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Relationally-Informed Clinical Interventions in Addiction Treatment

Posted on by Christy Weeks
The motto “the opposite of addiction is connection” has been popular in the recovery community for years, but why are social connections so important in the recovery from addiction, and how do they play out on a neurological level?

In a recent webinar for Harmony Foundation, marriage and family therapist Gabrielle Wynschenk, LMFT, LAC, explored the neuropeptide oxytocin’s important role in maintaining healthy relationships and how to integrate relationally-informed clinical interventions that improve treatment outcomes.

Wynschenk works at the Mountainside Treatment Center as a family wellness clinician. At Mountainside, she facilitates various psychoeducational group offerings for individuals in residential treatment, facilitates psychoeducational group offerings for family members of Mountainside clients, maintains a caseload in which she conducts individual and family therapy sessions, and creates group curricula on family dynamics. Wynschenk facilitates webinars and other educational offerings for community providers. She also writes articles for the Mountainside blog.

Neurological research has been looking at the human brain and its potentially overlapping mechanisms between addiction and connection for some time. “Oxytocin is an emerging area of interest” in this regard, Wynschenk told her webinar audience.

“The release of oxytocin is triggered by various external cues,” explained Wynschenk. “These include stimulation of the nipples and genital areas, during orgasm and in response to prosocial stimuli such as close physical proximity to someone of connection in a safe environment, as well as exposure to infants.”

The functions of oxytocin include bonding, increasing interpersonal trust, reducing anxiety, reducing stress response, reducing immune and inflammatory responses, altering memory and information processing, and reducing the sensation of pain.

Genetics and life experiences both have an impact on the development of a person’s oxytocin system, and any changes in that system have an impact on its sensitivity and the synthesis of the neuropeptide, which in turn can inform differences in relationships and lead to a propensity to addiction.

“Recent studies have shown that higher oxytocin levels are correlated with reports of higher relationship satisfaction,” said Wynschenk. “Healthy relationships have also been linked to optimal health across research. It’s been postulated that oxytocin plays a role in that, as it also has physiological functions such as mitigating the stress response and reducing inflammation.”

Since addiction is frequently driven by extreme stress and trauma, the anxiety- and stress-reducing effects of healthy relationships can help counteract addiction. “In rodents, oxytocin was shown to lessen obsessive and repetitive behaviors in subjects addicted to cocaine,” reported Wynschenk in the webinar. “Similarly, in animal studies, rodents stopped self-administering both cocaine and opiates when receiving high levels of oxytocin.”

Research is now looking at oxytocin as a protective factor for addiction. Since oxytocin reduces anxiety and stress which also builds resilience around triggers, it can help reduce the occurrence of relapse. “Human studies showed that oxytocin reduced cravings and reduced withdrawal symptoms for people detoxing from alcohol and cocaine,” said Wynschenk.

Managing Deficient Executive Functioning Skills

Posted on by Christy Weeks

Executive functions are a set of processes that all involve managing oneself and one’s resources to achieve a goal. They serve a command and control function and can be viewed as a kind of conductor of all cognitive skills.

Andrea Pitman is the executive director and founder of The Nectar Group. She has over 18 years of experience working with children, adults, and families through cognitive skills training, consulting, and teaching. In a recent webinar for Harmony Foundation, Pittman discussed the importance of executive functioning skills for human behavior and mental health.

Executive functioning (EF) comprises skills such as response inhibition, emotional control, sustained attention, goal-directed persistence, task initiation, time management, toleration of stress, and more. It’s a kind of “air traffic control” of the brain, Pittman explained, enabling people to focus, hold and work with information in the mind and filter distractions.

Furthermore, executive function skills make it possible to mentally play with ideas, think before acting, meet novel, unanticipated challenges, resist temptations, stay focused to complete tasks, and override the brain’s autopilot.

This means that executive functioning is essential for mental and physical health, success in school, work, and life, as well as cognitive, social, and psychological development.

“Lapses in executive functioning are common,” Pittman told the webinar participants. “Their seriousness and frequency can reflect individual strengths and weaknesses when it comes to executive functioning.”

Strong executive function skills develop through healthy relationships (caregivers provide a consistent, reliable presence and support children’s efforts); activities (caregivers help children learn how to cope and foster open-ended, creative play); places (environments that feel safe); and development (accountability and independence are encouraged).

The development of EF skills can be impaired by cognitive skill deficits (genetic or external trauma), poor content knowledge, lack of healthy relationships, unstable environments, trauma, and a lack of opportunity to develop independence and problem-solving skills.

EF weaknesses occur on a spectrum: they can be mild, mild-moderate, moderate, moderate-severe, and severe. Effective treatment moves the patient to the less severe end of the spectrum and in some cases, off the spectrum if diagnostic criteria are no longer met. There are two treatment approaches: compensation through accommodation or overcoming through treatment intervention that addresses the root causes. “Compensatory measures focus on coping with the disability and symptom management,” said Pittman. “Intervention focuses on overcoming the disability by treating the root cause.”

