Is Logic Compatible with Recovery?

Victor P. Gilbert, MSW, LISACBy Victor P. Gilbert, MSW, LISAC
Primary Therapist, Sierra Tucson

The views expressed herein are derived from observations of persons in my groups during the course of my career as a therapist. When possible, I have attempted to reconcile these observations with known long-term outcomes.

Early on in my profession, there was an individual in my group who presented as being less than highly motivated. That person completed (superficially in my opinion at that time) the treatment plan and discharged. For the subsequent five or six years, a Christmas card arrived containing a detailed report of her successful recovery. Those Christmas messages presented both a joy and a challenge. The challenge being, how could my assessment of her motivation have been so inaccurate?

Several more years of observations of persons in my groups followed. Then the answer to the challenge became clear. The assessment I had made had been based upon my need to see a motivation connected to logic. The important piece that had been overlooked was the value she had placed upon herself. Thus my question (and the title of this article): Is logic compatible with recovery?

A clarification of terms as used in this article would be appropriate at this point.

Logic: Typically defined as correct reasoning that is valid deduction or induction.

Recovery: Identifying and changing something in one’s life that is not working and/or is causing distress. Recovery will be considered as being of two phases: 1) early recovery and 2) continuing recovery.

Early recovery involves making a decision to change an identified, unwanted aspect of one’s life. It is in this phase that logic often gets in the way.

I like logic, but not when misapplied. It is not unusual to find persons coming into treatment wanting a logical answer to any number of “why” questions. Those persons are seeking a linear cause-and-effect relationship external to themselves. If one is able to establish this relationship, there is no need to change one’s thinking. Years ago it was not unusual to have a staff member say to a client, “It was your best thinking that got you here.” Or as Albert Einstein is reported to have said, “We can’t solve problems by using the same kind of thinking we used when we created them.”

If not logic, then what? Early recovery, to be successful, requires one to make a commitment to self. I often refer to this as developing a recovery attitude. An “I-will-do-whatever-it-takes-because-I-am-worth-it” type of mentality. This commitment is particularly important given that recovery is often tiring and inconvenient.

Sustaining this commitment requires that one dispute the “logical” proofs that one is defective, not good enough, stupid, or bad. The list of self-deprecating beliefs people bring into treatment can be long and strongly held.

These self-critical beliefs have become embedded, so completely, into one’s internal dialogue as to be highly resistant to discovery and change. This resistance is supported by guilt, shame, fear, and emotional pain. Applying Einstein’s statement, the thinking to be changed is that which determines how one views self. A change which requires working through the emotional charge attached to facing character “defects.” The potential danger of attempting to use logic at this early stage of recovery is that often, logic has been invoked to support the “truth” of one’s so-called defects.

As stated earlier, I like logic. Where then, does logic fit into the recovery journey? Logic is critical to sustaining continuing recovery. The relationship is simply this: If I do not continue that which I have found to work for me, I will quickly return to my pre-treatment pain.

For more information about Sierra Tucson’s comprehensive residential programs, please call our Admissions Coordinators at (800) 842-4487.

Eating Disorders vs. Disordered Eating: When Is It Time to Seek Treatment?

treatment for eating disordersAs a society, we put a lot of pressure on ourselves to look, act, and feel a certain way. With the infiltration of, and our obsession with, social media, we are subconsciously (and even sometimes knowingly) comparing ourselves to a perceived image of perfection.

According to the National Eating Disorders Association (NEDA), many individuals struggle with body dissatisfaction and disordered eating attitudes and behaviors. And, the best-known contributor to the development of anorexia and bulimia is body dissatisfaction.

Psychology Today reports that up to 50 percent of the U.S. population has experienced some sort of disordered relationship with food, body and exercise. Given that nearly half of Americans are struggling with food issues, makes it even more important to talk about the differences between eating disorders and disordered eating.

Do You Know the Difference?

Eating Disorders include psychological disorders characterized by abnormal or disturbed eating habits:

  • Extreme emotions
  • Attitudes
  • Behaviors surrounding weight and food issues

Eating disorders are serious emotional and physical problems that can have life-threatening consequences for females and males, such as anorexia, bulimia, and binge eating.

