Jean-Paul Michael has recently started a career as a community case manager and is going through a motivational interviewing training session. Addiction psychiatrist Dr. Wiplove (Wip) Lamba is a member of the motivational interviewing network of trainers, has led many workshops in the past. Today, JP and Wip have a conversation about Origins of motivational interviewing.

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#Addiction

#Psychotherapy

#Caseworker

#Healthcare provider

#Healthcare provider education

#captain hooked

#Psychiatry

#addiction medicine

# motivational interviewing

#stimulant use disorder

Contingency Management

In this talk. We discuss why addiction case manager JP cares about CM, an example where he used it in his work and personal life, addiction psychiatrist Wip shared two examples where he used it with his kids, and they went over the key concepts in Nancy Petry’s phenomenal book and guide.

JP loves evidence based topics, and he also also knows CM has the best evidence for stimulant use disorders.

Nathan Azrin toilet training book

“Toilet Training in Less Than a Day,” by Nathan H. Azrin, PhD and Richard M. Foxx, PhD, hit bookstands in 1974.

https://www.amazon.ca/Toilet-Training-Less-Than-Day/dp/0671693808/ref=nodl_

Nancy Petry’s book that covers everything.

https://www.amazon.ca/Contingency-Management-Substance-Abuse-Treatment/dp/0415882893/ref=nodl_

Citation

Petry, N. M. (2012). Contingency management for substance abuse treatment: A guide to implementing this evidence-based practice. Routledge/Taylor & Francis Group.

Abstract

The concerns surrounding Contingency Management (CM) are many and reflect how poorly understood and rarely utilized this evidence-based treatment model is in practice settings. Despite being identified as the most efficacious intervention for substance use disorders, a significant gap persists between research and practice, at the client's expense. Nancy Petry, an experienced researcher and consultant for organizations such as the National Institutes of Health, has begun to fill this gap by authoring the first clinician-oriented text that focuses on CM protocol development and implementation. In this well-organized and clear book she provides a foundation for understanding CM and details how to design and implement a program that can work for any clinician, whether he or she works for a well-funded program or not. She also addresses realistic concerns such as: (1) How to describe CM to eligible and ineligible patients; (2) How to calculate the costs of CM interventions; (3) How to solicit donations and raise funds to support CM interventions; and (4) How to stock a prize cabinet and keep track of prizes. Over 50 charts, worksheets, and tables are provided to help the clinician pinpoint exactly which behaviors to target, brainstorm how to reinforce change, and develop a treatment plan that incorporates cost, length of treatment, and method for determining patient compliance. Included with the book is a CD-ROM of editable logs, forms, tables, and worksheets for personal use. More than just filling a void. Dr. Petry provides all of the tools clinicians require to successfully apply a novel treatment in practice. (PsycINFO Database Record (c) 2019 APA, all rights reserved)

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#Addiction

#Psychotherapy

#Caseworker

#Healthcare provider

#Healthcare provider education

#captainhooked

#Psychiatry

#addiction medicine

#contingency management

#stimulant use disorder

Hey! How do I learn more???

CRA (community reinforcement approach) and CRAFT (community reinforcement approach and family training) are the two best therapies for people who use drugs and their family members respectively.

Maybe a little bit of bias in that statement lol.

The outcomes are solid, but it hasn’t had the marketing you see in regular CBT and other psychotherapies.

In this video, Wip shares 2 books for the therapist.

Enjoy!

Wip and JP talk about these therapies a lot in other "Captain Hooked" podcasts.

Happiness scale on page 8 of this random pdf I found on google

https://www.chestnut.org/resources/09e144cc-c87b-488c-8c93-9793272f610c/section%202%20cra%20a-cra%20forms%200617%20english.pdf?trackid=section%202%20cra%20a-cra%20forms%200617%20english.pdf

THERAPY FOR PATIENTS

Book (a bit pricey, consider getting from your university library)

https://www.amazon.ca/Community-Reinforcement-Approach-Addiction-Treatment/dp/0521026342

Robert Meyers website

https://www.robertjmeyersphd.com/books.html

CRA basics:

https://youtu.be/xgK6eWTwuRc

YouTube talk by the psychiatrist who taught me everything I know about psychotherapy

https://youtu.be/DZhnKACt7gQ

THERAPY FOR FAMILY MEMBERS

Book:

https://www.amazon.ca/Motivating-Substance-Abusers-Enter-Treatment/dp/1593856466

Here is a great YouTube video covering the basics

https://youtu.be/hlYFcXb0JBk

Website with all the modules

https://alliesinrecovery.net/what-is-craft/

Peer support line in Canada

https://www.farcanada.org

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#Addiction

#Psychotherapy

#Caseworker

#Healthcare provider

#Healthcare provider education

#Captain Hooked

#Psychiatry

#addiction medicine

TLDR: buy the book!

