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How can one decide between a treatment plan that is strict on abstinent behaviours and one that offers stages of reducing addictive behaviours (“harm-reduction”). Some may prefer the latter because, to them, complete abstinence seems unrealistic, overwhelming, and destined for failure. Families may encourage abstinence programs because of the impact that addictive behaviour has made on family members’ lives. Nonetheless, the difficulty in choosing the right treatment program is not made any easier from simple internet research.

Studies have shown that regardless of the method employed to become sober/clean, the number one factor for sobriety success is a permanent commitment to discontinue use permanently; a commitment to abstinence. It actually is much easier to just give it up entirely than punish yourself trying to moderate or control your addictive behaviour (SMART Recovery).  That said, the more times you work on quitting an addiction, the better your chances of reaching the goal of quitting permanently.

Data from several countries shows that treatment policies that insist on abstinence lead to a greater number of deaths than those that allow some kind of substitution therapy, with safer opioids such as methadone or buprenorphine (Subutrex) for heroin use. Although less well studied, the same is likely to be true for alcohol, where substitution therapies such as oxybate and baclofen exist but are less widely used (The Guardian).

Many recovery program staff and professionals espouse that abstinence is the only viable approach, and they reject any program that does not demand abstinence. This is such an obvious truth for these disciples that further thought is pointless. (Canadian Harm Reduction Network)

Despite their popularity, abstinence programs have come increasingly under pressure from research. Scholarly studies based on motivation theory, pharmacotherapy, and cognitive-behavioural therapy have shown that abstinence is not the sole route to recovery from addiction. Although proponents of the abstinence approach have argued that drug use is the defining feature between recovery and addiction, most experts believe that recovery is more accurately represented as a process in which clients move through a series of distinct stages, including relapse (Prochaska, Norcross, & DiClemente, 1995).

The different forms of information out there are not providing much ease in choosing the right treatment program. The choice should not be made according to majority votes or majority statistics. The choice should be made based on the addicted individual’s (1) willingness to recover, (2) individual goals, and (3) understanding of the impact the addictive behaviour has on his/her life and the life of others. When these are established, treatment programs can effectively address the person’s specific needs as well as those in their family.

Contact us today for more information and to start an individual assessment and to explore your addiction treatment program options.


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A relationship does not have to be romantic to be considered toxic. A toxic relationship may occur in friendships, parent-child relationships, between siblings and in work relationships. When toxicity in relationships can be identified early, we prevent ourselves from enduring excessive negativity and improve our ability to develop better relationships.

Toxic relationships may appear different from different people. Usually a relationship that is not serving us well will have these characteristics:

  • Abuse: emotional, financial, physical, or sexual
  • Consistent and draining arguments (blame and finger pointing)
  • Feelings of worthlessness, disrespect, hurt and sadness
  • Withdrawal from personal goals, family events, and social gatherings
  • “coping” behaviours that go against personal values (drugs, violence, etc.).
  • Decrease in academic/work performance and
  • Increasing feelings of anxiety, grief and depression

Identification of destructive relationship qualities tends to be easier when we are looking in from the outside. Some level of objectivity allows us to more easily identify the relationship as problematic. This is not as easy when we are the one in the relationship, especially in romantic relationships. A few signs or “red flags” may provide subtle hints that the relationship is unhealthy, however, we seem quite able to minimize, justify and even full out deny these signals. We may take blame, hope better will arrive soon and/or magically believe that this “icky” time will simply go away on “its” own.

It becomes common to push away from friends and family who advise us to get out of the relationship. We assume these people do not understand us nor do they try to relate/accept those we choose to spend our time with. They also, most times, don’t really know the whole situation or how to solve it anyway.

So how do we get out?

An important first step is accepting that this toxic relationship does exist and we are part of the equation. Then we establish that we want better for ourselves and increase our openness to work for it and get help. These initial steps display caring for ourselves, a willingness to seek assistance to change and move forward in our interpersonal lives.

Allow us to help you with the next steps. To improve relationship skills or maybe to just assess the relationship that you have questioned for so long, contact us today.

