The Parable of the Sweet Potatoes

September 26th, 2015 was a very long and emotional day. My Dad finally rested with Mom. Together once again Dad, just like you wanted.

I told a story at the cemetery on that Saturday, that I call “The Parable of the Sweet Potatoes”. It was hard to get through that story, but, with many pauses in between, I got through it. I share it with you now, as a testament to how stories can positively affect, and change us.

When I was 12 years old, in 1964, my parents bought a house in Hialeah, Florida. $11,000. Yes. You read that correctly. A 3 bedroom 1 bath, newly constructed starter home. $325 down, $68 per month. Unbelievable, huh? I grew up in that house. Dad still lived there 50 years later.

The front yard was “sodded” with little clumps of St. Augustine. The back yard was just white sand. Soon after we moved in, the back yard was a mass of crabgrass and weeds. Green, but very, very weedy.

One day, Dad calls me out to the back yard and hands me a long pole with a metal blade-looking thing on the end. I asked, “what’s this?” and he said “a hoe”. “What is this for?”, I asked. My blistered hands soon found this to be to an extremely dumb question to ask. Live and learn!

Dad proceeded to explain what my goals would be. I was to remove a rather large section of the weeds growing in the back yard. This was called, “preparing”. Once I “prepared” the ground, we would spread rich black dirt. Then, we would plant sweet potatoes. Then, we would fertilize, and water, and weed periodically (like daily!). The “we”, obviously, was my brother and I. “Follow these steps, and wait to see what happens”, Dad said.

• Prepare
• Sow (plant)
• Fertilize
• Water
• Weed
• Reap

This, my Dad explained, was how the whole process worked. You could not reap until you sowed, and then in-between, completed all the remaining steps. After the sun, rain (or good old Hialeah well water!) and God, we would see the “magic”.

My father was essentially, a formally uneducated man, having only gotten through the 6th grade. But he was extremely intelligent, with a huge amount of common sense and worldly wherewithal. Despite his lack of a formal education, he became the production floor supervisor for a very large shoe manufacturer. He was operationally sound, and a born leader. He could spot issues in a flash, and was quick and decisive with solutions. And people naturally followed him.

I did not know this at that time, as I looked down at my blistered and aching hands, but he had just taught me one of the most valuable life lessons one could ever learn. The law of the farm. He may not have realized the informal education he was imparting to me, but nonetheless he must have instinctively known that I needed to learn that you prepare, plant, fertilize, water, weed, and let God do the rest. Only then could you reap what you had sown.

In the end, we ate sweet potatoes for months! And boy were they big, and did they taste good, no matter how Mom chose to prepare them. We enjoyed them, blistered hands and all.

This is the Parable of the Sweet Potatoes. Old Salty was one smart and loving man.

You can read my blog HERE, connect on Twitter HERE, LinkedIn HERE and Facebook HERE.

Approaches to Addictive Disorders: Does One Size Fit All?

In the world of psychiatry, as in the field of science, validity and acceptance of theories and ideas are evidence-based. However, evaluating results in mental health and substance abuse cases is an arduous and often inconclusive task. What, then, defines the right approach to treating patients suffering from addictive disorders? Is there really a single approach that can provide resolute results?

Renowned psychiatrist and conceiver of the self-medication hypothesis of addiction, Edward J. Khantzian writes for The Fix on how different approaches are required in treating addictive disorders.

Second Thoughts About Addiction

A seminal figure in understanding and treating substance misuse reflects on his legacy.

Source: Shutterstock

Edward Khantzian, MD is one of the most significant figures in the history of addiction treatment, having put forward, in 1974, the “self-medication hypothesis” of addiction, which asserted that substance use is best construed as effort to relieve an inner psychological struggle or discomfort. It also maintains that the choice of substance that comes to be relied on is therefore extremely relevant to developing treatment strategies. The self-medication model has had an enormous impact on our understanding of the etiology and treatment of addiction. Now, over 40 years later, and in a period in which a “disturbed brain mechanism” of addiction is perhaps dominant, Dr. Khantzian reflects on our current view of addiction, and his own.—Richard Juman.

It has been awhile since I treated intravenous, opiate-using patients. But there was a time when they were the group with whom I worked predominantly and where I began to develop my ideas about what makes dependency on addictive substances so powerful and compelling. See full post here

For more information on addictive disorders and different methods of treatment, visit Recovery Coach Training.

Daily Actions that Enhance Your Coaching Practice

In this International Coach Federation (ICF) Blog article, Suzanne Muusers, a Financial Advisor Coach and Business Plan Consultant shares some key daily actions that keep your coaching practice productive and thriving.

April 7, 2016: Spend 10 Minutes a Day on these 5 Actions for Your Coaching Practice.

Do you start your working day wondering what you should be doing? Are you wandering aimlessly through your work life? If you want to work on your coaching practice in a productive manner, then this article is for you.

When I first started my coaching business, I was at a loss for how I should be spending my days. I asked myself, “What should I be doing today to grow my coaching business?”

Being no stranger to owning a business, I used my previous experience to guide me in becoming a productive coaching business owner by thinking about what I’d done in the past to make sure I was on track with my business goals. I wanted a process that wouldn’t take much time but with actions that would be meaningful.

Here are five things you can do daily in less than 10 minutes that will keep you moving forward in your coaching practice. Read more

Effective Professional Recovery Coaches support people to change their behaviors BEFORE treatment. And AFTER treatment, Professional Coaches help people to maximize their recovery process.

Expand your career options. Explore adding Professional Recovery Coach Credentials here: http://ift.tt/1AwZyYw

 

Doctor-Patient Rapport: How Lenient Should It Be?

