Report from Hawaii

Now I've had a chance to dig out from under the backlog and the frontlog that piled up while I was in Hawaii, I'm going to take a few minutes and jot down a report and some memories, and post some photos.

The main purpose of this trip was to try to get LifeRing started in Hawaii. To do that we needed someone or someones in Hawaii to come up with the airfare and hotel. Would you believe it took almost two years to get that done?

The principal engineers were Lorraine Robinson, head of a women's prisoner re-entry program; Eddie Merseneaux, head of a North Shore recovery program; and Bernie Strand, representing Access to Recovery (ATR), a federally funded granting and training council.  In this team, Lorraine was the sparkplug, Eddie was the engine, and Bernie was the fuel pump -- she found and moved the money.  Here's me with Lorraine, photo above.  Lorraine's program is called Ka Hale Ho‘ala Hou No Na Wahine-- Hawaiian for The Home of Reawakening for Women. More about that later.

My main job was to do an all-day workshop explaining LifeRing to treatment professionals.  Even though this had been talked about for many months, the authorization for the money didn't get cleared until three weeks before the date of the workshop.  I was a bit concerned that there might not be much of a crowd, with so little time to prepare.  But Lorraine and Eddie and Bernie each turned out their staffs and their contacts, and Eddie's email blast hit just about every addiction and mental health professional on the island -- an impressive list. It also helped that the island of Oahu is not all that big, and almost everybody knows almost everybody.  Result: the conference room was full up with 50 people, all but one being staff at one or another treatment agency.  

Some very senior people attended, including the counselor who heads all substance abuse training in the State of Hawaii; at least one psychiatrist medical director; and a lot of younger staff as well.  Here's a photo of me with Eddie.

We met in a kind of unusual location: the conference room of Hilo Hattie's, probably the leading vendor of all things Hawaiian in Honolulu.  You wandered to the conference room through aisles and aisles loaded with Aloha shirts and every other conceivable item of Hawaiian merchandise, and soft hula music wafted in the background.  That was lovely and very relaxing, but there was a downside.  The conference room walls didn't reach to the ceiling; they were just partitions.  Moreover, there was another conference room directly to one side, where another program was going on.  And after lunch, a hula class began on the other side. But the price of the room was right!  Luckily, I have a robust set of vocal cords, so that even after the microphone gave out, which it did, I was able to reach the back rows without too much trouble.

I started the program by asking people to identify themselves and say why they were here, and I was struck by how closely these folks followed the consensus of other treatment professionals I had met at conferences such as NAADAC, CAADAC, and APA (search this blog for those acronyms for details).  That is, they all had clients who were willing to do recovery, but the 12-step approach was not their cup of tea.  They were looking for additional tools, choices, to offer their clients. OK, that's why I was there. Hilo Hattie's provided a nice big flatscreen TV on which to run my PowerPoint, and I presented a somewhat modified and expanded version of the 200-slide workshop I had given previously to two different CAADAC audiences in Oakland and in Sacramento.  You can download the original version from lifering.org here.

At lunch, we had a prominent guest speaker, Gary Hooser (right), the outgoing majority leader of the Hawaii state senate and candidate for Hawaii lieutenant governor. I had the privilege of being introduced to Gary before his talk, and gave him a LifeRing lapel pin, which he wore during his talk. He spoke mostly about political realities in general, but also disclosed that his father was an alcoholic and his brother was a drug addict, so he knew something about the topic of our concern.  I've met a number of politicians in my time but I thought Gary was rather special in his frankness, directness, and courage.

After lunch, I started off by showing the 1 min 37 second Flash animation of how LifeRing works (here).  I'd not had the chance to test this with a live audience before.  It was fun to switch back and forth between the screen and audience faces to gauge the reaction. Somebody important once said that the measure of a good idea was whether you could explain it in 30 seconds as well as in 3 days, and I like to think that the LifeRing idea is passing that test, at least on the short side.  On the long side, both Eddie and some other listeners felt at the end of the day's presentation that there had been enough material presented for three days, and encouraged me to prepare a longer workshop. I have to agree; I barely scratched the surface of the Recovery by Choice workbook, for example, and never touched on some of the issues in the later chapters of Empowering Your Sober Self. There were some great questions asked. BernieStrand asked a brilliant one, namely whether it made sense to talk about building a Personal Recovery Program with a person on day one of their recovery, in view of the presence of cognitive distortions, etc.  I could have spent an hour on that one alone.  Here's a photo of Bernie and me, to the right.  A longer workshop format would leave time for more audience participation, breakouts, demonstrations, one-on-ones, and the like.  So, that's for the future.

After the day's workshop, Lorraine took me to her program for a short visit, and I got a chance to meet three of the residents.  Lorraine's program is a six-month residential program that helps women who have been released from state prison on parole to try to reintegrate into the community.  I got a lucky break there.  One of the women, M., told the story of her job interview earlier in the day, when she was turned down because of her felony rap.  She said that on the bus ride afterward, her mind was a battleground between part of her that wanted to say "f*ck it" and get drunk and go back to prison, and the other part that boosted her courage and urged her to hang in (she did).

The next day, Lorraine invited me to give a short talk to her program residents, and then lead them in a LifeRing meeting.  We met on plastic patio chairs under a canvas awning in the parking lot that forms the internal courtyard of the program.  I had given a few LifeRing talks to parolees, but never to an all-women group, and I mentally listed about 10 different ways that I could screw it up. I chose to use M.'s story about her mental battle after the job interview as the boat on which to sail into my talk about the A and the S and about empowering your sober self.  That was a happy approach, and after I had finished my introduction, I started the round of "How Was Your Week?" to my left and sat back to watch. The residents took to the format like ducks to water. It took just a tiny nudge to start the crosstalk, and I was treated to a phenomenally excellent LifeRing meeting, with the women giving each other support all across the circle.  The sun set and we had a few showers as the meeting went on. We spent two hours going around, and I worried that fatigue and short tempers would set in, but no need.  The engaged body language and the animated facial expressions of the women sustained the session until we were all the way around the circle.  We then broke for refreshments, prepared by the residents, and I got excellent one-on-one feedback from several of the women, who contrasted the LifeRing approach positively with other kinds of meetings they had attended.

