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Letter from the Publisher

It seems these days that one cannot open a newspaper or turn on the television without seeing a scandalous story about unscrupulous addiction treatment providers. The response from the vast majority of ethical providers and professionals is, “That’s awful,” and “What’s that have to do with me?” State legislatures and federal lawmakers have begun to… [...]

Bayes’ Theorem: Increase the Chances of Doing Better Clinical Work

This article argues that the most important clinical factor in addiction treatment is accuracy. Without it, you risk making erroneous clinical evaluations, decisions, and treatment selections, one after another. The cornerstone of this argument rests on something you may not want to hear: that all your clinical hunches, evaluations, assessments, and even prized educated theories… [...]

Hyperacusis and Misophonia: A Review for Counselors

There are no consensus criteria for the diagnosis of the clinical syndromes referred to as hyperacusis and misophonia (Potgieter et al., 2019; Taylor, 2017; Tyler et al., 2014), although a working set of criteria for misophonia has been proposed (Dozier, Lopez, & Pearson, 2017; Schröder, Vulink, & Denys, 2013). The boundaries between these two conditions… [...]

Recover Yourself: A Different Perspective on Addiction and Recovery

We have more and easier access to addictive chemicals than ever before. Moreover, we now know the addiction potential of the refined sugar and flour in the food many of us consume on a regular basis (Ifland et al., 2009). The old street corner drug dealer now competes with the Internet and schools where students… [...]

Influencing the Quality of Outpatient SUD Care: Alerts and Incentives

Financial incentives for quality improvement and timely performance feedback to treatment agencies are two potentially effective strategies for improving treatment quality. Until now, treatment for individuals with substance use disorders (SUDs) has been the focus of only a few studies using these strategies. Therefore, we examined the effects of these interventions by randomizing outpatient substance… [...]

Ask the LifeQuake Doctor

Dear Dr. Toni, I’m a woman in my late fifties. I’ve been a psychotherapist for twenty years. I primarily use a process for trauma in working with addicts called “brainspotting.” I’ve found it to be very helpful for PTSD. I’m writing you because recently my twenty-one-year-old son committed suicide. He struggled with addiction for years…. [...]

Four Questions to a Brutal Conclusion

“Arthur is an addict, a loving flawed parent, a kind soul, and . . . stuck. Should . . . can I keep trying?” asks Nancy, his wife. I frequently have either individuals or couples trying to figure out if they should keep trying or quit, divorce, or separate. I ask these clients four questions…. [...]

Issues with Treatment Planning

According to ICANotes, an electronic health records (EHR) company, “Psychiatrists, psychologists, mental health counselors, social workers, and other behavioral health professionals use treatment planning as a tool to effectively treat patients. Without a clear plan in place, it can be hard to track progress, stay organized, and keep a record of individual patient care” (Sandy,… [...]

Advances in Family Treatment

“We believe you deserve to heal from addiction too.” – from brochure of St. Joseph’s Addiction Treatment & Recovery Centers’ Family Program, Saranac Lake, New York When we talk about advances in treatment, what are we calling “advances,” and who are the intended beneficiaries? Are we remembering the long-time, but still present fear, confusion, and… [...]

Engaging African Americans with SUDs in Treatment

Evidence indicates that client engagement is among the most important evidence-based practices (Duncan, Miller, & Sparks, 2004). You could be a master therapist with expertise in motivational interviewing (MI), cognitive behavioral therapy (CBT), mindfulness meditation, and acceptance and commitment therapy (ACT), and if you cannot keep clients engaged in treatment, your expertise matters little. Research… [...]

Improving Adherence to Treatment, Part II

In my previous column (April 2019), I wrote about the various factors that affect clients’ adherence to treatment. In this second and final installment on adherence, I will present ways to improve and foster clients’ adherence to treatment. Successful adherence and retention in treatment and recovery is a shared responsibility between clients and practitioners. Integrated… [...]

Wellness and Environmental Awareness

For close to ten years I have been blessed by living in the heart of the beautiful Sonoran Desert just outside of Tucson. Almost every morning my wife and I start the day with a vigorous hike in nearby Catalina State Park, truly one of the wonders of the world. Living in this pristine environment… [...]