Aftercare and Rehabiliation

Rehabilitation Centers, 12 Step Programs, Therapy

RDD Center is committed to your success. RDD center cannot emphasize enough the importance of aftercare. Some patients feel that 30 or 60 day rehabilitation centers are of great benefit after the anesthesia detox treatment. Others find the 12 step program helpful and continue attending meetings for years. We feel it is important to also seek therapy in your own hometown because this is where you live, where your family and friends are for support, where you spend your time, where you are familiar, where anxiety and problems arise, and this is where you need to stay strong and learn to say “no” when you are confronted with temptation and stress. Regular visits to a therapist in your area are more conducive and convenient and can be an on-going, continued treatment without having to devote a lot of time away from home and work, etc. Therapists cannot prescribe medications and we feel it is good to try and remain drug free and work on more healthy solutions to cope with stress, anxiety, etc. The attitude that “a pill” is needed for everything is sometimes where the addiction started in the first place.

Cognitive Behavioral Therapy-CBT

It is best to find a therapist that is skilled and certified in CBT. You can visit the National Association of Cognitive-Behavioral Therapists website, specifically the CBT Referrals section to find a therapist in your area. CBT is a brief psychotherapeutic approach that hopes to change troubling behavior and dysfunctional emotions and cognitions through a 12-20 week goal oriented treatment. Relapse prevention may require more sessions. Many report this is an enjoyable experience. The sessions start with formulating a plan that the patient is actively involved in the process. Then the work begins of assisting the patient to reorganize dysfunctional thoughts and find ways to change behavior. This is typically done in a collaborative effort from both the patient and the therapist. This dual effort approach helps the patient gain some self control and helps with negative thinking about themselves, others and their future. Typically together they talk about expected outcomes, practice the skills learned and have active role-playing during sessions. Ultimately, the goal of CBT is for the patient to gain the ability to think more positively and productively and to independently address cognitions and behaviors. This encourages the patient to go forth in the right direction by pacing themselves and their thoughts, etc. Thoughts that are automatic are not eliminated but they are understood and restructured. Patients learn to go forward in a more positive direction and to focus on learning skills to improve their behavior and responses.

It is most important to help patients become aware of their actions, be able to gain meaning from their experiences, evaluate their responses and reactions to everyday life. Patients are encouraged to try new ways of reacting both cognitively and behaviorally. It is important to seek therapy from a therapist that sees events from their patient’s perspective. The therapist should be warm and sympathetic and be able to quickly establish a good rapport through genuine concern and care for the patient.

13 “Self Help” Books Highly Rated by Therapists

1. Feeling Good: The New Mood Therapy Revised and Updated
2. How to Stop Worrying (Overcoming Common Problems)
3. Overcoming Anger and Irritability (Overcoming)
4. Managing Anger
5. Overcoming Anxiety (Overcoming)
6. Overcoming Depression: A Step-by-Step Approach to Gaining Control Over Depression
7. Overcoming Obsessive-Compulsive Disorder (Overcoming)
8. The Relaxation & Stress Reduction Workbook
9. Self-Esteem
10. 10 Days to Great Self-Esteem
11. Overcoming Low Self-Esteem (Self-Help)
12. You’ll Get Over It
13. Overcoming Traumatic Stress (Overcoming Series)

Most can be purchased from amazon.com

The Benefits of Working Out

Adopting a regular exercise program is an important part of addiction treatment. Not only does it improve overall health, but exercising also reduces stress and anxiety which many times provoked the addiction in the first place.

Exercise stimulates the production of endorphins; the natural opiates. In a recent study, “the effect you find using aerobic exercise alone in treating clinical depression is similar to what you find with antidepressant medications,” according to Dr. Trivedi, one of the study authors. “The key is the intensity of the exercise and continuing it for 30 to 35 minutes per day.”

Diet

Proper nutrition is always beneficial. We encourage fresh fruits and vegetables and protein intake should increase. Include smoothies, fish, chicken, eggs and limit red meat.

Probiotics/acidophilus are helpful for bowel health. Probiotics are live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut. They are also called “friendly bacteria” or “good bacteria.” Probiotics are available to consumers mainly in the form of dietary supplements and foods.

Brain Scans and Brain Chemistry Analysis

We hear of a few centers talking about the benefit of brain scans and brain chemistry analysis. A few anesthesia detox centers will mention these tests most do not perform these tests once the patient actually arrives for treatment. We feel this is very misleading and gives a patient false hope that they can “fix their brain”. These tests really have no medical credibility and are not accepted in the medical community as anything more than theory. If such tests could pinpoint a physiological reason for a person’s negative behavior and/or drug use, it would be the biggest breakthrough in medical science in years and would readily be used as a defense in many courtrooms. For more information about this subject read our blog post “Addiction Isn’t a Brain Disease”. Drug use may cause a deficiency of certain chemicals that effect mood, energy, sleep, etc. but by giving more drugs such as antidepressants, hormones or amphetamines, it hinders the body’s own ability to naturally repair itself and discourage the return of normal hormone production. Once the patient is detoxed from the opiates, patients regain former health, natural chemistries, a more stable emotional state and proper hormone levels return.