Disordered Eating includes behavior commonly associated with eating disorders, such as:

  • Food restriction
  • Binge eating
  • Feelings of guilt when unable to maintain healthy eating/exercise habits
  • Chronic yo-yo dieting

It’s important to note that while individuals with eating disorders may show signs of disordered eating, not all disordered eaters are diagnosed with or have an eating disorder.

Call a Doctor If…

While nearly 30 million people in the U.S. battle an eating disorder and 50 percent suffer from disordered eating, the numbers are suspected to be far greater because so few seek treatment. Following are some warning signs that it’s time to seek help:

  • Showing signs of anorexia, including rapid weight loss, eating very little, and being overly concerned about weight and appearance
  • Fearful of gaining even a small amount of weight
  • Being secretive or lying about eating habits
  • Feeling the need to exercise excessively, especially after meals
  • Abusing laxatives/diuretics, or vomiting voluntarily
  • Excessive and uncontrollable eating

Family Matters

Positive communication is critical for making a change. One thing we know about families dealing with mental health disorders is that somewhere along the way, communication collapses. When one person in a family behaves in a way that harms others despite their hopes, expectations and previously understood norms, it can cause an entire family to crumble.

At Sierra Tucson, we believe that family involvement is a fundamental part of the recovery process. Because we know that friends and family members are considerably affected by a loved one who is struggling with an eating disorder or any other mental health challenge, their participation is an essential component of our comprehensive treatment programs. Our Sierra Tucson Family Program is available for all family members age 18 and older. The goal of this program is to create a shift in attitudes and behaviors among family members, and provide them with the tools needed to become healthy, supportive figures.

If you would like more information on the Eating Recovery Program at Sierra Tucson, please call our Admissions Coordinators today at (800) 842-4487.

Understanding Access to Care is Critically Important in Choosing the Right Treatment Center

3grqsh8c4_e-mariaBy Michelle McCabe-Gray

Are you or a loved one considering treatment? It could be one of the most important decisions you will ever have to make. Here are some things to consider when determining if treatment is right for your needs.

What type of treatment are you looking for?

Treatment centers come in all shapes and sizes. It is critically important that you do the necessary research to make sure the facility “checks the boxes” needed to aid in your recovery and ultimate success in treatment. Some examples of treatment needs may include:

  • Level of Care – Detoxification, inpatient rehabilitation, partial hospitalization with or without housing, intensive outpatient and/or outpatient program. Remember, many treatment centers have excellent relationships with other programs to help fulfill all of your needs.
  • Special Requirements – Ambulatory issues, dual diagnosis services, and/or dietary restrictions, to name a few.

Does the treatment center take my insurance?

When searching for a treatment center, you want to be sure to ask about insurance coverage. Just because they may not be in network with your specific insurance, the treatment facility may meet all of your other needs and therefore, you may want to utilize your out-of-network insurance. Some good questions to ask are:

  • Do you accept [xyz] insurance?
  • If you do not, do you take out-of-network benefits?
  • If you do not, do you provide any type of courtesy billing to my insurance?

What will a typical day look like when I am in treatment?

If you or your loved one is not yet ready to make that “treatment decision,” ask what a day in treatment looks like. “What will I be doing?” “Do you have any type of specialty programs like acupuncture or outdoor activities while in treatment?” Just finding some of the options and opportunities can be the deciding factor in getting into treatment.

Do you have a family program component and what does the alumni program look like?

Oftentimes, we do not think about the next step post-treatment prior to coming into treatment. It is never too early to ask about family visits, as well as what type of alumni activities and groups the treatment center offers.

Always keep in mind that when you or a loved one makes the important decision to begin the journey of recovery, the right treatment center can make all the difference. The admissions, business development, and marketing teams will help guide you through any and all questions or concerns you may have.

