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Inspiring Success on the Road to Recovery

Friday, December 16, 2016

Make Sober Holidays a Reality

By: Jaime W. Vinck, MC, LPC, NCC, Chief Operations Officer for Sierra Tucson

While many of us grow excited about the holiday season and the celebrations and traditions that consume us, the holidays can be overwhelming for some.  The events of the season can impose temptations and challenges for recovering addicts, especially those with co-occurring disorders, such as depression, anxiety, grief, trauma, and codependency, which can be heightened by the festivities that surround them.

During this time of year, holiday blues are often more appropriately described as situational depression, and can be significantly reduced by following these three prevention tips:

1.      Face depression and addiction realities as a family

a.       During this holiday season, let us be mindful of these people and the addictions and emotions they battle against.  Whether you know somebody who is still battling an addiction or somebody that is in recovery, make the effort to be considerate of what they are going through. 
b.      Whether a drug, alcohol, food or other addiction, a person recovering from such will need extra support during the holiday season.  Try to be mindful of the unique struggles associated with your loved one’s individual addiction by offering support.  It will make a difference that could positively impact the New Year for them.
c.       These times can present anxiety and tension.  Showing love, care and concern during this intense time can make a huge difference to somebody struggling.

2.      Avoid emotional drains

a.       Simply by choosing more positive friends, a positive environment, and uplifting activities, it can reduce depression.
b.      Avoid Alcohol - Alcohol can exacerbate any feelings of situational depression while drinking, and even the day after. Many use alcohol to numb the pain or sorrow of depression when it actually makes it worse.
c.       Avoid Sugar Binges – Eating too many cookies and cakes can create feelings of lethargy, similar to an emotional crash.
d.      Avoid over-spending – The rush of giving extravagant gifts can backfire with depression when the bill arrives after the holidays.
e.       Avoid resentments - Holding resentments is like drinking poison and expecting the other person to die. Invite Uncle Bob to a holiday dinner even if there was tension last year. Look at what can be done before family gatherings to let go of the tension. Clearing emotional space will make for a more pleasant time with those family members.

3.      Replace addictions with healthy habits

a.       In addition to avoiding energy drainers, recognizing weaknesses and replacing them with positive activities is another great way to stop holiday blues.
b.      Instead of drinking that bottle of wine, try a yoga or art class instead.
c.       Over the holidays, volunteering to help those less fortunate also is very therapeutic.

Jaime Vinck joined Sierra Tucson in August 2014 as Chief Clinical Officer. She oversees the complete program design and provisions in management for all Sierra Tucson programming, including Family Therapy, Primary Therapy, the Therapeutic & Recreational Activities Program, Continuing Care, Integrative Therapies, and Residential Therapies. Jaime takes great pride in the quality of resident care that Sierra Tucson provides and in being a part of the multidisciplinary team of professionals in which therapists, psychologists, and staff work together to provide the best treatment for residents. In December 2015, Jaime was promoted to Chief Operations Officer, where she continues to be responsible for clinical services, as well as strategic direction and creating the overall resident experience.Prior to joining Sierra Tucson, Jaime served in a number of positions with Journey Healing Centers from 2006-2014, including Outpatient Services Director and Corporate Clinical Director. She also began her own private practice in Scottsdale, Arizona, in 2007, where she continues to focus on couples and families struggling with addiction and mental illness.Jaime is a Certified Equine Interaction Professional (CEIP), with a specialization in mental health, and has recently been elected to the Board of Directors of CEIP.Jaime received a Bachelor of Arts in Employee Relations at Michigan State University and a Master of Arts in Counseling at Ottawa University.


Tuesday, December 6, 2016

Whole Health Care: A New Meaning at Terros Health

By Bridget O’Gara, Terros Health

“Addressing both the medical issue and the substance use or mental health condition are essential to the individual’s whole health and healing.”


Visit a Terros Health Care Clinic and you may not hear the phrase “whole health care,” but you’ll no doubt experience it. 

Dr. Robert Allen
“Physical and mental health conditions used to be treated in silos, but this is starting to change,” said Robert Allen, M.D., Terros Health Primary Care Physician and Addictionologist. “At Terros Health, we have begun treating the ‘whole’ person and the outcomes have been promising.” 

Terros Health physicians, nurses, patient navigators, counselors and other providers are gaining a reputation for successfully merging top-quality primary medical care with excellent recovery addiction services and exceptional mental health care. Also known as “integrative medicine,” whole health care the Terros Health way brings together patients and providers to focus on healing the mind and body.

“Changing our name from ‘Terros’ to ‘Terros Health’ was a significant
Peggy Chase, CEO
milestone,” said Peggy Chase, Terros Health President and CEO. 
“Our new name better encompasses who we are now, as well as where we are going as an integrated, whole health care company caring for the minds and bodies of our patients.”

