When Life Became Unmanageable | Alumni

Written by MARR on June 22, 2016. Posted in MARR Articles, Resources.

I had my first drink at sixteen, and what started out as relatively normal teenage rebellion and social experimentation, quickly became daily drinking by the time I was 19. When I drank, it took away all insecurities and helped me feel comfortable in my own skin. As a result, I taught myself that alcohol was the solution to pretty much everything. Consequences from my drinking came relatively quickly, starting with loss of trust with my parents, legal incidents, car accidents, loss of jobs, the dissolution of any and all meaningful relationships, and ending with ultimate feelings of helplessness and hopelessness. I had no idea what was wrong with me and why I couldn’t stop drinking and doing the things that caused me and those around me so much pain.

I was 22 years old and six months sober when I walked into MARR Women’s Center in 2013. Prior to MARR, my first treatment was July 14, 2012 at a 45-day program. I thought it was just what I needed to learn to manage my drinking like “normal” people. I was just going through the motions at this point. Upon completion of that program it was recommended that I go to a recovery residence in order to ease my transition back into “the real world”. After four months in the residence I ended up back in my hometown. It became very apparent to me and my parents that I had barely scratched the surface. After diligent research on my parents’ part, they came across MARR. My mom and dad felt very strongly about the program at MARR and what it had to offer. I won’t say that I went kicking and screaming but to say that I was thrilled with the prospect of going to treatment again would be an understatement!

I arrived at the WRC January 17^th 2013. I quickly learned that I clearly could not manage my own life and I had to turn it all over to something greater than myself, which at that time was the staff at MARR WRC. I had to make some serious changes in order to not only stay sober, but to live the life I dreamed of having. The therapeutic community and group setting that MARR provided has forever changed my life. I have real friendships that I never imagined possible, and a relationship with my family that I can finally be fully present for. All the blessings in my life today would not have been possible without the scholarship I received. My family and I will never forget that gifts from people we didn’t even know allowed this miracle to happen. I am so blessed and beyond thankful for MARR and the foundation they provided for living a life of hope, serenity and gratitude!

Emily B.

Successful Outcomes from an Abstinence-Based Model

Written by MARR on June 22, 2016. Posted in MARR Articles, Resources. 6 Comments on Successful Outcomes from an Abstinence-Based Model

By Jim Seckman, MAC, CACII, CCS

First of all, before you form an opinion based on the title of the article, please let me state as clearly as possible, that the use of buprenorphine (suboxone) is not really my issue here. If we back up for a moment, I can absolutely affirm that the values of programs who prescribe buprenorphine and those of abstinence-based programs are exactly the same: We all want to save lives. That really is the bottom line. I agree there is evidence that shows that the use of buprenorphine allows many individuals to get off heroin and participate in treatment. That evidence is not my issue either.

The issue for me is the unqualified endorsement of the use of buprenorphine as the only viable treatment for opioid use disorder to the exclusion of other treatment modalities that are also proven to be effective.

The opiate epidemic has intensified fears of families and communities, and with good reason. In a reaction to the demands of communities, there has been a movement from legislators and the medical community towards medication-assisted treatment (MAT) that focuses almost exclusively on the use of buprenorphine, which is itself an opioid based narcotic. This has also led to treatment becoming more individualized and away from a longer length of stay and the therapeutic community model.

And, what is even more disturbing, is that many of the most vocal proponents of MAT completely ignore approved medications that are extremely effective, but not opioid based: Naltrexone and Vivitrol (extended release Naltrexone). These medications negate the effects of opiates in the brain and have been shown to reduce cravings, thus allowing clients to participate fully in treatment without any opioid based medications.

MARR has just completed an 8-year study that demonstrates the efficacy of an abstinence-based model that works with clients who are suffering from opioid use disorder. We found that as we modified our program structure to meet the needs of these clients, we began to see higher retention rates and successful completion rates that consistently surpass the national averages for long-term treatment programs.

I have no doubt that evidence shows that buprenorphine works. However, it is unfortunate and misleading, to the public at large and to helping professionals, to ignore existing and emerging evidence that shows that abstinence-based programs, particularly those that are long-term, based in the therapeutic community model, and who use Naltrexone and Vivitrol as support medications, are effective as well.