Michelle McCabe-GrayAbout the Writer
Michelle McCabe-Gray is the Director of Business Development of Huntington Creek Recovery Center and Pocono Mountain Recovery Center, located in Northeastern Pennsylvania and members of the Acadia Healthcare family. She can be reached at 570-881-1177 or

Spotlight on Our Treatment Placement Specialists

Marina Rodina with Acadia Healthcare

Marina Rodinam, Business Development Director of Acadia Healthcare’s Recovery Division

by Marina Rodina
Director of Business Development
Acadia Healthcare’s Recovery Division

Acadia Healthcare’s exemplary team of Treatment Placement Specialists (TPS) was created in response to an overwhelming need for pre-treatment consultation services. This team was also established as a means of both assisting professionals in linking clientele to the services needed and alleviating the frustration and intimidation that can result when one is seeking care for mental health, behavioral health, and/or chemical dependency concerns. It is for these reasons that the TPS team works closely with a vast array of healthcare professionals, as well as individuals who are struggling, to determine the type and level of care required to elicit the most favorable treatment outcomes.

When a person participates in effective treatment, that individual is more likely to achieve his or her treatment goals and decrease the requirement for more intensive care in the future. The TPS team aims to help individuals access effective treatment, both through professional referrals and direct contact, and does so by providing the following to all who request TPS services:

  • Thorough assessment of each individual
  • Detailed information about treatment options
  • Individualized guidance that is tailored to the person’s needs
  • Beneficial care coordination between the individual and the most appropriate treatment center
  • Resources that will help the person reintegrate back into his or her respective community following treatment completion

Professionals who elect to work with the TPS team will ultimately have access to a variety of options that can provide those they treat with services that foster long-term healing and recovery. Furthermore, individuals who utilize TPS services are armed with information that can empower them to make the most informed decisions about treatment.

In keeping with its initiative to help individuals access appropriate care, the TPS team is national and possesses strong professional relationships with numerous treatment providers all across the country. In doing so, the following levels of care can be available by those who utilize TPS services:

  • Detoxification services
  • Residential treatment
  • Partial hospitalization programming (PHP)
  • Intensive outpatient programming (IOP)
  • Neuropsychological testing
  • Outdoor adventure-based treatment
  • Medication-assisted treatment (MAT)

Additionally, the TPS team can serve as a gateway to a variety of specialty services:

  • Age-specific treatment
  • Disorder-specific treatment
  • Dual-diagnosis treatment
  • Faith-based treatment
  • Gender-specific treatment
  • Programming for military members and veterans
  • Programs that treat complex pain and mental health and/or substance use concerns

Lastly, if a type of care is needed that a provider within the TPS team’s network cannot deliver, the team will work with the referring professional and/or individual to ensure his or her needs are met.

Yet another benefit to using TPS services has to do with the professionals with whom a person will be working. The TPS team is comprised of dedicated and compassionate individuals who strive to help people of all ages and backgrounds access appropriate services and improve their overall quality of life. Whether or not a person ultimately requires more intensive treatment, such as residential care, or more supportive services following the completion of a higher level of care, such as PHP, the TPS team can help referring professionals, men, women, and young people alike find the treatment that can bring about healthier, more productive lives. The TPS team is able to assist people in accessing the care required to overcome mental health, behavioral health, and/or chemical dependency issues. Providers include:

  • Addiction Specialists
  • Counselors
  • Nurses
  • Psychiatrists
  • Social Workers
  • Therapists

Acadia Healthcare’s Treatment Placement Specialists are specially trained and able to utilize their expertise and national network of partners to provide individuals with viable treatment options. At the same time, the TPS team will work with professionals and individuals to locate a treatment program that is cost-effective, so as to reduce financial concerns as a barrier to receiving beneficial care.

If you are a healthcare professional with a client in need of additional services, or you know someone that is struggling with mental and/or behavioral health conditions, please visit Acadia Healthcare’s Treatment Placement Specialists website at and contact the TPS representative in your area.

With just one phone call, the start of a brighter, healthier, and happier tomorrow can begin today.


Sierra Tucson is a proud member of the Acadia Healthcare family.

Healthy Social Media Tips

Healthy Social Media TipsOn January 27, 2017, Sierra Tucson Chief Operations Officer Jaime Vinck, MC, LPC, NCC, CEIP, was featured on News 4 Tucson – KVOA, weighing in on the harmful effects of social media addiction. Compulsive behavior such as checking one’s news feed several times per day, or comparing oneself to the ‘perfect’ life of his or her friends, can actually lead to more serious conditions like depression and anxiety. Here are a few tips for healthy social media management.