How do Terros Health patients experience whole health? 

The Terros Health team is specially trained to address what are called “co-occurring” conditions. This can mean a medical condition — such as high blood pressure, diabetes or a heart condition — that spirals out of control for someone who is involved in substance use or who has a mental health condition. Addressing both the medical issue and the substance use or mental health condition are essential to the individual’s whole health and healing.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 7.9 million adults in the United States had co-occurring disorders in 2014. Additionally, people with mental health disorders are more likely than people without mental health disorders to experience an alcohol or substance use disorder. 
Co-occurring disorders are difficult to diagnose. Their symptoms can be complex and subtle with one disorder being more severe than the other. Often, people receive treatment for one disorder while the other goes untreated. This may happen because both mental health and substance use disorders can have biological, psychological and social components.
“For those suffering from addiction, finding integrated primary and mental health care — like Terros Health offers — has proven to be especially beneficial,” Dr. Allen said. “Primary care doctors can identify the signs of drug use and abuse in their early stages. This is significant given that approximately 40 million Americans are dealing with a milder form of drug use called ‘medically harmful substance abuse.’”

The whole health care services provided by Terros Health include:

Physical health care
Addiction care
Prevention services 
Health education initiatives 
Mental health care  (including for severe and persistent mental illness)
Wellness programs
Mobile crisis (in partnership with Crisis Response Network and municipal first responders)

Meet Nicole and Martin

After experiencing a tragic loss, one Phoenix family benefitted from the whole health care approach provided by the Terros Health team. The mother, father and three children receive primary and behavioral health services through Terros Health at the Terros Health Care Clinic 27th Avenue, 3864 N. 27th Avenue in Phoenix.

Nicole, the mom, was the first family member to seek out Terros Health to address grief due to the death of her 3-year-old son. 

“The counseling really helped,” Nicole said. “I also go there for my primary care.”
Martin, the father, said the mental health care he receives has helped stabilize his depression and anxiety. He also receives excellent medical care for his diabetes with the nonprofit health care organization. 

“I will keep going to Terros Health,” he said. “They take time to listen to me.”
It’s a family affair as 20-year-old Eric receives help from Terros Health’s behavioral health professionals. 

“I need counseling to help me with my ups and downs,” he said, “and to better manage my anger outbursts.”

Eric also receives primary care at Terros Health, as does Mishelle, his 16-year-old sister. Their older brother, Quinn, plans to reach out to Terros Health for his medical care.

For Nicole, she values the convenience of having all aspects of the family’s health care managed from a single location. 

“We even get our prescriptions filled there,” she said. “We would not be doing nearly as well without Terros Health.”

Knowledge is Power

In Arizona and nationwide, the importance of treating the whole person is particularly critical. According to a SAMHSA report, in Arizona the lives of people with Serious Mental Illness (SMI) are shortened by 30 percent. Nationally, people with SMI die 25 percent earlier.

A recent study of 1.1 million people with bipolar disorder supports this disturbing statistic. It also firmly links physical and mental health. Published in JAMA Psychiatry, the researchers found people with SMI were 3.5 times more likely to die than the general population during the study period. A staggering 85 percent of the early deaths among people with SMI were due largely to preventable conditions: high blood pressure, high cholesterol, diabetes and heart disease.

Why is this? It’s a complicated question, but many experts point to a whole health approach as part of the solution. For example, it’s been recognized for some time that people with SMI, including bipolar disorder, also often have unhealthy lifestyle behaviors—poor diet and lack of exercise. Additionally, people with bipolar disorder are more likely to smoke than people with no mental illness. All of these unhealthy behaviors contribute to many of the physical problems this population experiences. 

Meet Monica

Thankfully, because of her introduction to Terros Health, Monica has been able to effectively address her SMI. 

When her mother passed away in 2015, Monica’s life began to spiral out of control. Previously diagnosed with bipolar disorder, she went into a manic state after receiving a large sum of money from her mother’s estate. 

“The insurance payout made it all real,” Monica said.  The weight of her significant personal loss caused Monica to consider unpleasant thoughts of suicide. 

After receiving advice from a friend, Monica voluntarily checked herself into Recovery International last summer. It was the same day Monica was introduced to Tracy McDowell, a crisis transition navigator, from Terros Health who was assigned to help her make a smooth transition out of the hospital and back into her daily life. 

Tracy was quick to take action. She set up a SMI evaluation, as well as a primary care appointment with a nurse practitioner, at the Glendale Primary Care and Counseling location. Within four days, Monica received an SMI diagnosis, which is often a lengthy process that can sometimes take up to 20 days. The nurse practitioner also assessed Monica’s medication and referred her to Terros Health’s behavioral services for further care.