What happens when a doctor realizes that their patient is recovering for the wrong reasons? What happens when a doctor cannot identify symptoms of a patient’s relapse? Where do the responsibilities of the physician end?

In this article, Dr. Anna Lembke provides insight into the machinations of an opioid addict’s mind and her own.

Pro-Voices—Inside the Mind of An Addiction Medicine Physician

Dr. Anna Lembke caused quite a stir in 2012 when her perspective piece Why Doctors Prescribe Opioids to Known Opioid Users was published in the New England Journal of Medicine. In it, she delivered a no-holds-barred accounting of the reasons why patients with histories of addiction receive opioid pain medication from physicians. Here she helps us see behind closed doors in the clinical practice of addiction medicine, as she grapples with a variety of forces that factor in to her decision-making in providing care to a well-known patient.

Source: Shutterstock

As I scanned the schedule of patients I would be seeing that day, my eyes hovered on my 10 am visit – Sophie. I felt a warm glow as I anticipated meeting with her. I’d been seeing her for more than 2 years, and I liked to think that my initial involvement in her care propelled her into recovery. She’d been addicted to prescription stimulants, opioids, and benzodiazepines when she first came through my clinic, telling herself and anyone else who would listen that her use was legitimized by her ADHD, lower back pain, and anxiety. See full post here

For more information, visit Recovery Coach Training.

Hypnosis: A Cure for Addiction?

Hypnotherapy has long held stature as an effective treatment method for various disorders, and finds its proponents among many medical professionals and recovery coaches. How effective is it in treating addictive disorders?

Wendi Friesen writes for The Fix in advocacy of employing hypnosis as a recognized treatment method for addiction and related disorders.

Is Hypnosis the Cure for Addiction?

Source: The Fix

Hypnosis has a long track record of effective application in health care settings as well as a long history of use for entertainment purposes. The mixed reputation should not get in the way of objectively investigating its efficacy as a treatment for addictive disorders. Certified hypnotherapist Wendi Friesen argues that hypnotherapy deserves a place in the treatment of addictive disorders….Richard Juman.
See full post here.

 

Visit Recovery Coach Training for more information on substance abuse disorders and treatment methods – standard as well as unconventional.

Mental Health and Substance Abuse: Working In Tandem?

The recovery of an addiction patient is hampered when their other problems are not taken into consideration. Substance abuse patients often suffer from mental health disorders, and it’s important to treat both afflictions concurrently.

In this article from The Fix, Dr. Robert M. Lichtman talks about how mental disorders and substance addiction co-exist in most patients, and describes 12 points that every clinician needs to know in order to treat addiction and mental health patients.

Dealing With a Dual Diagnosis

Many addicts and alcoholics also suffer from mental health problems. Here are 12 suggestions to guide a treatment strategy.

Source: The fix

 

People who suffer from both mental health and substance use disorders present the clinician with a unique set of challenges. Only in recent decades have we begun to accurately identify and effectively treat such co-occurring conditions. But after a slow start, progress is finally being made. See full post

Recovery Coach Training puts great emphasis on treating all patient disorders concurrently and effectively. For more information, visit Recovery Coach Training.

3 Ways to Avoid a Frenetic Frenzy

I define a Frenetic Frenzy as that state of mind you get yourself into, when things are not going exactly the way you want. You are distraught, you despair, your mind goes around and around, and, before you now it, you have driven yourself into a Frenetic Frenzy.

It is important to address this state of mind quickly. I find I am considerably ineffective if I try to sort through an issue, make decisions, or resolve problems when I have been overtaken by a Frenetic Frenzy. Its important to change your frame of mind, and get your Frenzy under control.

Here are the 3 things I do when I have gotten myself into a Frenetic Frenzy.

1. Take a very large step back – Immediately, when I find myself in a Frenetic Frenzy, I get away from the situation, shift my focus, and switch to doing something completely different. Sometimes, this involves putting on the television, writing, listening to music, or tackling a household chore. The more different the alternative activity, the better it is for fighting off the Frenetic Frenzy. Taking your mind completely off the issue that caused the Frenzy is one of the keys. The other is to do something that will provide a positive outcome, and have you feeling a sense of accomplishment and effectiveness.
2. Re-examine the issue objectively – After you take that step back, and some time has elapsed, giving your mind the opportunity to clear, sit down and ask yourself the following questions:
   1. What is the true impact of the issue?
   2. How important is it to address the issue right away?
   3. What are the potential solutions?
      • List the pros and cons of each
      • Rank the solutions in the order that they best address the issue
      • Choose the highest value solution
3. Check in with a trusted adviser or mentor, a voice of value. Explain the issue, stay factual, state no opinions and give no solutions. Ask for a reaction, then sit back and listen. After this discussion, you may want to review potential solutions, listing pros and cons, and then rank them as above.

Our lifestyles, circumstances, and the world we live in, quite often drive us into a Frenetic Frenzy. The above tactics are 3 things I have found to be helpful in dealing effectively with life’s Frenzies.

I trust they will be helpful to you as well.

You can read my blog HERE, connect on Twitter HERE, LinkedIn HERE and Facebook HERE.

Treat People Not Brains

The idea that addiction is a brain disease is not new and has been reaffirmed by multiple studies. However, commencing treatment with emphasis on the fact that it is the brain we are treating and not the person can unduly hamper the course of treatment and recovery.

Andrew Tatarsky from The Fix writes about how important it is to ‘treat the patient’ rather than ‘treating the brain’. Take a look.

We Don’t Treat Brains, We Treat People

The idea that addiction is a “brain disease” is a common one. But does it lead treatment professions to approach the problem in the wrong way?

