marc lewis, phD
Carrie wilkens, phD
Andrew Tatarsky, PhD
ZOI Andalcio, MS, lmhc
Ross Ellenhorn, PHD

MARC LEWIS, PhD : Addiction is Not a Brain Disease: and that Matters

​

Over the past 20 to 30 years, medical authorities have come to define addiction as a brain disease. However, the disease model skews the science of addiction, diverts attention from key social-psychological factors, and justifies harmful policies for prevention and intervention. In this talk I review the distortions and omissions inherent in the disease model and highlight corresponding problems in policy and clinical practice. I then outline an alternative model of addiction based on principles of learning and development. This model views addiction as an entrenched habit for regulating emotional needs, learned through the repeated pursuit of highly-motivating rewards. The model does not overlook brain changes in addiction, but reinterprets them in the context of social-emotional impediments. Developmental-learning models of addiction help explain individual differences in vulnerability (and recovery) based on early emotional difficulties and current psychological and social resources. 

​

 

CARRIE WILKENS, PhD : CRAFT and the Invitation to Change Approach: Combining Science and Kindness for Families

​

The family members and friends of people struggling with substance use (or other behaviors) are incredibly motivated to help their loved one, yet often face huge barriers to getting guidance that works.  They experience the fear and exhaustion of dealing with struggles they never imagined having to face, shame, isolation, and a constant sense of how high the stakes are ("something terrible could happen to my child").  They face a culture where addiction is stigmatized and the advice given is antiquated, ideological and punitive ("tough love" or detachment) and get blaming messages that by helping they are "codependent" and "enabling". These messages come from well-meaning friends and relatives, the media and treatment professionals and increase the shame and fear these families already feel.   

There is research supported and clinically tested knowledge for families (parents, spouses, grown children) about how to help in ways that are positive and supportive of the whole family. Families can learn these skills and help their loved one.  The Invitation to Change Approach draws from the most effective strategies found in 3 evidence-based treatments for substance use disorders: CRAFT (Community Reinforcement and Family Training), MI (Motivational Interviewing), and ACT (Acceptance and Commitment Therapy) and is designed to help families and communities understand the problem they face and approach it compassionately and effectively.

​

 

ANDREW TATARSKY, PHD : Beyond Disease: Re-humanizing the Addiction Paradigm

​

Addiction is one of America’s most urgent humanitarian crises. This is most painfully evident in escalating rates of accidental lethal drug overdose over the last 20 years. We will consider how the way we think about addiction as a disease or moral weakness is responsible for our failure to effectively treat it. This thinking is soaked into the fabric of American society at every level and lives within each of us consciously and unconsciously. This thinking has led to social responses that have caused exponentially more harm than problematic drug use itself.

​

There is wonderfully good news! We will explore an emerging alternative view of addiction as a multiply meaningful response to our social conditions and their emotional and physical impact on us - a process that is a universal human experience. I will discuss how this paradigm shift is setting the stage for a transformation of our culture of stigma and punishment into one based on compassionate pragmatism – the philosophy expressed in therapy, efforts to support loved ones and personal efforts to heal, grow and make positive change based on an integrative harm reduction framework. I will share principles and practices that you can begin using immediately in your lives.

​

 

ZOI ANDALCIO, LMHC, CPT : Integrating the Values of Compassionate Pragmatism on a Harm Reduction Continuum in the Community: An IDDT Approach

​

Treatment for Dual Diagnosis and/or Co-Occurring Disorders is currently offered throughout the country. As increased focus on the interplay between psychiatric diagnoses and issues of substance misuse intensifies, old disease-oriented paradigm threaten to re-emerge as the central narrative. As we unpack the complexity of addiction, there should to be guiding principles and values to inform our work with dual diagnosed clients that lead us away from the old model of treatment.

​

There are as many assumptions made about what is viewed as a success when working with addiction as there are about success in psychiatric care. This presentation is poised to shift the paradigm away from thinking sobriety and the treatment of symptoms alone are indicators of success, to a view that autonomy, purpose, and hope are the most important targets, regardless of whether sobriety is obtained or symptoms are full reduced.

​

In this presentation, Zoi Andalcio will focus specifically on the challenges that community harm reduction based treaters face when working with dual diagnosed clients and provide criteria for helping addiction programs grow in clinical care and compassion while still meeting the needs of clients. He will specifically describe a version of a community-based model called Integrated Dual Disorder Treatment that resists such negative assumptions, and takes seriously the significantly negative social factors affecting people diagnosed as mentally ill and how these factor influence use.