Deep Dive with Dr D
Discussions on life and living with Dr D. A man who has risen from the lowest depths of life to the amazing life he has now.
Deep Dive with Dr D
Breaking the Mold: Rethinking Addiction Treatment
The Douglas Method proposes a revolutionary approach to substance use disorder treatment that respects individual paths to recovery, challenging the outdated one-way Minnesota Model that has dominated for 75 years.
• The traditional Minnesota Model of treatment created in the 1950s still forms the foundation of most substance use treatment programs today
• Many people are shamed when the standard 12-step approach doesn't work for them, rather than being offered alternatives
• Multiple recovery pathways exist including 12-step, SMART Recovery, medication-assisted treatment, Buddhist and secular recovery options
• The Douglas Method consists of six modules: Respect and Dignity, Education, Recovery Support, Family, Purpose and Identity, and Accountability and Empowerment
• Treatment should eliminate shame-based approaches and use person-first language
• Education on physical/mental health, family systems, and financial literacy empowers sustainable recovery
• Connection to community and finding purpose are crucial elements of successful recovery
• True individualized treatment means allowing each person to find their own unique path to recovery
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Hi everyone, welcome to the podcast. I'm glad you're here and yeah, boy, we're in season two. I think this is episode three is what it'll be, and I think I'm going to talk a little bit today about treatment for substance use disorders. I have finalized what I'm coining the Douglas method, the Douglas method of treatment, it looks. I'm just going to read this here for you.
Speaker 1:The path for an individual to find recovery from a substance use disorder is unique. The Douglas method understands this throughout its processes. Each person who begins the Douglas Method will be treated as an individual and not treated as one of many. The creation of the Douglas Method by yours truly, dr David A Douglas, has been a years-long process where he has seen first-hand effects of the one-way or the highway methods of treatment for substance use disorders. Dr Douglas's master's and doctoral research has proven, through readily accessible information, that the paths to recovery are many. And then I break it down into multiple areas of one's life to look at for being a person in recovery.
Speaker 1:Now let me start with this. Historically, like we have, treatment right now someone can access is an issue of course, but if you have insurance or cash money, you can get into treatment today in any state. Some states have a few more options than others. As far as businesses that offer treatment, and, uh, they're historically and still to this day has been, um, a primary method of treatment that is used and it's based on a model that came out of the 50s, which we're looking at. When we say the 50s, the minnesota model of treatment, that is, oh my gosh, 75 years ago. And and while I'm talking, I'm going to, I'm going to verify, I'm going to fact check, you can hear me type in here model of treatment history. Okay, let's take a look.
Speaker 1:The origins of the Minnesota model of treatment Yep, 50s, yeah, there we go. One was to become a psychologist, the other was to become a psychiatrist, neither of whom had prior experience treating people with the substance use disorder. The model first to a small not-for-profit organization called the Hazleton Foundation, still in place today, and then throughout the country. Now, the key element of this novel at the time novel approach to addiction treatment was the blending of professional and trained non-professional people with lived experience staff, basically around the principles of Alcoholics Anonymous. Okay, so there was an individualized treatment plan with active family involvement in a 28-day inpatient setting and participation in Alcoholics Anonymous both during and after treatment. The education of patients and family about the disease of addiction made this a busy program from morning to night, seven days a week. That's the origins, right. So the Minnesota model of treatment created in the 50s you can Google it yourself and learn about it At its core is basically, in a professional setting with clinicians and non-clinicians, was teaching people the 12-step program and giving a little bit of counseling.
Speaker 1:That's it Now, and here's what I'm going to tell you. 75 years later, that's still the primary method of treatment in a lot of treatment agencies. Agencies have added other layers on top of this, but this is still the primary method of treatment and you might think, well, it must be working if it's still being used. And I might say, certainly that is the case for some, but it's not the case for all, just like any treatment for a behavioral health condition. You know, you try this. Someone might go to treatment, get the Minnesota model of treatment and it might work for them. Great, it worked for me along the way until I decided to naturally transition away from the 12-step model and do what I do to support my recovery, and I know many other people.
