How to Choose the Right Treatment Modality

Innovations in the range of evidence-based treatments, therapy and psychosocial services such as treatment centers, psychiatric rehabilitation, housing, employment and peer supports have made wellness and recovery a reality for people living with addiction and mental health conditions.

Choosing the right treatment modality and supports that work for you or your loved one is an important step in the recovery process. Treatment choices for addiction and mental health conditions will vary with each individual. Even people with the same diagnosis will have different experiences, needs, goals and objectives for treatment. There is no “one size fits all” treatment.

When people are directly involved in designing their own treatment plan, including defining recovery and wellness goals, choosing services that support them and evaluating treatment decisions and goals, the overall experience of care is much better.

There are many things that can improve and enhance the experience of healing. Therapy, social support, community involvement and education. Medication and medical assistance is also a consideration depending on your situation. How to know which modality is right for you or your loved one can be challenging. Many people start with going to an individual therapist to help navigate what they need. This is a good place to start if you are having life stressors or you simply need someone neutral to discuss and try to improve. If your issues are more pressing or you are unable to function in the capacity that allows you to have a fulfilling life, you might want to consider more. Perhaps an assessment with a medical professional like your internist or psychiatrist is indicated. You and your therapist can start by creating some goals for treatment, come up with a working diagnosis, and track your improvement over a period of a few months.

Therapy can take many forms, from learning relaxation skills to intensively reworking your thinking patterns. Social support, acceptance and encouragement from friends, family and others can also make a difference. Education about how to manage a mental health condition along with other medical conditions can provide the skills and supports to enrich the unique journey toward overall recovery and wellness. If you decide with your therapist that you may need more than therapy, ask for help in designing a plan that meets your individual needs. There are so many treatment options available and sometimes navigating through this process is daunting unless you have help.

Treatment for mental health conditions and substance use or what has been termed “dual diagnosis” or “co-occurring disorders” is not a one size fits all approach. Treatment can include therapy, support groups, treatment centers, private doctors, community mental health centers, emergency rooms, hospitalization. Knowing where to look and what to expect can help reduce confusion and stress.

Treatment centers that provide a “one stop shopping” can have many benefits. If you and your therapist or doctor have decided that going into treatment is right for you, here are some things to consider when choosing the right fit.

Some things to consider when choosing the right program for you:

  • Work with your current treater to figure out what the best level of care is for you.
  • Do your homework. Ask your treater and others which treatment centers they have worked with and prefer.
  • Research the treatment center online, look at reviews.
  • Speak to the admissions counselor and have a list of questions prepared.
  • Look at the staff page on their website. Ask about specific doctors and staff and how often they are at the facility and how often you will see them.
  • If possible, tour the facility

Coronavirus Anxiety

The Coronavirus is causing necessary and unnecessary anxiety.

If you’re wondering how to cope with anxious feelings as it is surfacing, here are some tips to help you in the coming weeks.

If you already struggle with anxiety, worries about your health, or obsessive thoughts and actions, you might need additional assistance,

Knowing how to manage your own anxiety always takes a little thought so try to answer these questions:

  • What do you fear the most?
  • Do others around you seem more or less anxious?
  • What usually helps you handle worries?

When there seems to be heightened anxiety as we are seeing with the press from the Coronavirus, it is important to stick to numbers and facts that are put out by reputable sources. Try not to listen to friends, co-workers or people on social media…you will simply get misinformation and you will be in jeopardy of taking on others peoples anxiety instead of focusing on necessary concerns.

Please don’t overdose on hype or worry or misinformation. Get regular updates from credible sources in the morning and check again briefly toward the end of the day. There’s no need to stay tuned in 24/7, it can actually make your anxiety much worse.

When anxiety rises because we’re facing a distressing threat like the new coronavirus, we need to focus on what tends to work for us to ease.

Keep these thoughts in mind. You’re fully prepared to help yourself. You can take steps to calm and steady yourself. Remember what works for YOU in times of crisis.

Try to connect with friends and supportive people through video, phone calls, texting, and email. It really helps to feel the strength of your connections to your friends and loved ones, even though you may not be with them in person.