Addictions case manager and former addict Jean-Paul (JP) Michael reached out to addiction psychiatrist Dr. Wiplove (Wip) Lamba this week, seeking info on CRAFT (Community Reinforcement, And Family Training). Seeing there was an audiobook, he started reading the version for family members. (Wip and JP currently prefer audiobooks to paper).

For substance use disorders care, we usually focus on the individual. The family is kept separate. Robert Meyers, a psychologist and scientist out of New Mexico developed the CRAFT model so that the family member can help the loved one get sober. There are three main goals to craft.

1. Help reduce your loved ones substance use

2. Help move them towards treatment

3. Improve your life whether or not someone stops using substances.

People are sometimes so stuck waiting until “rock bottom” that they forget we can sometimes create an environment where it is easier for the person to move towards sobriety.

Sanjeev Arora and project ECHO

https://hsc.unm.edu/echo/about-us/

Here is the article from the Atlantic on substance use in Iceland

https://www.theatlantic.com/health/archive/2017/01/teens-drugs-iceland/513668/

Overdose rates in Canada pre and post Covid

https://health-infobase.canada.ca/substance-related-harms/opioids-stimulants/maps

Rat park

https://www.psychiatrictimes.com/view/what-does-rat-park-teach-us-about-addiction

Here is the book:

https://www.amazon.ca/Get-Your-Loved-One-Sober/dp/1592850812

Summary sheet and list of references for CRAFT

https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Community-Reinforcement-Family-Training-Summary-2017-en.pdf

Here is the information for FAR canada. Families for addiction recovery. They have peer support workers who have been trained in ACT (acceptance and commitment therapy), CRAFT and MI (motivational interviewing) and are there to help family members.

https://www.farcanada.org

Here is the information for Al-Anon. Members share their own experience, strength, and hope with each other. You will meet others who share your feelings and frustrations, if not your exact situation.

https://al-anon.org/

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#Addiction

#Psychotherapy

#Caseworker

#Healthcare provider

#Healthcare provider education

#captainhooked

#Psychiatry

#addiction medicine

#Unity health

#Robert Meyers

#Community Reinforcement Approach

#DBT

#Al-Anon

#Alateen

#CRAFT

#harm reduction

#Self-care

#farcanada

We have always admired strong women. Wip’s Grandmothers and his mother were incredibly inspiring to him, and now he learns great life lessons through his wife and daughter on a regular basis. In over a decade of clinical work in psychiatry, both Wip and JP have worked under many strong women leaders.

This memoir was incredibly inspiring to us for several reasons.

1. This is a person at the peak of their career

2. The childhood experiences this person encountered would have caused PTSD like symptoms in almost anyone.

3. It gives clues as to the character traits and choices that people make that lead to resilience.

Interestingly, Viola dedicates her book to her entire family, names and all. This is her husband, daughter, 4 sisters, her mother and her father.

I have read several memoirs of people I admire, and this one, at this point in my life, has stayed with him the most.

I know you will find it an interesting, powerful, and moving experience.

https://a.co/d/7weeBYI

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#Viola Davis

#Finding Me

#strong women

Viola Davis quotes Anton Chekov at the start of her book. Psychiatrist Dr. Wiplove (Wip) Lamba didn’t realize who he was.

“I think human beings just have faith or must look for faith, otherwise life is empty, empty. To live and not to know why the cranes fly, why children are born, why there are stars in the sky. You must know why you are alive, or else everything is nonsense, just blowing in the wind.” - Anton Chekhov

Anton Chekhov is a famous Russian writer and playwright whom some argue is only second to Tolstoy in his acclaim. He grew up in poverty in an abusive household. Medicine was his main professions and he described writing as his mistress. He believed it was his role to share reality as it was and not provide answers and solutions, and that was clear in his stories.

His writing lessons are shared in every playwriting class.

“If in the first act you have hung a pistol on the wall, then in the following one it should be fired. Otherwise don't put it there.”

Wip went through the audiobook and commentary for the proposal, the girl with the dog, and the beggar. And interestingly, the beggar contained the major controversy in addiction treatment. The role of pushing for personal responsibility vs the value of compassion and serving the other.