Speaker 1:I truly believe, and when I talk about the method that I've created. I truly believe that we need to offer many modalities to support one's life and recovery, and that's where I say the one way or the highway method has to die. What do you mean? The one way or the highway? Here's what happens with the Minnesota model of treatment. Someone goes to treatment for a substance use disorder. They are admitted and they go and they learn about the 12-step program. They meet with their peers who are also learning about this. They do group counseling, they do individual counseling and certainly there might be recommendations. Hey, you should see a mental health professional for your mental health disorders. There might be some discussion about nutrition and exercise. I hope there is. There should be Right, but the primary method being that Minnesota model, you should learn the steps, get a sponsor, go to meetings, blah, blah, blah. Add infinitum. Right, okay, great for those that that works for.
Speaker 1:But let's say, someone goes and they're like you know, this just doesn't work for me. Is there something else? What will happen if that person returns to use? Okay, and this happens a lot for people who don't have the resources meaning really good insurance and cash money that they can find, seek out a different model, which there are some, but not many. If you're relying on taxpayer-funded, state-funded treatment, you're going to be sent, likely back to the same treatment center.
Speaker 1:So here's where it gets interesting. So someone has gone to treatment, they returned to use and they've said you'll hear people say throughout you know, I just don't know about the 12 step thing. I'm not into a higher power, however it looks for me, I'm not into just that setting it. Just they're not into it, it's not working for them. So all of that to say they returned to use because that method of treatment didn't work, what's going to happen? Here we go, they find their way back to treatment, back to that same treatment center, and they have said all along I, you know, this method of treatment doesn't really work for me.
Speaker 1:Is there another method of treatment? They're told nope, this is it. And maybe you need to listen this time. They're shamed and guilted. Well, maybe, maybe that you need to hit rock bottom. Well, maybe you need to pray more. Maybe did you do the steps? Did you work with the sponsor? They're just told that this is the way and either you figure it out or this is it.
Speaker 1:And I don't agree with that. I 100% believe that people should be given a multitude of options. We have treatment centers that say they provide individualized treatment, but it's not, it's cookie cutter treatment, right, it's the same thing. Wash rinse cycle, repeat. Wash rinse cycle, repeat.
Speaker 1:And when someone says this method doesn't work for me, they're guilt, they are guilted and shamed. They're told well, you must not want it, bad enough. No, I want recovery. Do you have another method? Do you have another way? I do know this is on the on the positive side.
Speaker 1:There's actually a treatment center in the area I live in in central Washington, in Wenatchee. It's called the Center for Change and they use a different method. That is actually rare. This isn't in a lot of treatment centers. It's called the choice theory and it's where I think they might do some teachings of 12-step. But also, the primary method is that you do have a say, you do have a choice, you can make different choices. That's another method. Some treatment centers I know they're out there, but probably far and few in between allow for there to be a wide range of recovery pathways and this is in a module of the Douglas Method that I support and it's recovery support, introducing a wide range of recovery pathways. There's certainly 12-step. Yes, there's smart recovery, which, prior to learning about smart recovery this is personally true to story, true to life for me to learning about smart recovery, this is personally true to story, true to life for me that all I knew about these other ways was what I was hearing in the rooms of Alcoholics Anonymous and Narcotic. Well, smart recovery, you know, is that really recovery? Yes, I learned later. Yes, it is. They use. They use it's a skill-based recovery support system and I actually started a meeting here, locally where I lived for a little while. I'd do it again if someone wanted system and I actually started a meeting here, locally where I live for a little while. I'd do it again if someone wanted it, and it's a great method.
Speaker 1:Medication assisted treatment this has gained traction in the last well, almost decade probably. It's actually been around a long, long time. There's been medication for people to use an aversion therapy to stop them from drinking. They take a pill and if they drink while taking that pill, they get violently sick, right? There's some literature to support that in some ways and there's some literature to say that using aversion therapy may or may not work. Schick Shadle is one that uses. Anyway, they force you to get sick. Maybe that works for someone right.