And they were just getting started. In less than two weeks, Monica and Tracy worked together to build a strong resume, submit applications for jobs, and schedule counseling and primary care appointments for the next 90 days.

Today, Monica is stronger. 

“I didn’t know what to expect when I was set up with a crisis transition navigator,” she said. “I thought once I got out of the hospital they would just leave me to my own devices, but that wasn’t the case. Tracy really changed my life.”

Whole Health Concept Grows

The idea of healing the whole person is gaining national traction. In fact, the National Institute of Mental Health (NIMH) is focused squarely on the issue. 

Susan T. Azrin, Ph.D., Program Chief, Primary Care Research Program, Division of Services and Intervention Research at NIMH, has described the premature and preventable deaths of people with SMI as “a tremendous public health concern.” 

She’s called for strategies designed to reduce common health risk factors – high blood pressure, poor diet, lack of fitness, and smoking — among to people with SMIs.

Peggy Chase noted this is the centerpiece of the Terros Health whole health model. She also said the organization is eager to share what her team has learned about the benefits of whole health.

“We collaborate with community, government agencies and health systems to efficiently deliver the best patient experience and quality care,” she said.

Meet Ryan

Ryan is a Terros Health client who has thrived, thanks to the organization’s whole health approach to care. 

Ryan had a difficult childhood. Witnessing his family deal with substance abuse and mental health issues, he used drugs and alcohol at a young age as a way to cope. At 14-years-old, he checked into his first rehab facility.

“He went to numerous rehab facilities after that,” said Karen, Ryan’s mother. “They would always try to diagnosis him with ADHD and depression, but could never agree on a diagnosis.”

In 2014, Ryan’s battle with addiction and mental health issues came to a breaking point. After losing his grandfather, Ryan seemed to lose his will to live. He attempted suicide by ingesting 45 Xanax pills. Doctors shared the bleak news with Ryan’s family that he would not likely survive. And, if he did pull through, Ryan may have sustained serious organ damage. Miraculously, Ryan survived unscathed.

“That’s when I asked for help,” Ryan said. 

He entered an inpatient program at the Urgent Psychiatric Care Center. There, he learned about Terros Health.

“I knew that I didn’t want to get lost in it all after I was discharged, so I enrolled in the LADDER program,” said Ryan.

LADDER Leads to Diagnosis

It was through LADDER, an outpatient counseling program that Ryan first started to understand co-occurring disorders and dual diagnosis. 

“I always just thought I was an alcoholic,” Ryan said. “I never knew that I had some deep-seeded mental health issues as well.” 

Ryan was diagnosed with major depressive disorder and substance abuse disorder. Both Ryan and his mom were relieved to see how much there was to learn about his health challenges. 

“For six months, he would take two different buses, every day, to get to LADDER,” Karen said. “He was ready to change.”

Shortly after Ryan graduated from LADDER, he was offered a job at a construction company by a man who shared a similar dream as Ryan: to open up a sober living facility. Now, that dream is becoming a reality, as their first sober living home is due to open this month. Ryan, who will be the director of operations at the new facility, said he’s content with where he is in life. 

“I’m so thankful that I’m gainfully employed and have my family back,” he said. “Terros Health brought me to the understanding that anything I go through is manageable.”

Inspiring Change for Life

According to Chase, the Terros Health story is best told by its whole health partners, people like Nicole, Martin, Monica, Ryan and others.

“Many thanks to these brave individuals for sharing their journeys,” Chase said. “It feels good to hear such touching stories of empowerment and life transformation. These heartfelt testimonies illustrate how our focus on whole health provides better outcomes for our patients and our community.”

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For more information about Terros Health, visit www.terroshealth.org or follow us on Facebook at www.facebook.com/TerrosHealth and Twitter @TerrosHealth. 

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Terros Health is an Arizona, not-for-profit, integrated whole health care organization with specialization in mental health and addiction care for adults, adolescents, children and families. Terros Health provides whole health care through the patient centered medical home — an all-in-one place location dedicated to meeting the needs of a person’s mind and body. 






Valley Professionals honored by Sierra Tucson

On December 2,  Sierra Tucson held its 9th Annual “Gratitude for Giving” celebration honoring Valley professionals in the Phoenix area for their outstanding contribution to our community. The honorees were nominated by local colleagues and professionals in the field of addiction recovery and behavioral health. Congratulations and thank you for being the pillars in the field of hope and healing.