  1. Evaluate your social media use and ask yourself, “Does it bring me joy?” If the answer is no, review your patterns of use, as well as the feelings that you experience about your place in the world when you use. Journal your use and associated feelings for a week. Decide if social media is worthy of your precious time. When we ‘Facebook stalk’ our high school nemesis that appears to have the perfect life, only to experience pain, it is a form of self-harm or “Cyber Cutting.”
  2. Take an inventory of how much time you are spending on social media. Ask yourself or your loved ones if your use is getting in the way of your relationships. Are you less productive at work or school due to constant viewing of Twitter or Instagram? Does your significant other feel that he or she is in competition with your phone? If any answers are yes, then commit to not checking your personal email or social media accounts during business hours, and do not bring your phone to the dinner table.
  3. Practice mindfulness when it comes to social media. Be present and in the moment, practicing deep breathing and active listening. This will result in a peaceful feeling of tranquility that exists only in the present, increasing your awareness of your surroundings. How many opportunities are missed because of the distraction of a buzzing phone and others’ updates?
  4. Set healthy boundaries with your technology. Limit use to one hour per day, only after self-care has been implemented. Take care of yourself—mind, body, and spirit—and turn to social media once those needs have been met. Feed your body and your soul before giving in to the urge to check the Twitter feed!
  5. Strive for internal validation by living a life that you know is “on purpose.Know who you are and why you are here, regardless of the number of “likes” you receive on your recent photo or how many followers you have. Finally, please avoid comparing yourself to others, as their persona is not necessarily their truth. Everyone has seasons of pain and challenges. Most important, you are a child of the universe and deserve happiness!

For more information about Sierra Tucson’s comprehensive residential programs, please call our Admissions Coordinators at (800) 842-4487 .

The Power of Connection

LeeAnne Long, Connect365 Coordinator

LeeAnne Long                       Connect365 Coordinator

Sierra Tucson’s Connect365 makes all the difference in early recovery
By LeeAnne Long, Connect365 Coordinator

Nestled in the foothills of the magnificent Santa Catalina Mountains, Sierra Tucson exudes spirituality and enlightenment and is surrounded by a magical aura different from any other residential treatment center.

Each resident that enters Sierra Tucson embarks on a journey of self-discovery. This journey brings forth the ability to see the world differently as their clouded, pain-filled eyes start to clear up and brighten.

As residents move past the lobby, staff members may see what appears to be a glimmer of a smile on their face with a hint of hesitation and perhaps a little fear behind it. But the smile is genuine and feels good, even if they don’t understand it. A new universe is unfolding before them; they now have hope and no longer feel alone. This is where change begins.

The stunning, scenic beauty and spirituality of Sierra Tucson are not its only attributes. This renowned treatment center has many unique and groundbreaking programs and services to offer each resident.

One of these services is Connect365, Sierra Tucson’s signature continuing care platform that is offered to residents for one full year following treatment completion at no additional cost. Every resident is provided with a personal Recovery Coach, as well as an interactive recovery management system that can be accessed via mobile device. Participants are scheduled for Connect365 workshops and one-on-one individual coaching sessions during the first week of their stay, so they can immediately build a rapport with their Recovery Coach.

Connect365 promotes accountability and the importance of following a continuing care plan. Participants commit to calling their Recovery Coach each week to check in, stating their feelings/mood and reporting how they are doing with their plan. Coaches kindly give peer support and remind them to keep moving forward by applying the skills they learned at Sierra Tucson to their daily life. Connect365 helps to bridge the gap between residential treatment and the outside world. This is where change continues.

A technologically advanced phone app designed specifically for Sierra Tucson helps former residents, now clients, stay accountable to themselves and their coaches. Coaches will assign their clients tasks that coincide with their continuing care plan. Each time a client completes a task, he or she logs into the system from a mobile device and records it, which then syncs with the Coach’s desktop. The task bars change from red to green once a client has completed an assignment or attends an appointment/meeting on his or her itinerary, allowing the Recovery Coach to check on compliance.

Sierra Tucson strongly recommends building a healthy support network in the outside world, and the Connect365 phone app was designed to accommodate the client’s support team. Connect365 participants sign up support members to log into the app with their own username and password to help with accountability. A support team is never too big. Clients are encouraged to sign up as many people as they wish, including family members, friends, sponsors, professionals, and providers.