The US government estimates there are 80,000,000 Americans with diagnoses of substance abuse, dependence or binge patterns, and we treat a tiny, tiny fraction of them effectively. We spend billions on the war on drugs, on research and on treatment and yet have little overall impact on the epidemic. As Dr. Richard Juman and others have noted, when you look at the repertoire of addictive behaviors evidenced by Americans, we have become a “nation of addicts.” Is addiction untreatable or are we simply going about it the wrong way?. See full post

Recovery Coach Training puts emphasis on individual needs and provides alternative routes to recovery for patients suffering from substance addiction. To Learn more, visit Recovery Coach training.

The Lines between Denial Fear and Stalling

Oftentimes, we subject people who seem to avoid confronting their addictions to admonitions and criticisms. It gets easier and easier to brush their behavior off as a standard case of denial. However, the lines between denial, mortal fear and simple stalling can be too fine at times.

Edward M Paul talks to The Fix about how cases of denial are not as black and white as they seem.

I Don’t Believe in Denial

Source: Shutterstock

How an experienced addiction psychiatrist helps patients navigate the bumpy road to recovery.

Although some physicians in addiction medicine concentrate chiefly on prescribing medications, renowned addiction psychiatrist Edward Paul believes in a more holistic approach. As seen below, Dr. Paul fastens his therapeutic seat belt and uses a multimodal approach to help his patients navigate the “peaks and valleys” that often characterize the path to recovery. Psychotherapy, family sessions, medications and creative interventions, all delivered in the context of a therapeutic alliance that allows full expression of his patients’ ambivalence about substance use, are some of the methods used by Dr. Paul as he helps patients navigate the “gradual learning process” of recovery. —Richard Juman. See full post

Coaches certified by Recovery Coach Training are trained in dealing with patients suffering from denial and related issues. For more information, visit Recovery Coach Training.

Who You Gonna Call? An Interventionist!

Sometimes when we’ve exhausted all other approaches to solving a drug use related problem, the only plausible approach that provides some hope is an intervention. To some, intervention is a ray of hope – a final expectation of a resolution. And to some, intervention is a sign of disregard for the autonomous rights of the patient. Whatever your views, it has been noted that interventions do help in some cases.

An experienced interventionist can jump start the process of recovery and pave the way to complete recuperation.

Richard Elmore shares a case example of intervention on The Fix.

Source: Shutterstock

A Case Example of Intervention in Alcohol Use Disorder

How an experienced interventionist can jump start a successful treatment episode.

Although there is some controversy about the effectiveness of interventions, there are undoubtedly situations where, lacking intervention, an individual’s downward spiral would likely continue. In these situations, a skilled interventionist can prove the catalyst that begins the journey to lasting recovery for the patient while also uniting family and friends behind a chosen treatment plan. Rickard Elmore, an experienced addiction and mental health interventionist, recalls a case in which multiple challenging variables were overcome in order to help a man begin treatment and attain early recovery…Richard Juman. See full post

Visit Recovery Coach Training for more information on different substance use disorders and their treatments. Stay updated with the latest news and advancements in addiction recovery.

Harm Reduction: A Better Approach to Recovery?

Harm reduction aims to reduce negative consequences of substance abuse by forming strategies and procedural ideas to alleviate health and social conditions of the patient. Harm Reduction also recognizes that people suffering from drug abuse have certain rights that should be respected.

Interestingly, harm reduction does not support abstinence as a conclusive means to addiction recovery.

Here is an article by Joe McGuffin who wants to be a Harm Reduction Counselor. Take a look at this article from The Fix.

I Want to Be a Harm Reduction Counselor

How the phrase means more than just the opposite of abstinence.

                                       Source : Shutterstock

As in many other arenas, it can take a long time, often years, for evidence-based findings in addiction medicine to “trickle down” to the practitioner level. That means that there is frequently a disconnect between what researchers know, what clinicians believe and what they are actually able to implement in their clinical practice. Does the harm reduction approach to addiction treatment fit this paradigm? Here, a young clinician, The author struggles with the disconnect between what he finds intuitively valid and the abstinence-oriented treatment philosophy that is often mandated by referral sources and government entities…Richard Juman.

Yes. I want to be a harm reduction counselor. There, I said it. You should try it; it feels good. After all, who among us does not want to reduce harm? The problem is, for many in our field, these two words are a dog whistle for something other than abstinence. There are places where uttering these words is verboten, blasphemous, or even professional suicide. I worked for one agency in which the lead counselor would have run into the director’s office, waving this article and demanding my immediate termination. I am a graduate student and a novice in the field of substance use counseling, and as such, I am in the process of forming my style and approach to the helping profession. At this moment, I am convinced that harm reduction is the future of our field. I am not going to explain what harm reduction is, or why its time has come; Debra Rothschild does a fine job of that here. I am not going to explain how abstinence is included under the “harm reduction umbrella”; Jeannie Little does that beautifully here. I want to explain in my own words why I am inclined to view my work as part of the harm reduction paradigm. See full post

Read about more interesting topics on Recovery Coach Training; stay updated with recent developments in addiction recovery.

Hospitals and Opioid Overuse

One of the things that the Affordable Care Act has sought to ensure for patients is that they are well cared for during hospital visits. Medicare payments are allocated to hospitals based on patient satisfaction surveys. These surveys ask patients to measure how well their pain was taken care of during a hospital stay. Physicians find that it’s hard to make people happy without opioid-level pain control, and although it’s not the only factor in the surge of opioid use, this method of measuring a hospital’s success seems to have fueled opioid overuse in the hospital setting.

Time Magazine article April 13, 2016: How Obamacare is fueling the Opioid Epidemic bySean Gregory.

Some doctors say a quirk in the program is a dangerous incentive to prescribe potentially dangerous painkillers.