Supplements

There is no ‘magic pill’ to correct a person’s brain chemistries. All that is advised by centers that promote the controversial ‘brain scans’ are supplements. A good book that may be helpful: End Your Addiction Now: The Proven Nutritional Supplement Program That Can Set You Free can be purchased at bookstores or at amazon.com. Nutritional supplements believed to help correct imbalances certainly cannot hurt and are easily purchased at your local health food store. The nutritional supplements are listed below:

5HTP (Tryptohan)

An essential amino acid believed to relieve migraine headaches, stress, depression and insomnia.

Calcium

A mineral that may help to improve emotions, feelings of irritability and insomnia.

Magnesium

A mineral that some claim helps metabolize carbohydrates, amino acids and other minerals.

Vitamin B-Complex

B Vitamins are necessary for nerve functioning, supposedly helps develop neurotransmitters Gaba, Dopamine and Norepinephrine. B Vitamins may help with anxiety, depression, sadness and lack of energy.

DHEA

DHEA is a precursor to testosterone. DHEA may help with improved mood, libido, energy levels and improving pain.

L-Glutamine

L-Glutamine is believed to help with fatigue, fibromyalgia, arthritis and may improve memory.

DL-Phenylalanine

DL-Phenylalanine may improve libido, memory and alertness. It is believed to be an anti-depressant. DL-Phenylalanine may help replace Enkephalins which helps mood. It also is supposed to contribute to development of Dopamine and Norepinephrine which could help to relieve pain.

L-Methionine

L-Methionine is believed to be necessary for the production of serotonin, dopamine, adrenalin and nor-adrenalin.

L-Glutathione

L-Glutathione may help liver to metabolize metabolites of Methadone, etc.

Melatonin

Melatonin is a hormone released from the pineal gland at night for sleep and is also considered an antioxidant.

GABA-Gamma-Aminobutyric

GABA-Gamma-Aminobutyric is an amino acid that may have a calming effect and help with anxiety.

Tyrosine

Tyrosine is an amino acid and precursor to Neurotransmitter [pdf] (particularly dopamine and norepinephrine). It can be used either alone or combined with Vitamin B6 to combat malaise.

Omega 3 Fatty Acids (Essential Fatty Acids)

Omega 3 fatty acids may help with fatigue, mood swings or depression.

B12 (Sublingual)

B12 plays a key role in the normal functioning of the brain and nervous system.

Probiotics with FOS

Probiotics with FOS can increase the natural healthy flora in the bowel and calms the bowel. This should be taken on an empty stomach.

Pancreatic Digestive Enzymes

Pancreatic Digestive Enzymes help with digestion of food contributing to bowel health and increasing vitamin absorption within the bowel. This can help with a bowel that is overactive after meals. This should be taken with every meal.

Ferrous Bisglycinate

Ferrous Bisglycinate is a form of iron that is easier to absorb with less side effects and is crucial for the distribution of oxygen and special detoxification processes in the liver.

Vitamin D

Vitamin D is vital for the proper functioning of our body. It regulates the calcium and phosphorus levels in the blood and helps to absorb these minerals from food.

Capsaicin (The Active Chemical in Red Chili Peppers)

Capsaicin possibly stimulates endorphin release. Topical capsaicin cream which can be purchased at a pharmacy is sometimes used as a treatment for certain types of chronic pain

Amino Acids (Some Mentioned Above)

One of the most important functions of amino acids is to create neurotransmitters in your central nervous system. These transmitters help regulate mood and process the proteins that our bodies need to survive. In many cases, amino acids help depression.

There are over 20 amino acids that we need in order to live healthy lives. A few of these are helpful in treating depression. Some amino acids that may help depression are:

Tryptophan

Tryptophan is a biochemical precursor to the neurotransmitter serotonin. Increased levels help to elevate mood.

L-Glutamic Acid and GABA

It is believed that levels of certain types of GABA (gamma-amino butyric acid) are a biomarker for people more susceptible to suicide during bouts of depression.

L-Glycine

It is recommended for the treatment of certain types of manic depression and is an effective amino acid that helps depression.

Tyrosine

When combined with other vitamins and minerals, tyrosine is used by many as an alternative to taking antidepressants. Tyrosine is considered an amino acid that helps depression.