Connect365 participants and their support members can access sleep, exercise, and nutritional information from the phone app. There are also links to additional resources for mood disorders, eating disorders, chronic pain, trauma, and addictions at their fingertips. Sierra Tucson Alumni information is available as an added bonus to the app.

If clients are unable to call, they can check in with their Recovery Coach by sending a secure message uniquely built into the phone app. Coaches have the ability to message them back immediately for reassurance. This provides an additional and effective means of communication.

A Recovery Coach may be called on to help with discharge planning if a previously created continuing care plan needs adjusting. The Recovery Coach will give the client the name and number of the Acadia Healthcare Treatment Placement Specialist (TPS) in his or her local community so as to gather additional resources and compose a new plan if needed. This wisely designed safety net between Recovery Coach, TPS, and client can prevent unnecessary panic or isolation that often leads to relapse. Bottom line: The participant can always turn to his or her Recovery Coach in times of distress.

Without a doubt, the Sierra Tucson’s Connect365 has helped change many lives since its inception in November 2015. Clients call their Recovery Coach and simply state, “I need your help. I don’t know what to do.” A client may call several times in one day, reaching out to his or her Recovery Coach to stay focused and grounded. One client said, “I feel safer just hearing your voice, and now I know I can get through this because you are with me.”

A secure message may be sent to the Coach that reads, “I’m not doing well. Can we talk?” Or, an SOS such as “I quit my IOP today!” flags the Coach that an immediate phone call is in order. On a more positive note, messages like “Thank you for everything, you help me a lot” or “I want to thank you for all your support; it makes me feel like someone cares,” are also received by Coaches, further reiterating the significance of this service.

Once a participant completes her or her year in Connect365, the Recovery Coach smoothly transitions the client to the Sierra Tucson Alumni Relations team, where he or she is received with open arms and a welcoming phone call of acknowledgement. Now, the client is provided with a lifetime of alumni services.

In closing, here is a quote that a graduating participant sent to his Recovery Coach, which touched the hearts of Sierra Tucson staff members for the lifesaving work they do:

“Thank you for everything. The gift I got from Sierra Tucson is something that will always be cherished. Sobriety is priceless. Recovery and moving from an unmanageable life to leading a meaningful life is something for which I will always be grateful. Thank you for everything; my regards to the whole team; farewell and Happy New Year.”

The Worrier Gene

Maureen Schwehr, NMD  Director of Integrative Services

Maureen Schwehr, NMD           Director of Integrative Services

By Maureen Schwehr, NMD
Director of Integrative Services

Stress is ubiquitous in our society. How we respond to stress has a big impact on our physical and emotional wellbeing. Stress is almost always an initiating factor in a crisis. For years, I have suspected that some of us are genetically set up to have stress impact us more than others. With advancements in genetic testing, we are beginning to get a better understanding of how and why this happens. In 2013, The New York Times published an article about the “Worrier” gene—the gene that codes for the COMP (catechol-O-methyl transferase) enzyme. This enzyme breaks down epinephrine, norepinephrine, and dopamine in the brain.

Worrier vs. Warrior

There are two variants of this gene. One variant is referred to as the “Worrier” gene; it breaks down catecholamines more slowly. The second variant is referred to as the “Warrior” gene; it breaks down these neurotransmitters more quickly. Those with the slow breakdown Worrier variant tend to do well in school and work, but they worry. Under low-stress situations, this variant may provide an advantage. The higher levels of catecholamines allows for better focus and memory. Individuals with this variant often score higher on IQ tests. However, when put under pressure, they do not break down these stress hormones as quickly and they can become overwhelmed. Long-term stressors have a bigger impact on the mental and physical health of these individuals.

The Warrior variant codes for a quicker breakdown of catecholamines. Warriors tend to do better when under pressure. Stress increases their catecholamine levels, which improves their focus, but they can quickly break these down and return to a state of low activation. They get the benefit of the stress without the catecholamines lingering to create longer-term stress. Warriors are able to let go of stressful events faster.