Not long ago Dr. Bill Sullivan, an emergency-room physician in rural Spring Valley, Ill., refused to prescribe a potentially habit-­forming painkiller to a patient that had requested it by name. That might seem like a good thing since opioid addiction has become a national epidemic. But in fact, as a result of reforms put in place under the Affordable Care Act, he may have put his hospital at financial risk.

As part of an Obama­care initiative meant to reward quality care, the Centers for Medicare and Medicaid Services (CMS) is allocating some $1.5 billion in Medicare payments to hospitals based on criteria that include patient-­satisfaction surveys. Among the questions: “During this hospital stay, how often did the hospital staff do everything they could to help you with your pain?” And: “How often was your pain well controlled?” Read more

Prescription opioid pain relievers are at the forefront of opioid addiction. They are the driving factor in opioid overdose deaths. Prevention includes educating people and developing strong support BEFORE serious drug use begins to occur.

Professional Recovery Coaches can provide preventative help before treatment is necessary, or help individuals after treatment to learn to implement the skills necessary to stay clean and avoid relapse episodes.

If you are interested in learning more about our Certification Programs in Professional Recovery Coaching visit us here: http://ift.tt/1AwZyYw

When I Become AWARE I Change

I used to wonder why it was so hard to make changes in my life. When I say change, I am talking about changing stuff about me. For example, exchanging bad habits for good ones (or better ones), changing aspects of myself that needed changing (like intolerance, impatience, pride, arrogance), or changing an intellectual or skill area (like learning a new skill or closing an intellectual gap). The same would apply to any changes one would want to make related to dependencies on substances or other things.

How does one change? I’ve spent a lot of time thinking about this, trying different recipes, throwing out what didn’t work, expanding on what did. For a period of time in my life, I had a lot of “thinking” time on my hands, and many opportunities to see people successfully changing, resisting change, not wanting to change, and failing at change. I saw people make changes, only to fall back into unwanted behaviors, and old, hard-to-break habits.

After time, I was able to get to the heart of the matter, the way that I was able to observe making long lasting changes. This led me to the creation of a model for change that I saw people using without realizing it, and that I have used successfully to make positive changes in my life, and to analyze when I wasn’t successful at making changes.

I change when I become A.W.A.R.E. That’s the name of the model. A.W.A.R.E. What does it mean?

A = Acknowledgment. I see that something needs to change and I acknowledge it. I recognize it and own it as mine.

W = Willingness. I decide that I am willing to change that which I recognize as needing change.

A = Ability. I recognize that what needs to change is based on an old way of looking at something (a paradigm) or of doing something (a habit) and I acquire the ability to do it differently, or to not do it. In other words, I acquire the ability to change. This could take me an hour, a day, even weeks. It might even involve engaging someone to help me through the change, research how to do it differently, or avoid doing it at all.

R = Resistance. I realize that there is resistance to change and I work through how to break through that resistance. I also develop a resistance to fall back into the old way, the old habit.

E – Enablement. Making a change permanent requires practicing it, repeating it until the skill is mastered and becomes part of me. The key is to be able to own the new skill, to make it an integral part of me, so that I don’t even have to think about it, I “Nike” it (Just  Do It!).

So, there it is, a simple model, but one that has worked for me.

Now, you are probably saying to yourself, “Easy to describe, hard to do”.  And I totally agree. There is a lot of detail and hard work behind the model, which is really the important part that makes the change happen.

I’ll be digging deeper into the model in future posts. I’ll be sharing the details behind what makes the model tick. For example, the ability to make a change, involves a significant level of effort, including training, coaching, mentoring, and other techniques. We will be diving in to that and more in the future.

For now, this is how I have successfully brought about lasting change, in many areas of my life. I continue to use this model on new opportunities for change as well.

Let me know what you think! You can read my blog or follow me on fiallo.com here, follow me on Facebook here, on Twitter here and on LinkedIn here.

8 Myths About Self-Employment

Do you dream of being self-employed, but feel like you don’t have the money, knowledge, or skills to get a business going? Your concerns might be unfounded – and grounded in some of the common myths about self-employment.

Imagine being able to increase your income and have a more flexible schedule. These benefits are a real possibility when you’re your own boss.

So let’s starting exposing the myths for what they really are:

1. Self-employed means working long hours. Many people who work for themselves do work long hours, but this is frequently a choice. They simply love what they do. You will know what level of time commitment it will take be productive and effective, and you will be in control of hours you work.
2. Being an employee is less risky. Employees get laid off all the time. And what if you need to raise some extra cash quickly? That’s tough to do when you’re working for someone else and your income is fixed. Being self-employed gives you more control over your income and the assets of the business. Control helps to reduce risk.
3. Self-employment means putting all your eggs in one basket. If you’re an employee, the main customer you have to please is your boss. If that customer is not satisfied with your services, you risk losing all the eggs in that basket. But if you have many customers or clients, and there is one you are not able to satisfy, you have lost one egg. Having many customers spreads out your risk of loss. You would have to displease all your customers to lose all your eggs.
4. Self-employment equals stress. When you work for yourself, you can create whatever work environment you choose, you can have greater stability over the long-term, and you have more control over your hours. You also have the ability to choose a line of work according to whatever level of stress you find acceptable.
5. Being self-employed is lonely. Actually, working for yourself can be a much more sociable lifestyle, if you choose. With more flexibility, you can often rearrange your schedule to suit your social life. Make friends at trade-related events and meetings. When you work for someone else your co-workers tend to be your social life and over time that can get old.
6. Self-employment means doing everything yourself. It depends on the type of work you choose whether or not this is a burden. While you’re the one that has to ensure that everything gets done, some careers where you are providing professional services can be done without a large team of people. And if in fact your business will require a workforce, you will be hiring others to get the work done.
7. Running your own business is complicated. Yes, there is quite a bit to know, but none of it is complicated. There are books and experts available to help you along the way. Nothing is overly complex about insurance, payroll, taxes, and bookkeeping. It’s just new to you. This can be an invigorating adventure when you have shifted to depending on yourself and your own drive, skills and ability for your income. Seek out expert advice before you take the leap to ensure you are prepared as best you can be.
8. You can’t start a business without a lot of money. That largely depends on the type of business. A website and hosting can cost less than $100 a year. Your home phone or cell phone is already paid for as part of your monthly expenses. A tank of gas isn’t that expensive, relatively. Utilize free advertising or exchange services to advertise through someone else’s active network. Hit the pavement to drum up leads for new clients.