Here are some tried and true ways to ease your anxiety:

  • Regular meditation is very calming. Many apps teach simple forms of meditation, such as Headspace or Calm.
  • Yoga is a stress reducer. Yoga Studio and Pocket Yoga are good apps to consider. You can also access a lot of yoga classes on
  • Breathe- You can do deep breathing as a way to relax you mind and body. Take ten deep breaths in and pay attention to your mind body connection.
  • Read a good book, watch a funny movie, do an art project, clean your closets.

Try to stay calm. News about the virus will likely grow worse, then grow better. Listen to public health experts who can help us navigate the path ahead. Take sensible steps that can help us all: get your bearings, practice good hygiene, use calming strategies that work for you — and maybe try something new. Making healthy, reasonable choices about what to do and what not to do will make a big difference in being able to stay as safe and as well as possible.

New Year Resolution: Self Care

If you’re anything like I am, you have mixed feelings about New Year’s resolutions. Believe it or not, approximately 40% of Americans make New Year resolutions each year. However under 10% of us actually follow thru with achieving them. Maybe this is because our resolutions are unrealistic and based in external desires. People tend to make resolutions about losing weight, going to the gym every day, or falling in love with their dream partner.

I would like you to consider making a different resolution this year. To come up with and stick to something that will add to you or your life as an individual- make you more creative, productive, and generally more content with in yourself.

Self-care is the discipline of taking care of your physical, mental, emotional, relational, and spiritual well-being. And it’s a great option for your New Year’s resolution, because it’s very doable no matter where you are in life, and a very holistic approach to bettering yourself. In other words, self-care focuses on what’s best for you.

Here are 5 New Years resolutions that are “Self Focused”or based in “Self Care”

1. Meditation or Progressive Relaxation

Incorporating meditation or progressive relaxation techniques in to your daily routine is important. This can be as simple as downloading an app on your phone and sitting in a chair in a quiet space in your home for 10-20 minutes and follow the direction of the meditation.

2. Sleep

Getting enough sleep is associated with several physical and mental health benefits? Because of this, getting better sleep could be a great self-care area to focus on in the new year. The average person should get between seven and nine hours of sleep.

3. Enjoy- physical activity or exercise

Do something fun as your New Year’s resolution. Maybe there a hobby you’ve been wanting to try but just haven’t gotten around to it. Just pick one thing to try to get you started and then go from there. Try to incorporate something physical that makes you feel good. Don’t focus on the weight loss aspect or that you “have” to do this. Focus on something you enjoy doing- if you like to shop, go window shopping.

4. Change your Morning Routine

Changing your routine in the morning can really set the tone for the rest of your day. A rushed morning where you wake up already feeling behind and have to hustle out the door without eating breakfast doesn’t set your day up for success. But a morning where you are able to get ready in an unhurried way can help increase your chances for having a successful day.

5. Start Therapy

Everyone needs therapy! Therapy is not just reserved to go to when you are having a life crisis or problems. Therapy is the ultimate self-care act that you can do for yourself. Make an appointment and see if it is something you enjoy. Whether it’s one of these suggestions or another simple self-care practice, focusing on your overall well-being is a great way to improve yourself in the new year ahead. Plus, focusing on a lifestyle change, rather than a goal you have to check off on your list, means that you are making a lasting change in your life for the better.

Methamphetamine and the Crime Connection

I recently appeared on The Dr. Phil Show on 12/4/19 as an expert addressing methamphetamine as it relates to criminal activity.  The Dr. Phil Show guest Alexis, is a twenty-something woman who had never been involved with the law or criminal activity previously.  She got in with the wrong crowd, began to do meth…and went on a crime spree with her boyfriend which ended them up in trouble.  Fifty to seventy percent of all property crimes are committed by meth addicts. This includes burglary, shoplifting, motor vehicle theft, arson and vandalism. While local supply of meth has greatly diminished due to rigorous law enforcement, demand continues to increase.

Meth is a popular stimulant, especially among young adults.  However, it is extremely addictive, often hooking users in after their first use.  Addiction leads to desperation, and even young adults who have otherwise been law abiding kids, can turn to criminal activity without a second thought. Property crimes are usually number one. Fifty to seventy percent of all property crimes are committed by meth addicts.  This includes burglary, shoplifting, motor vehicle theft, arson and vandalism.

What Is Methamphetamine?