An evaluation survey filled out by the residents the next day gave LifeRing very high marks; I'm going to post that separately.  There was strong support for having the LifeRing meeting at this facility once a week.  One of the guests at this meeting was a counselor from a related program, who volunteered to be the convenor.  Plans were laid to transition the meeting to an outside location, where nonresidents of Lorraine's program could join in.

That was the end of my LifeRing business in Hawaii, but I had planned to stay for the weekend and do some R&R. After all, it's Hawaii. My new friends were exemplary in their Aloha spirit, driving me literally all around the island to see the beautiful beaches and other sights.  I also got to eat poi, the traditional Hawaiian dish, which tasted like lightly grape flavored ice cream (not at all like library paste, as I'd been warned).  Hawaiians are legendary for hospitality, and my friends were shining embodiments of that legend.  I took a ton of pictures (like these plumerias), which I will post somewhere when I get the time, and I have a head full of wonderful memories.

Well, working to get LifeRing started in Hawaii was a tough assignment, but somebody had to do it.  LOL.

P.S.  I just heard from Rachaell at the Service Center that a Hawaii agency has ordered more than 100 LifeRing books.  That's a good sign.  Lots of people told me they wanted to help LifeRing get started in Hawaii, but one never knows how serious it is until they cut the check.

Growing in Dublin

This email came in to the Service Center this week from a counselor in Dublin, Ireland:

I am writing to you in the hope that I may receive information about facilitating LifeRing meetings within our organisation. We are a community based organisation based in Dublin 12, we work with both problematic alcohol and drug users. We have at the moment A.A meetings being held each week, but it has come to our attention that the amount of people attending these meetings is far less than the amount of people who need help. When we put the question to the people who don't attend, their response is that they believe it was themselves who chose to drink or take drugs and that it should be themselves who chooses and has the power to stop. Since finding out about and from reading your web-site,(which I really enjoy and agree with) I have mentioned it to some of our service users and they seem excited at the idea of attending these meetings.
I understand that there are 2 meetings being held in Dublin, but I am hoping that maybe we can facilitate them here also. Is there any possibility of this? Or can I receive some information please about training myself to become a convenor of LifeRing.

Dennis S., the LifeRing convenor who founded the first two LifeRing meetings in Dublin, promptly contacted the writer and offered his assistance and cooperation.  It's very likely, from the looks of it, that Dublin will soon have three LifeRings.

Note that this email comes from a counselor at a program that so far is exclusively 12-step oriented.  If you looked at this program from the outside, seeing only the surface, you might write it off as a stone 12-step program, beyond hope.

But the clients on the inside have different ideas.  The amount of people attending the 12-step meetings, the writer observed, "is far less than the amount of people who need help."  That's just about a universal condition in every 12-step program.  As we know from AA's own triennial membership surveys, reported in Don McIntire's journal article (covered in my book Empowering Your Sober Self), out of 100 people who approach AA, at the end of 90 days, 90 per cent have walked away.

It doesn't take a rocket scientist to figure out that there's a gap here.  To its immense credit, the staff at this program in Dublin actually asked the people who don't attend AA, why don't they?  This is almost revolutionary in a profession that's very strong on talking at clients but not so good at listening to clients.  But the client-centered spirit of Carl Rogers is penetrating even into substance abuse treatment, the most backward province in the kingdom of mental health treatment, and the result is what you see:  clients who insist that they're not powerless to get free of alcohol and drugs, and who want support groups that acknowledge that power and reinforce it.  In short, clients who want LifeRing.

Even in Ireland.  Or perhaps: especially in Ireland.

Wants Meeting in Bend OR

This message from Chuck H. in Bend, OR arrived at the Service Center yesterday:

There are only 12-step meetings in Central Oregon - no secular approaches.  We are interested in starting a secularly-oriented group and would appreciate any assistance that can be offered. The treatment centers here are all 12-step focused.  -- Thanks!

Chuck:
Thanks for your message.  As with similar requests that come in to the LifeRing Service Center, we will be happy to help you with an initial supply of brochures and some other materials that you can use to spread the word about your planned new meeting.  And when you have a room and a date and time that can be posted on the online meeting list, we will send you display copies of each LifeRing Press publication on invoice. 

Do not hesitate to approach the 12-step treatment centers about your project and to ask their assistance.  The 12-step world is not a monolith.  There are "my-way-or-the-highway" types, to be sure, but there's also the "whatever-works" types.  In every treatment center there are clients who are willing to do recovery but don't find the 12-step approach a good fit for them.  In many treatment centers there are professionals who see it as part of their ethical responsibility to offer the client choices and to help the client find an approach that works for them, whatever it may be.  Like any new approach, you will probably find doors slammed in your face at first, and you will need persistence and tenacity to prevail. It's not a sprint, it's a marathon.

Note also that there are now others in Oregon working on starting LifeRing meetings.  Please get in touch with the persons starting LifeRing in Eugene and in Portland, and share your experiences and resources.

Letter from Tampa

From Tampa, Florida, reader D.L. writes today:

I would like to start a meeting in the Tampa area.  I have been to meetings in Pinellas Park on Friday evenings and enjoyed them.  I also have read the book by Nicolaus and as a physician I agree with many things he has said.  It was also nice to read about the work of one of my psychiatry professors at UCSD School of Medicine, Dr. Mark Schuckit.

Howver, driving to Pinellas is not an option for me any more.  I started working Friday evenings.  I would be willing to search for a meeting place for starting a meeting here in Tampa.  There are at least five people who would like to come to the meetings initially.  Also, I want to go to the treatment centers (12-step based) to ask them if they would be willing to pass information to the people about LifeRing.  I would need information about how to start a meeting and also any supplies that you find necessary for the start.  If I find a place for rent, could I count on you to help me out at least initially with it?

