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Webinar presenter offers guidance for uniting 12-Step, CBT approaches

April 9, 2013
by Gary A. Enos, Editor
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With such a disconnect between the addiction field’s most widely researched treatment approach (cognitive-behavioral therapy, or CBT) and its most widely used strategy (the 12 Steps), providers and patients alike would benefit from clinical programs that integrate the two schools of thought, said the presenter of an April 9 Addiction Professional webinar program.

“I believe there is a need for a new model,” said Adam Downs, director of substance abuse counseling and recovery services at the University of Alabama. At multiple locations where Downs has worked, including his current work with college students, he has employed an integrated approach that he refers to as “Recovery in Action.”

In this week’s hourlong webinar sponsored by Foundations Recovery Network and health management company Alere, Inc., Downs outlined the phases of a treatment model that involves a lengthier duration and more attention to family and social support than does CBT, along with better knowledge of 12-Step principles on the part of participating therapists.

“The therapist must understand the 12-Step process,” he said, including details on meetings in the community and the role of sponsors. He urged clinicians to “go to open meetings, and ask questions.”

Downs referred specifically to manuals that train clinicians in using CBT; these manuals in fact state that for many individuals, the relatively brief time frame that CBT occupies does not suffice, especially in the case of those who cannot maintain at least three weeks of continuous abstinence.

Downs, who in the fall will receive a PhD in human development and family studies from Michigan State University, described Recovery in Action as having no session limit and not being bound by a linear progression. “In phase three, you can go back to working on something in phase one,” he said of his approach.

The six phases of Recovery in Action, starting with identifying and coping with triggers and then progressing to preparing for and monitoring the future, combine 12-Step and CBT principles and emphasize the client skills of honesty, willingness and open-mindedness. Several phases incorporate written exercises, such as listing how a client will respond when faced with a high-risk situation; recounting the people the addict has harmed and how he/she will make amends; and chronicling seemingly mundane everyday decisions that could actually trigger high-risk behaviors.

Downs said the treatment model is designed for use in outpatient settings but could be modified for an inpatient milieu. He added in response to numerous questions from webinar registrants that it could easily be adapted to the treatment of co-occurring addiction and mental illness and to the treatment of process addictions.

Foundations Recovery Network on May 16 will sponsor another Addiction Professional webinar titled “Enabling, Rescuing and Controlling: It’s Not Just for Families Anymore,” Visit www.addictionpro.com/webinars for more information.                      

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