Addictions Counselling

Having a Person Centered approach means you as the client will direct the focus of each session and you will decide what you want your therapy experience to be. I am flexible and adaptive. I will meet you where you are at and offer you options on how we can proceed with our work together.

Do not misinterpret that as exclusively talk therapy or me being someone who does not challenge my clients. What it means is you will always get a say and consent is an ongoing process. Therapy is collaborative. If your preference is talk therapy, I will support you with that. If you want tangible skills and strategies or more intensive therapy (like EMDR) to shift things on a deeper level, we can do that. 

For more information on my Person Centered approach see the Motivational Interviewing section. 

Motivational Interviewing (MI) is a best practice (research backed) and my foundational approach to addiction counselling. Since MI is a person-centered counselling style, this means I will meet you where you are at in your process of change; even if that is a position of not wanting to change. 

Motivational Interviewing is a collaborative approach with the absence of confrontation. Force is not the pathway to change, rather acceptance and non-judgment is. Telling someone to change creates more resistance to change. Do you like being told what to do? I sure don’t!

Does that mean we do nothing? Not at all. Motivational Interviewing assumes people have mixed feelings about change (referred to as ambivalence). For example, people often have both positive and negative feelings towards their alcohol or drug use. In fact I myself have experienced having two contradicting thoughts at the same time about change. Navigating these contradicting thoughts and feelings can make it difficult to make a decision on what to do next. Because addiction can be so overpowering, it often makes the decision for us by maintaining the status quo. Indecision is still a decision!

Exploring the reasons why we don’t want to change along with the reasons we do want to change can get us closer to where we ultimately want to be. To do this I will ask open ended questions, provide positive feedback and encouragement and offer more information if you are interested. We will explore your relationship with substances and what it is in your life you want to change; it is likely we will even have some laughs along the way! 

Having fun is part of the process because making people feel terrible doesn’t help them change. Also shame is part of the cycle of addiction, so I will not shame you, even if you relapse. 

As in its name, Motivational Interviewing (MI) is an approach that can help people find their motivation and confidence to make the positive changes they desire. The spirit of MI is partnership, acceptance, compassion, and evocation. The latter of which is the act of tapping into our inner truth and bringing it to the fore front. This process can take time and I will patiently wait for your readiness before we incorporate further interventions. 

Motivational Interviewing (MI) is the opposite of telling someone what to do. MI is about empowering people to make their own decisions about change when they are ready to do so. 

Motivational Interviewing works with the stages of change as identified by Prochaska and DiClemente:

PRE-CONTEMPLATION – being unaware of the need to change or not being ready to change. This stage can also be referred to as denial.

CONTEMPLATION – this is that ambivalence stage; mixed thoughts and feelings. It is an exploratory stage.

PREPARATION – the decision to change has been made and preparations for change are being made. 

ACTION – implementing a plan and making changes.

MAINTENANCE – maintaining the changes that have been made. Relapse prevention is part of this stage.

Having a holistic lens means that I will invite you to consider the physical, mental, emotional, and spiritual (if you are open - but not necessary) aspects of your wellbeing and how they intersect to contribute to your mental health. For example, emotional dysregulation plays a big role in substance use/addiction. But cognitive skills and emotional awareness are only two pieces of the puzzle. For example, physical components to wellbeing such as lack of sleep or food intake (low sugar levels) can also contribute to emotional dysregulation. 

I remember when I worked at a residential treatment center. I had a client come to me one day to share they were struggling with excessive anxiety. Through our conversation I asked them how many cups of coffee they had consumed that day; turned out they had had ten cups! I suggested that was likely a contributing factor.

We have to look at mental health from all angles because if we don’t, we may miss some simple, yet powerful information that if addressed can provide significant relief to a person's condition. 

By addressing these physiological needs we can improve our mental health baseline. For this reason I may recommend my clients consult with a Naturopath or Psychiatrist for physiological support beyond my scope.

Substance use is often used as a means of escaping uncomfortable feelings. Therefore learning to manage our feelings in a healthier way is one of the goals of recovery. 

Emotional regulation refers to managing emotional responses in a way that is appropriate for the situation we are in. Feelings are normal and healthy to have. It is how we behave when we have these feelings that can be problematic. We also want to be able to control our responses to feelings so they do not control us. 

Improving emotional regulation can support positive mental health, enhance interpersonal relationships, and increase our overall wellbeing. 

When it comes to tools and strategies I am eclectic. This means I pull from a variety of modalities including (but not limited to): Eye Movement Desensitization and Reprocessing (EMDR) Therapy, Cognitive Behavioral Therapy (CBT), Solution Focused Therapy, Mindfulness-Based Therapy. Whatever works for you!

Psychoeducation is sharing information or teaching about themes related to mental health and overall wellbeing. The objective is to educate and increase awareness. To empower you with the knowledge to improve your circumstances and quality of life. 