Various strategies can be employed to address EF weaknesses, such as lessening multitasking, providing a quiet work and study space, reducing distractions, modify or limiting task length and demand. To strengthen emotional control, triggers may be reduced or eliminated, and coping mechanisms explored and rehearsed.

To improve organizational skills, the structure of the environment could be improved and rooms decluttered. Goal-oriented persistence can be achieved by setting SMART (specific, meaningful, adaptive, realistic, and time-framed) goals.

And don’t forget to take regular breaks!

After a thorough cognitive assessment, a therapist can provide intensive coaching to achieve improvements in executive functioning. Coaching works by stressing a weak area through mental exercise, encouraging the brain to build new neural networks. Executive function and study skills coaching may improve skills such as self-advocacy, study skills, time management, and organization.

Harmony Foundation is one of the longest-running and most successful addiction treatment centers in the world. If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (866) 686-7867 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

Healing Families With Structured Family Recovery

Posted on by Christy Weeks
“Family is always the prominent force, before, during, and after addiction treatment,” says Debra Jay, the coauthor of Love First and the creator of the Structured Family Recovery program. SFR is “so simple, so obvious, it’s a wonder it hasn’t been done before,” she wrote in her 2014 book It Takes A Family. Until then, families had been “mostly left out of the recovery equation,” Jay wrote, but that has changed significantly in recent years. “Structured Family Recovery starts with a family and ends with a family recovery team.”

In a recent webinar for Harmony Foundation, Jay discussed the importance of family engagement in achieving lasting sobriety. SFR “works with family as a whole unit” to bring “the family back together again,” Jay told the webinar audience.


“SFR is best known through the stories families tell about themselves,” explained Jay. “We just need to listen to the family’s narrative.” She presented a quote from the wife of someone with alcohol use disorder: “During our recovery journey, our SFR counselor was the first person to treat us like a family full of love rather than a broken family.” The sister-in-law of an addicted person found SFR “the most applicable and relatable thing that I have ever done, and I’ve done therapy all my life.” The father of a “beloved addict” described SFR as “the language of post-resurrection: forgiveness and love.”

We don’t need to ask what families want; they want to be happy again! It has been said many times that connection is the opposite of addiction. Consequently, SFR is all about belonging, trustworthiness, and happiness.

Jay stressed that Structured Family Recovery is not therapy but a program of action. In It Takes A Family, she wrote that SFR “supports Twelve Step recovery for alcoholics, addicts, and family members, but it isn’t AA or any other Twelve Step group… it supports ongoing recovery—designed so that every member of the family contributes to preventing relapse, healing the whole family, and building trust.”

Families meet once a week for an hour, usually via conference calls, so it doesn’t matter where people live or whether they are at home or traveling. If the addicted persons are in residential treatment or a recovery residence, they can still easily participate.

The meetings have a simple format, and team members focus on themselves. SFR is never punitive or judgmental. The content of each meeting is directed by weekly topics. “Those topics are not random but coordinated with the Twelve Steps,” explained Jay. A list of topics can be found in It Takes A Family.

“Everyone learns where to find their power and what they are powerless over,” Jay wrote. “With time, everyone can begin to forgive and eventually can trust. There are bumps in the road, to be sure, but together, as a family, they work through them.”

In SFR, everyone creates a recovery plan. Every team member needs to engage in the simple and straightforward process of developing a plan appropriate to their recovery situation and role in the family.

The recovery process is ongoing and takes time. “Most families complete at least a year. Even when they started out wondering why they are doing SFR,” said Jay.

Harmony Foundation offers a modified family engagement workshop to all families of current and former clients. It provides education to family members about the disease model of addiction. This gives family members a place to express themselves and begin the healing process.

Harmony is one of the longest-running and most successful addiction treatment centers in the world. If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (866) 686-7867 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

Spirituality and Recovery

Posted on by Christy Weeks

This presentation is no longer eligible for a CEU.

Understanding the core of belonging centers on energy within. Substance use, abuse, and disorder block that energy. Discover the core through a reconstituted way of life and energy. Find joy within by knowing and living the principles. Annetta’s greatest passion is helping the human spirit recover and transform trauma, grief, and addiction. Join us for the knowledge she has gained personally and professionally from a wide area of experience.