We are all working very hard to save lives and address this terrible epidemic. It is clear that we need a variety of modalities in our treatment approaches in order to be effective across a broad spectrum of clientele. Please don’t be intimidated by the strong, singularly focused voices out there right now. Let your voice be heard about the practices and modalities that you know work for your population!

Connections in Recovery

Written by MARR on April 5, 2016. Posted in MARR Articles, Resources.

By Jim Seckman, MAC, CACII, CCS

At MARR we work with people who have a very complex and powerful disease that affects every aspect of their lives. In fact, it is so powerful that it easily overwhelms all situations and people surrounding it.

How can recovery work?

We cannot effect change in our lives and get into recovery by ourselves. By working together in a community of others committed to recovery, a therapeutic community, and by trusting and relying upon God, true change and recovery can take place. It’s really the only way to fight this disease and start truly living.

The community model sets MARR apart, promoting accountability, responsibility, and acceptance. Together in a home-like setting, clients learn to live healthier lives through a connection with self, others, and a Higher Power. Balancing the daily activities of treatment, groups, employment, and home life within the therapeutic community offers the necessary life skills for long-term recovery.

At MARR, we work together with the clients to bring total and lasting recovery to addicted individuals and their families. I can’t, we can becomes the foundation for the work that needs to be done.

MARR Recognizes National Eating Disorder Week

Written by MARR on February 26, 2016. Posted in MARR Articles, Resources.

By Jessica Brothers, LPC

We want “whole-person” recovery.
While much of the nation’s focus has been on the opioid epidemic, it is also important to highlight that Eating Disorders can be just as harmful. Here in the United States, millions of people are suffering with a Substance Use Disorder, and typically only 10% seek out treatment. The same alarming statistic can be seen with Eating Disorders. The mortality rate for certain substance related deaths have quadrupled in the last decade, however, Eating Disorders continue to have the highest mortality rate of mental health diagnoses. Recent research has shown that not only is there a genetic predisposition for alcohol and substance dependence, but also for eating disorders. In fact, some of the same genes may be involved with both, having similar pathways in the brain. It is important to seek help and treat both. MARR believes it is important to recognize National Eating Disorders Awareness week because of the correlation between substance abuse and eating disorders.

MARR was established in 1975 as a residential service for men. In 1980, the founders added a similar program for women, but wanted to remain gender-separate to cater to the uniqueness of each person. As MARR grew, we found a correlation between women with substance abuse and unhealthy eating behaviors and body image issues. In the early 2000s, MARR’s Disordered Eating (DE) program was created to help educate these women on their co-occurring body image and eating disorders to their use of drugs and alcohol.

Most patients enrolled in our DE program have been previously diagnosed or currently meet subclinical criteria for an Eating Disorder. Though MARR’s primary focus is on substance abuse, it is important to address the disordered eating behaviors to prevent relapse on either. According to the National Eating Disorders Collaboration, “disordered eating is a disturbed and unhealthy eating pattern that can include restrictive dieting, compulsive eating or skipping meals,” (NEDC,2015). It extends to other behaviors, such as a pattern of excessive dieting including fasting, hiding food, eating in the middle of the night (night eating), self-induced vomiting, laxative or diuretic use, steroid use, eliminating certain foods or an entire food group from their diet, and compulsive exercise.

Many of our patients have not been active in these DE behaviors recently, as they were more focused on substance use. When their primary coping mechanism, drugs and/or alcohol, is taken away, these unhealthy eating behaviors tend to resurface. As the patient’s relationship with food and body image can become a trigger for their relapse, MARR believes it is critical to address these behaviors and thought patterns to achieve “whole person” recovery.

Generally, 30-40% of the women enrolled in our program participate in our DE Program. These women are provided with additional support; a registered dietitian to help create a healthy eating program, psycho-education groups on DE behaviors, additional weekly groups to address body image, and exploring new coping mechanisms. Because of the extra support, 60-65% of women in the DE Program successfully complete treatment, which is higher than the national average of women completing treatment.

While some patients are able to identify the harmful behaviors associated with their co-occurring disorders, many have not realized the connection between food and body image and their substance use. While at MARR, patients are challenged to explore all issues associated with addictive patterns in order to treat the whole self and support total and lasting recovery.