Dear D.L.:  I salute you on your initiative to start another LifeRing meeting in the Tampa Bay area.  The area is certainly large enough to support more than the single meeting that now exists there, the Friday night group at Pinellas Park.  To put it more strongly, a city of that size needs to have a multiplicity of LifeRing meetings in order for the LifeRing concept to become established and to replicate.  Many people in recovery, particularly in early days, want and need more support than one meeting a week.  LifeRing may not appear like a viable support option to them until they have three or more LifeRing meetings per week within driving range.  Treatment professionals who do referrals see it the same way.  We've heard it time after time: I can't be referring clients to a group that has only one meeting.  (Of course, there would be more meetings if they made more referrals; but that's another topic.)  And so, a LifeRing meeting that's the only one of its kind in an area leads a difficult existence, and it takes extraordinary dedication, tenacity and hard work on the part of its core group regulars to keep it alive in the long haul.  When there are more meetings, all of them benefit and all of them can prosper.

That being said, the topic is how to proceed.  Your best guide is to read the book, "How Was Your Week," available from LifeRing Press.  A key chapter is available free online here.  You should definitely approach the treatment centers, no matter how 12-step they are, and ask for meeting space, bulletin board space, and referrals.  Some of our oldest and best meetings are at 12-step treatment centers; they need us there.  If you are able to get meeting space at a treatment center, there is rarely any rent to pay, as you are providing a service to the clients.  The LifeRing Service Center does not have the resources to subsidize room rentals for meetings, even at the beginning.  What the Service Center can and will do is to send you brochures and other literature to help you get started; and as soon as you have a meeting room and a time that can be posted on the online meeting list, then we can send you display copies of LifeRing Press books on invoice.

It is excellent that you know of a group of five or six people who are ready to attend the new meeting once it finds a home.  It would be good if you could enroll all of them as a search committee to speed the process.  Please also enroll yourself in the LifeRing convenor email list, and read and comment on this convenor blog.  Break a leg!

Treatment Journal Reviews Empowering Your Sober Self

The current issue of Alcoholism Treatment Quarterly contains a review of my book Empowering Your Sober Self.  The reviewer, who is none other than the distinguished scholar William L. White (Slaying the Dragon and other works), writes, in conclusion:

Nicolaus offers us a clear window into the basic approach of LifeRing Secular Recovery, one of the major secular alternatives to AA. LifeRing was founded in the San Francisco Bay Area in 1999 and became a national organization at a founding conference in Florida in 2001. LifeRing hosts face-to-face recovery support meetings, a range of e-mail lists for member- to-member communication, online (www.unhooked.com, www.lifering.org) chat rooms and Internet forum (bulletin board), an online social network (lifering.ning.com), LifeRing social events, and the annual LifeRing Congress.

In Empower Your Sober Self, Nicolaus has created an engaging text for individuals seeking recovery and for service professionals wanting a greater understanding of LifeRing’s core ideas and recovery support strategies. Empower Your Sober Self also includes the voices of many LifeRing members whose personal stories illustrate key points in the book.

 The discussions in this book include some of the more controversial issues in the addictions field. Nicolaus outlines positions on these issues clearly and forcefully and in ways that help distinguish LifeRing Secular Recovery from 12-step programs and from other 12-step alternatives. This book is intended to inform rather than convert. Not everyone will agree with the ideas and approaches set forth here, but for the past decade, individuals and families have used LifeRing Secular Recovery as an effective framework to initiate and maintain long-term recovery from life-impairing addictions. Those recoveries are cause for celebration, and this book details how they did it. Those seeking a solution to alcohol and other drug problems and professionals assisting people with such problems will find great value in Empower Your Sober Self.

This strikes me as a fair and even-handed assessment and I'm grateful to the writer.  It's also a good sign that the journal, which goes to the more research-minded echelons of the treatment profession and to academics, has taken note of this book.  Hopefully, the review -- and the book, for those who will read it -- will persuade a larger number of treatment professionals to include LifeRing meetings in their referral pool.

For a PDF copy of the complete review, click here.

A Preferred Provider in Boulder CO

Stephanie Bryan emailed the lifering.org website yesterday:

I'm a therapist in private practice in Boulder.  I recently learned about LifeRing as I was searching for a secular support system for a client.  I attended a Wednesday meeting in Denver, learned about Empowering Your Sober Self, found copies at The Tattered Cover (the premier locally-owned bookstore in Denver) for my client and myself, read the book in its entirety and loved it, took my client to a Thursday meeting in Denver, was able to purchase a copy of Recovery by Choice at that meeting, and was able to use it with my client before he left town for a long-term in-patient treatment program in Arizona for people age 17-25.

I purchased two copies of Recovery by Choice directly from the LifeRing Service Center so I will have them for future clients.  I notice you do not have any treatment providers listed in Colorado, so I was wondering if I could be listed.  This is what I would like:

Stephanie Bryan, LCSW, CAC III, NCAC II
REAL Parenting
1530 55th Street
Boulder, CO  80303
303-397-0646

"I am a Licensed Clinical Social Worker, Certified Addictions Counselor, and Certified Parent Coach.  I have worked in mental health and addictions since 1984.  My parent education and parent coaching work is primary prevention, helping parents raise kids who won't make some of the poorer choices their parents made.  I recently learned about LifeRing when I was seeking a secular recovery program for a client.  I attended some LifeRing meetings, read Empowering Your Sober Self, and realized the LifeRing approach is compatible with the clinical work I do.  I am trained in Cognitive Behavior Therapy, EMDR, and Brainspotting."

My website is www.REALParenting.net.

Stephanie:
Thanks for your post.  On the lifering.org website there is a "Find Treatment" tab and a page listing "Preferred Providers."  Preferred providers are, of course, providers like yourself who offer their clients treatment modalities beyond (or other than) 12-step.  We do not charge for these listings, although we always appreciate it when listed providers make a tax-deductible donation.  I, as the webmaster, am sometimes slow in responding to emailed requests for a listing, particularly when the request doesn't indicate any particular affinity with the LifeRing approach.  Sometimes the requests come from stone 12-step programs that are pretending to be better than they are so as to lure more clients.  But in a case like Stephanie's I am happy not only to post her listing, but to feature it in this blog, because Stephanie has actually read and used LifeRing literature with a client and has personally checked out a LifeRing meeting.  That makes her a Preferred Provider, for real!