Presented By:
Annetta M. Sutton, MA, AAPC
Author & Founder – Five Point Consulting

Annetta M. Sutton, MA, AAPC, author, founder, and CEO of Five Point Consulting. Over 40 years of recovery experience, 12 Step spirituality, and transitions. Professional life includes Spiritual Care Professional Hazelden/Betty Ford, Director of the Office of Social Concerns, prison, hospital, police chaplain, educator, program developer, and speaker. Author of Catholic Alcoholic: A Witness to Addiction and Redemption, Our Little House on the Prairie, Minister With a Badge, and authored a monthly column, Living Justly.
Educational background; Bachelor of Arts in Ministry/ Addiction Counseling-University of Mary; Master of Arts in Pastoral Counseling from Emmanuel College Boston, MA. Certified through the American Association of Pastoral Counselors. Internships: Clinical Pastoral Education and West Central Human Services.

It Takes A Family: Cooperative Approach to Lasting Sobriety

Posted on by Christy Weeks

This presentation is no longer eligible for a CEU.

This presentation is designed to help you gain the capacity to articulate a basic understanding of Structured Family Recovery, how it is implemented to transform families into recovery teams, and how the newly recovering person is invited to join the team. Continue reading “It Takes A Family: Cooperative Approach to Lasting Sobriety” →

Tobacco Cessation Can Improve Long-term Outcomes in Addiction Treatment

Posted on by Christy Weeks

Tobacco smoking rates among US adults with significant depression and/or substance use disorder (SUD) declined between 2006 and 2019 at a steeper rate than among individuals without substantial depression and/or SUD, according to research from the National Institute on Drug Abuse (NIDA).

The findings, which were published in JAMA in April, suggest that groups at risk for nicotine addiction can be reached by tobacco cessation efforts. While such efforts have been effective, the NIDA researchers noted that individuals with psychiatric disorders still reported higher smoking rates than those without, although the gap is narrowing.

“This study shows us that, at a population level, reductions in tobacco use are achievable for people with psychiatric conditions, and smoking cessation should be prioritized along with treatments for substance use, depression, and other mental health disorders for people who experience them,” said NIDA Director Nora Volkow, MD, co-author of the study, in a news release.

“Therapies to help people stop smoking are safe, effective, and may even enhance the long-term success of concurrent treatments for more severe mental health symptoms in individuals with psychiatric disorders by lowering stress, anxiety, depression, and by improving overall mood and quality of life.”

The NIDA study analyzed data from more than 558,000 individuals 18 and older who participated in National Surveys on Drug Use and Health between 2006 and 2019. While individuals with major depression, SUD, or both were more likely to smoke cigarettes, cessation rates among these populations improved during the period studied.

“It is crucial that healthcare providers treat all the health issues that a patient experiences, not just their depression or drug use disorder at a given point in time,” Dr. Volkow said. “To do this, smoking cessation therapies need to be integrated into existing behavioral health treatments. The result will be longer and healthier lives for all people.”

The Harmony Campus is Tobacco-Free

Harmony Foundation has been providing the holistic approach to addiction treatment Dr. Volkow suggests. The treatment team at Harmony works daily to address all relevant needs a client might have. Our cutting-edge addiction treatment at Estes Park in Colorado includes tobacco cessation. Consequently, clients are not allowed to bring any tobacco products to our tobacco-free campus.

Like other drugs, nicotine engages the reward cycle of the brain. “A transient surge of endorphins in the reward circuits of the brain causes a slight, brief euphoria when nicotine is administered. This surge is much briefer than the ‘high’ associated with other drugs,” explains the relevant NIDA page. “However, like other drugs of abuse, nicotine increases levels of the neurotransmitter dopamine in these reward circuits, which reinforces the behavior of taking the drug.”

Since tobacco engages the same brain circuits as other addictive substances, smoking is counterproductive in recovery. Harmony offers a tobacco cessation group as part of its holistic addiction treatment to help those seeking additional support. If you are interested in beginning a life of recovery and interested to hear more about how quitting nicotine can help your goal, our admissions team is here to help.

Since addiction is a biopsychosocial and spiritual disease, Harmony’s treatment program promotes physical, emotional, and spiritual healing, empowering patients to embark upon a lifelong journey of recovery. All our services are provided in a safe, culturally sensitive, and trauma-informed manner.

If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs and workshops, call us today at (970) 432-8075 to get the help needed as soon as possible. Our experienced staff is available 24 hours a day, seven days a week.

Harmony Foundation Names New Director of Clinical Services

Posted on by Christy Weeks

Harmony Foundation names Karen Cramer as its new Director of Clinical Services. Karen Cramer is a Licensed Chemical Dependency Counselor (LCDC) in Texas and a Licensed Professional Counselor (LPC) in Texas and Colorado. Karen received her Bachelor’s in Psychology and her Master’s in Counseling at Southern Methodist University in Dallas, TX. In her new role, she will oversee counseling, family programming, and case management and will serve as part of the executive leadership team. Her vast experience throughout her career brings a unique balance of clinical success and organizational operations.