References
Disordered Eating and Dieting. http://www.nedc.com.au/disordered-eating (2015)
National Eating Disorders awareness. http://nedawareness.org/about (2016)

Individualized Treatment Plan

Written by MARR on May 24, 2015. Posted in MARR Articles.

At MARR we develop an individualized treatment plan unique to each client. Although the disease of addiction has many common characteristics, each client comes to treatment with their specific history and clinical needs.

The individualized treatment plan structures the client’s care around specific issues connected with and underlying their substance abuse. The treatment plan then lays out goals and objectives for addressing each of these problems. This structured approach ensures that the clinical team’s interventions address the client’s core issues that have historically led to relapse.

Psychosocial Assessment

One of the primary tools used to develop the individualized treatment plan is the psychosocial assessment. This is one of the first items we work on with a client when he or she comes to MARR. Using this evaluation, the primary counselor talks with the client and takes notes on his or her life history, family background, medical history, and history of substance abuse, among other things.

From the psychosocial assessment, the clinical team works with the client to generate the list of problems that will be addressed during their time in treatment. Some examples are:

Inability to maintain sobriety
Inability to understand feelings
Inability to understand addiction
Relationship problems
Spirituality problems
Sexual trauma
Other forms of trauma
Depression
Anxiety
Disordered eating

Implementing the Individualized Treatment Plan

For each problem listed in the treatment plan, there is also a stated goal for the client’s treatment. Aligning with that goal, the individualized treatment plan specifies objectives and plans of implementation. Writing these out ahead of time provides the clinical team a guide to ensure that the client’s core issues are addressed throughout their time at MARR.

At the end of Phase I, the clinical team reviews the treatment plan with the client and assesses the progress that they see in meeting the client’s treatment goals. The treatment plan also serves as a point of reference for clinicians who interact with the client in the group or individual setting. Therapists leading groups or working with clients individually can use the treatment plan to ensure that the interventions they are using address the overall goals for the client’s stay in treatment.

Successfully and thoroughly addressing the issues that extend beyond substance abuse allows our clients to live a life of meaning and connection that they had not been capable of before treatment.

Expressive Therapy at MARR Expressive Therapy at MARR

Gardening as Expressive Therapy

Written by MARR on May 24, 2015. Posted in MARR Articles.

Expressive therapy, sometimes referred to as “experiential therapy”, is an approach to therapy that comes out of the holistic wellness model. By using physical and creative expressions like art, music, or play, expressive therapy helps clients to process emotions in a way that enhances and supports other forms of therapy that we provide at MARR like individual talk therapy, groups, and skill-based approaches.

Involving the physical body and creative expression allows clients an opportunity to work through emotions that they might not be able to in traditional talk therapy.

Gardening as a Recovery Tool

One of the ways that we implement expressive therapy at MARR is through our community vegetable gardens. Physically engaging with the life cycle of the plants facilitates a deep level of learning about the patterns of growth and development that translate into their lives outside of treatment.

Like gardening, recovery is a long, extended process that requires attention and care. It doesn’t happen overnight. It often involves setbacks and disappointments as well as moments of excitement and surprising growth. The patience required for both can be frustrating. This is particularly the case in the early days when there is not much to show for their efforts. Like the seed going into the soil, a new life in recovery starts from a humble place.

Through gardening, all of these lessons are learned deeper than one learns them by reading or hearing these metaphors. By getting their hands in the soil, our clients have an opportunity to learn these realities in a tactile way. The creative act of moving the dirt around puts them in touch with the pattern that all of life follows.

Normalizing the Process of Growth

One of the tricks that addiction plays is convincing the addict that their situation is absolutely unique to them. To counter this, the process of planting seeds and nurturing them as they grow allows our clients to physically experience that all the natural world follows the pattern of death and rebirth. They are not alone. The lessons they are learning through their struggles in early recovery are deeply tied to the pattern of life itself.

This daily activity of caring for something over the course of time carries a wealth of experience that translates into a life in recovery.

At MARR, the creative and expressive act of gardening is a therapeutic activity that allows our clients to work through and see the beauty of the rebirth they are experiencing in early recovery.