Teaching in Sacramento

Dr. B. J. Davis and I had a good day Saturday Nov. 21 in Sacramento CA, teaching a group of addiction counselors about LifeRing and Choice Theory.  LifeRing convenor Robert O. in Sacramento deserves major kudos for getting the event on the calendar and getting every detail, including ample refreshments, in place on the day of the event.  Two leading members of CAADAC (the California Association of Alcohol and Drug Abuse Counselors), namely regional director Pete Nielsen and regional vice-president Karl Hexberg, arranged for Continuing Education Units, email-blasted the regional membership, and prepared the paperwork, and Karl sat through the entire session.

We started at 9 am, and I began my 200-slide PowerPoint about half an hour later.  I covered basic facts about LifeRing, such as where the meetings were located and typical characteristics of our membership, and then outlined the 3-S philosophy.  I got to the end of the second S by lunch time.  It was a good interactive session with just about everyone in the room getting into the discussion and nobody falling asleep.

After lunch I finished the third S, and then Dr. Davis talked for about 45 minutes about Choice Theory and his research into Quality of Life in recovery.  Then I picked it up again and covered the LifeRing meeting format and the Recovery by Choice workbook.  I had to cut it short as we ran out of time but certainly the main points got across.  The audience were attentive the whole time.  There was lots of crosstalk, all of it positive.  Even though a number of folks present identified themselves as 12-step, there was no tension or animosity on either side.

Both Dr. Davis and I got a lot of thanks at the end, and I got a couple of inquiries about giving the LifeRing talk in other towns.  There were people from Vallejo, Petaluma, Yuba City, and other towns plus local Sacramento folks at the session.  Our only regrets were that not more people from social services agencies in the city attended, because apparently they were not included on the email lists.  We're talking about repeating this training in the spring, this time with broader advance publicity.

The whole set of my 200 slides is available for downloading at http://www.unhooked.com/trxpro/CAADAC workshop.ppt 

LifeRing Training in Sacramento Nov. 21

Following up on the well-reviewed Sept. 19 LifeRing training in Oakland, I'll be co-presenting a new LifeRing training for treatment professionals in Sacramento on Saturday, Nov. 21.  This'll be in part a replay of the Sept. 19 presentation in Oakland, and in part an entirely new and exciting event, with the addition of my co-presenter, Dr. B.J. Davis of Strategies for Change.  Dr. Davis is, of course, the author of the new DVD, What is Recovery?  A Quality of Life Analysis (available from LifeRing Press), and a frequent and dynamic presenter at professional conferences.  Here's an online flyer with the information about the event.  As in Oakland, there'll be 6 (six) CEUs available for treatment professionals.  Even better than Oakland, which cost $10, this event is FREE.  LifeRing convenors and other participants are, of course, invited to sit in.

Full house for CAADAC LifeRing Training

The turnout of treatment professionals for my full day LifeRing training yesterday surpassed expectations.  More than 25 people squeezed into the conference room next to the Service Center in Oakland.  Some had come from as far as Sacramento for the six-hour session.  All except three, who were LifeRing convenors, were working in the addiction treatment field.

Peg Miller, a Vice-President of CAADAC and responsible for organizing trainings in CAADAC Region 4, which includes the Bay Area, organized the event, handled logistics, and awarded people their certificates of completion at the end.  LifeRing CFO Robert Stump organized coffee and pastries in the morning and helped set up the room. Service Center volunteer Lou A. assisted with room setup the previous day.

The program took six hours, not counting an hour for lunch.  During five of those hours, I presented a slide show of exactly 200 slides. Here's my outline:

LifeRing
An Introduction for Addiction Professionals
By Martin Nicolaus MA JD
CAADAC Region 4 Training
Sept. 19, 2009

Objectives

• To understand basic facts about LifeRing
• To get how LifeRing works
• To pick up tools that can be used with clients
• To facilitate client involvement with LifeRing

Hour 1: Basic facts about LifeRing

• What is LifeRing?
• Where is LifeRing?
• Who goes to LifeRing?
• How is LifeRing organized?

Hour 2: The Three-S Philosophy

• Sobriety
• Secularity
• Self-Help

Hour 3: How LifeRing Works

• Empower Your Sober Self: A short overview
• In more depth:

o The Divided Self
o Horizontal Synergy
o Confrontation v. Support Strategies

Hour 4: The LifeRing Meeting Format

• Circle seating
• “How was your week?”
• Crosstalk
• Limits
• Aim: Living Room atmosphere
• Closing ritual: Round of applause
• Peer leadership
• Signup sheet -- basket

Hour 5: How people build Personal Recovery Programs (PRP)

Two Pathways to PRP
Through the “How Was Your Week” Meeting Format
“Random access”
Through the Recovery by Choice workbook
• Nine Domains (Work Areas)
• My Decision
o The A-S T-chart
• Domain 1: My Body
• Domain 4: My People
• Relapse Chapter
• Pulling the PRP Together
Result: Diversity of Programs
Pros and Cons of PRP

Closing Thoughts

• LifeRing is a Strength-Based Approach
• The Aim of LifeRing is Choice

o We need more pathways
o Choice should not be controversial

What can providers do?
Choice is good program policy
More choices = more recoveries

For more information:

• www.lifering.org – LifeRing, the organization
• www.lifering.com – LifeRing Press e-commerce store
• LifeRing Service Center, 1440 Broadway, Ste. 312, Oakland 94612
• service@lifering.org
• 1-800-811-4142

P.S.  Today, Monday, Peg Miller kindly sent me the program evaluations (feedback sheets) filled out by participants at the end of the program.  Namely:

WORKSHOP EVALUATION (scale is 0-below satisfactory to 5-above satisfactory)

Your overall rating of subject matter:
•    20 5's
•    2 4's
Your overall rating of the trainer:
•    17 5's
•    5 4's
Your overall rating of the materials'handouts:
•    15 5's
•    4 4's
•    1 2
•    1 0 with comment (needed handouts--powerpoint printouts)
•    1 not marked--"handouts" circled followed by comment:  "sparse  hard to follow"
Your overall rating of the training/workshop: 
•    16 5's
•    6 4's
Your overall rating of the fees:
•    18 5's
•    3 4's
•    1 not marked and with comment:  "two days I went to training in NAPA... cost $75...$10 is nice"

Comments on this page:

Very good TR...affordable in very hard times
Educational, motivational in terms of realizing the need for choice.
Helped solidify what I had gleaned from the web site and publications
It was great!!!
Uncomfortable room
Enjoyed this training...learned a lot
Very interesting!
Excellent presentation   Very worthwhile
I am glad that I had a chance to learn more about the organization.
Most important point missed...we refer less to LR with clients because there are few, and we teach clients to stay connected to others, to stay sober.
I was surprised by how much I learned today.
Difficult to sit in these chairs in small room
Lots of good info... Some areas/topics were too lengthy--redundant.  Good program--Glad to see it growing in availability.