2016 Honorees (left to right):   Jim Kreitler, CEO, LISAC, MS;  Kyle J. Penniman, CEO, MSW, LISAC, CADAC;  Barbara Gallagher, CTRS;  Jim Corrington, LCSW (on behalf of Sean Walsh, CEO, LISAC);  Annette Hill, LPC, MC, NCC


Sierra Tucson is internationally known and respected as a leader in the treatment of addictions, behavioral disorders, and chronic pain. 
For more information about Sierra Tucson please visit: www.sierratucson.com

Monday, December 5, 2016

Why Millennials are Failing to Launch

By Gary D. Hees MA, LPC

“Failure to Launch”— a term used to describe a situation in which a young person is unable to leave the protection of the parental home to begin living independently. These three words have gained significant attention recently as more young people are staying in the family home longer than in the past.

The Millennials (anyone born between the early 1980’s and early 2000’s) are facing an unprecedented level of financial insecurity; one of the most challenging job markets in recent history, and an extremely complex and fast-moving social life. While most young adults will effectively navigate these difficult waters and find the will and skill needed to enter independent adulthood, many others will fall by the wayside and find themselves stagnating without a sense of purpose or passion.

Who am I?

This issue is not just about a lack of motivation. The core issue is the lack of development of what Eric Erikson called “Ego Identity.” In plain language, a guiding set of internalized moral values that define and answer the question, “Who am I?” Once a young adult knows who they are, they can begin to decide how to express their identity in the world around them, often in terms of a career or a vocation of service. Parents and home life play a huge part in this development. Literature on the subject cites several factors impacting the development of identity, purpose and independent functioning. Permissive parenting or parenting that is not supportive of independent decision-making and functioning (Helicopter parenting) is closely correlated with lack of identity development, lower levels of moral reasoning, an external focus of control (giving in to peer pressure) and difficulty differentiating from the family and parents.

When developmental maturity is incomplete we see the formation, and later, concretization, of negative cognitions about the self. Most commonly, and in general, the beliefs are the negative side of the dichotomies presented by Eric Erikson as the stages of human development.

Rather than trust of self and others, there is mistrust, particularly of self, resulting in a sense of hopelessness and resignation. Some young adults avoid trying —  because they do not believe they can trust themselves to succeed.

Rather than autonomy, there is a sense of shame and doubt, often exhibited and interpreted by others as a lack of will and direction. These young adults will under-function, leaving it to others to ‘do it’ for them. In a sense, they demand an over-functioning counterpart, (parents), and will become expectant of being ‘taken care of’ the more this dynamic persists in the family.

There is a sense of passivity and taking initiative is rarely seen, with the exception of seeking, finding and using mind-altering substances and a job that provides subsistence. There is little or no sense of purpose. These young adults are often unemployed or under-employed, and are seemingly passionless and unengaged in life beyond a repetitive pattern of living.

Asking the question “Who are you” often provokes anxiety and anger, for the answer to that question is often unknown. This lack of identity generates tremendous anxiety and a sense that all activities are basically meaningless. This mental state often is expressed as response to peer pressure rather than thoughtful, independent decision-making. The relationships of ‘failure-to-launch’ young adults are often chaotic and characterized by using others and allowing themselves to be used.
Erickson’s vision of intimacy, the sharing of ones’ self with another, is blunted by the lack of knowledge of ones’ own self. How can we share what we don’t know?

If the above were not enough, other obstacles co-occur causing significant exacerbation of these factors and, unfortunately, reinforcing the negative cognitions of the self.  Some obstacles include mental health issues, trauma, substance use disorders and issues of organization and reasoning (Executive Functioning). These factors exacerbate a lack of identity and can make thriving in today's demanding world exceedingly painful and difficult for young people at a time when they are forming opinions of themselves and their relationship to others that will shape the rest of their personal and professional lives.

Failure to Launch and substance use disorder often go hand-in-hand. 

Whether young people succumb to substance misuse and lose the ability to focus and work effectively, or if they are self-medicating to overcome underlying mental health problems such as depression and anxiety, where you find failure to launch, you often find substance use disorder.

What the entire substance use disorder treatment industry must acknowledge is the extent to which Failure to Launch and substance use are intertwined. Treating substance use disorders in young adults without addressing failure to launch is tantamount to putting a band-aid on a gash. Lasting positive results will be, at best, elusive.

After years of recovery, and countless readings of The Big Book, I see the Fellowship of AA and recovery as the means to have a life, not the end purpose of life. It is a natural progression, if one is to address a failure to live in a positive and productive way, to use the 12 Steps to foster identity and integrity, and then to facilitate the young adult realizing the amazing array of choices open to them and help them direct that energy into a useful and fulfilling life. Why be satisfied with half measures?
In addition, developing the skills and mentality required to complete education, attain meaningful work, maintain relationships and live independently play a critical role in treating this condition. To address this wide range of needs, assistance must be given with identity achievement, mental health disorders, functional relationship building, educational, career counseling, and the trauma often found in people suffering from this issue. Life skill work instills good and healthful behaviors and thinking, including the areas of nutrition and financial literacy needed to live a healthy, productive and promising life.

