In my career as an addiction specialist, I have found that treatment is most effective in multidimensional form, when the twelve-step modality is combined with behavioral therapies, motivational enhancement therapy, psychiatric care, and other psychosocial methods. This type of comprehensive support system fully embraces the benefits of the twelve-steps while also recognizing they are most beneficial when used in conjunction with other modalities, particularly a clinically intense model.
The twelve-step facilitated (TSF) model is primarily targeted toward “students” of addiction. Twelve-step meetings teach awareness of the disease of addiction and participants aim to develop an understanding of how the disease is expressed in their own lives. By attending meetings and working the steps, individuals can create an awareness of the remedy and find the hope needed to achieve it.
The clinically intense model is primarily targeted toward patients, clients, consumers, and guests. Participants aim to acknowledge their disease through the development of insight, a commitment to recovery, and the reduction or elimination of inducements to use. The combination of these two models creates well-rounded, self-sufficient individuals who are able to achieve lifelong recovery.
I instruct my clients to focus on seven dimensions during their holistic recovery:
1. Abstinence. This means not having alcohol or drugs in your system, while also eliminating the other factors that cause dysfunction in your life, for example negative thoughts, codependent behaviors, self-defeating communication styles, or other individual issues that might be holding you back from achieving self-actualization.
2. Peer Support. Be it from twelve-step meetings, the community milieu, or both, peer support is a crucial part of the treatment experience. Healthy bonding and staying accountable to others is vital in working through issues keeping you stuck in unhealthy patterns. I urge clients to assist others on their recovery journeys by sharing personal experiences and advice, and encourage family therapy sessions to facilitate effective communication between loved ones.
3. Professional Guidance. I find that hiring passionate, dedicated staff members makes all the difference when it comes to treating clients. Many of the individuals I hire have overcome their own challenges with addiction and/or mental health, and can use those experiences (as well as their clinical training) to help others.
4. Medication Review. Medication assisted treatment (MAT) is an important part of addiction treatment for many individuals. I continually review past and current medications for each of my clients to ensure that their prescriptions are still necessary and effective.
5. Nutrition. Regular, healthy food intake allows for homeostasis in the brain and assists in healing the damaged neurons and synapses contributing to the disease of addiction. Nutrition needs are individual to each client, though a balanced diet is essential for everyone in recovery. In particular, I encourage a 4oz smoothie upon waking up in order to start the body’s metabolism in a healthy, natural manner.
6. Exercise. Regular exercise provides healthy neurological activity in the brain and has been shown to reduce anxiety and depression. I encourage the use of exercise for achieving mental peace in treatment, as opposed to meeting a certain physical standard.
7. Ritual/Twelve-Step Specific Component. Rituals and daily structure provide clients with the ability to gain self-confidence, as well as self-respect. Clients gain insight through therapy sessions and self-reflective journaling, while also making secondary gains in terms of accountability, self-respect, and responsibility.
This multidimensional approach to treatment assures benefits to everyone in some way or another. It encourages active participation in the lifelong recovery process and is designed to inspire self-sacrifice and “moral consciousness” in place of self-absorption. It incorporates taking moral inventory and seeking self-improvement, while benefiting from a communal approach to healing.
Hopefully down the line, all treatment facilities will be holistically centered in this manner and focused on outcomes, and not revolving door treatment centers that take people in and spit them back out without caring about their future.
Dr Andrea Barthwell MD is the Founder of Two Dreams Drug and Addiction Treatment. Megan Crants is Adjunct Clinical Staff Member and Head Writer.