Methamphetamine is a stimulant.  It increases energy, mental alertness and concentration.  Girls are often drawn to it for its ability to cause rapid weight loss.  It also increases libido and confidence.

Meth is either smoked, injected, snorted, swallowed, or inserted into the anus or urethra.  It causes a surge of dopamine, a pleasure hormone in the brain, giving the user a strong euphoria that can last as long as twelve hours.

It can cause the user to become obsessed with mundane, repetitive tasks.  It can also cause hallucinations, especially a well-known hallucination of insects crawling under the skin, causing the user to cut themselves obsessively. Meth overdose can cause brain damage, muscle breakdown and death due to stroke, heart attack or elevated body temperature, known as hypothermia.

Who is doing Meth?

While local supply of meth has greatly diminished due to rigorous law enforcement, demand continues to increase.  Eighty percent of the country’s meth supply comes from Mexico. The meth epidemic is real and country wide- moving from West to East.  It affects all communities and across gender and socioeconomic status.  Though originally produced for its popularity among motorcycle gangs or people in low income areas, it is now a favorite party drug among teenagers.

According to research statistics, over 1.2 million Americans as of 2009 over the age of twelve had tried meth at least once.  1.2 percent of eighth-graders, 1.6 percent of tenth-graders and 1 percent of high school seniors had abused meth at least once.  Despite increased law enforcement, these numbers continue to increase.

What do people do when they are on meth?

People using meth are unpredictable and will act in ways they would not if not on meth.  Aside from violent and non-violent crimes associated with money demands to pay for drugs, a number of others are affected by the meth epidemic.  Parents who start to do meth usually dismiss their parenting duties. Children are victims of meth in a way that is traumatizing and damaging to their lives and psyche long term.  Mothers who are meth addicts pass their addiction to their children through the placenta.

How can meth use be prevented?

The best way to stop meth abuse is to prevent the problem from happening in the first place. Educate your family on the dangers of meth and if someone is using the drug get them help.

Dr. Phil provided education about the results of meth abuse and these two young people who made bad decisions which can lead to long term psychological problems, family discord and ultimately prison time.

The guest came to treatment from the show and has done very well in treatment…looking forward to her new found sobriety.  Her boyfriend who is still in jail and looking at a lot of time behind bars was not so lucky.  Check out the show on Season 18, Episode 61 “Chased by Police and Accused…” on 12/4/19. I also have a clip from the show and a follow up video under my Media Page.

Do We Need Couples Therapy?

How do you know if you and your partner need couples therapy? Well there is a simple answer to this. YES you do! Everyone can benefit from relationship therapy. Why? Because we are not perfect people. We all bring our baggage from our past in to our current relationship in hopes that our partner will solve all of our relationship woes. This is our first mistake.

Some people are afraid if they talk about their problems it will make it worse. This is our second mistake. Communication is the key to a sustainable, fulfilling, long lasting relationship.

Most couples don’t talk about their issues; they avoid them in the hopes they’ll eventually fade away. NO! That will never happen, and before you know it, the whole relationship becomes a nightmare.

Here are 10 tips to help you to enhance your relationship. These are also things that can be practiced in couples therapy…

1. Be yourself

For a relationship to work, it must be based on trust. Be yourself, and don’t allow your significant other to change who you are. Stay true to your passions, dreams and goals. Above everything else, stay true to your own identity.

Chances are, unless you presented a false self in the beginning, the person who chose you likes you just the way you are. If you change, he or she will end up resenting you. We all know resentment leads to painful breakups.

2. Cherish the relationship

Give yourself daily reminders of “why” you chose the person you chose. Remind yourself of this and remind the person. It is easy for us once in a relationship to point out the other person’s faults. We tend not to point out the positives once getting too comfortable in the relationship. Daily romance is important- we often tend more to the little daily life things and negate the important people in our lives during this hustle and bustle. Make time (even if 10 minutes) to tell the person you love that you love them and all of the reasons why, or things you are grateful for about that person. This might sound simple, but rarely do people do this on a daily basis.

By focusing on the good in other, you will eventually ignore the lesser things happening in your life.

3. Communicate your “needs” not your “wants”

When we get in to a relationship we tend to “want” things from the other. Instead make a list of your needs. If the person is fulfilling your need list, you are golden.

