor chronic physical illness. The results were that in the year prior to diagnosis of the main patient, family members of those with SUD were more likely to themselves be diagnosed with mental illnesses including depression or trauma than those in the diabetes or asthma groups.[2]

Most people have trauma as a result of living with someone that has an addiction. Dealing with violence, emergencies, police and ambulance situations, verbal or physical abuse, mental abuse, worrying about someone else’s life or death all the time without the power to change it, being lied to or being blamed are all experiences that can create distress and leave people emotionally overwhelmed.

What starts off as trying to help your family member who’s struggling with drugs or alcohol (because it feels like it’s the right thing to do) often ends up becoming a life’s mission. Susan Barnes, Addiction Counsellor and Supervisor of Volunteers at Bellwood Health Services agrees, “Family members may not realize it because they are so focused on the addict.”  Loved ones dedicate every last breath and strength towards managing the unmanageable. They feel the need to fix everything. Resentments grow, isolation becomes the norm and boundaries become a thing of the past.

Support is Necessary for Family Members Too

Trying to change the behaviour of a person who’s been struggling with addiction takes time, support and professional treatment. So why wouldn’t it be the same for a family member? Family members take on roles and responsibilities as a way to cope with the chaos that comes with addiction. At Bellwood Health Services, family members are encouraged to attend the Family Program. The Family Program is designed to help family members understand what addiction means and how change is possible; there is a light at the end of the tunnel.

The Family Program is the first step towards recovery for family members. Think of the Family Program as the renovation of a building that holds new skills, education and goals. The Family Aftercare Program is maintenance for that newly renovated building.

Susan Barnes believes it’s important for family members to continue to receive support once their loved one has completed an addiction treatment program, “Family members need to heal from the trauma and the after effects of living with the addiction. It’s a long term process and it requires all parties to heal first before they are ready to heal the relationship.”

Research by the University of Birmingham states that “Good quality social support, in the form of emotional support, good information, and material help, is an invaluable resource for affected family members, supporting their coping efforts and contributing positively to their health.”[3] Bellwood’s aftercare program is just that according to Susan Barnes, “Family Aftercare has always been an integral part of the Bellwood Treatment Program. Addiction is the disease of the addict which can only be healed by the addict. However, the family can play a significant role by supporting the recovery behaviours and not enabling the addictive patterns. This requires education, a lot of practice and support for the family members before they are able to provide the healing environment.”

Providing a Healing Environment

Susan Barnes states that the healing environment has many layers. During family aftercare, loved ones learn facts about addict behaviours and addictions. Family members begin to comprehend how their own participation in the dynamic develops. Essentially, loved ones will learn about what is helpful and not so helpful in recovery.

There is something very powerful and healing that can come from a group of people that share the same experience. The following are some of the reasons why Susan Barnes believes group aftercare for family members works:

  1. Being with people who understand you.
  2. Being able to talk about things they normally hide.
  3. Non-judgemental environment.
  4. Hearing about experiences of others so they can learn from them.
  5. Finding hope and support.
  6. Finding self-esteem and confidence again.
  7. Developing your own voice.
  8. Learning to take care of their emotional needs.

 

Bellwood Family Aftercare Program

It doesn’t matter if you have a loved one in any of Bellwood’s substance abuse treatment programs or not, anyone is welcome to attend the Family Aftercare Program. Bellwood’s Family Aftercare Program can run up to two years facilitated by an addiction counsellor. Years 3, 4 and 5 are self-facilitated groups as they have much more insight and experience with addiction recovery. Group fees decrease with each year.

Whether it’s through a Bellwood family aftercare program or Al-Anon, participating in a continuing support program is important to move forward in your own recovery and to support your loved one.

If you’d like to learn more about this program or are interested in registering for this program, please call us at 1-800-387-6198 or email us.

[1] Copello, A., Templeton, L., Orford, J., Velleman, R., Patel, A., Moore, L.. . Godfrey, C. (2009). The relative efficacy of two levels of a primary care intervention for family members affected by the addiction problem of a close relative: A randomized trial. Addiction, 104(1), 49-58. doi:10.1111/j.1360-0443.2008.02417.x

[2] Copello, A., Templeton, L., & Powell, J. (2010). The impact of addiction on the family: Estimates of prevalence and costs. Drugs: Education, Prevention and Policy, 17(s1), 63-74. doi:10.3109/09687637.2010.514798

[3] Copello, A., Templeton, L., Orford, J., Velleman, R., Patel, A., Moore, L.. . Godfrey, C. (2009). The relative efficacy of two levels of a primary care intervention for family members affected by the addiction problem of a close relative: A randomized trial. Addiction, 104(1), 49-58. doi:10.1111/j.1360-0443.2008.02417.x

 

Is There a Relationship Between ADHD and Substance Use Disorder?

