Know Your Treatment Options

By Josh King 08/05/14

As helpers, it's our job to recognize our own biases and put them aside so we can offer our clients the options and the guidance to get the help they want and need, no matter what path that might be.

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Several years ago, my father was diagnosed with a form of leukemia. When we went to the doctors, the first questions we had were about the available treatment options, and then understanding the pros and cons of each of those options. There was an expectation that not only would we be provided with several options, but that our doctors would also provide us all the latest information that science had to offer in terms of what might be an effective treatment option. He knew we deserved to be able to make the most informed decisions possible. Why is this not the case when it comes to treatment for substance abuse?

When AA first came on the scene in the 1930s, it was the only option. It worked for millions of people and helped open our eyes to the idea that people who are struggling with substances can be helped. For this, and for the millions of people whose lives it saved, AA has earned our eternal gratitude and a deserved spot at the table of treatment options. And it is squarely at the table. Many research studies have found that clients who attend self-help meetings do well in many ways, for example they have longer periods of sustained abstinence. The table however, now has many seats and people deserve to be able to decide where to sit. Continued advancements in the field have brought us treatments that have proven efficacy, and they should be presented as options for anyone looking for help.

As a helper, I try to include every option when I talk to a client. I tell them about AA and SMART Recovery. If appropriate and it is their goal, I discuss moderation (the pros, the cons, and how realistic and possible it is as an option for that individual), I discuss abstinence. I discuss medication options and refer them to addiction psychiatrists if they are open to considering these options. I think through sober companions and sober living options to see if they are needed. I ask about their experiences in treatment so far and discuss different options in levels of care (inpatient, outpatient) and type of approach (CBT, 12-step, dual-diagnosis, etc.) and  different programs' strengths and weaknesses for their particular circumstances. I leave no stone unturned because my job is to help them find something that works best for them as individuals.

And, sometimes that means that they will end up working with someone else, which is also OK. Most often they work with me while adding in other supports like AA or medication. Because the goal is to get them to the help they want, and if helping them get to the right therapist for them is the first step, then I have done my job.

When my dad was ill, we would not have accepted anything less than a doctor offering us options, information, and guidance. Cancer doesn't have the same social stigma and doesn't rile people up in quite the same way as substance abuse. As helpers, it's our job to recognize our own biases and put them aside so we can offer our clients the options and the guidance to get the help they want and need, no matter what path that might be.

Josh King, PsyD is the director of Clinical and Digital Service Integration at the Center for Motivation and Change (CMC) in New York City. CMC is a private group practice specializing in evidence based treatments for substance abuse and compulsive behaviors and is driven by an optimism about people’s capacity to change and a commitment to the science of change. Contact Josh King.

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Josh King, PsyD is the director of Clinical and Digital Service Integration at the Center for Motivation and Change (CMC) in New York City. CMC is a private group practice specializing in evidence based treatments for substance abuse and compulsive behaviors and is driven by an optimism about people’s capacity to change and a commitment to the science of change. Find him on Linkedin or Twitter.

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