Gary D. Hees MA, LPC has worked in Behavioral Health for 22 years. He received his Master’s degree from the University of Houston-Clear Lake in Psychology-Marriage and Family Therapy. Gary has been licensed in Texas and Arizona for sixteen years. His has worked with Seriously Mentally Ill adults, adolescents in long-term treatment and presently with young adults. Gary’s clinical orientation is developmental and trauma informed. He is trained in Ericksonian Hypnosis, Motivational Interviewing, EMDR, Pia Mellody’s Post-Induction Model and multiple Family Therapy modalities. Gary has years of experience working with addiction, depression, anxiety, obsessive-compulsive disorder and bipolar disorder. 



Becoming Fearless with the Help of Al-Anon

The Mother of a Claudia Black Young Adult Center Patient shares her hope.


As my daughter does her recovery work from drug and alcohol addiction and anxiety, I too work my recovery through Al-Anon.

I won’t go into details of how my daughter and I both came to this point because I’m guessing many of you are already familiar with the scenario — failing grades, arrests, court appearances, isolation, detachment, and on and on.

I spent many fear-filled nights of insanity sleeping with my phone next to me waiting for that call parents fear most…
Was she in jail again? Was she in an accident? Did she overdose? Was she dead? I received one of those calls.

My daughter was in such a bad place that she couldn’t even finish her last semester of college.

Finally, I gave in to my fear, checked my ego, and accepted the help of many friends and family. With mixed emotions of anger, pain, shame, and guilt, I put aside my resentment of being forced to face my daughter’s issues, and on a Sunday morning her intervention team showed up at her college rental house. To say things didn’t go as planned would be an understatement. The well thought out plan of getting her to agree to go to treatment failed; she would not go.

I left the intervention feeling defeated and numb. What now? As hard as it was, I tried tough love and cut her cell phone service off and thus lost total communication with her. However, she still had our family dog, Bailey, at the rental house.

Little did I know that Bailey would be the link to finally getting my daughter into treatment. Late one night I received a call from my daughter’s roommates; Bailey was sick and they couldn’t get a hold of my daughter (no surprise). I went to pick up Bailey and had an enlightening heart-to-heart conversation with the roommates who were just as concerned about my daughter as I was. This unfortunate course of events (Bailey rebounded) helped me to formulate a plan to convince my daughter she needed treatment.

Four weeks following the unsuccessful intervention, my daughter was on a plane to treatment. She was fortunate to have some of the best treatment service available and after five months, a few relapses, and with the grace of God, she is now home.

While my daughter was in treatment I knew I had to do something for myself, so I found an Al-Anon group and started going. I knew that what I had been doing in relation to my daughter wasn’t working, and my hope was that through Al-Anon, I would be able to find new tools to help me get through these new challenges I was facing.

I’ve learned so much from the Al-Anon fellowship and hearing the experience, strength, and hope of others dealing with the disease of addiction. By working the 12 Steps through Al-Anon I have learned that I am powerless over the disease of addiction; I didn’t cause it, I can’t control it, and I can’t cure it. With this new knowledge, I fearlessly let go of the control I so tightly held onto in the hope of changing my daughter. Fear still creeps in, and when it does, I have learned to let go and let God. It’s one day at a time but I am committed to not letting fear define me, my life or my choices.

Reprinted with permission The Meadows. 

The Claudia Black Young Adult Center is a groundbreaking, intensive, and experientially based inpatient treatment program for young adults ages 18 to 26. Our goal is to help restore hope, healing and health to young adults who have lost focus and who are unable to embrace independent lives due to unresolved trauma, addictions or other issues, including unsuccessful previous treatment.

For more information visit www.themeadows.com or call 866.932.2036



Another Layer of Denial: Children

By Debra Alessandra


As a group facilitator in a local treatment center and a person with long-term recovery, one of the saddest and most concerning things I hear from clients and members of the recovering community sounds something like this. “Well, at least the kids weren’t really affected.”

Perhaps it’s a way to avoid an uncomfortable discussion. More often, however, the motivation is less obvious. The lack of knowledge of a starting point is a major block. For if we don’t know where or how to begin, we do nothing.

When it comes to families, many parents of young children rationalize and opt to do nothing. They hope the pain they caused will disappear without effort on their part other than staying clean and sober. They don’t know how to begin, yet they must. Harmony doesn’t come from one instrument alone.

Somewhere deep in the mind of a person with addiction, an ‘off-switch’ keeps them from fully accepting this unpleasant truth. Yet this is a truth that must be addressed to heal. Whether it is overt or covert, the fact remains: Your children have been impacted by the disease of addiction. The ramifications are critical and can extend into adulthood.