Genetic Testing & A Healthy Stress Response

At Sierra Tucson, our genetic testing includes an analysis of the COMT gene. This has proven to be helpful in allowing our residents to better understand why they respond the way they do to stressful events. Studies have shown that people with the Worrier variant can do better under stress with training. Knowing how an individual’s body breaks down stress neurotransmitters provides our multidisciplinary team with a framework for identifying what is happening biochemically. Furthermore, we’re able to tailor each resident’s treatment plan in order to give him or her skills needed for a healthy stress response.

In practice, I have noticed that individuals with the Worrier mutation often choose professions and situations that have an elevated level of stress. Increased catecholamines can be addictive. They often get by until an additional stressor pushes them over the edge. One resident came to Sierra Tucson after a relationship ended. This individual had a job that involved 10–12 hour workdays, and health problems started to ensue. Once the relationship ended, the stress of the breakup was overwhelming and alcohol consumption increased, eventually resulting in alcohol dependency. When we reviewed the genetic test results and I explained the Worrier gene to the resident, it helped the individual to see how this pattern developed.

When the Worrier mutation is present, it is very important that individuals maintain balance. Sierra Tucson offers many ways in which residents can find effective relaxation techniques. For this particular individual, yoga and shiatsu massage were helpful ways to decompress. We performed some basic nutritional tests and found that there was a deficiency in Vitamin D and evidence that B12 levels were low. Alcohol use also depletes other important B vitamins including B1 (Thiamine), B2 (Riboflavin), B3 (Niacin), B6, B12, and Folate. The B vitamins are important co-factors needed to create our hormones and neurotransmitters. Deficiencies in B vitamins are associated with increased depression, anxiety, and fatigue. We provided nutritional support for the individual in the form of a high-quality B complex and Vitamin D3. In addition, I prescribed a concentrated lavender formula called Lavela that has been shown to decrease anxiety. It helps the body to stop overreacting to stressors and I have found it to be helpful for residents who have the COMT mutation.

It is very human to blame ourselves when we are overwhelmed by stress. Testing for mutations such as the COMT gene helps our residents understand how their life choices can impact their biochemistry in a way that either supports or undermines their health and happiness. By the end of treatment, the individual’s continuing care plan included herbal and vitamin support for mood, a daily routine that would incorporate yoga, and a goal to find a job with less demands and hours.

To read The New York Times article on the Worrier gene, click here.

The Opioid Epidemic: Prevention, Recognition & Treatment

Teresa Jackson, MD, Director of Sierra Tucson's Addictions / Co-occurring Disorders Program

Teresa Jackson, MD, Director of Sierra Tucson’s Addictions / Co-occurring Disorders Program

By Teresa L. Jackson, MD
Director of Addictions / Co-occurring Disorders Program

Prince, Michael Jackson, Heath Ledger, Whitney Houston, Amy Winehouse, Philip Seymour Hoffman, John Belushi, River Phoenix, Janis Joplin…the list goes on and on. It’s shocking to hear when a famous rock star or actor has died of a drug overdose.

What’s more disturbing…

  • 91 people die each day in the United States from an opioid overdose.
  • 33,000 people died from an opioid overdose in 2015. Half of these deaths were from prescription opioids.
  • Drug overdoses are the leading cause of accidental death in the United States, ahead of motor vehicle deaths and firearms (deaths).

In the last 15 years, the number of prescriptions for opioid pain medications has quadrupled. Prescription opiates like methadone, oxycodone (Percocet), and hydrocodone (Norco and Vicodin) are the leading cause of prescription opioid deaths. The United States uses 99 percent of the world’s hydrocdone. The majority of people that use heroin started with an opiate pill. Sadly, heroin is readily available and less expensive. We are in the midst of an opioid addiction and overdose epidemic in the United States.

The best way to prevent opioid overdose deaths is to improve opioid prescribing, reduce exposure to opioids, prevent abuse, and stop addiction. Prescribing physicians must carefully regulate opiate prescriptions. Preventing abuse of prescription opiates is a combined effort between physician, pharmacies, patients, and family members. It is very important to keep all controlled substances in a secure location. Never share your prescription and always destroy the medication when it is no longer needed. Pharmacies often accept medications. In addition, they can be discarded in cat litter or coffee grounds.