POST TEST INFO:

What did you learn today from Martin A. Nicolaus about LifeRing?

•    Three-S Recovery Philosophy; Strength-Based Sober Self Empowerment engine is positive practice of reinforcement; abstinence only is foundational; Personal Recovery Plans are highly individualized through support mtgs plus workbook; able to combine with variety of the models
•    Choise is best...many different paths
•    LifeRing is truly secular; LifeRing offers a choice other than faith based or 12 step; LifeRing emphasizes empowerment and positive reinforcement of the individual
•    A lot.  Ways I can improve the program I work for by LifeRing tech and beliefs.
•    Many interesting things, among others personal recovery plan, that I found very powerful tool in recovery.
•    The S & A model for recovery and how it works through reinforcement.  That all "personalities" are equally capable to become addicted.
•    It is focused on building on strengths of the individual--provides a choice--Personal Recovery Plan.
•    Lots--the choice factor; the love--feeding the S; forgive me--I'm way too tired and burnt to say more, but I got so much out of it.
•    Philosophy and history of LifeRing.  I am a convenor.
•    How to get treatment programs to mention LifeRing as a group option.
•    That it mirrors my thinking about Treatment Approaches.
•    We have another option
•    Focus on individual treatment.
•    The client is instrumental in his own recovery if given the opportunity.
•    Secular spirituality--support sober self.
•    There is an alternative approach to group support other than NA/AA.
•    Friend.
•    Lots!  I knew nothing of LifeRing.
•    The PRP program.
•    Philosophy...mtg structure.
•    It gives clients more of a choice.

How will you incorporate this information into your practice as a drug and alcohol counselor personally and in the agency you work in?

•    Philosophy and concepts (client choice, strength based, flexible treatment and support options);  Skills--workbook exercises--alt. HWYW support mtg formats.
•    Continue with MET, RET  use LifeRing principles in class, educate staff, talk with LifeRing meetings as Option more.
•    By A--facilitating myself with the visual and cognitive tools and use them in 1 on 1 sessions and groups; B--suggest to agency to use LifeRing possibily in continuing care program.
•    Investigating L.R. for and in my own recovery.  The applying LR to the program.
•    I will use the point that the patient takes responsibility for his own recovery more than I did before.  I would share todays experience with coworkers.
•    The strengthening of each individual will be the focus.  And shifting the focus from flaws to what they are capable of and what they find works for them.
•    Help clients and staff understand the nature of building up the sober self through the interchange bewteen people--focusing on here and now
•    I bought the work book--I'm sure I'll use it next week!
•    My meetings will have an enriched meaning due to the workshop today.
•    Refer
•    I will introduce the information about LifeRing to my director.
•    Gives me encouragement to do more research on the subject.
•    Already do--offer as a choice of support group.
•    I hope to start a group for teens.
•    Present client with choices...give basic info about LifeRing.
•    Working more with clients to focus on a personal service plan.
•    Plan to discuss implementation of LifeRing on the approval by my Program Director.
•    Consider choice.
•    LifeRing used to do presentations at NCADA...can do again.
•    Not in field.
•    I am a convenor.

How can you contribute this material to your fellow counselors?

•    Educate and consult re: LifeRing as resource; inputs to program policy and planning; follow ups to stay current on related research
•    In community meeting; 1 on 1 discuss content
•    Familiarizing myself with the materials and sharing them at staff mtgs.
•    Word of mouth.  Introducing things from work book into our program.
•    Through LifeRing Website.
•    Case conferencing, loaning my materials and discussing the information.
•    Not sure yet.
•    I will discuss the information with other convenors ASAP (any who were not present)
•    Talk about it
•    Sharing interaction.  Communicating presentation ideas.
•    Tell them to check it out.
•    Already do.
•    Do presentation.
•    Share information, go to LifeRing meeting, go to web site; present it in Case Conference.
•    Staff Meeting.
•    Discuss this training with them.
•    Shared information.

To your clients?

•    Client info and materials re: LifeRing; use workbook exercises--ind, and group; Encourage ? families LifeRing
•    Will use stuff from workbooks; agian, refer as much to LR as AA
•    Sharing the ideas learned; by continually recognizing the sober person living inside my clients
•    Introducing things from workbook into our program--word of mouth.
•    Refer them to the closest meeting place and website.
•    The strengthening of each individual will be the focus.  And shifting the focus from flaws to what they are csapable of and what they find works for them.
•    Plan to start a LifeRing group and turn it over to a group member eventually.
•    Pamphlets of where meetings are and the workbook.
•    NA
•    None yet.
•    Continue letting them know there is no one road or treatment towards recovery.
•    Give them another option.
•    Give them choice at intake.
•    Do a presentation.
•    Incorporate LifeRing materials to practice.
•    One on one sessions.
•    Paroles/State prison
•    Consider choice.
•    Shared info.

--------------------------------------------------------

P.S. 9/28/09:  I've posted the PowerPoint at http://www.unhooked.com/trxpro/CAADAC workshop.ppt -- just the slides, no sound track.  When I get time I hope to create a sound track and make a Flash video (or a series of them) based on this presentation. -- MN

What If There Were LifeRing Treatment?

Quite a few recovering people in various treatment programs have expressed the wish that LifeRing filled more than an hour in their week.  The desire for "more LifeRing" is especially strongly felt in programs where the other hours consist of heavy-duty 12-step lectures and meetings. 