Imagine how much better recovery would be it could be if the entire family were involved? All instruments playing in harmony. And yes, the entire family includes children. Not only teen aged children, but younger children as well.

Sometimes quickly, sometimes slowly, I have witnessed parents come to the realization and recognition of the impact of their addiction had on their children. Not only do they recognize the damage, but they make attempts to remedy the situation.

Children: Worth the focus

My mission is to help families navigate the path of recovery together. I believe we must be willing to go the extra distance and try to meet their needs.
I understand the challenge of opening a conversation about recovery with children. Many recovering parents ask, “What is a good starting point? How much can they understand? Is it really necessary?”  They often justify, “Isn’t my changed behavior enough?” As you can see, strength and courage on your part are required.

12 Steps 12 Stories offers a way to approach the steps of recovery at a level children can grasp. It helps children feel comforted, valued, and included.

Comforted

Children may struggle to make sense of the changes in the home. Even good changes are stressful. Frequent small, but meaningful conversations can soothe children and alleviate their confusion. When children have some basic understanding, they feel more comfortable.They adjust to the new ‘normal’ with greater ease.

Valued

When you acknowledge their needs in this area, you can share one of the most precious resources you have: time. Children know they are valued if you devote time to their emotional needs. Taking time to offer age-appropriate explanations can go a long way in assuring your children of their value to you.

Included

All children need information. This helps them feel included. Stories can encourage them to talk openly and honestly about their feelings and concerns. When they can identify with the characters, they are more likely to want to have a conversation. Introducing the 12 key concepts in a recovery based lifestyle will broaden the depth of family healing. Short and simple spiritual messages can be easily shared. Follow-up questions and talking points further the conversation.

The End Results

Perhaps the culture of drug and alcohol abuse and addiction can change if children have a working knowledge of the 12 steps of recovery.  After all, children who are informed can and do make better choices.

It is my deepest wish that children empowered by knowledge of the 12 step recovery progress may benefit now and for years to come.

Let’s shape a generation of spiritually knowledgeable children and share the hope and joy of recovery with children.


Debra Alessandra spent over 30 years as an educator, Prevention Specialist, and Drug and Alcohol Counselor. She holds a BA in Sociology and Elementary Education. Having witnessed the harmful effects of alcoholism and substance abuse on all members of the family, Debra carefully crafted a unique set of 12 stories to build bridges of understanding for children and families. Visit www.12steps12stories.com and on facebook.com/12Steps12Stories.

Sober Living and the Holidays



by Sandy Boller-Bilbrey, RN

As anyone who has been through it themselves or with a loved one knows, getting — and staying — sober is no small feat. It takes strength, determination and dedication to live a life of sobriety, especially during the holiday season. These tips can help reinforce your commitment to sober living and give you valuable tools to stay on track.


  • Stay away from the first drink. If you don’t start, you won’t have to worry about stopping.
  • Easy does it. When you feel overwhelmed or anxious, relax. Take a deep breath and a few minutes to physically and mentally calm yourself.
  • Remember the serenity prayer. Ask for the strength to accept the things you cannot change, the courage to change the things you can and the wisdom to know the difference.
  • Change old routines. If your usual holiday celebrations include parties and events where you know there will be alcohol served, change it up. Seek out get-togethers that do not center around drinking, and avoid temptation by celebrating the season with others in recovery to remove the temptation.
  • Use the 24-hour plan. It is much more realistic to pledge that you will not take a drink in the next 24 hours than never again. 
  • Don’t test your willpower. 
  • Remember your last drink,  or last hangover, DUI, job loss, or drunken fight. Be honest with yourself about  how ugly the “good old days” truly were.
  • Check in with a 12 step group, a rehabilitation center or church group for support only a fellow addict can give.
  • Fend off loneliness. Isolation can be dangerous. Spend time with family and friends who will support your recovery and provide companionship and positive reinforcement.
  • Be good to yourself. Addiction beats you up. Now that you’re in recovery, treat yourself kindly. 

The Year of Redirection

By Alan Cohen

One way I like to make the end of a year work on my behalf is to assess how the past year has redirected me. It’s tempting to look back and regret errors I made or things that seemed to not work out.  But failure and regret exist only at the shallowest level of appearances. What seems to be a dead end sign is an arrow pointing you in another direction. The universe is saying, “This is not it. There is a better direction for you. Go that way and you will find what you are looking for.” No movement in life is wasted. It all has a purpose. You just have to know how to read the signs.
Dee and I were shopping for a new home when we found a lovely parcel on a mountainside. The lot was large with magnificent views, a meandering stream running through it, and decently priced.

Although we would have preferred a property with a home already on it, we liked it and told the real estate agent we were going to make an offer. She arranged for us to meet the owner.