Don’t let a bunch of myths stop you from taking the plunge to self-employment. You can even start a business on the side and continue working your regular job until your new business is bringing in enough income to replace it. If you are considering making the leap to self-employment, and you want to use your knowledge and experience to help others break out of life controlling cycles, a career as a Professional Recovery Coach might be something to consider.

For more information on how you can build a satisfying and profitable Career as a Professional Recovery Coach sign up here for our next webinar. http://ift.tt/1QUTN32

 

 

 

 

 

Addiction Recovery and Self-empowering Treatment

Where does the power in recovery come from? Does it come from a ‘higher power’, pharmaceuticals, group support or from within the patient?

These are some of the questions addressed in this article from The Fix. Richard Jumantalks with Tom Horvath, President of SMART Recovery to discuss SEATA and “self-empowering” treatment.

Where Should the Power in Addiction Recovery Come From?

Tom Horvath, President of SMART Recovery, discusses a new association for providers of “self-empowering” treatment.

Is there a necessary and sufficient “power” source for addiction recovery? Twelve-step programs encourage members to accept a “higher power” as the key element in recovery. Medical providers and advocates of the “hijacked brain” concept of addiction might argue that pharmaceutical power is the logical fuel of recovery, as manifested in Medication-Assisted Treatment. Others, including Dr. Tom Horvath, believe that the power that generates solid recovery should come from within the client, and views treatment as a vehicle for promoting “self-empowering” recovery. In many such cases, clients will opt for a program of recovery that does not necessarily include abstinence from mood-altering substances as an immediate or even an eventual goal. Here, Dr. Horvath describes the concept and SEATA, the new association and directory of like-minded treatment providers…Dr. Richard Juman

Continue Reading…

Hospitals and Opioid Overuse

One of the things that the Affordable Care Act has sought to ensure for patients is that they are well cared for during hospital visits. Medicare payments are allocated to hospitals based on patient satisfaction surveys. These surveys ask patients to measure how well their pain was taken care of during a hospital stay. Physicians find that it’s hard to make people happy without opioid-level pain control, and although it’s not the only factor in the surge of opioid use, this method of measuring a hospital’s success seems to have fueled opioid overuse in the hospital setting.

Time Magazine article April 13, 2016: How Obamacare is fueling the Opioid Epidemic by Sean Gregory.

Some doctors say a quirk in the program is a dangerous incentive to prescribe potentially dangerous painkillers.

Not long ago Dr. Bill Sullivan, an emergency-room physician in rural Spring Valley, Ill., refused to prescribe a potentially habit-­forming painkiller to a patient that had requested it by name. That might seem like a good thing since opioid addiction has become a national epidemic. But in fact, as a result of reforms put in place under the Affordable Care Act, he may have put his hospital at financial risk.

As part of an Obama­care initiative meant to reward quality care, the Centers for Medicare and Medicaid Services (CMS) is allocating some $1.5 billion in Medicare payments to hospitals based on criteria that include patient-­satisfaction surveys. Among the questions: “During this hospital stay, how often did the hospital staff do everything they could to help you with your pain?” And: “How often was your pain well controlled?” Read more

Prescription opioid pain relievers are at the forefront of opioid addiction. They are the driving factor in opioid overdose deaths. Prevention includes educating people and developing strong support BEFORE serious drug use begins to occur.

Professional Recovery Coaches can provide preventative help before treatment is necessary, or help individuals after treatment to learn to implement the skills necessary to stay clean and avoid relapse episodes.

If you are interested in learning more about our Certification Programs in Professional Recovery Coaching visit us here: http://ift.tt/1AwZyYw

When I Become AWARE, I Change

I used to wonder why it was so hard to make changes in my life. When I say change, I am talking about changing stuff about me. For example, exchanging bad habits for good ones (or better ones), changing aspects of myself that needed changing (like intolerance, impatience, pride, arrogance), or changing an intellectual or skill area (like learning a new skill or closing an intellectual gap). The same would apply to any changes one would want to make related to dependencies on substances or other things.

How does one change? I’ve spent a lot of time thinking about this, trying different recipes, throwing out what didn’t work, expanding on what did. For a period of time in my life, I had a lot of “thinking” time on my hands, and many opportunities to see people successfully changing, resisting change, not wanting to change, and failing at change. I saw people make changes, only to fall back into unwanted behaviors, and old, hard-to-break habits.

After time, I was able to get to the heart of the matter, the way that I was able to observe making long lasting changes. This led me to the creation of a model for change that I saw people using without realizing it, and that I have used successfully to make positive changes in my life, and to analyze when I wasn’t successful at making changes.

I change when I become A.W.A.R.E. That’s the name of the model. A.W.A.R.E. What does it mean?

A = Acknowledgment. I see that something needs to change and I acknowledge it. I recognize it and own it as mine.

W = Willingness. I decide that I am willing to change that which I recognize as needing change.