A need is something that a person must have- something needed in order to live, succeed and be happy. A want is a desire or want for something, something that we might like as opposed to a requirement for healthy living.

When determining your list, think about this. Can I live without it? Why do I really need this? What tells me whether I want or need this in my relationship? Have I seen this need modeled in a relationship I know?

4. Compromise

Relationships do not work without compromise. Simple right? You agree on everything in the beginning! NOT! As the relationship advances, you’ll notice you share different opinions. This is normal. You don’t have to agree with everything your partner says, but you have to listen to this person to try to reach common ground. Couples who are genuinely satisfied in their relationship long term understand that compromise is the key to the success of their relationship.

5. Prepare to fight

It’s really important for couples to acknowledge it is totally normal to disagree and even have fights. In the beginning you will hear couples say “oh we never fight.” Well that is because in the beginning we are in a honeymoon phase where nothing usually bothers us. It is important to know that it is okay to disagree as long as you respect and listen to the other person.

6. Fight Fair

As individuals begin to settle in to their relationship, they start to disagree more often. Fighting is normal, but not if you do not fight fair. What does this mean? Ask yourself one question…what is my intention? Conflict arises when arguments don’t come to an end. If your intention is to resolve a conflict, you will see that the fight will not continue on…

Talk to each other and say what bothers you out loud.

Replace feelings of hostility and resentment with good will and humor. You’ll feel a lot better. If you have an argument, try not to hit below the belt. You’re fighting with the person you love most in this life, which basically means it can’t be that bad.

7. Don’t try to change your partner

Couples in stable, sustaining relationships are usually healthy, positive individuals. They see the good in their partners, and they won’t try to change them. Appreciate the person sleeping on the other side of the bed, and show him or her your utmost respect. Remember you loved everything about this person at one time, try to remember why…maybe you need to change your expectations that your partner is not “you.”

8. Be Honest

This sounds easier than it is in practice. Be honest with your loved one if you want things to work out in the long term. It is much better to tell the truth from the beginning. Couples tend to present their best self in the beginning which could include fabrications about the past. If you build the foundation on honesty from the beginning, it will most likely continue throughout the relationship. Your partner will be more understanding and forgiving in the beginning because whatever you are spilling most likely happened prior to meeting your partner. Your partner will more likely give you a pass than if they find out that you lied.

9. Lose your Ego

A lot of people go to couples therapy because they can’t give up their ego in their relationship will work. For things to go smoother, you have to give something up in order to get something else in return. Accepting that you are not always “right” is important in relationships.

Being able to say “I am wrong” or “I made a mistake” is very powerful and will often solve a lot of problems.

10. Say “I am sorry”

Saying you are sorry to your partner is powerful. Couples tend to hold on to “I am right” and this leads to conflict, stubbornness and ultimately our partner not wanting to give us what we “need.” Saying you are sorry when indicated shows your partner that you are willing to admit when you are wrong, or that you feel their pain, care about their feelings and ultimately do not want them to feel hurt by something you said or did.

Couples therapy is indicated for anyone in a relationship who wants to enhance, improve and hone their communication skills with another…who doesn’t want that????

Holidays and 8 Coping Strategies to Combat the “Holiday Blues”

Holidays can be a time of joy for many… yes. But for others it can be the most depressing time of the year. For some people it can be a lonely, anxiety filled time of dread. You’re not a Scrooge and you’re most definitely not alone. The “holiday blues” are real and much more common than you think.

Here are some coping strategies that you can implement to help during this difficult time.

Here are 8 ways to help you get through the holidays:

1. Plan in advance

If you know that the holidays are a difficult time for you, try to plan something based in self-care. Do something that you enjoy doing. Do something out of your comfort zone.

2. Avoid Conflict with others

Chances are you are already feeling down and in a negative head space. This is not the time to call someone who you tend to get in to conflict with. Reach out to people who support you. If you do not have anyone in your life you falls in to this category, go to a local support group. There are resources for people who are having trouble around the holidays, or people struggling with depression.

3. Honor your loved ones’ memories

If you have lost a loved one around the holidays or it is the anniversary of this loss, plan to honor this person around this time. Remembering the good times, celebrating fond memories can help with holiday blues. Whether you visit a loved ones grave, visit a place that they enjoyed, create a memory box with special items, pictures, etc. and go through it on a special day.