Early recognition and treatment of addiction to opiates can save lives. Medication-assisted treatment (MAT) combines the use of medication with counseling and behavioral therapies. Unfortunately, behavioral interventions alone have a poor success rate in opioid addiction, with a relapse rate that is greater than 80 percent. The addition of medication to behavioral intervention greatly increases the outcomes. FDA-approved medication such as buprenorphine (Suboxone, Subutex), methadone, and naltrexone improve the success rate and decrease the associated risks of opiate addiction, including HIV, Hepatitis C, and overdose. Extensive literature and systematic reviews show that maintenance treatment with either methadone or buprenorphine is associated with retention in treatment, reduction in illicit opiate use, decreased craving, and improved social function.

Often, patients express concern about seemingly trading one drug for another. Abstinence is always an option; however, MAT allows the brain to heal from opiate dependence. The patient can concentrate on recovery without ongoing withdrawal symptoms and cravings. The brain gradually heals from opiate dependence and the medication can be slowly tapered. One of the most common fears for patients is withdrawal. The Surgeon General and government are responding to this epidemic by increasing funding for the treatment of addiction, including MAT. In addition, life-saving medications that can reverse an opioid overdose are now available to patients who are prescribed opiates and for the loved ones of patients addicted to opiates. Naloxone (Narcan) can reverse an opiate overdose. The nasal spray is easy to use and more readily available now.

Early treatment for opioid addiction saves lives. If you are concerned about a loved one’s use of prescribed opiate pain medication or use of illicit opiates such as heroin, please seek professional help. The combined use of medication, counseling, and behavioral therapies may save his or her life.

MAT: A Case Study

Jane is a 34-year-old woman addicted to heroin. She started using oxycodone in college on the weekends. She began working after college and married a man that also used oxycodone. After a miscarriage and the death of her father, Jane’s use escalated to daily use of up to 600 milligrams of oxycodone. She was spending $600 daily on oxycodone. Her drug dealer introduced her to heroin. Her use of heroin escalated to 2 grams per day. She tried stopping on her own and could not. She tried two detox programs and immediately returned to using. She was overwhelmed with anxiety and cravings without heroin. Upon admission, she was prescribed Suboxone® to help with withdrawal symptoms. Within 24 hours of her admission, her withdrawal symptoms were gone and she was feeling well and participating in groups and activities. Because Jane had been using for many years and relapsed several times after trying to stop on her own and detox, she is candidate for MAT. She was discharged on Suboxone maintenance therapy for at least six months. Suboxone®, in addition to Intensive Outpatient Treatment (IOP) and relapse prevention meetings, is the reason Jane is drug-free today and enjoying life.

The Need to Belong: Understanding Grief and Loss in Adoptees

Kimberly_Craig_DSC04512_cl-edits_121615By Kimberly Craig, MA
Program Director, Sierra Tucson

During the holidays, families recently came together to celebrate roots, heritage, and cultural traditions. But for some adoptees who do not have knowledge of their biological history, it can be a very difficult time that brings up many conflicting emotions. Honoring old traditions are important – they help to create family bonds that provide an individual with a sense of belonging and connection. However, they also can accentuate the relational dysfunction for an adoptee, creating some anxiety upon entering the New Year.

The lack of knowledge about personal biology and heredity is referred to as Genealogical Bewilderment, which was a theory utilized by H.J. Sants in the 1960s to help explain the confusion adoptees can experience concerning their origins. The desire to know more about one’s personal history is completely normal and natural, but for the adoptee, it can create a complex paradigm or a double bind that makes it difficult to process feelings and be authentic. An adoptee who does experience a sense of loss resulting from his or her adoption may feel extreme guilt for having these feelings, which can lead to an attempt to hide them. The adoptee also can have a great fear of being perceived as ungrateful to his or her adopted parents, which brings up a greater fear of abandonment. Many adoptees may attempt to conceal these feelings to avoid hurting or betraying their adopted parents.