Written by: Dr. Charles Whelton, MD, FRCP(C ), ABAM

During their initial psychiatric evaluation at Edgewood, patients often describe a lifelong history of poor attention, hyperactivity and distractibility.  Many patients wonder if they have attention-deficit/hyperactivity disorder (ADHD), and ask if this could be tested for, and treated if it is present, while they are at Edgewood.

The relationship between ADHD and substance use disorder (SUD) is one that has significant clinical importance.

ADHD is an illness characterized by a persistent pattern of inattention and/or hyperactivity-impulsivity, beginning in childhood, and causing functional impairment in social, academic or occupational settings.  Difficulty in sustaining attention is often the cardinal feature, but patients may also display disorganization, distractibility, forgetfulness, or failure to complete tasks.  Hyperactivity may be manifested by fidgetiness, restlessness, difficulty in remaining seated, excessive talking, or simply always being ‘on the go’, as if ‘driven by a motor’.  Impulsivity may present as impatience, interrupting others excessively, or engaging in activities without consideration of possible consequences.  Persons with ADHD may get bored easily, and consequently may frequently look for new experiences.  Paradoxically, individuals with ADHD may focus well or even hyperfocus, when the task is something that they are interested in.  Longitudinal data suggest that childhood ADHD persists in 50% of cases into adulthood.

Higher than expected rates of ADHD are found in populations with SUD.  Although ADHD affects 6-9% of children, and up to 5% of adults worldwide, fully 25% of adults with SUD have ADHD, with an earlier onset and more severe SUD associated with the presence of ADHD.  Conversely, approximately 20-40% of individuals with ADHD have a lifetime history of an SUD.  Prospective studies of ADHD children have provided evidence that ADHD itself is a risk factor for SUD. Children with ADHD who also have co-occurring conduct disorder or bipolar disorder seem to have the poorest outcome with respect to developing SUD.

There is some controversy about the effects of early ADHD treatment on the development of SUD.  An aggregate of the literature suggests that early stimulant treatment of ADHD reduces or delays the onset of SUD; however, the protective effect is lost in adulthood.  This may be due in part to adolescents stopping their ADHD treatment in later adolescence and young adulthood, and therefore losing the protective effect of this treatment.

The precise reason why individuals with ADHD develop SUD remains unclear. It has been proposed that some people with ADHD ‘self-medicate’ with substances, to treat their ADHD.  When substance abusing adolescents with and without ADHD were compared, adolescents with ADHD reported using substances more frequently to attenuate their mood and to help them sleep.  No overall differences in types of substance used emerged between these groups however.

Symptoms need to be assessed carefully before making a diagnosis of ADHD, particularly in persons with SUD.  Some ADHD symptoms are similar to symptoms that can be associated with SUD.  Attention problems can occur in some substance withdrawal syndromes, for instance.  Furthermore, some individuals may want to be diagnosed with ADHD in order to obtain a prescription for stimulants, and may feign ADHD symptoms. A thorough assessment is required.

The Canadian ADHD Resource Alliance (CADDRA) has designed a useful evaluation package, included in the Canadian ADHD Practice Guidelines.  This includes an evaluation of current symptoms and related functional impairment, as well as retrospective evaluations of childhood symptoms, by both the patient and by an independent observer such as a parent.  Collateral information can be very useful if available, such as past educational records and psychological assessments.  There are many conditions that can mimic aspects of ADHD including anxiety and mood disorders, conduct disorder and oppositional defiant disorder, personality disorders including borderline and antisocial personality disorder, and substance abuse itself.  When in doubt, neuropsychological testing can be helpful.

The treatment needs of individuals with SUD and ADHD need to be considered simultaneously, however, in general, the SUD should be addressed and stabilized first.  Addiction stabilization may require inpatient treatment.  Intervention for ADHD could then be considered in tandem with an addiction treatment program.

Not all patients with ADHD require medication.  Many adults with ADHD have learned ways of coping with their ADHD symptoms, and would prefer to not use medication.  Cognitive and behavioral therapies for both ADHD and SUD have been shown to be effective.  Adults with ADHD may benefit from psychoeducation, coaching or skills training.  However for others, medication can serve an important role in reducing the symptoms of ADHD and in improving functioning.