Of course, there is no such thing as a LifeRing treatment program, and there probably oughtn't to be.  We are a peer-to-peer support group, and should always remain that.  So much of our fundamental approach is premised on horizontal support dynamics that the introduction of vertical relationships -- inevitable in today's insurance-dominated treatment settings -- would bring about wrenching distortions.  Still, wouldn't it be liberating if today's treatment professionals saw their role as not only facilitating 12-step involvement but also facilitating LifeRing involvement?  Whatever works best for the client?

For treatment professionals in Northern California, an opportunity to learn the basics of LifeRing is coming on Saturday, Sept. 19.  Thanks to sponsorship by CAADAC, the California association of addiction professionals, I'll be presenting an all-day workshop at the LifeRing Service Center in downtown Oakland.  I'll be selecting material from Empowering Your Sober Self (my new book), from the Recovery by Choice workbook, from How Was Your Week (our convenor handbook) and from other sources.  This six-hour program is aimed at treatment professionals, and six hours of Continuing Education credit, plus an hour of Professional Development credit, are offered.  However, space permitting, any interested person, including of course any LifeRing participant, is welcome to take part.  It only costs $10.

Here's a page with details about the venue, parking, meals, etc.  Hope to see you there!

Choice is the Law: Forthcoming Article

The October issue of Counselor magazine, the premier monthly journal of addiction professionals, will include an article I wrote about a recent federal court decision that requires a secular option in coerced treatment settings.

I reported on this court decision -- Inouye v. Kemna -- in a talk to the 2008 CAADAC conference, and there is an informal video and a slide show of the presentation on the LifeRing website, here.  But the upcoming Counselor magazine article is the first print coverage of this important federal court decision, and of its precedents, in a nationally distributed medium read by addiction professionals.

The court decision says, in a nutshell, that criminal justice officers and addiction treatment professionals in a government setting should be aware by now that they cannot force clients into 12-step treatment or support groups over their objection, but must provide secular alternatives; and if they do coerce clients into 12-step, they and their agencies can be sued for money damages.

Remembering Kay Rossi Ph.D.

LifeRing convenor Carola Z. writes:

Kaye Rossi, PhD, was a psychologist and addiction counselor at the Center for Recovery at John Muir/Mt. Diablo Hospital in Concord. She passed away on June 16th. She was 52.

Kaye was pro-LifeRing and I actually first heard about Lifering through her. We once asked her to be on our Advisory Board. Some of you on this list may have known her, too.

I first met Kaye when I checked into the CFR alcohol recovery program 6 ½ years ago. She had a great impact on me and my recovery. I joined her after-care-group, however, I dropped out after a year since I thought I could recover on my own without any group support. I relapsed shortly after and called Kaye the very next day. “I’m glad you called…” she said and pointed me into the right direction – I rejoined her after-care-group and went to LifeRing meetings. Now, 5 ½ years later, I am a Board Member and lead weekly meetings where I often quote from Kaye’s insights. I would like to share this one:

In one of her group sessions, a young man who was going to go on a safari trip to Africa soon, expressed his concern about possibly being triggered to relapse when gathering around the campfire. “Use your cellphone and call somebody” was the advice he got from a group member and he replied: “At $3.00 per minute, that’s expensive!” Kaye simply asked him: “So, what’s it worth – your sobriety?” That stuck in my mind.

A couple of years later around dinner time, I got upset about my mother-in-law and while looking at our worn-out, hand-me-down rug under our dining room table that she had given us, I was seriously contemplating getting drunk. “What’s it worth – your sobriety?” I remembered and instead, I asked my daughter to come with me that evening to buy a new rug. We did.

I never buy on impulse, and this one cost me $450.00. Was it worth it? Absolutely, Kaye!

I will never forget her.

-Carola

Thank you, Carola. Outstanding treatment professionals like Kaye Rossi are priceless, and their loss is a blow to the whole community of recovering people. My sympathies to her family and to all her clients.

Letter From a Faith-Based Treatment Program

This email came to the LifeRing Service Center today:

I am the owner of a outpatient drug and alcohol treatment facility located in B___, NJ. Some of our clients are resistant to the disease concept of addiction and to the "powerlessness" suggested in the 1st step of AA. Our agency is faith based, however, we are open minded regarding providing treatment services that are secular for those who are not inclined to practice the 12 Step philosophy. Do you think LifeRing secular treatment would be beneficial? What is LifeRings philosophy/vision statement? Thank you for your response.

Dear Ms. _________:

You are not alone. I have spoken with dozens of treatment providers at all kinds of programs and heard the same message that you have expressed. The 12-step approach works well for some clients, but by no means for everyone. A program that has high professional standards will offer clients choices, so that more clients find something that fits and works for them.

LifeRing publishes a workbook, Recovery by Choice, that embodies the LifeRing approach. Its 300 pages in 14 chapters contain many dozens of worksheets and exercises that treatment providers find useful in a variety of settings, inpatient or out. There is easily enough content for a long-term program. For shorter interventions, the counselor is advised to select key items from each chapter, or from the chapters that are most applicable to the particular client.

The LifeRing approach in the most general terms is based on positive social reinforcement. It is, broadly speaking, a cognitive-behaviorist approach.

You can find out more from the following sources:

http://lifering.org/faq/index.htm -- a very short FAQ page

http://www.unhooked.com/lsr/three_s_philosophy.htm -- outline of the basic philosophy

http://www.unhooked.com/trxpro/index.htm -- Introduction for treatment professionals, with more resources

http://unhooked.com/lifering.org/index.htm -- About LifeRing, the organization

http://lifering.com/ -- Online bookstore, where you can order print and CD publications about LifeRing, including the workbook

I hope this is helpful and that we can be of assistance in offering your clients more pathways to recovery.

Another door opens by a crack

A few weeks ago, as I reported elsewhere, I was invited to speak about LifeRing at Mountain Vista Farm, one of the oldest rural inpatient treatment programs in California. Mountain Vista's reputation is that of a citadel of the 12-step approach. Yet there was genuine interest in hearing about the LifeRing approach, and my presentation appeared to resonate with quite a few of the counselors in attendance.