A = Ability. I recognize that what needs to change is based on an old way of looking at something (a paradigm) or of doing something (a habit) and I acquire the ability to do it differently, or to not do it. In other words, I acquire the ability to change. This could take me an hour, a day, even weeks. It might even involve engaging someone to help me through the change, research how to do it differently, or avoid doing it at all.

R = Resistance. I realize that there is resistance to change and I work through how to break through that resistance. I also develop a resistance to fall back into the old way, the old habit.

E – Enablement. Making a change permanent requires practicing it, repeating it until the skill is mastered and becomes part of me. The key is to be able to own the new skill, to make it an integral part of me, so that I don’t even have to think about it, I “Nike” it (Just  Do It!).

So, there it is, a simple model, but one that has worked for me.

Now, you are probably saying to yourself, “Easy to describe, hard to do”.  And I totally agree. There is a lot of detail and hard work behind the model, which is really the important part that makes the change happen.

I’ll be digging deeper into the model in future posts. I’ll be sharing the details behind what makes the model tick. For example, the ability to make a change, involves a significant level of effort, including training, coaching, mentoring, and other techniques. We will be diving in to that and more in the future.

For now, this is how I have successfully brought about lasting change, in many areas of my life. I continue to use this model on new opportunities for change as well.

Let me know what you think! You can read my blog or follow me on fiallo.com here, follow me on Facebook here, on Twitter here and on LinkedIn here.

 

Enrique Fiallo

I am an author, lecturer, speaker blogger, coach and mentor. My life experience includes roles as a CEO, CIO, COO, Chief Technologist, Teacher, Program and Product Manager and Scrum Master.

8 Myths About Self-Employment

Do you dream of being self-employed, but feel like you don’t have the money, knowledge, or skills to get a business going? Your concerns might be unfounded – and grounded in some of the common myths about self-employment.

Imagine being able to increase your income and have a more flexible schedule. These benefits are a real possibility when you’re your own boss.

So let’s starting exposing the myths for what they really are:

1. Self-employed means working long hours. Many people who work for themselves do work long hours, but this is frequently a choice. They simply love what they do. You will know what level of time commitment it will take be productive and effective, and you will be in control of hours you work.
2. Being an employee is less risky. Employees get laid off all the time. And what if you need to raise some extra cash quickly? That’s tough to do when you’re working for someone else and your income is fixed. Being self-employed gives you more control over your income and the assets of the business. Control helps to reduce risk.
3. Self-employment means putting all your eggs in one basket. If you’re an employee, the main customer you have to please is your boss. If that customer is not satisfied with your services, you risk losing all the eggs in that basket. But if you have many customers or clients, and there is one you are not able to satisfy, you have lost one egg. Having many customers spreads out your risk of loss. You would have to displease all your customers to lose all your eggs.
4. Self-employment equals stress. When you work for yourself, you can create whatever work environment you choose, you can have greater stability over the long-term, and you have more control over your hours. You also have the ability to choose a line of work according to whatever level of stress you find acceptable.
5. Being self-employed is lonely. Actually, working for yourself can be a much more sociable lifestyle, if you choose. With more flexibility, you can often rearrange your schedule to suit your social life. Make friends at trade-related events and meetings. When you work for someone else your co-workers tend to be your social life and over time that can get old.
6. Self-employment means doing everything yourself. It depends on the type of work you choose whether or not this is a burden. While you’re the one that has to ensure that everything gets done, some careers where you are providing professional services can be done without a large team of people. And if in fact your business will require a workforce, you will be hiring others to get the work done.
7. Running your own business is complicated. Yes, there is quite a bit to know, but none of it is complicated. There are books and experts available to help you along the way. Nothing is overly complex about insurance, payroll, taxes, and bookkeeping. It’s just new to you. This can be an invigorating adventure when you have shifted to depending on yourself and your own drive, skills and ability for your income. Seek out expert advice before you take the leap to ensure you are prepared as best you can be.
8. You can’t start a business without a lot of money. That largely depends on the type of business. A website and hosting can cost less than $100 a year. Your home phone or cell phone is already paid for as part of your monthly expenses. A tank of gas isn’t that expensive, relatively. Utilize free advertising or exchange services to advertise through someone else’s active network. Hit the pavement to drum up leads for new clients.

Don’t let a bunch of myths stop you from taking the plunge to self-employment. You can even start a business on the side and continue working your regular job until your new business is bringing in enough income to replace it.If you are considering making the leap to self-employment, and you want to use your knowledge and experience to help others break out of life controlling cycles, a career as a Professional Recovery Coach might be something to consider.

 

 

 

 

 

 

For more information on how you can build a satisfying and profitable Career as a Professional Recovery Coach sign up here for our next webinar. http://ift.tt/1QUTN32

Addiction Recovery and Self-empowering Treatment

Where does the power in recovery come from? Does it come from a ‘higher power’, pharmaceuticals, group support or from within the patient?

These are some of the questions addressed in this article from The Fix. Richard Juman talks with Tom Horvath, President of SMART Recovery to discuss SEATA and “self-empowering” treatment.

Where Should the Power in Addiction Recovery Come From?

Tom Horvath, President of SMART Recovery, discusses a new association for providers of “self-empowering” treatment.

                                                                         Tom Horvath Tom Horvath

Is there a necessary and sufficient “power” source for addiction recovery? Twelve-step programs encourage members to accept a “higher power” as the key element in recovery. Medical providers and advocates of the “hijacked brain” concept of addiction might argue that pharmaceutical power is the logical fuel of recovery, as manifested in Medication-Assisted Treatment. Others, including Dr. Tom Horvath, believe that the power that generates solid recovery should come from within the client, and views treatment as a vehicle for promoting “self-empowering” recovery. In many such cases, clients will opt for a program of recovery that does not necessarily include abstinence from mood-altering substances as an immediate or even an eventual goal. Here, Dr. Horvath describes the concept and SEATA, the new association and directory of like-minded treatment providers…Dr. Richard Juman

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Visit Recovery Coach Training for more information on different substance use disorders and their treatments. Stay updated with the latest news and advancements in addiction recovery.