Speaker 1:But medication-assisted treatment, matt, as we know it today, came out of really the explosion of it out of the opioid epidemic and it's a method of supporting someone's life in recovery. I know people who have used medication assisted treatment and they live amazing lives. Their lives have improved right. There's a Buddhist recovery, there's secular recovery, there's a multitude of different ways to support someone's life in recovery and I'm 100% and I'm 100% supportive of that right. So that's a little bit of history and the current situation with treatment in our society.
Speaker 1:So what I say and this is based on my educating myself. Well, I was kind of forced into educating myself when I earned my bachelor's degree. I went into a master's degree and then a doctoral program. All my research is in the recovery arena and that's where I learned my eyes were thrust wide open that there's more than one way to get to and stay in recovery. It's like, yeah, this is, oh my gosh, this is great and I support whatever works for you, the individual right. Like I do my thing. I have a great, amazing life and I support my life in recovery, my life as a whole, in my unique way, through I've talked about it through my circle of influence. I have four or five people in my life that I talk to on a regular basis about the good and bad and ugly. That's my support circle, if you call it that.
Speaker 1:I go to a counselor, a mental health therapist. If I need to do that, I do it absolutely. I talk to my doctor about options for medication to support improving and maintaining my mental health issues right. I believe in exercise and paying attention to what I put in my body. That works for David. It may or may not work for you, and my method, the Douglas method, allows for that. So I just want to go through the six modules. Okay, one module one.
Speaker 1:First and foremost, respect and dignity. In this method of treatment there is no room for shame and guilting people into recovery. I just won't allow it. It's listen. People who have lived a life in addiction fully understand shame and guilt. I shamed and guilted myself into continuing to use and continuing to just ruin my life. I didn't need anyone to tell me how bad I was doing so.
Speaker 1:Certainly, when someone finds a path to recovery, they should be allowed space for respect and dignity, using person first language, person centered language, person with a substance use disorder instead of labeling people. Again, I have friends who love the 12 step models and they go to meetings. And if I were to choose to go to a meeting, maybe within that space I might say, yeah, my name is David, I'm an addict, but mostly I'm just going to tell you friends. I don say, yeah, my name is David, I'm an addict, but mostly I'm just going to tell you friends I don't use those words to describe myself. I use person first, language First of all. My name's David and I'm a human living on this earth, right? So I personally don't use labels to describe myself. In the Douglas method, that's the same thing. And avoiding words, any language that reinforce shame, guilt and stigma.
Speaker 1:You don't have to go too far to see, feel and understand the massive amount of stigma that surrounds people with a substance use disorder. It's pervasive in our society, and why? Well, because of a lot of reasons. This is the one health condition, behavioral health condition that is stigmatized, moralized and judged than any other. And then thinking about going back to that shame and guilt, right, most people who have lived a life in addiction have a lot of shame and guilt. They don't need more, so we won't do that when they're in treatment, respect and dignity is the first thing. And then module two won't be a surprise if you know me education Education for me has helped me improve my life and recovery so much.
Speaker 1:And I'm not talking about a formal education necessarily. If someone wants to do that, great. But I'm just talking about educating on physical and mental health, basic things we can do to improve our physical health. Educating on family systems when we start understanding peeling the onion back and understanding families as systems, wow, our eyes can become more open to not just our behavior but all of the tentacles that are within a family system. Talking about financial literacy, about career paths, about communication right All of these specific skills that can help people launch into an amazing life and recovery. There should be more of this, not less. Staying updated with evidence-based materials, things that are new and innovative, that are working, really thinking about those things.
Speaker 1:Module three is recovery support. I've been talking about that. Introducing a wide range of recovery pathways 12 steps, smart, medication-assisted treatment, buddhist recovery, secular recovery, whatever it is. There's all recovery meetings, all different pathways. Introducing those and supporting them in treatment from day one right. Encouraging people to explore and to have a choice. No more of the one way or the highway, no more. Well, this is how we've always done it, this is the way. And it's an unfortunate reality that there are many well-meaning people, professionals in the field, who are in recovery themselves, who perpetuate the one way or the highway, who say, oh, I'm open-minded, but really they're just saying in different ways, they're doing that shaming. Well, you can try a different way. No, you can try a different way. Let's look at that. Let's give you those options. That's what it's about.