Now comes an invitation to speak about LifeRing at another well-known bastion of the 12-step approach, the Henry Ohloff program in San Francisco. I will be addressing staff at the outpatient center on June 2. Like Mountain Vista, this program is not ready to host a LifeRing meeting, and it may be quite a while before the treatment protocol opens up to the reality that there are many roads to recovery. But meanwhile, there are staff members in these tradition-bound programs who have their eyes and ears open for new developments that may help some of their clients.

This is certainly a welcome sign. If I ask why it is occurring, the answer is that patients/clients are driving it. In at least 80 per cent of the cases where we are contacted by a treatment professional and asked for more information about LifeRing, a patient or client was the driver. A patient or client introduced the professional to LifeRing literature or the LifeRing web presence, or informed the professional that he/she was attending LifeRing and that it was helping.

And even when an individual patient or client is not directly the driver, in the sense that he or she located LifeRing and put LifeRing on the professional's radar screen, it is still patients/clients who drive the process passively, by voting with their feet when the professionals only offer an approach that does not work for them. A treatment program that only offers the 12 steps and nothing else is going to experience, sooner or later, the reality that 80 per cent of newcomers to AA walk away within 30 days (and 95 per cent within a year).

While few treatment programs retain a patient as long as a full 30 days -- the average stay at one nominally 28-day program I know is around 10 days -- the client resistance to 12-step may well show up from Day One of treatment. If the program has nothing else to offer, it's going to lose clients earlier than if it offered choices. Monomodal treatment translates into high patient turnover. You don't need to be a rocket scientist to figure it out.

And so, the wheels turn, and sooner or later a call goes out to LifeRing, or another alternative approach. Quite a few LifeRing convenors now have had the experience of explaining LifeRing before audiences in treatment programs. To be sure, it's far too early to proclaim a tsunami, but if we compare the interest in LifeRing from treatment programs ten years ago and now, we're almost in a new era. Ten years ago, most minds were closed and we couldn't get in the door. Today, we're frequently in the embarassing situation of getting requests from a program director to start a meeting, and not having a convenor to take the room. It's a problem, but it's a better problem to have.

LifeRing at the APA in Boston

From Kathleen Gargan, who represented LifeRing at the American Psychological Association Conference in Boston:

I'm back from the 2008 American Psychological Association Conference in Boston. This was a fascinating, if exhausting, experience. The exhibition Hall was open from 9:00 a.m. to 5:00 p.m. on Thursday, Friday and Saturday, and from 9;00 a.m. to noon on Sunday.

On Thursday and Friday, I handed out 317 "Welcome to LifeRing" pamphlets, and repeated my "In a Nutshell" description of LifeRing: "Can I tell you about LifeRing? LifeRing is a non-profit, secular alternative to Alcoholics Anonymous and Narcotics Anonymous for people who don't relate to the spiritual or religious focus of the 12 step approach."

I learned quickly how important it was to get the word "nonprofit" out of my mouth as soon as possible, since most of the other booths were there to sell something. On Saturday and Sunday, traffic was much lighter and I gave out 75 pamphlets and visited exhibit booths of treatment centers, as well as academics who were giving papers on addiction related topics.

I also visited the AA and NA booths and was received cordially in each case. By far, most of the people I talked to were very positive about LifeRing. No one wanted to argue about The One True Way to get clean and sober.

One man asked if AA was "threatened" by our group. I told him that it certainly doesn't need to be, and asked him what made him ask such an interesting question. He laughed and said something about territoriality.

Even people I interrupted as they walked by very quickly with the "my destination is more important than anything you could possibly tell me" vibe thanked me for stopping them when they heard about LifeRing.

Several people wanted to know if we had studies to show the effectiveness of LifeRing; some asked if we were related to Rational Recovery, and many people expressed surprise to hear that such a thing as a secular recovery program could exist!

Therapists from Oregon, Rhode Island, New Jersey, Kentucky, Pennsylvania, Tennessee, the Carolinas, Massachusetts and Utah wanted to know if there were face-to-face meetings in their area. Psychologists and students from Kuwait, Egypt, Spain, the US Virgin Islands and Puerto Rico now know about LifeRing.

I collected cards from several people who want more info One author from Pennsylvania expressed interest in doing an article about non 12 step recovery programs for the state Psychologists' journal. I plan to follow up with an email to each one. It was wonderful to hear so many people say that there is a great need for a secular alternative to 12 step programs.

It seems to me that having a presence at this event automatically gave LifeRing a certain gravity; as if we should be taken seriously as a resource for recovery. There were no representatives from Women for Sobriety, Smart Recovery or S.O.S. Likely this is because it is expensive to participate. (I learned when I arrived that we were

required to rent 10 square ft of carpet, $218.00 for 3 & 1/2 days,

and if we wanted a table and chair, we would need to rent them as well, and for equally appalling amounts)

I also feel that it would be helpful to have more than one person "personning" the booth. Sometimes as I was talking to someone, I noticed 4 more people walking by. Also, as time went on, I found I had less energy to approach people. I would have helped to have had at least one other person there to reach more people and to trade off with. Of course this will not always be possible, but it's something to think about for future conferences.

All in all, I'm very glad I got to do this gig, and I recommend to all!

I'm sure there is pertinent information I am leaving out. Please ask me questions if you want to know more!

-- Kathleen

Letter to Dr. Davis from an Audience Member

[Note: Dr. B.J. Davis, Clinical Director of Strategies for Change in Sacramento, was guest keynote speaker at the 2008 LifeRing Congress in Berkeley May 31 2008. See Congress review page. After his talk, which was met with a standing ovation, Dr. Davis received the following letter from an audience member.]

Dear Dr. Davis:
I attended your presentation at the LifeRing Congress yesterday. I am passing on a monumental and heartfelt thank you for offering me something that you may very well not be aware of. Your efforts helped me release something that although I was not fully conscious of, I have been holding onto for several years now. I struggled with binge drinking, starting in 1998 and came close to death on a few occasions. I was admitted into Clearbrook - a 28 day, 12 step program in Pennsylvania in 2002. I had attended AA meetings prior to that time and it never resonated with me. In fact, the bulk of that which AA stands for always felt completely contradictory to who I am and what I believe.