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Substance Abuse and Domestic Violence

Alcohol consumption has long been associated with domestic violence, and erratic temperamental issues. Different studies have pitted substance abuse as either a cause of domestic violence or as a means to aggravate and reveal underlying biases. In any case, substance abuse seems to promote intimate partner violence.

For a more in-depth analysis of this link between substance abuse and domestic violence, read this article from The Fix. Richard Juman talks with Dr. Kenneth Leonard, the award-winning director of the Research Institute on Addictions at the University of Buffalo, to shed some light on this matter.

 

Examining the Link Between Substance Use and Domestic Violence

Looking back on your body of work to date, what aspects do you feel have had the most significant impact on the addiction field? 

Kenneth Leonard: There have been two aspects of our work that I think have had the greatest impact. The first of these has been our work on substance use and intimate partner violence. We began this work in the late 1980s, focusing primarily on alcohol use. At that time, there were consistent findings from college students in laboratory studies that acute alcohol consumption resulted in increased aggression, and although based largely on one study and cross-cultural observations, there was a growing sense that intoxication was used as an excuse for aggression, but did not have any causal impact. Click here for full post

Visit Recovery Coach Training for more information on different substance use disorders and their treatments. Coaches certified by us are trained to provide assistance to patients with special requirements.

How to and How not to Counsel Young People

A lot of people today are dealing with substance abuse. Drug and alcohol addiction is rising at an alarming rate. When dealing with a loved one’s drug addiction, people often lose their forbearance and try to impose their sense of reality on them. It’s no surprise that parents are becoming paranoid and trying what they think is best to prevent their children from drug abuse. However, being too confrontational can backfire and prevent children from expressing themselves to their parents. This further hampers their condition as they end up depending on unreliable support systems instead.

Image Source: Shutterstock

As responsible adults, it is our duty to provide young people with the care and attention they need without resorting to judgmental behavior.

Robert Schwebel from The Fix sheds light on ways you can push young people further down the rabbit hole. In the second half of the article, he describes methods to make young people comfortable in letting you help deal with their addiction.

How to Make Sure Young People Never Get Drug Counseling

Tell them they are powerless, tell them you trust them but conduct drug tests, be an alarmist and other effective ways to get your kids to avoid getting help.

Because so many young people have been mandated into drug treatment, counselors and counseling agencies have taken client participation for granted. They now face the challenge of trying to make their services more appealing to clients, an effort that they have not had much experience in. One exception has been The Seven Challenges program, created 25 years ago by Dr. Robert Schwebel as a way of engaging young people in a discussion about their relationship with drugs so as to empower them to consider self-directed change in their patterns of substance use. His methods are in contrast to the majority of programs that continue to use coercion and enforced abstinence as strategic pillars. Here, Dr. Schwebel begins by lightheartedly depicting the folly of the current dominant treatment models before discussing how to design a treatment program that could engage young people in ways that promote hope and optimism…Richard Juman, PsyD. See full post

For more information on substance abuse and your recovery options, visit Recovery Coach Training.

4 Reasons Why Broken and Restored is Better Than New

Western society discards used and broken items like so much flotsam and jetsam. Once something loses its shiny and new appearance, we don’t want it anymore. Trash piles and landfills are replete with mounds of unwanted, broken and discarded things. First desired and valued, once we have “put a few miles” on these treasures, once they have become broken and flawed, we are quick to disregard, to snub, to throw away.
We do this with people as well. We kick once close friends to the curb if they fall from grace. We brand as forever useless and shameful, those that no longer meet our definition of the beautiful, desirable and ideal. We are quick to judge, slow to forgive and relentless in our persecution of those unfortunate human beings that make mistakes, fall off the wagon, and no longer measure up to our self defined and imposed standards.

Japanese society and culture is quite different. The Japanese continue to treasure and value once broken things, repaired and restored to a new level of beauty. The essence of this philosophy is called Wabi Sabi.

Wikipedia defines Wabi Sabi as the comprehensive Japanese world view or aesthetic centered on the acceptance of transience and imperfection. The aesthetic is sometimes described as one of beauty that is “imperfect, impermanent, and incomplete”.

Wabi Sabi is well captured in the concepts of Kintsukuroi, the art of repaired pottery, also known as Kintsugi, golden joinery, or joined with gold. Basically, when an item of pottery or ceramic is broken, it is not looked down on and discarded. It is repaired, with gold and lacquer or epoxy. The repaired item now takes on a new life, and is even more treasured and valued than it was originally.

Let’s relate these concepts to people. People rise to great heights, emotionally, spiritually, mentally and physically. In both their professional and personal lives, people excel, they prosper and achieve great success. But at times, people “fall of their shelf” like a piece of beautiful pottery, and break. They can be dropped like we would drop a treasured ceramic serving bowl, no longer able to serve the original purpose, becoming pieces of brokenness and shame. They are shunned, snubbed, discarded.

What if we were to apply Wabi Sabi, utilizing techniques like Kintsugi, like Kintsukuroi, to repair and restore these broken lives? Why wouldn’t their value be restored? Why couldn’t we once again begin to cherish and treasure them, as we once did in their original state? Why wouldn’t their lives be able to start anew?

I submit to you that all of the above can and should apply to people who have been repaired and restored. As a former truly broken and shattered person, due to a period in my life I am not proud of, I can attest to both the shunning and shame, as well as to the restoration and value that takes place after a period of applied Kintsurukoi.