ADHD adults with SUD, noradrenergic agents (e.g. Atomoxetine) and antidepressants (e.g. Bupropion) should be considered first, to reduce the risks associated with using stimulants in this population.  If this approach is ineffective, extended-release or longer acting stimulants (Concerta or Vyvanse) with lower abuse liability and diversion potential are preferable to the short acting stimulants (Ritalin or Dexedrine), which can be more easily abused.

Regardless of the pharmacotherapy being used, patients with ADHD and SUD should be monitored carefully.  Treatment compliance should be evaluated regularly, and random drug screens performed as indicated.  If stimulants are used, care should be taken to monitor for abuse of the stimulant.  Treatment should be coordinated between all care providers, including family doctors, therapists and addiction counsellors.

When ADHD co-occurs with SUD, treatment for ADHD can help patients to focus and to complete tasks, and to be less restless and impulsive. This may in turn help with the treatment of the SUD.  Not all problems with attention are due to ADHD however, and careful assessment is required.  Furthermore, if ADHD is present in an individual with SUD, careful consideration of management options is essential.

 

(The following paper was the source of much of the information used in the preparation of this manuscript:   Wilens, TE and Morrison, NR.  The intersection of attention-deficit/hyperactivity disorder and substance abuse. Curr Opin Psychiatry, 2011 Jul: 24(4): 280-285.)

 

How Do You Know If Someone Is Addicted to Drugs or Alcohol?

Man drinking beer“I drank too much the other night, that won’t happen again!” “I just need one more hit. I’m fine!”  You may have often heard people you care about say these phrases and not think twice about them- until recently. Perhaps, there have been changes in their behaviour that have you concerned.

Changes in behaviour can be a sign of mental illness or addiction. Unfortunately, many people don’t understand what addiction is or how it develops. Addiction is not something that happens overnight. It’s not something you decide to try as you would decide to try Starbuck’s latest Frappuccino.

The World Health Organization (WHO) states that addiction and mental illness affects approximately 10% of the population at any point in time. WHO also reveals that one in four families has at least one member currently struggling with addiction or mental illness. Addiction has no boundaries.

At Bellwood, we’ve seen all walks of life enter our doors and all of them share the same disease. Many of them have lost, or are on the brink of losing so much because their drinking or substance use has spiraled out of control. How do you define addiction? How do you know if someone’s drinking or drug abuse has become a larger problem than previously believed?

Addiction is the inability to stop using a substance despite the negative consequences experienced. People have many different reasons why they become addicted but there is one thing they do share in common. That is the desire to change the way they feel or in some cases, numb the pain. The feelings they get from using alcohol or drugs are what can lead to substance abuse and eventually result in physical and psychological dependence.

Individuals struggling with addiction may:

 

Other common characteristics of addiction include disconnection and isolation. Trauma or previous experiences in a person’s life may have been the reason why the person turned to substances to medicate unpleasant emotions. As a person plummets deeper into the disease of addiction, isolation becomes more apparent.

Do these behaviours sound familiar? If you’re concerned about a loved one’s drug or alcohol use, or perhaps it is yourself that you’re concerned about, Bellwood has an online quiz for alcohol and drug abuse. Responses to these questions may indicate that you need to talk to an addiction counsellor.

  1. Do you ever get drunk or high alone?
  2. Has drinking or using drugs stopped being enjoyable?
  3. Do you find that your choices of friends are selected based on your alcohol/ drug use?
  4. Do you drink or use drugs to cope with your feelings?
  5. Is it difficult for you to imagine a life without drinking alcohol or using drugs?
  6. Do you plan your life around your use of drugs or alcohol?
  7. Do you drink or use drugs to avoid dealing with the problems in your life?
  8. Are you ever not completely honest about your use of drugs or alcohol?
  9. Have relatives or friends every complained that your use of drugs or alcohol is damaging your relationship with them?
  10. Has your use of drugs or alcohol caused problems with motivation, concentration, memory, and relationships, at work or with your health?
  11. Have you failed to keep promises you made about cutting down or controlling your use of drugs?
  12. Do you feel anxious or concerned about how to obtain more drugs or alcoholic beverages when your supply is near empty?

 

Addiction is a disease that affects many people and is often described as a family disease. It’s important that you consult with a professional to get a better understanding of what’s happening with your family member or with someone you care about. Bellwood Health Services is an addiction treatment centre that provides support and treatment options for individuals, family members and employers.

Talking to someone is an important step towards addiction recovery. Give us a call at 1-800-387-6198 or email us at [email protected] to learn how we can get you started on your path of recovery.