 

 

Welcome Our Newest Associate-Intern2014-03-07 15.30.55

Jeff Packer MSW & Associates is pleased to welcome Dan Blomme to our counselling practice. Studies in counselling psychology, at OISE with the Universtiy of Toronto, along with specialized studies in addictions have prepared him well. Additionally, Dan brings a wealth of experience gained at the Centre for Addictions and Mental Health (CAMH) in Toronto.

Dan has significant expertise assisting individuals with substance abuse/misuse issues, addictive behaviours as well as people suffering from depression and anxiety. Adding to his years with CAMH, providing residential and outpatient counselling services, Dan is a professor with Durham College, in the School of Health and Community Services. His specialty teaching areas include addictions, mental health and social service work. Dan’s professional practice is strengthened by the latest research and practice applications available to help people overcome challenges and improve their quality of life.

Dan has openings a couple evenings a week for those individuals who would like a professional assessment and counselling interventions aimed to help get “unstuck” from negative thinking, emotions and behaviours.  Book an appointment with Dan today!

 

What is peer pressure?


                                                            Photo credit: Oleander from morguefile.com

Some may define it as when friends or peers attempt to influence how you think or act, however, it may also include how we perceive peer influences. While peer pressure can be helpful at times, it can definitely affect our decisions or make them slightly more difficult. During adolescence, developing healthy relationships is a new, fresh experience, like an adventure someone takes without much of a map or with little pre-planning or direction.

Some teens may not realize they are being “pressured” or influenced in any sort of way.  For instance, we may hear these statements like these from our teens: “They’re my friends, you don’t know what you’re talking about.”… “They care about me more than you do!”… “You’re too old to understand.”… “My friends really care and have my back”.

What are the negative effects of peer pressure?

When a peer or friend behaves in a way that has a teen questioning right from wrong, most likely that teen is being exposed to peer pressure. This may not always be negative, yet we usually think of peer pressure as leading another into something harmful or wrong. Friends may persuade teens to do things they may not want to do, such as: defying parents, staying out past agreed upon times, engaging in sexual activity, drinking alcohol prematurely or “experimenting” with drugs, stealing or other crime-related behaviours, poor school performance (e.g., skipping classes or homework assignments).

Choices and decisions may not always stem from peer pressure though. Some teens may admit to willingly making the choice to engage in destructive behaviour. Nonetheless, teens might experience an increased pressure from others to make certain choices in their lives, often without getting much advice from an adult. They may ask themselves any or all of these:

  • If I say no, will I be called a loser?
  • What if they don’t like me anymore?
  • Isn’t this my chance to be a part of the group?
  • Is this what having a real friendship is like?
  • They will have my back if I get in trouble….right?

There are positive effects to peer pressure?

There are positive effects to peer pressure. Some peers influence others to join school activities, play sports, and help reach goals. With this kind of support, the growth and development at adolescence is beneficial. It can go a long way to boost self-confidence and improve self-esteem. When peers influence each other toward positive behaviours, teens are better able to socialize, engaging in activities, sports and talents, improve academic performance and have a generally more relaxed, confident and positive outlook on life.

Counselling can be a great resource for teenagers, parents, and friends to find a balance with peer and family influences. With professional counselling, individuals are able to build the self awareness to more clearly consider the consequences of behaviours before acting impulsively. Strategies are available to help teens understand thoughts, related feelings and how these influence behaviour patterns. Counselling also helps people create action plans to recover and move away from difficult situations that may cause or increase chances of danger or harm.

Remember that you are not alone, and talking to an un-biased, non-judgmental counsellor can help.  Book an appointment with us today.

I come home from school every day and cry.

I don’t think I’m bossy.

I am a little shy.

The kids at school won’t play with me.

I think I’m nice and caring.

I don’t feel comfortable around the kids at my school.

I like going to the playground, but I don’t play with anyone there.

Kids do not talk to me very much.

I hate my life.

I am 8 years old… “my life sucks!”