We do know it is true that some people will never repair and restore. They will remain broken and flawed, mostly due to a self-imposed sense of shame and lack of self-esteem. They will forever be relegated to the landfills of life, never to be valued again. But many can and will regain their beauty and value. And again I submit to you that they are worthy of our admiration and re-acceptance. Here are 4 reasons why:

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1. When people break and shatter, the ordeal and the process of restoration teaches valuable lessons. We can greatly benefit from these lessons. Re-engaging with restored people will in turn add significant value to our lives as we learn from their lessons
2. Repaired and restored people are great role models. We can point to the breaks as pitfalls to avoid in our own lives
3. We enrich our own lives and fulfill one of the prime reasons we exist, by extending a helping hand, and by putting those restored people back on their valued place on the “shelf”
4. Putting people back to good useful work, much like putting that serving dish back into service, is an effective and efficient use of valuable resource, something which our planet sorely needs.

We can learn much from Japanese culture. Wabi Sabi, embodied in the concepts of Kintsugi and Kintsukuroi, are lessons our society should adopt and embrace. There are a lot of formerly broken people, now repaired and restored that should be welcomed back into our lives. They should be put back on their “shelves” to be admired and revered. They deserve it, and we deserve benefitting from the valuable lessons and renewed beauty they have to share with us.

Let me know what you think about all this. I’m keenly interested!

My blog is located HERE

Non-compliant Patients and ‘Carefrontation’: Challenging Stigma

Often faced with stigma, patients who do not adhere to treatment procedures do not take confrontation well. In fact, it can sometimes push them further into denial and refusal to accept their condition. Sometimes a more careful approach is necessary.

Richard Juman asks Dr. Harris Stratyner about his “carefrontation” approach to treating diffident and non-compliant patients. Here is the article from The Fix.

Source: Dr. Harris Stratyner

‘There is No Room for Stigma’ in Addiction Treatment

How a prominent clinician developed “Carefrontation” in his work with patients.

Dr. Harris Stratyner, PhD is a licensed ​psychologist and an internationally recognized expert on addiction, with a particular specialty in co-occurring disorders. He is the Vice President and New York Regional Clinical Director of Caron Treatment Center and Clinical Associate Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai. Dr. Stratyner​ also​ maintains a private practice in New York​. He is the co-author of the PDR Guide to Pediatric and Adolescent Mental Health​.

His treatment approach, in contrast to those that rely on confrontation when patients fail to adhere to prescribed behaviors, holds them to a single standard, that they strive to become experts about their illness and devise a treatment plan that will set them on a road to stable recovery. See full post

In order to ensure proper recovery, it’s important that we encourage patients to be responsible for themselves. Being too confrontational can bring undesired results to fruition and make the patient lose any control over their behavior; while giving them care and support without enabling their addictive behavior can turn the tables and help them recover quickly.

For more information and regular updates, visit Recovery Coach Training.

What Makes Some People More Vulnerable to Addiction?

It has long been argued that substance abuse is a symptom of psychological distress, and that people get addicted as a means to overcome their emotional and mental duress. Thus addiction can be viewed as an attempt to relieve this stress. Could it be then that people with certain psychological imbalances are more prone to addiction?

Source: Shutterstock

Renowned professor of psychiatry, Edward Khantzian who is known for propagating the self-medication hypothesis of drug abuse writes for The Fix on why some people are more vulnerable to addiction than others.

Why Are Some People More Vulnerable to Addiction than Others?

“I don’t use the heroin to get high; I use it to feel normal.”

Addiction Treatment pioneer Edward Khantzian has had a bird’s eye view of every substance use trend and drug epidemic over the past half-century. His Self-Medication Hypothesis, which encourages the view of addiction as an attempt, however unsuccessful or self-defeating, to relieve the user’s internal psychological distress, has demonstrated both empirical and intuitive validity over time. In his second piece for Professional Voices, Dr. Khantzian looks at the Q Ball phenomenon, in which people seek out and “misuse” the powerful antipsychotic Seroquel…Richard Juman. See full post

Coaches certified by Recovery Coach Training are trained to deal with all aspects of patient recovery. We understand that every patient has their own set of needs, and we treat every patient in a unique way most suitable to them.

Treatment Resistance, ‘Background Noise’ and Psychopharmacology

During the course of recovery, patients might get disillusioned with their treatment and start resisting it. Many people find it hard to go through the treatment without understanding its fundamentals.

Psychiatrist Francis Mas, MD describes to The Fix how he treats patients who are treatment resistant, and explains the idea of “background noise”.

How Psychiatric “Background Noise” Interferes with Optimal Functioning

An eminent psychopharmacologist works like a detective to help patients gain access to their inner core of strength.

In practice for almost 40 years, Francis Mas, MD, has become a “psychiatrist’s psychiatrist” because of his mastery in treating treatment-resistant and complex cases, working with patients who often feel depleted by multiple previous treatment failures. One reason for his success is his ability to quickly form a positive therapeutic working alliance with patients by framing their psychiatric symptoms as “background noise” that is interfering with their access to inner resources of their core self. This paradigm allows him to operate with a shared language that patients and consulting psychotherapists can use to communicate about the vicissitudes of the patient’s clinical presentation and ability to do deeper work on the essential psychic issues. Working like a detective in search of clues as to the nature of diagnosis, exploring the difficult niches found between categorical DSM approaches, Dr. Mas’s goal is to help his patients gain access to their authentic natures. Here, he explains the origins of his approach and highlights its application in his work with a patient with an unusual clinical presentation…Richard Juman, PsyD. See full post

At Recovery Coach Training, we put a lot of emphasis on complete recovery. Our coaches are trained to deal with all kinds of substance abuse patients, and help them and their families through the hard phase of recovery.