Can Therapy Dogs Play a Role in Addiction Recovery?

Do therapy dogs have a place in addiction treatment? According to a 2015 research initiative by three Canadian universities (University of Regina, University of Saskatchewan, McMaster University) therapy dogs can help people with addiction and mental illness. The study had therapy dogs visit patients at various addictions and mental health treatment centres for six months.

The study found that therapy dogs can help people with mental health, addiction, and trauma concerns. According to this study, “in 2014, the Substance Abuse and Mental Health Services Administration (SAMHSA)  identified six evidence- based principles for service providers to address the consequences of trauma in the individual and to facilitate healing.” These principles focus on supporting recovery, resilience, emotional regulation and relational connection.

It was discovered at the end of the study that the dog’s instincts and “effortless interactions” with participants were in accord with those principles. These principles are:

 

One of the researchers from the University of Regina states that dogs can help patients focus and feel more comfortable to open up during counselling sessions. The interaction with man’s best friend “initiates the release of the hormone oxytocin in humans, which makes us feel good.” Edgewood Health Network last year introduced a therapy dog at each of our addiction treatment centres.

Findlay- therapy dogFindlay, a beautiful Rhodesian Ridgeback trained therapy dog, owned by Cara Heitmann- therapist at Bellwood Health Services introduced him to Bellwood’s inpatient community last December and so far the feedback has been positive. Cara says that clients and staff love having Findlay at Bellwood. “Clients comment on how much they love him, how it brightens their day to see him, and how it helps clients who are missing their pets while they are here.”

Cara believes having a therapy dog like Findlay provides many benefits for clients and clinical staff during therapy sessions and for overall mental health. “Findlay attends group therapy and individual therapy sessions with me because with his mere presence he can calm the room. As for staff, we have a job that can be highly stressful and I have heard many staff members share that seeing Findlay’s face brightens their day and their interaction with him is very soothing.”

Cara remembers a time where Findlay helped a new client entering treatment feel welcomed, “Introducing Findlay certainly has made a difference. An example that immediately springs to mind is a first day client who came to group late due to an orientation of sorts, knocked on the door before entering and was immediately greeted by a smiling face with a wagging tail. I can’t imagine that didn’t ease some discomfort! I have had many, many clients share how Fin has helped them while in treatment and they are shocked that anyone would not just automatically know that. It’s a no brainer.”

According to the Executive Director of National Service Dogs (NSD) in Canada, they’ve received a ton of praise from their clients about the benefits of using service dogs in the treatment of PTSD. Last year, Wounded Warriors Canada donated $50,000 to help fund more certification of service dogs for Canadian Forces members, Veterans and First Responders with Post Traumatic Stress Disorder (PTSD) in BC and Alberta.

In addition, NSD believes animals can lower anxiety, reduce the cost of medication, provide comfort and security for a client and their loved ones. Cara believes therapy dogs work because the connection is different than that with other humans, “It’s less threatening and highly comforting. A dog’s instinct to sense when a person is struggling or having a difficult moment and seeing how they are comforted has no words.”

Colleen Dell one of the researchers that was part of the study last year was amazed to see how consistent the outcomes were from all the centres they had considered. It didn’t matter if they were youth, seniors or groups of people. In their study, therapy dogs had a positive impact on each person’s “healing journey in a multitude of ways, from providing comfort through to increasing therapeutic alliances with service providers.”

Chalmers, research from the University of Regina believes there are still other animals that need to be studied, such as horses to better understand the benefits of service animals. The three universities released their study’s findings during Addictions Awareness Week last year on purpose, “The theme of Addictions Awareness Week this year is ‘Addiction Matters.’ And it is precisely for this reason that our team has stepped outside the box, so to speak, to research an intervention that can potentially support long-term recovery.”

As more research is conducted and more testimonies are accrued, it seems therapy dogs can play a role in helping clients who are in rehab by providing comfort, security and non- judgmental love.  Cara shares, “I am honoured to have Findley work for a number of years. Every time I see that interaction it warms my heart, puts a smile on my face, and makes me proud to be his mom.” At Bellwood it seems Findlay’s natural instincts and interactions continues to have a positive effect on our clients and team.

In our next issue of the Phoenix magazine we discuss in further detail EHN’s valuable experience introducing therapy dogs at our treatment centres. To subscribe to our magazine, please click here.

Want to learn more about our addiction treatment programs and what they include email us or give us a call at 1-800-387-6198.

 

Sources:

Colleen Anne Dell, Nancy Poole, (2015). Taking a PAWS to Reflect on How the Work of a Therapy Dog Supports a Trauma-Informed Approach to Prisoner Health. Journal of Forensic Nursing, Volume 11, Issue 3.