Phenylalanine

Phenylalanine converts to tyrosine in the body creating norepinephrine which is found in some antidepressants.

Cysteine

It is believed to increase cysteine levels in your body and to help relieve depression and elevate mood.

Methionine

Methionine is considered to be a quick and extremely effective natural amino acid to help depression. It is often used as an alternative to harsh antidepressants.

Unfortunately, few long-term clinical studies have been done to thoroughly document how amino acids help depression. However, small case studies indicate that these and several others to be highly effective, natural alternative remedies for depression. www.nutritional-supplement-educational-centre.com

Herbs

Zyflamend

1 capsule 2 times a day. This supplement may help to relieve chronic back pain.

Butterbur

75-100 milligrams, 2 times per day may help to relieve Migraine headaches.

Passion Flower

Passion Flower may relieve anxiety, insomnia, fatigue and help with digestive problems. Drinking brewed passion flower tea may have calming effects

Lemon Balm

Lemon Balm may help with insomnia and digestive problems. The oils of this herb may have calming effects, works as a sedative and may help with anxiety. Lemon Balm can be brewed into a tea.

Peppermint

Peppermint may help with muscle pain, insomnia, nausea, stomach pain, Inflammatory Bowel Syndrome and headaches. Peppermint can be consumed as a tea.

Panax Ginseng

Panax Ginseng may help to increase strength and energy and decrease stress and low libido. It may work with the central nervous system to help with physical and emotional stress and contains a non-caffeine stimulant.

Mucuna Prureins

It may help with restless leg syndrome, depression and low energy. Mucuna Prureins contains high levels of levadopa which is precursor to a neurotransmitter located in the pleasure center of the brain.

Valerian Root Extract

This extract may help with insomnia, anxiety, headaches and muscle spasms. It is thought to have a sedative effect.

Because of the potential for side effects and interactions with medications, dietary supplements and herbs should be taken only under the supervision of a knowledgeable health care provider.

Addiction Help Guide

Here are some “Words of Wisdom” from a person who recovered from addiction and has been clean for over 8 years: Addiction Help Guide [pdf]

Spirituality

For some individuals, to overcome addiction, they must first realize that their success is entirely up to them. They must realize that the addictive behavior does not bring gratification and fulfillment; it actually distances them further from the peace and comfort they seek. They must focus on how the addiction is affecting their life. Instead of looking around to find outward causes for their addiction, such as relationships, family, stress, chemical imbalances and health concerns, they must turn inward to discover the problem in their inner spiritual reality.

Spirituality is often described as a connection to yourself, others, and the society and world around you. To heal addiction, people must first begin by restructuring their spirituality to be of service to others, to focus on making good choices and to take responsibility for their own actions. A stronger sense of spirituality helps people bring color and depth to their lives and inner reality gradually replacing the temporary pleasure the addictive behavior may bring. A solid spiritual core cannot originate sobriety, but as spirituality is developed and strengthened, the resulting peace and connection to the world becomes crucial to ensuring a successful recovery.

Follow-Up Information for Outpatient Psychotherapy or Counseling after You Are Discharged

Choosing the Right Therapist

As you go through the process of choosing the therapist that best serves your needs, deciphering the confusing array of academic degrees, licenses, and certifications used in the psychology profession can seem daunting to say the least. You may come across literally dozens of designations, such as Ph.D., M.D., MA, Psy.D., M.F.C.C., or L.C.S.W.

Some are “licensed”, some “certified”, and others “registered.” They may list a particular orientation like psychoanalytic, psychodynamic, cognitive/behavioral, gestalt, or solution-focused. Quite understandably, many people are confused about what all of these initials and titles mean. Wisdom, empathy, compassion and character are all attributes you should seek in your therapist, but they aren’t enough. Knowledge and superior professional training are essential.

You will want a therapist who has acquired all of the following:

• Intensive academic study in a field of mental health
  • A good, competent therapist starts with a master’s or a doctorate in a field of mental health (e.g., MA, MS, MSW, PhD, PsyD, MD)
• Supervised clinical experience
  • It is important to know whether or not the therapist you are considering choosing completed an extensive psychotherapy training program (“clinical training”). This should be part of their academic degree or a piece of a separate postgraduate program. Psychotherapy cannot simply be learned out of a book or in a classroom. You require a therapist who has also benefited from supervised training.
• Certification or registration or licensure
  • Following successful training, the therapist is pronounced worthy by an authority to which they then are accountable. This can be a government licensing board or some other credentialing organization. Some of the more common designations you might see include: LCSW, CSW, MFT, LMFT, MFCC, AAPC, LPC, NCC, or NCPsyA. The type of credential is not as important as some may want you to believe.