Resource Connecting includes informing you of other professionals, groups, community organizations, or tools that may be able to provide additional support for your circumstances and enhance your healing journey. It is a way to expand your support network. 

Addiction is a disease of isolation so it is important for our recovery to be connected to others. We also don't want to be dependent on just one person in our recovery because if something happens to that person and they are no longer able to support us, we no longer have support. We want to have a support system, not just a single person to rely on. 

Eye Movement Desensitization and Reprocessing (EMDR) therapy works with the assumption that emotionally charged experiences are overly influencing your present day experiences and that Bilateral Stimulation (BLS) can reduce or even eliminate this interference.

Traumatic events or negative experiences often do not get stored in our memory in adaptive ways and that is why when that memory is triggered we can have a physiological reaction to it. It can feel like we are reliving that experience in the present moment even though it can be something that happened way in our past. The emotional charges that come from these triggers can disrupt our functioning in the present. It can even cause us to enter a fight or flight response even though there is no danger present. When we are in this state it is difficult to regulate our emotions or think logically.

EMDR therapy desensitizes and reprocesses these memories so that they can be just that; a memory without an emotional charge or physiological reaction. Bilateral stimulation (BLS) is the EMDR technique that enhances the brain’s ability to process and integrate information, including memories, which ultimately reduces the emotional charge related to the memory. 

Bilateral stimulation (BLS) involves alternating sensory stimuli on both sides of the body either through visual, auditory, or tactile means. BLS stimulates the right and left hemispheres of the brain in a rhythmic, back-and-forth manner (Right, Left, Right, Left, Right, Left). It was initially achieved via having the client track the finger of the therapist with their eyes from right to left (eye movements). However other BLS strategies include tapping on one’s body, auditory/sound stimulation, or my favorite...handheld paddles (buzzies) that vibrate in the palm of your hand, one at a time. 

EMDR is my preferred modality of therapy because it creates results faster than talk therapy and it creates change at a deeper level than other therapies. EMDR is research based and a best practice for trauma therapy, however it can also help with a number of other conditions. It even helps with addiction recovery! 

Desensitization of Triggers and Urge Reprocessing (DeTUR) is a protocol within EMDR therapy that is used for addiction recovery.

Highlights of EMDR DeTUR Protocol:

1. Desensitize Substance Use Triggers
2. Decrease Urge to Use Substance
3. Instill alternative coping strategies
4. Commitment to abstinence NOT REQUIRED
5. Generally less intensive than regular EMDR
6. Quicker results than talk therapy

With this approach we use EMDR to target your substance use triggers and desensitize them. The result is that the things that used to trigger your substance use become less triggering improving your ability to make logical choices around your substance use. 

For example, if other people drinking triggers your urge to drink alcohol we would identify this as a trigger, target it via EMDR DeTUR, and desensitize it so that in the future when you are around other people drinking, your urge to drink is less and you have increased control over your choices. 

Not everyone who has a problem uses their substance of choice daily. In fact a lot of people who have a problematic relationship with alcohol or drugs don't use daily. There is a common false belief that using daily is the marker for addiction. This is simply not accurate.

Binge drinking or drugging can be just as problematic. Binge using involves consuming large amounts of your substance of choice over a short period of time. It relates to the quantity of the substance consumed, rather than the frequency. 

If your intention (when consuming your substance of choice) is to get drunk or high  - in other words, to get numb or to escape - this could be a problem. Many people believe that not using their substance of choice daily or going for long periods without it means that they do not have a problem. 

The key is to focus on what happens when you do use. What kinds of problems present? 

• Do you get into conflict with your loved ones? 
• Do you make poor choices you would not make if you were sober? 
• Do you experience regret or shame after you sober up? 
• Do you get into legal trouble? 

If you experience any of these when you drink or use drugs you may have a problem. 

The other factor to consider is that Addiction is Progressive. Without help it will get worse over time, not better. 

Examples of Progression:

• Increased tolerance 
• Decreased control
• Decreased ability to manage life
• Change in behaviors
• Identity conflict 
• Deterioration of physical health, mental health, and overall wellbeing.
• Negative impact on relationships
• Increase of other consequences (legal, financial, work, etc.)

• Addictions Counsellor at a residential treatment center 
• Facilitator at an inner city outpatient day program
• Facilitator at a family recovery support program
• NNADAP worker on reserve/first nation community
• Probation Officer for provincial community corrections 

• Alcohol
• Marijuana/Cannabis
• Uppers - Cocaine, Methamphetamine, etc.
• Downers - Opioids, Prescription Pills, etc.
• Tobacco/Nicotine
• Caffeine
• Other

1. Abstinence-based: is when a person  completely  refrains from using the selected substance. Many believe that controlling or minimizing the use of a substance is not possible and thus completely abstaining from it is the best way to find freedom from addiction.