4. Relaxation and Sleep

Schedule rest, relaxation and sleep. Listen to relaxation tapes, guided imagery or sounds of nature in an attempt to meditate and quiet your mind. Try to do things that will help you sleep. Do something for yourself like taking a meditation or yoga class. Another way to assist with this process is breath work. This is something that can be done on your own or in a class setting with a certified breath work expert.

5. Exercise

If you have trouble with this one…you are not alone. This does not mean go to the gym if this is not your regular routine. But we know exercise produces endorphins and makes us feel better. So even if you simply go for a walk around your block or at the beach, you are producing endorphins that will help with the holiday blues.

6. Sunlight

Sunlight can help with Seasonal Affective Disorder, or SAD so getting some exposure to sunlight can help with the holiday blues as well. Simply sit in the sun at the beach or you can use a lightbox if the weather is not conducive.

7. Focus on what matters

The holidays should not be all about the presents. Financial stress is real around the holidays and stress adds to the holiday blues. Try to rein in the stress. Get back to basics. Focus on self- care, people you care about and spend quality time, not quantity.

8. Try to be in self-care, not self-harm

Holidays can be a time to indulge. Instead try to focus on healthy eating by preparing healthy meals in advance. Limit alcohol and sugary foods because this will tend to create mood swings and depressive symptoms in excess.

Blackout Drinking

I recently appeared on The Dr. Phil Show- I was asked to be an expert on a show dedicated to a guest who was on the verge of death from “black out” drinking.  If you want to tune in, it was Season 18 Episode 38 “Black and Blue Blackout drunk.” I think it is common for people who drink too much to say “oh I was blacked out so I don’t remember.”  But when does black out drinking turn from just too much drinking to a problematic deadly game.

Blackouts happen when you drink too much alcohol. Drinking quickly or drinking large amounts of alcohol raises your blood alcohol level (BAC). Blackouts usually start when your BAC reaches 0.15 or higher. A BAC level of 0.15 is considered very high; a BAC level of 0.08 means you’re legally drunk.

Being blackout drunk is considered “normal” in our society for several reasons. Lots of comedy movies feature main characters blacking out and having fun. College culture and binge drinking often go hand in hand, too. If blacking out is a regular occurrence, it may seem harmless. Between frat parties and off-campus get-togethers, it seems that heavy drinking is pretty normal. The truth is that blackout drinking isn’t about funny moments or bonding with friends. Blackouts can be a sign of trouble. This makes it important to know all of the facts. Read on to learn about this common drinking behavior and what it can lead to.

Have I had a black out?

Research says a blackout is a type of amnesia that happens when you’re drunk but still in a conscious state. People can act “normally” while in a black out- they can act normally while blacked out. Partial blackouts cause people to forget bits and pieces of time. Total black outs consist of people forget significant events and large amounts of time. So if you are wondering if you have had a black out, if you have had memory loss while drinking, you’ve experienced a blackout. Some people don’t know if they have had one because they ironically cannot remember. But if you wake up after drinking and cannot remember much about the night, how you got home etc. you have had a black out!

So is losing your memory while you are drinking that big of a deal? Memory loss or being a bit too drunk on occasion might not be a big deal.  However, things can happen when you are walking around “appearing” to be normal, but in reality you have no idea what you are doing.

Why do I black out?

Blackouts happen when you drink too much alcohol. Drinking quickly or drinking large amounts of alcohol raises your blood alcohol level (BAC). Blackouts usually start when your BAC reaches 0.15 or higher. A BAC level of 0.15 is considered very high; a BAC level of 0.08 means you’re legally drunk. If your BAC reaches 0.15, you may experience:

  • motor impairment
  • loss of physical control
  • blurry vision
  • loss of balance
  • increased anxiety
  • blackouts
  • decreased happiness and excitement
  • severely impaired judgment and perception

In addition to drinking too much, other factors can increase your chances of blacking out. One common factor is drinking on an empty stomach. Your height, weight, and metabolism can also affect your blackout risk. There are a few tips you can try to prevent blacking out. You can read those in this post and learn how to practice safer drinking. But first, we’ll discuss the risks of drunk actions during blackouts.