Individuals often wonder if they would do better with a female or a male therapist. Trust your instincts to determine if the gender of the therapist is a significant issue for you. The nature of your particular problem, as well as your own preferences, should lead to a decision that is best suited to you. While the therapist’s age and cultural background are certainly not determinates of their capacity for empathy or their skill at providing effective therapy, these may also be characteristics that you have either an intuitive or preferential response to. Choose what feels right for you personally.

As you evaluate a potential therapist, there are some specific questions to ask that provide valuable insight into how good a match they are for you. Ask for further details during the initial phone call to the therapist (usually the first phone call is quite brief and primarily focused on setting a first appointment), or during your first meeting.

Basic questions to ask that will help you decide if a therapist is right for you include:

• “What expertise do you have with my type of problem?”
  • Although the therapist does not necessarily need to have experience in helping with your exact problem, she or he should be at least familiar with your type of situation and be prepared to tell you how they have helped others in similar circumstances.
• “What do you think is usually the cause of most people’s problems?”
  • There are many ways to approach people’s problems. Depending on their personal background, training, and preferences, therapists attribute problems to different sources. Some look to childhood events, some to the interrelationship of family members, others to faulty thinking, bad habits, or societal and cultural influences. Make sure your therapist’s beliefs are at least somewhat in sync and aligned with your own views.
• “What is your fee?”
  • If you have no mental health insurance coverage or you must pay a portion of the fee out of pocket, determine if you are able to comfortably afford the therapist’s fee. During the first session, you and the therapist determine an approximate length of therapy necessary to help with your particular issues and goals. This information provides you with a “ballpark” figure for the total cost of therapy. If you have severe financial concerns, there are practitioners and clinics that have a sliding fee scale. Additional resources might be a community mental health center, a social service agency or a university psychological clinic (for the community, not the students) associated with a psychology graduate training program.

When you feel confident that a particular therapist’s overall criteria meet your needs, you are ready for the first visit. Although, you might be feeling nervous during this initial conversation with the therapist, it offers an opportunity to evaluate how clearly you are able to communicate with one another and how the rapport feels. Remember, you are the one doing the choosing.

During your first meeting with the therapist, pay attention to how you feel in their presence and in the therapeutic setting they have created. Note how “listened to” you feel and how their style of responding to you and sharing information makes you feel. Although, making yourself vulnerable to another human being is always anxiety provoking, observe how you feel as the session progresses including changes in your level of ease and shift in the depth of information you reveal.

It is important to remember that therapy is a much, much richer experience than just problem-solving. The foundation of good therapy is the relationship you and the therapist build together. Because this relationship is going to be so crucial to the effectiveness of your therapy, it is essential you find someone with whom you feel a comfortable connection, someone who makes you feel understood and accepted, a therapist who creates and maintains an environment which you feel safe to explore even the most deeply felt sources of pain or conflict.

Understanding Therapists’ Professional Degrees

As you may already know, there are many types of mental health professionals, each with specific educational backgrounds, training, licensure, philosophies, and techniques.

Therapists’ academic degrees include:

• Ph.D.: Doctor of Philosophy Degree in Psychology
  • A Ph.D. in clinical or counseling psychology qualifies the professional to be a practitioner or a researcher. Psychologists with a Ph.D. frequently work in a clinical practice and/or an academic setting. Ph.D.’s are trained in psychological assessment and diagnostic treatment for a full range of psychological disorders. Clinical psychologists are in school from 5 to 7 years, attend many courses in personality, therapy, take supervised practices in therapies, have at least a year of supervised Internship before graduating and at least two years further supervised work post-graduation.
• M.D.: Psychiatrist — Doctor of Medicine
  • Psychiatrists are medical doctors who undergo four years of clinical residency in psychiatry after receiving their medical degree and are trained in the biology, medical aspects, assessment, and diagnostic treatment of the full range of psychological disorders. As M.D.’s, psychiatrists can prescribe medications. Most often psychiatrists focus on psycho-pharmacological treatment and primarily prescribe medications to help in controlling psychological disorders.
• M.S. W.: Master of Social Work (Also M.S.. M.S.S. W., MA. or A.M. in Social Work)
  • Social Workers apply social work theory, knowledge, methods and ethics to restore or enhance the functioning (social, psychosocial, or biopsychosocial) of individuals, couples, families and groups, as well as organizations and communities. Social workers are educated and trained to consider their clients within a social context and, in particular, to be attentive to diversity and the ways in which cultural influences affect individuals and families.
• MA. or M.S.: Master of Arts (Science) Degree in Psychology
  • An M.A. degree is essentially a counseling degree with an emphasis on clinical experience and psychotherapy. Therapists with an MA or M.S. in psychology have a background in the assessment, diagnosis, and treatment of mental disorders and emotional issues.