It is very difficult for any parent to find out that their young child is not happy with his or her life. Our hearts are broken when we hear comments like those above. We just want our kids to be happy. We also understand the importance of developing healthy relationships, so how can we help our children grow and establish healthy and appropriate social skills?

It is important to identify what may be contributing to or fueling your child’s discontent. There are numerous reasons why children may have difficulty developing friendships. Let’s first remember that friendship skills are acquired, learned over time. These can be taught, practiced and fine tuned. Of course, each child is different. Some children’s personalities are highly introspective and even somewhat introverted. It may seem easy for some to make friends, however, for this personality type, it can often be a daunting task to reach out to and communicate with their peers.

Teen TroublesOthers may be more outgoing or extroverted, yet still may struggle with relationships for a variety of reasons. Studies suggest that a child without siblings may have a more difficult time making friends than a child who has siblings. Social relationships are pretty much developed from birth and can be fostered when siblings are involved.  These children may, yet not always, have an easier time meeting, playing and getting along with other children.

Even different parenting styles can contribute to how children develop social relationships. The level of parent cooperation, flexibility, structure and discipline all play an important role. How parents themselves get along with each other and socially interact strongly influences how their children approach others. In addition, stressors in the family such as health concerns, death and loss, moving, employment issues, family conflict and separation can significantly interrupt social development.

There is hope! Fortunately many resources, materials and yes… manuals are available. We often hear; “These kids don’t come with a manual”, yet this is simply not true. Most bookstores and libraries carry thousands.

Many parents seeking help will come across many “easy-to-do” steps from these books and internet sources yet find the advice difficult to put into practice. For instance, some “experts” suggest the following:

  • Be yourself
  • Relax – “Don’t sweat the small stuff”
  • Be a good listener
  • Give compliments and encouragement
  • Join a team/social club

Seeking help from therapists, school counsellors, pastoral counsellors and books are effective ways to help both parents and children learn about social relationships. In counselling, parents and children can explore current relationships, understand themselves and others better (in the social context), and develop a plan to reach the goals they wish to accomplish (e.g. improving confidence, learning communication, problem-solving and assertiveness skills).

Parents can also receive coaching to help them develop strategies to increase self esteem, competence and confidence at home.

If you find your child struggling to get along with others and are uncertain how to help, remember this is common as we tend to get very little formal training in parenting. While many find books and other media resources helpful, these may not be sufficient for the specific issues you have. Don’t wait. Get proactive and find the right solutions that work for you and your child.

Research counsellors experience, expertise and qualifications.  Then find one that you and your child feel comfortable with. To book a consultation and assessment with professional relationship coach call us today .

 


Photo credit: Pwin from morguefile.com

Narrative Approaches Help Conquer Disordered Eating

The approaches found most effective to recover from eating disorders and “disordered eating” behaviours include (but are not limited to) cognitive-behavioural, narrative, family systems and developmental theories. These knowledge bases help those struggling with body image issues and eating disorders to work alongside mental health therapists, dietitians and doctors to improve health outcomes. Today’s blog post provides a sample of the approach in one homework assignment completed by a teen girl. She was asked to first write from her perspective and then, second, re-write the story from the perspective of a five year old.

**********

1-      “Stinkin Thinkin”

Once there was a girl named Rae. She went into the front doors of the school and walked up the stairs alone. When she got to the hallway of her locker, she stared down it and looked behind her. ALONE, she thought. She turned the combination key until it was open, and began organizing her locker and getting the books that she needed.

People started filling into the halls, some would say hi but they would still leave. They don’t really want to be with me anyways, she thought. The halls were now crowded and she just wandered until the bell rang, When it did, she walked into class and sat down. She acted happy and engaged in conversation; meanwhile she was feeling like complete crap.

At lunch time she debated on eating. DON’T EAT, you’ll lose weight, she thought. But she was hungry, so she ate anyways. Don’t eat when you get home, she thought. But she did, and became into a binging session, which lead to purging. PurgepurgepurgepurgepurgepurgepurgePURGE. The voice inside her head was loud enough to make her listen. She didn’t eat for the rest of the night.