There are simple ways in which therapists and family members can support an adoptee during this time and help to shape his or her identity:

  1. Ask and encourage the adoptee to talk about his or her feelings: Many adoptees have a desire to talk to someone, but refrain from doing so due to fear of abandonment, which will prevent them from being honest and open about their feelings. Be patient and encourage them to process their feelings related to not knowing.
  2. Normalize feelings: Let the adoptee know that it is normal to have conflicting emotions such as guilt, sadness, and even anger about the loss that can occur with adoption.
  3. Create new rituals: By creating new rituals throughout the year – including holidays, the New Year, and birthday celebrations – it helps to build connection and provide the adoptee with a sense of acceptance and belonging.

It is natural for some adoptees to find times of family gatherings difficult, as they reflect on their personal history that began with adoption and the loss of an ancestral connection. This can result in feelings of rejection, grief, and sadness related to losing their own biological and cultural histories. This is a time for sincere understanding as adoptees continue their journey toward healing, integrating, and enjoying the ultimate feeling of triumph.

For more information about Sierra Tucson’s comprehensive residential programs, please call our Admissions Coordinators at (800) 842-4487 .

Sierra Tucson and EAGALA: Making connection through horses

ST Equine img_5937By Jessica Miceli, MAC, LSC, EAGALA Certified Professional

On January 19-21, 2017, Sierra Tucson will host the Equine Assisted Growth and Learning Association’s (EAGALA) “Training the Trainers” workshop. Founded in 1999, EAGALA is a nonprofit organization that has set the global standard in offering a fully developed, professionally endorsed treatment model for mental health professionals practicing equine-assisted psychotherapy. EAGALA has over 4,500 members in 50 countries (“The EAGALA Model” 2009-2010).

Since 1983, Sierra Tucson has been internationally renowned for its effective therapies, dedicated staff, and extraordinary setting. Sierra Tucson provides integrative treatment to identify and resolve underlying issues. This supportive path has led to recovery for over 30,000 individuals who have suffered from alcoholism, drug addiction, depression, anxiety, trauma, eating disorders, chronic pain, and other mental health disorders (Sierra Tucson 2016).

Sierra Tucson is one of the first facilities in the nation to use horses as therapeutic partners in residential treatment. Equine therapy at Sierra Tucson was founded by Barbara Rector, a pioneer in the field, and Wyatt Webb, who has written books such as “It’s Not About the Horse.” In 1981, before the adult unit opened in 1983, Sierra Tucson’s Integrated Riding Resource Program’s (STIRRUPS) purpose was to elevate the troubled adolescent’s self-esteem through therapeutic work with the horse and the horse experience.

Horses are large and powerful creatures. This creates a natural opportunity for some individuals to overcome fear and develop confidence. They are social animals, with defined roles within their herds. They respond with unique insight into exactly who we are in the moment. Because horses can read and respond to the nonverbal messages we are always sending, they begin to act in ways that feel familiar to other relationships or dynamics in our lives. The lesson is that by changing ourselves, the horses respond differently. They provide this immediate feedback to real changes that we make – not what we just talk about (“So Why Horses and No Other Animals?” 2009-2010).

Sierra Tucson’s equine services have evolved over the years to include EAGALA-based practices, and both entities share much of the same philosophies. Both models involve:

  • No riding or horsemanship
  • Client-centered and solution-oriented
  • Team approach (always two co-facilitators)
  • Horses are an integral part of the treatment team (they are our counselors!)

Working with horses on the ground enables clients to better perceive the horses’ actions and reactions as they work to process and solve their life challenges. Horses offer clients an understanding of how their processes and actions affect others and impact their lives (“The EAGALA Model” 2009-2010).

Additionally, Sierra Tucson and EAGALA see the clients as best at determining the kinds of life changes they need to make to improve their lives. The job of the staff is to engage the intuitive power of horses to help them understand their process and practice the changes they want to make in a safe, supportive setting (“The EAGALA Model” 2009-2010).

Sierra Tucson is hosting the “Train the Trainers” workshop January 19-21, 2017, because it allows for a unique exchange of ideas between the two pioneers in their respective fields. Sierra Tucson sees the value in paying it forward by providing a beautiful setting to a nonprofit organization that certifies equine therapists all over the world. Nestled in the foothills of the Santa Catalina Mountains, the breathtaking views, helpful staff, warm climate, and wide variety of horses make Sierra Tucson an ideal location.


Sierra Tucson. (2016). Retrieved from

The EAGALA Model. (2009-2010). Retrieved from