Speaker 1:Module four is family. This does happen in treatment. Now, I know it does. There are family programs, there are opportunities for families to engage in the treatment process and it for sure will happen in the Douglas method. And it for sure will happen in the Douglas method teaching healthy communication and healthy boundaries, right, really teaching that and supporting that, offering family to be a part of the treatment process. Again, I know that happens now in many treatment centers and that would happen in the Douglas, the Douglas method.
Speaker 1:The fifth module is purpose and identity. From from from the get go, from right now, you know, maybe not day one, but as part of the, the process of the Douglas method and treatment, helping clients see that they have it within them to set goals. See that they have starting from a strength base. Not See that they have starting from a strength base, not, you know, tearing people down or shaming, but saying, no, you do have skills. Let's talk about goals for you, right, supporting vocational or creative and community involvement. I always say this when I lecture in treatment centers. I have a lecture I give and I say get involved in the community you live in, right, Volunteer with your local rotary or volunteer with a downtown association or wherever you want to do. Get involved. That helps people see that they're a part of the community, that connection.
Speaker 1:There's a journalist, johan Hari, I just thought of this. He has a saying that I 100% believe in the opposite of addiction. Oh, it wasn't Johan Hari, I just thought of this. He has a saying that I 100% believe in the opposite of addiction. Oh, it wasn't Johan Hari, it was another guy. Anyway, I don't remember exactly who it was, I'm sorry. I think it was an actual researcher and his name's eluding me. But here it is. The opposite of addiction is connection. When you help people feel connected to the world around them, to their community, to their family, wow, your job is done right, so to speak.
Speaker 1:And then the last module is accountability and empowerment. Accountability and empowerment, accountability and empowerment Framing the accountability that I and this is true for me I want to help people see that they can take their power back by making responsible choices, by calling that creditor or calling that agency they owe money to and saying you know what, here I'm rebooting my life and I want to re-engage and and I want to do what I can to pay this bill back. Wow, there's freedom in that. I tell people early recovery, get a job, any job, not because it's like you need to get a job, no, no, get a job because, man, then then you have a place to be, then you have some, you have some say in your life, because then you're earning some of your own money. That's how I look at accountability and empowerment, using those really powerful motivational interview techniques. Throughout each of these modules, it's about helping people see their worth, see their value. I say this this is my catchphrase in life I want to help people see that they have it within them to do amazing things.
Speaker 1:Those are the six modules in the Douglas method. This is actually publicly wide, wide ranging. It's going out on my podcast the first time that I'm really putting this out there and maybe to force me to open a treatment center. I've said I want to do that. People have heard me talk about this in little ways and this actually wasn't my plan today, but this is what's happening.
Speaker 1:But it's more than a treatment approach. It's really, for me, a philosophy of care as people who use the Douglas Method. It's about treating truly, truly treating each client, each person who inserts treatment using the Douglas Method as an individual, truly doing that, friends, that will be hard, no cookie cutter approach and respecting and encouraging every path to recovery. Right, I'm a person with lived experience and and I've been a counselor and I was in that place too. So, my friends who are working in the field I get it who you know well, this, this way in my head I would, this way has really worked for me.
Speaker 1:So this is what I want to teach people, because I know it to be the best way for me and therefore it must be for you, and we can't do that. We have to truly allow for the paths to recovery that work for the individual that's sitting in front of you, not not what's worked for you, not what's worked for David, I have to allow for the way that's going to work for the individual. Certainly, there will be people that sit in front and go, wow, I really like what you do. I'm going to emulate that and that's going to work great. Okay, I hope it works. But if I'm teaching, if I'm in a position of power as a counselor and I have a say over your life that's kind of what it is I have to allow for every path to recovery.
Speaker 1:Modeling this is the last takeaway Modeling dignity and integrity, being who you are right, being true to you, like, yeah, absolutely Whatever way of recovery is working for you. Modeling that, but also modeling that I want to help you in the best way that's going to work for you. That's the douglas method, and this is yeah, wasn't planned, promise you. Here it is, it's going out to the world the douglas method. I hope everyone has a great start to their week. Love to all.