The day before we were to sign, I received a letter from the bank that mortgaged my current home, informing me my mortgage would be more than doubled starting the next month. This had to be an error, so I phoned the bank. The agent informed me the loan I had taken out had been based on interest only for ten years, and now I would have to start paying principle. This news was burdensome, considering I would have to pay a large mortgage on our current home until it sold, plus the new one and build a new home. I felt overwhelmed and told the real estate we would not purchase the new property.

A month later we discovered another property closer to the ocean, a few miles down the hillside from the one we had looked at. This property already a well-built turnkey house on it, a great view, plus a car and truck thrown in with the deal, all at a price not much higher than the mountainside property.  We fell in love with the place, a friend offered us the money to finance it, we made a deal, moved in, and loved it.

Living at the lower altitude, we discovered the weather in this microclimate was entirely different than those nearby. We looked up the mountainside to see the property we had originally considered and noticed it was extremely rainy. Our new property was almost constantly sunny. We could hardly believe the difference in rainfall over just a few miles distance and a few hundred feet in altitude. But it was so.  We were grateful that we didn’t purchase the mountainside property.

Looking back on the process of the mortgage being more than doubled at that exact moment, dissuading us from purchasing the mountainside property, I see  the mortgage increase was a huge gift. Spirit was redirecting us to live in a place more desirable, and avoid the work of building a home. What seemed to be a curse was a blessing. We eventually sold our house, so everything worked out perfectly.

Everything is working out perfectly even when it doesn’t appear to be so. All spiritual traditions teach that the world we believe is so real is really a manifestation of maya, or illusion. When a job, business deal, or relationship falls through, don’t be fooled by the current appearance. There is more going on than meets the eye. If this was right for you, it would have worked out. There is something better in store. Relax, breathe, and be patient. You are being redirected.

What is right for you will find you without struggle or suffering. If you have to fight with yourself or someone to make something happen, it’s not it. There is a better fit for you, and you can have it if you let life take you where it—and you—want you to go. How has this year redirected you to get clear on what you want and — don’t, where you would like to head now?

Alan Cohen is the author the bestselling A Course in Miracles Made Easy: Mastering the Journey from Fear to Love. Alan H. Cohen (author), and Twitter @alanhcohen

Ho Ho Ho!! and Holy Cow

By Dr. Dina Evan

This Christmas some of you may be feeling it’s hard to find something for which to be jolly. However, this is exactly the sort of time, when I am exhausted, disgusted and annoyed as hell, that my favorite word becomes my mantra. That word is...and.  

The election was a zoo. Never in the history of our country has an election become crasser, more combative, fraught with hostility and filled with far flung, ridiculous accusations. And, with our democracy could this occur.

Only here, could two diametrically opposed candidates provide people with such an obvious choice. Good, bad or indifferent, only here can people say their truth, whatever that truth may be, even if it’s not the truth at all.

We have experienced the worst weather in history, with the highest number of deaths and the greatest devastation to homes and communities ever. And, for the first time people who believed global warming was a farce, are only now beginning to understand the ramifications of that denial.    

We have the worst addiction rates in the history of this country. And, there are more sober-living homes, 12 step meetings and centers of support, more compassion and knowledge around this issue than ever before.  

When I started teaching spirituality in the early 70’s people called me the next Jim Jones. And, today there are in excess of 300 million websites and many more teachers who teach consciousness and spirituality.

In 1982, I fasted 37 days on water for the E.R.A. Women across the country had ratified the amendment in all the states but five and we only needed three more to pass it. The insurance companies bought off the Senators who had promised us their vote so they could continue to charge women higher premiums. We pay women 79 cents on the dollar and minority women earn 63 to 54 cents on the dollar depending upon ethnicity. At the rate of change between 1960 and 2015, women are not expected to reach pay equity with men until 2070.

And, there are more women owned and managed companies than ever before, more glass ceilings shattered and more women supporting women in business than ever before. Women can now run for President. In other words, women have stopped asking for equality and we are giving it to ourselves and each other.

Here’s the point, in every situation and circumstance there is always an and. Whether a personal challenge or universal one, there is always an and. To
o often we forget this and become overwhelmed by the micro-awareness instead of the macro.

This is a time to be joyful and grateful. The choices about who we want to be and how we want to act are crystal clear. There is no middle ground. You are either principled or not, truthful or not, loving and compassionate or not. This is not a time to be half-hearted about anything, and this is a great thing. It’s bumping all of us up a notch.

During the Holidays, we can spend an hour or two doing nothing except being together.
We make time to take in the scents and sounds of the day, laughter, conversations, music and the sharing. Every color seems more vivid, every expression a bit more poignant and every minute together more precious. And, in a country that abhors and avoids feelings like a plague, we allow ourselves to feel the full gambit of them on the holidays. We give into the moment and the feelings on holidays.  