Abstinence can be accomplished by gradually weaning off the substance or stopping it "cold turkey." Most substances will have withdrawal symptoms that can range from extremely uncomfortable to life threatening. Symptoms can impact a person cognitively, emotionally, and physically. Please consult a medical professional and educate yourself on the common withdrawal symptoms of your substance before abstaining. This will support your recovery success and ensure your safety. 

2. Harm Reduction: can be anything that decreases the harm to the individual while they are in active addiction: creating safety around use, using a less harmful substance instead of the substance of choice, supporting other wellbeing (food, hydration, sleep) while using, or decreasing frequency or amount of use. This is an approach for people who do not want to eliminate their use but wish to make some changes. Harm reduction can be the goal or a step in the process of recovery.

I can work with both approaches and will meet my clients where they are at in terms of their substance use goals. 

Cross-Addiction is when you exchange one addictive substance (or addictive behavior) for another. In the beginning incorporating the substance or behavior may seem like a good strategy to escape the addiction of the primary substance of choice. However, what often happens is the development of a secondary addiction, thus resulting in two things to be addicted to instead of one! Therefore it is important to deal with the root causes of addiction and establish healthy coping strategies to replace addictive substances or behaviors. 

12 Step Program such as Alcoholics Anonymous (AA) and other addiction fellowships.

What they do really well:

• Create connection and fellowship.
• Provide support well beyond the capacity of one therapist.
• Provide an accessible service. There are ongoing meetings daily (and even hourly) and recovery support outside of business hours (including sponsorship). They can be attended in person or online anywhere in the world. 
• Educate about addiction & recovery. Including producing their own literature. 
• Provide a guide for daily lifeskills.
• Provide hope.
• Produce results.

Limitations:

• Some people cannot get around the higher power aspect.
• The content is repetitive. 
• Some people's challenges require professional support beyond the program and not everyone in these programs encourages access to professionals despite the founders themselves recognizing this limitation and documenting this in their literature.
• The program is not trauma treatment.
• Not everyone is ready for the regressive work that is part of the step-work and there is no professional guidance around this.
• Some people are not ready for abstinence.

Overall I do believe 12 Step Programs can be an instrumental aspect to recovery and if my clients are open, I do encourage them to seek additional support from these programs. However, I do not force my clients to do anything they do not want to do. 

Absolutely not. In fact we can ignore the spiritual component altogether if you wish. It is not a requirement. It just may be an angle of wellbeing that you want to acknowledge and if so I will support you to do so. 

•  Prescribe medication to support cravings and/or withdrawals.
• Complete the medical paperwork for a residential treatment application.
• Refer you to a psychiatrist.
• Support you with mental health medication. For example  for things like depression, anxiety, ADHD, etc.  
• Address any physical health concerns that could be a contributing factor.

• Detoxification Support
• Nutrient IV Therapy (to replenish vitamins, minerals, and amino acides depleted through addiction and the withdrawal process)
• Nutritional Guidance
• Herbal Remedies
• Mind-Body Techniques (Acupuncture or Mindfulness)
• Support the healing of physiological root causes (Ex: chronic stress/cortisol or other hormone imbalances)

• Talk Therapy including Motivational Interviewing
• Psychoeducation & Resource Connecting
• Skill Building & Coping Strategies
• Provide referrals to public funded programs like Day Programs or Residential Treatment Programs.
• Connect you with their Interdisciplinary Team (for example they may have a psychiatrist they work with).

What they are unlikely to provide is a more intensive therapy such as EMDR or trauma treatment. In addition they are less accessible, often booking monthly sessions only and booking far in advance. 

Working with a private therapist like me for Addictions Counsellig has more flexibility in the type of work we can do; it can be more intensive (EMDR) and frequent. I often see my addictions counselling clients on a weekly basis until they stabilize (if that is within their financial means).

You can also ask me about Addictions Counselling Intensives where our treatment plan can be condensed and I could see you more frequently than weekly.

If you prefer to work with a public health addictions counselor (Alberta Health Services Addiction and Mental Health) and you are in the Edmonton, Alberta, Canada area: Contact Access 24/7 for an Intake at 780-424-2424. 

You can also ask me about Addictions Counselling Intensives where our treatment plan can be condensed and I could see you more frequently than weekly.

Alberta Health Services Detox in Edmonton, Alberta, Canada, located now at Alberta Hospital Edmonton:

https://www.albertahealthservices.ca/findhealth/Service.aspx?id=1071286&serviceAtFacilityID=1132502

Other Medically Supported Detox available in Edmonton, Alberta, Canada at the George Spady Society:

https://www.gspady.org/medical-detox

PEP Society offers professionally facilitated family support programs:

https://pepsociety.ca/

Al-Anon is a peer facilitated (12 Step) family support program:

https://al-anon.org/