CBC News Saskatchewan

National Service Dogs

CBC News British Columbia

CTV News

The Reality About Group Therapy

Written By Sophia Scholtes, BSc

Sharing thoughts and feelings with a group of strangers. It sounds a little intimidating doesn’t it? As a professional who has been in group therapy sessions, I can tell you that group therapy has many benefits. Having people listen to your problems or feelings can seem intrusive and perhaps, overwhelming at first, but you really don’t know the power of a group therapy until you’ve partaken in it.

Participating in group therapy will offer you a sense of hope as group members can support you by sharing their personal experiences and struggles with you.  You learn how to rely on others for help, a habit which is crucial beyond treatment. Self-reliance leaves room for dysfunctional thinking. In group therapy, people identify unhealthy behaviours in others often what is not obvious in themselves. As people are in different stages of treatment their participation offers a richer therapeutic experience and more therapeutic traction than one to one therapy.

Group therapy offers a safe space for you to work on your problems and emotional struggles. By listening and sharing between people with different backgrounds and personalities, you’ll gain insight into how addiction affects everyone’s lives. In making these interpersonal connections, a perspective is also offered on how your disease is affecting your present behaviours and thinking. The group helps explore these thoughts and behaviours, which have festered in addiction, relating them to their own experiences. People then give feedback on what they are hearing and seeing from each person.

Some behaviours fall outside your own awareness, which is why feedback from a group is essential. Not only can they provide you with a source of second-hand information, but the group allows you to learn about how they react to them and how they can relate to you.

The concept of using group therapy as a tool to help you makes a lot of sense. Notoriously prone to excruciating bouts of insecurity and over-reactions to day to day life situations, addicts are often deemed anti-social. So group therapy work can help you get more comfortable being around people. That offers an alternative to isolation – that all-too- often deadly cousin of relapse.

Lauren Melzack, MSc, CAC, a long time addictions counsellor at Edgewood Treatment Centre in Nanaimo, British Columbia, says group therapy is an invaluable tool for her staff. Patients at Edgewood’s residential centre attend group therapy almost every day for at least an hour.

“Group therapy is particularly helpful for those who deluded themselves into thinking they can do it on their own. One addict does not have the power to fight this disease, neither does one counselor,” says Melzack.

Given that it is a basic human need to belong and function within a network of people, working on relationships and communication in a group is essential in your recovery process. People affected by addiction often grow isolated and disconnected from friends and family. The reality is that you need to learn how to become honest and open in communication. By doing so, you’ll begin to take ownership for how unmanageable your life has become.

Of course that level of honesty is not always easy. It might be difficult for you to discuss your thoughts and feelings openly and trust your group, but group therapy obviously offers a valuable opportunity to overcome your inhibitions. It allows you to practice healthy relationship dynamics. Group, therefore is beneficial to everyone, as attitudes and behaviours are confronted and challenged.

Working through your emotions such as guilt and shame, the group works as an emotional support network for you and everyone else there, while also holding each member accountable across sessions. The group provides a space of understanding and acceptance, rebuilding a lost sense of self-worth. The group therapy environment is a place of emotional healing from trauma or adverse life circumstances. Moreover, as uncomfortable feelings arise in the moment an alternative experience of coping with them is made. The discomfort in those feelings you’re experiencing has often been regulated by drugs, alcohol or unhealthy behaviours and driven addiction in the past. In support of the group, you can learn to express, recognize, and work through the underlying issues at hand.

Melzack says having a qualified facilitator is crucial when it comes to leading group therapy.

“The role of the group facilitator is to avoid traumatizing group members with the information shared. The group is about confronting feelings rather than exploring details of trauma,” she says.

And group is helpful not just for those doing the talking. As you begin to hear about the experiences of others it will become clear that you are not alone. This produces a sense of compassion and empathy, while creating a sense of community and belonging.

Is group therapy suitable for everyone? Arguments could be made either way. The only way for you to find out is if you show up with a willingness to get well and participate in the process. While everyone have their own needs and backgrounds, each is equally valuable in their contribution to the learning process.

Group Therapy is an important part of Edgewood Health Network’s inpatient and outpatient treatment programs. We offer guided group therapy for open honesty in a safe, supportive environment. To learn more about our programs click here or give us a call.

Sophia is a student from Leiden University currently doing her Clinical Psychology practicum at Edgewood Treatment Centre. She is set to earn her Master’s degree in February 2016.