Drunk Blackouts and Alcohol Poisoning

Dr. Phil confronted the guest on the show about his blacking out, memory loss, driving while drunk, falling and hurting himself and having the police come to the home…all while he had no memory of this. When Dr. Phil showed his guest a video of himself drunk, he was stunned. 

The guest later said he was horrified to see himself in a drunken state and had no recollection of this behavior.  Dr. Phil educated his viewers about alcohol poisoning so if you want to see his full explanation tune in to the show. You can type in to Google “Black and Blue Blackout drunk” to watch the show which aired Season 18 Episode 38.

You now know two important facts. First, you can blackout when your BAC reaches 0.15. Second, your drunk actions can be very dangerous. When you are blacked out, you might continue drinking alcohol without remembering it. You may also resist if people ask or tell you to stop drinking. This can result in alcohol poisoning.

Alcohol poisoning can happen when your BAC reaches 0.16 or higher. That means there is a very fine line between blackout levels and fatal levels of drinking. Alcohol poisoning requires medical intervention. Passing out with alcohol poisoning is the most dangerous outcome. Below are the symptoms of alcohol poisoning:

  • vomiting
  • seizures
  • disorientation
  • slow or irregular breathing
  • pale or slightly blue skin
  • decreased body temperature
  • passing out from alcohol
  • death

On the show, Dr. Phil confronted his guest on being close to death.  The guest seemed to have no recollection of how close he was to death. Dr. Phil pointed out that the police were concerned he was close to death.  The guest still had no recollection of how bad off he was.

If you or someone you’re drinking with experiences these signs, take action. Call 911 and give them as much information as possible. It’s also important not to leave someone with alcohol poisoning alone. Keeping them conscious is important.

Unfortunately, blacking out may cause you to wander off alone. And you may not be able to call 911 and keep yourself awake. You may also be less accepting of help and assistance from people around you. This is all a risky combination that you don’t want to face.

Overall, there is a direct link between blackout drinking and alcohol poisoning. This means it is important to stop blacking out when drinking. There is no foolproof solution besides staying sober. But you can take some basic steps to drink safely.

How can I stop blacking out when drinking?

There are a few things you can do to stop blackout drinking. These tips are pretty simple. Keep them in mind when you drink alcohol. They can prevent a lot of risks, problems, and danger.

  • Eat a meal before you drink. Food in your stomach can help absorb alcohol. This prevents it from getting into your bloodstream quickly. Your chance of a high blood alcohol level is reduced.
  • Drink water before you drink alcohol. If you drink alcohol while you’re thirsty, two things can happen. You’ll likely drink faster and drink more. This can lead to a blackout. Make sure you’re hydrated beforehand.
  • Pace yourself when you drink alcohol. There’s no need to rush and have multiple drinks per hour. When you drink too fast, the chance of blacking out is high.
  • Try to avoid drinking when you’re tired. Being tired can impact mental clarity, and alcohol can do the same thing. You may also be more likely to pass out or blackout if you are not well rested.
  • Be very cautious if you take medication. Over the counter and prescription medications can be dangerous when combined with alcohol. Always check the label to see if there is a warning about alcohol. Follow the label’s directions to avoid blackouts and other dangerous health risks.

These instructions are easy enough to follow every time you drink. There is no 100% guarantee that you won’t blackout. But taking precautions can reduce your chances. You now know the dangers of getting blackout drunk. Why take the risk when you can prevent it?

If I am blacking out, do I have an alcohol problem?

Blacking out while drinking is a sign of alcohol abuse. If you regularly have drunk blackouts, it’s possible you have a drinking problem. Alcohol abuse and addiction can occur quickly. Overcoming these issues alone is very difficult and sometimes impossible.

There are some great resources available. Learning the signs of alcohol abuse and alcoholism is an important first step. This can help you realize if you or someone you know has a drinking problem. If you are questioning whether you have a problem there are easy online quizzes you can take to find out.  You can also seek professional help by looking up a substance abuse counseling center or licensed professional in your area.  Chances are if you think you have a problem, you do. Detoxification from alcohol can be dangerous, so do not consider doing this on your own if you drink regularly and want to quit. Consult a professional, even you internist to make sure that you are proceeding with you medical safety in mind.

The “black and blue black out” guest accepted treatment while on the show! Check out my website for follow up video on how he is doing now!