TIPS & TOPICS Volume 6, No. 8 December 2008 In this issue — SAVVY — SKILLS — SOUL — STUMP THE SHRINK — UNTIL NEXT TIME Happy Holidays to you and your family. Welcome to all our new readers and welcome back to all who have been with us for a while.
TIPS & TOPICS Volume 6, No.7 November 2008 In this issue — SAVVY — SKILLS — SOUL — SUCCESS STORIES — Until Next Time
TIPS & TOPICS Volume 6, No.6 October 2008 In this issue — SAVVY — SKILLS — SOUL — Until Next Time Welcome to October’s TIPS and TOPICS (TNT). Occasionally I have a respected friend and colleague contribute their ideas to TNT, especially where there has been a topic of debate or controversy in the addiction and mental health fields. This is one of those months. SAVVY Gerald D. Shulman, M.A., M.A.C., FACATA has been in the design, delivery and administration of addiction services long before many of you thought about entering the field. Jerry’s years of experience on the frontline of services as well in training and consulting around the country has given him a perspective about a variety of issues that not many have a chance to match. This month in SAVVY, Jerry shares some thoughts on Medication Assisted Treatment. With his permission, I’ve edited his work; and all of the text in italics is excerpted from a larger manuscript he is preparing for future publication. Medication Assisted Treatment (MAT) in Addiction Services Stirs Attitudes and Practices Early treatment for alcoholism in the USA consisted of psychosocial interventions, modeled on the philosophy of the Twelve Steps of Alcoholics Anonymous. Early clients were “rehabilitatable” (e.g., had acquired the skills to function effectively, but whose drinking interfered with the application of these skills). Later, clients referred to treatment presented with a much greater complexity and pathology, and often these clients were only “habilitatable.”) Riding a Unicycle The only treatments available were psychosocial, and even when evidenced-based practices were used, successful treatment outcome was considerably less than desired by providers, payers and the clients themselves. The use of psychosocial treatments alone was like riding a unicycle, very difficult to do, many falls while learning and limited to only a small number of people, and for clients, of limited effectiveness alone, especially after initial treatment. Graduating to the Bicycle It became clear that without environmental supports (e.g., housing, education, employment, etc.), that even the best psychosocial treatments would be limited in effectiveness. In part because of the Center for Substance Abuse Treatment’s (CSAT) Access To Recovery grants, the field then began to couple Recovery Support Services (RSS) with psychosocial treatments. The field graduated from trying to ride a unicycle to riding a bicycle, something that provided more support (two wheels instead of one) that many more people could do, rather than to ride a unicycle. But even at this point, the hoped-for outcomes for alcoholism treatment fell far short of expectations. Moving to a Tricycle More recently, there has been a focus on Medication Assisted Treatment (MAT), particularly the use of medications which reduce craving and therefore increase probabilities of remaining abstinent. MAT is not designed to replace, but to augment, psychosocial treatments and RSS. To complete the analogy, we have now moved to a tricycle. A cycle that can effectively be utilized by the greatest number of people including young children who have not yet acquired the skills to ride; and older …
TIPS & TOPICS Volume 6, No.5 September 2008 In this issue — SAVVY — SKILLS — SOUL — SUCCESS STORY — SHAMELESS SELLING — Until Next Time Welcome to all our new subscribers and to everyone after the summer (or winter) break. This month in the USA, it has been National Alcohol and Drug Addiction Recovery Month. Even though we are at the very end of September, I will continue this focus in this edition of TIPS and TOPICS.
TIPS & TOPICS Volume 6, No.4 July-August 2008 In this issue — SAVVY — SKILLS — SOUL — STUMP THE SHRINK — Until Next Time Welcome to our summer, two-month, merged edition so we can “smell the roses” and take some time off. Hope your summer (or winter) is going well too.
TIPS & TOPICS Volume 6, No.3 June 2008 In this issue — SAVVY — SKILLS — SOUL — Until Next Time Welcome to June’s edition of TIPS and TOPICS (TNT). Thanks for all your e-mail feedback and comments. I do appreciate them, even if I can’t respond to all personally. If you have a SUCCESS STORY to share, please send that along too.
TIPS & TOPICS Volume 6, No.2 May 2008 In this issue — SAVVY — SKILLS — SOUL — STUMP THE SHRINK — Until Next Time Welcome to the many new subscribers to TIPS and TOPICS (TNT). Just a reminder: there are 5 years of Back Issues you can read or download. Simply click on “Read Back Issues” on the homepage of www.DMLMD.com. Coming soon – a revamped website with a Search function to search by topic.
TIPS & TOPICS Volume 6, No.1 April 2008 In this issue — SAVVY — SKILLS — SOUL — Until Next Time This month’s TIPS and TOPICS (TNT) marks the start of our sixth year of sending our free monthly e- newsletter. That means there are five years of material on the website that you can read, download and share. The time is getting closer when you will be able to search all that material; there are consultants revamping the website as we write
TIPS & TOPICS Volume 5, No.11 March 2008 In this issue — SAVVY — SKILLS — SOUL — SHAMELESS SELLING — As a RESULT of your FEEDBACK — Until Next Time Welcome to March’s Tips and Topics (TNT), especially to the many new subscribers. As usual we are running late, so this March edition will likely get to you in early April. It is after all, free, so I guess you get what you pay for!
TIPS & TOPICS Volume 5, No.10 February 2008 In this issue — SAVVY — SKILLS — SOUL — STUMP the SHRINK — SURVEY FEEDBACK — Until Next Time In February, many of you celebrated Valentine’s Day, the traditional day on which lovers express their love for each other. So this edition will take a slight twist away from the purely clinical world. Sigmund Freud talked about the need for a balance of love, work and play to be happy, healthy and content. So this month we’re all about —-love. Also, a huge votes of thanks to the over 125 people who took the time to provide Feedback on my website (and TIPS and TOPICS, TNT). See at the end who are the three winners of the random drawing.
TIPS & TOPICS Volume 5, No.9 January 2008 In this issue — SAVVY — SKILLS — SOUL — Until Next Time Happy New Year and may 2008 be a successful and productive year for you and your team. January’s edition takes a fresh look at the Mission, Vision & Values of both your agency and your personal work. Similarly I also am taking a fresh look at my Mission, Vision & Values and -my website, www.DMLMD.com.