So, here is a feeling from Together AZ for you. Each month, Barbara and each of the columnists sit down, we breath and we take a moment to feel what you might most want or need to hear from us. And then, we let it flow with a sense of joy and gratitude, hoping it touches each of you in some way that is meaningful. We invite you to let us know how we are doing and to let us know what you want to hear more about. We are incredibly grateful you have given us a way to fulfill our purpose and share the thoughts of our hearts and soul. From all of us, to all of you, we wish you profound, connected moments with everything your heart desires.

Hot Topics - December 2016

Intensive Workshops 2017


  • Rio Retreat Center at The Meadows offers a variety of unique workshops led by world class Meadows clinicians, as well as industry leaders who specialize in specific areas of personal growth. Workshops include:
  • Men’s Sexual Recovery — Offers men healthy alternatives to compulsive sexuality and/or sexual behavior outside of v2alue system.
  • Love Addiction/Love Avoidance — Explores the interactive cycle between relationship dependence and avoidance.
  • Journey of A Woman’s Heart: Finding True Intimacy — Addresses sensitive sexual concerns experienced by women.
  • Healing Intimate Treason: for Partners of Sex Addiction — Designed to repair the trauma experienced by partners of sex addicts.
  • Discovery to Recovery: An Intensive Series for Couples Healing from Sex Addiction — Three-part intensive designed to help couples whose relationships have been shattered by sex addiction to begin to heal and recover.
  • The Betrayal Bond: Breaking Free of Abusive and Exploitive Relationships — Designed to help participants free themselves from, and recover from, exploitive relationships, processes, and situations.

Detailed information, dates and registration can be found at www.rioretreatcenter.com/workshops or by calling 866-932-2036.

Facing Addiction in America 

The Surgeon General's Report on Alcohol, Drugs, and Health identified alcohol and drug misuse and substance use disorders as the most pressing public health concern facing America. The release of the landmark report marks the first time a U.S. Surgeon General has dedicated a report to substance misuse and related disorders.

The report addresses alcohol, illicit drugs and prescription drug misuse, with chapters dedicated to neurobiology, prevention, treatment, recovery, health systems integration and recommendations for the future. It provides an in-depth look at the science of substance misuse and addiction, calls for a cultural shift in the way Americans talk about the issue, and recommends actions we can all take collectively to prevent and treat these conditions, and promote recovery.

The Surgeon General's report is being issued at a critical time, when our country is in the throes of a national opioid addiction epidemic: between 1999 and 2014, approximately 193,000 Americans died from causes related to prescription opioids, and we know that three out of four current heroin users previously misused prescription pain relievers.
Attention was brought to the role that prescribers can play in addressing this health crisis when the Surgeon General issued a letter this past August to more than 2 million healthcare providers urging them to help turn the tide of opioid abuse problems facing the nation.

The Surgeon General's report issued calls for increasing prescribers' awareness of and compliance with the most recent federal guidelines for opioid prescribing, expanding the use of evidence-based treatments and effective integration of prevention and treatment services, and reliance on the use of prescription drug monitoring programs by healthcare providers.

The Partnership, along with the FDA, is committed to insuring that prescribers have the education, the resources and the tools they need to play their indispensable part in rescuing millions of American families – and their kids – from the pain and loss of addiction. http://www.drugfree.org/heroin.

Addiction Doesn’t Take a Holiday


Addiction does not take a break from wanting to destroy and take a life if it can. While this time of year is happy and joyful in many ways, it can also be a time when sadness, loneliness, isolation and depression sets in. Many of us grew up with the Hallmark card image of the holidays, yet never experienced it. I didn’t.  When active in my drinking and using, this time of year was another great excuse for going “overboard.” Lying to myself  and others. Oh, I just wanted to be part of the celebrations — but that rarely happened. Every time I drank I blacked out. I embarrassed myself,  was overwhelmed with shame and concocted lies upon lies on to who was to blame for my behaviors. It was nothing short of a nightmare existence.

Like many others, in early recovery I wondered if I would ever have fun again — then I realized I never experienced true fun at all under any influence.

The heartfelt laughter, camaraderie and happiness comes from surrounding myself with like minded people in recovery who band together like family. If you are new to recovery or not; during this time of the year — stay with the people who will support you in sobriety. There are many of us to reach out to, we are your family.

Wishing you peace, joy and gratitude this season.  Barbara

Email me at aztogether@yahoo.com 


This issue of Together AZ is dedicated to the memory of Guy Davidson, John Bradshaw, Deanna Brown, Sally Lara, Pat Mellody and our founder, Bill Brown.