“Karen has been a critical part of the core leadership team that has made Harmony Foundation what it is today,” stated president and CEO Jim Geckler. “This change in role will help continue that path by providing her greater focus on clinical development.”

Previous to running multiple departments at Harmony, Karen helped open a women’s Dallas-based Intensive Outpatient Program (IOP). She has also worked in private practice and at the SMU Family Counseling Center. This experience will contribute to upcoming changes to Harmony, including its IOP, which currently serves clients across the state. Karen is in long-term recovery herself, which adds to her passion for helping others that suffer from the disease of addiction.

“Harmony’s unwavering commitment to its mission is recognized nationwide, and continual innovation has and will be key to providing excellent treatment,” added Karen Cramer.

Karen is an active member of the National Association for Alcoholism and Drug Abuse (NAADAC), the National Association of Addiction Treatment Providers (NAATP), and is a member of The National Board for Certified Counselors, Inc. (NBCC) with a passion for collaborating on outcomes and best practices. She also serves on the board of directors for Medicine Meadow Heard: Rescued Horses, Healing Humans.

September is Recovery Month!

Posted on by Christy Weeks
National Recovery Month (Recovery Month) started in 1989 and is a national observance held every September to promote and support evidence-based treatment and recovery practices, the nation’s strong and proud recovery community, and the dedication of service providers and communities who make recovery in all its forms possible.
 
“In celebration of Americans on the road to recovery, this National Recovery Month we recommit to helping prevent substance use disorder, supporting those who are still struggling, and providing people in recovery with the resources they need to live full and healthy lives,” President Biden wrote in the official proclamation. “When our fellow Americans recover from substance use disorder, our Nation becomes stronger and more resilient. Still, we recognize that the path to full recovery can be long and demanding.”
 
Recovery Month was preceded by Overdose Awareness Day on August 31, with events to commemorate those who died from an overdose and to reflect on the grief of those they left behind. Many people continue to live with the stigma associated with having a close family or friend die from an overdose.
 
Drug overdose is the leading cause of death for people ages 18 to 45 in the United States today. More than 100,000 people died of an overdose in the United States in 2021, according to provisional data from CDC’s National Center for Health Statistics.
 
Addiction is a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual’s life experiences. People with addiction frequently require comprehensive treatment and deserve our compassion. 
 
The recovery community utilizes the annual campaign to increase public awareness surrounding mental health and addiction recovery. In the years since Recovery Month launched, the federal Substance Abuse and Mental Health Services Administration (SAMHSA) has timed announcements of initiatives and grant funding during Recovery Month while collaborating with private and public partners to celebrate individuals during their long-term recoveries.
 
This year, to address the nation’s growing crisis of substance misuse and overdose deaths, SAMHSA is launching initiatives that promote and support evidence-based treatment and recovery practices, the emergence of a strong and proud recovery community, and the dedication of service providers and community members across the nation who make recovery possible.
 
An estimated 67,000 Coloradans with substance use disorder (SUD) are not receiving the treatment they need. Barriers include stigma, financial cost, and a shortage of available services. Untreated SUDs contribute to unemployment, homelessness, physical health problems, incarceration, and premature death. 
 
Harmony Foundation has been part of the recovery community for decades. We are one of the longest-running and most successful addiction treatment centers in the world. If you or a loved one are struggling with alcohol or drug addiction, or you have questions about our programs, call us today at (970) 432-8075 to get the help needed as soon as possible.

Conquering Executive Function Woes

Posted on by Christy Weeks

This presentation is no longer eligible for a CEU.

Disorganization, poor time management, and difficulty shifting gears are just a few symptoms of poor executive functioning. EF skills are essential throughout all stages of life and are the most inquired about skills from both parents of children and adults in the workplace from our experts at The Nectar Group. These skills enable us to develop leadership, time management, and prioritization, along with allowing us to follow multi-step instructions, think critically, and adapt to change. We’ll build a solid understanding of and cover how you can help you and your clients develop these critical skills! Continue reading “Conquering Executive Function Woes” →

Improving Addiction Treatment Outcomes Through a Relational Approach

Posted on by Christy Weeks

*This presentation is no longer eligible for the 1 CE credit*

The phrase “the opposite of addiction is connection” has been floating around recovery spaces for years. Research is beginning to look at the validity of this statement, even on a neurological level. This webinar will review important information to consider when working with individuals and families in early recovery, both in terms of clinician considerations for self of the therapist’s work, and as it relates to clinical application. We will explore recent research that points to the importance of taking a relational approach to addiction treatment, looking at the neurological intersections between relational functioning and addiction. Participants will gain knowledge regarding the power of meaningful connection as it relates to sustaining long-term recovery and will also learn clinical interventions that can be utilized in sessions in order to improve treatment outcomes. Continue reading “Improving Addiction Treatment Outcomes Through a Relational Approach” →