Quite frankly I found the whole thing offensive, short sighted, and erroneous. At the same time, the aggressive, hostile, shame-inducing, punitive, thoughtless, deeply insensitive, and invalidating tactics of the 12-step treatment center made AA, on its own, seem light-weight, in terms of harm. My time in treatment is truly one of my most disturbing memories - in my adult life, anyway. I hesitate to go too deeply into it because firstly, it would require dozens of pages, but more importantly, I believe that to whatever extent I hold the responsibility for having created the circumstances for which I ended up in treatment, I am also able to create and put for my solution to the same extent. I like that the solutions to all of my life challenges remain in my hands.

Since years have passed since my treatment, I felt that for the most part I had moved beyond my negative and enormously frustrating feelings as well as the deep conflict that I endured during my 28 days. During your presentation, it became apparent that I had not fully let go of that experience and its impact, until today. As I heard you speak the very essence of what I have felt, believed and attempted to express on countless occasions -- during and subsequent to my treatment, I realized that there were still pockets of stored sadness, desolation, deep frustration, and even fear -- fear of once again being misunderstood, or being accused of having a sick-mind, even though I knew (ironically, in my mind) that my mind was precisely the very part of me that held my solution. If my mind had guided my decisions, I never would have had a drink. I was always clear that my poor choices and decisions were directed by emotional conflict, pain, etc. and my mind at those times was abandoned.

To hear you speak so confidently and knowingly of the very things that I too have known, yet have failed to successfully communicate and in some ways, fully embrace, proved to be quite a profound experience for me. Therefore, I have to point out your one inaccuracy, which is that you said at the beginning of your presentation that you did not have anything profound to offer. That proved to be unquestionably false for me. As I heard your wise and insightful words combined with your compassion, understanding, and alignment with universal truths that transcend any short-sighted concepts and beliefs espoused by AA (and other organizations), I somehow felt compelled and safe to release whatever was left inside of me that once felt so hurtful.

Without sounding too dramatic here, I came close to leaving the room during your presentation, because I actually got teary eyed and was fearful I might just burst into heavier tears. Yet my tears did not reflect any current sadness, but rather a release of old sadness, replaced with a renewed feeling of freedom and hope that I had neatly tucked away and fiercely protected. Thank you so much for offering me the segue between having shut myself down and feeling safe and free to re-open certain places in my heart and mind.

Again, I may be treading dangerously close to drama here, but after treatment, I felt much like I imagine a little boy would feel after being punished for doing something wrong that in reality he didn't do at all. Or better stated, being accused and punished for doing something wrong and bad in the face of attempting to do something quite pure, innocent and good. Your insights touched me similarly to how a boy would have felt if a parent believed him for the first time after years of carrying around the guilt and shame for something he never did. That pretty much sums it up for me.

Truly, thanks so much for your courageous efforts, your big heart and your wise mind. I personally think you should have an endless supply of Ben n Jerry's and anything else your heart desires..... and so it shall be.

Sincerely,
(Name Withheld)

Draft of new brochure, for comment

This past week I've given LifeRing presentations to two groups of lawyers, one in Hayward and another one here in Oakland, today. At the Oakland talk a number of social workers were also in the audience. There were expressions of surprise both from the lawyers and from the social workers when I mentioned the recent federal court case that said 12-step groups are religious and that a government official cannot refer a client exclusively to 12-step groups. I was surprised they were surprised -- I kind of thought that maybe lawyers would know this stuff and that social workers would have been told by their employers. Am I naive, or what! Sooo, right after the noontime talk today I drafted up a new LifeRing brochure, called "Choice of Support Groups: It's the Law," and I would appreciate it if those of you concerned with this issue would have a look at it and give me the benefit of your comments on the brochure. The draft is posted for your download here. Please post comments on the brochure here.

The text of the brochure is drawn largely from my earlier blog post about this court case, there. Please post comments about the court decision there. Thank you.

Confrontation Therapy, R.I.P.

Two of my favorite scholars have combined to write a powerhouse of an article that everyone interested in addiction treatment will want to read. William R. Miller, co-author of the Handbook of Alcoholism Treatment Approaches (reviewed here), and William L. White, author of the monumental history Slaying the Dragon (reviewed here), have written what hopefully will be an obituary for an era, entitled "Confrontation in Addiction Treatment." It's in Counselor Magazine.

I've posted excerpts and a short comment in the New Recovery Blog; go there.

Email from a Treatment Professional

The head of a hospital-based treatment program where LifeRing meetings started last year sent this email to the LifeRing convenor who had asked to move the LifeRing meeting to a larger room on a different evening:

"All the newest scientific literature in recovery says "one size does not fit all - and should not" implying people should have choices that will keep them coming, as it is difficult to affect change when the patient does not attend. Historically, we have viewed resistance to 12-step programs as "denial". We are moving away from that dogmatic approach to substance abuse counseling. This is my long-winded way of attempting to say I no longer view LifeRing as "competition" to [12-step], especially given the extraordinary acceptance it has had among our IOP patients who would not have otherwise attended AA or NA.

Consequently, I suggest you move the meeting to whatever date and time you wish.... Given what we are learning about substance abuse treatment, disallowing to the change would not be in the best interest of the patients wishing to attend, and therefore hard to justify. ...

So, in summary, I say move the meeting on your own.... Again, congratulations on a very popular treatment alternative that has meant the difference between attending or not attending self-help groups for a large number of our patients."

Education level of CA counselors

CAADAC, one of the California addiction professionals' organizations, has released a membership survey showing, among other things, the highest educational level reached by its membership. It shows that 29 per cent, the largest single category, do not have a junior college certificate or college degree; they have completed unspecified drug/alcohol studies only. Another 18 per cent have a junior college degree. Twenty-eight per cent have a B.A. as their highest degree; 20 per cent have an M.A., and 5 per cent have a Ph.D. Altogether, 47 per cent don't have a college degree; 53 per cent do. The association's membership includes counselors and program administrators. Source.