After her shower, she regretted glancing in the mirror because now she was sad and angry. She grabbed the fat on her stomach and began to cry. I hate my body, she thought. She looked away, put some pj’s on and cried herself to sleep. I can’t wait until the day that I can love myself, she thought.

**********

You can see here a small sample of how pervasive the thoughts can become underlying disordered eating patterns. Of course, the feelings of disgust, loneliness, anger, confusion, worry, anxiety, sadness and isolation will drive and increase the negative behaviours of over exercise, laxative use, food restriction, binging and purging. With these thoughts, feelings and behaviours the person’s story about themselves, their bodies and their options  for recovery, worsens.

When taking a narrative approach, combined with cognitive-behavioural strategies to change, people suffering are asked to consider the perspective from a five year old’s vantage point. In order to contemplate change and re-writing of the negative story, clients are to ask themselves; What would a five year old me say about eating, body, exercise, food etc.? The following is the second part of the teen girl’s homework; narrative “re-writing” of disordered eating from the five year old’s view;

**********

2-      “Five year old”

Once there was a girl named Rae. She went into the front doors of the school and walked up the stairs alone. When she got to the school, she looked around her and thought, people will be here soon, I’m just early. She played and waited for people to arrive.

People started arriving, some would say hi but they kept walking past her. They’re just busy, she thought. The halls were now crowded and she just wandered until the bell rang. When it did, she walked to class and sat down. She acted happy and engaged herself in conversation, meanwhile she was feeling pretty badly.

At lunch, she debated on eating, if you’re hungry eat, she thought. So she did. You can always have a snack when you get home too, she thought. She felt guilty for eating and was contemplating purging. Ew don’t do that, that’s gross, she thought, so she didn’t.

After her shower, she looked in the mirror and felt confused about her body. Every body is different and unique, she thought. She looked away, found some pj’s and went to sleep.

**********

Thanks to this courageous teen author for sharing her narrative homework above in her efforts toward a healthier and happier future.

For experienced, professional guidance in this area, book your appointment today.


Photo credit: presto44 from morguefile.com

Boundaries: What Does It Mean?

BBeing honest and

Oopen. Having

Uunderstanding conversations that

Nnurture positive feelings and thoughts.

Ddetermining your wants and values and

Aassertively helping others become aware of these.

Rrespecting yourself and others by making

I –  intentional efforts to improve your relationships.

Eempathetic and effective communication so all involved feel

Ssafe and secure.

For many couples after separation or a break up, or even those underneath consistent conflict, deciding to reconcile can be difficult to visualize. Sometimes reconciliation does not mean re-establishing a romantic relationship. Some couples choose, after separation, to establish a new relationship for cooperative and positive parenting to take place.

Without a doubt, it is quite difficult for most couples to reach an amicable closure of the romantic part of their relationship. This, however, is an essential step toward effectively developing a positive co-parenting relationship. For some, this may indeed seem almost impossible; moving from a couple once in love to negotiating and implementing a mutually respectful cooperative parenting agreement. Parents interested in the healthiest environment for raising children can benefit from professional coaching to reach this goal as soon as possible after their separation.

Feelings of grief, betrayal, hurt, confusion and disappointment can cloud perceptions, potential for forgiveness and severely limit healthy and clear communication. The identification and development of healthy communication and negotiation processes are central to building an effective co-parenting relationship. This is where boundaries come in to play. While emotions are high, and pools of uncertainty exist, boundaries establish clarity and safe measures to begin the process; deconstructing one part of the relationship while reconstructing another.

Examples of cooperative parenting agreements include guidelines for how and when to talk, what to discuss and with who (e.g. with children, family, friends), when to have flexibility and how to negotiate or renegotiate changes. Additional topics to be worked out include ways to stay child focussed, shared parenting time, drop offs and pick ups, extracurricular activities, holidays and the pre-planned calendar of events.  Boundaries that are firm, with modest flexibility, greatly reduce the chance for disagreements, enhancing the likelihood parents and families will have caring, calm and relaxed “post-separation” relationships. 

For experienced, professional guidance in this area, book your appointment today.

 

Ice Coated Trees – Dec. 2013