Here is his Wikipedia page

https://en.m.wikipedia.org/wiki/Anton_Chekhov

Funny comedy sketch about Chekhov’s Gun

https://youtu.be/PQOvv_b9TpY

Hindi review of the proposal for preparation for Indian exams

https://youtu.be/JlQt-NUpwT4

Play in Hindi for the proposal

https://youtu.be/n4jP44vG-uY

Summary cartoon of the proposal

https://youtu.be/CbexKBelE4M

The Indian movie that reminded Wip of the proposal (well, the title song)

https://youtu.be/89LuS5pkReQ

The beggar audiobook

https://youtu.be/wtZ9mEdewt0

His most celebrated work, the girl and the dog.

https://youtu.be/e9QOcArzS58

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#russian writers

#russian

#alcoholism

Trauma informed care is a buzzword with different definitions and different implementation protocols depending on who you talk to. In this podcast, addiction psychiatrist Dr. Wiplove (Wip) Lamba and addictions case manager and former addict Jean-Paul (JP) Michael discuss the challenges in working with people who have trauma, difficulty creating a safe place within large institutions, lessons from the “body keeps the score” book by Dr. Van der Kolk, aces scores (adverse childhood experiences), how to do a trauma history, the primary care ptsd screener (pc-ptsd), and foreshadow future sessions on treatment for trauma, substance use and PTSD.

Website on trauma informed care

https://mentalhealthactionplan.ca/tools/mental-health-training-framework/trauma-informed-care/

A YouTube talk Wip liked

https://m.youtube.com/watch?v=5_UD36xPi8Y

Easy grounding techniques

https://youtu.be/Z7C0v4GfUUI

Book, "The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma"

https://www.amazon.com/Body-Keeps-Score-Healing-Trauma/dp/0143127748

Dr. Van Der Kolk talking about trauma.

Briefly

https://youtu.be/ZoZT8-HqI64

At length

https://youtu.be/53RX2ESIqsM

Developmental trauma disorder - proposal for dsm v

https://www.cttntraumatraining.org/uploads/4/6/2/3/46231093/dsm-v_proposal-dtd_taskforce.pdf

Adverse childhood experiences

https://www.cdc.gov/violenceprevention/aces/index.html

YouTube video on aces

https://www.ted.com/talks/nadine_burke_harris_how_childhood_trauma_affects_health_across_a_lifetime?language=en

PC PTSD screener

https://www.ptsd.va.gov/professional/assessment/documents/pc-ptsd5-screen.pdf

What’s next?

Seeking safety

https://www.treatment-innovations.org/seeking-safety.html

Basic handouts for seeking safety

https://www.treatment-innovations.org/uploads/2/5/5/5/25555853/1-4-2022-basic-handouts-for-ppl-without-books.pdf

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#Addiction

#Psychotherapy

#psychiatry

#Caseworker

#Healthcare provider

#Healthcare provider education

#captainhooked

#Psychiatry

#addiction medicine

# trauma

# trauma informed care

#how to take a trauma history

#adverse childhood experiences

#The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

#PTSD

#PTSD Screener

#aces

This is a talk about the Community Reinforcement Approach developed by Robert Meyers, a scientist and psychologist who did his training under Dr. Nathan Azrin.

The key principle for the Community Reinforcement Approach is that you want to make your sober life so interesting that you would not want to miss a day by using.

Steps include happiness scale, goal setting, sobriety sampling, principles of rational emotive behavioural therapy, social club, functional analysis of unhealthy and healthy behaviour, recreational therapy, couples counseling, job retraining and social club.

Here is a summary of Dr. Azrin’s work

http://www.nathanazrin.com

Robert Meyers information and training opportunities.

https://www.robertjmeyersphd.com/index.html

Info sheet essentials of CRA

https://www.ccsa.ca/sites/default/files/2019-04/CCSA-Community-Reinforcement-Approach-Summary-2017-en.pdf

Key training book

https://www.amazon.ca/Community-Reinforcement-Approach-Addiction-Treatment/dp/0521771072

Forms for CRA from a random google search

https://www.chestnut.org/resources/09e144cc-c87b-488c-8c93-9793272f610c/section%202%20cra%20a-cra%20forms%200617%20english.pdf?trackid=section%202%20cra%20a-cra%20forms%200617%20english.pdf

Comments by Wip - Wip mentioned that no one wants to be divorced at about the 8 min mark. He meant that he did not want to get divorced and used that language in referring to himself.

Around the 9 min mark, JP asked Wip about “how did you do it”. Thinking about it, Wip realized that it was not that he did “nothing”. He did start rock climbing and other sober activities in the evenings. He just didn’t remember in the moment as he wanted to share a short cut for behaviour change.

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#Addiction

#Psychotherapy

#Caseworker

#Healthcare provider

#Healthcare provider education

#captainhooked

#Psychiatry

#addiction medicine

#Unity health

#Robert Meyers

#Community Reinforcement Approach

#CRA

#CBT

#Dr. Azrin

#happiness scale

#goal setting

#sobriety sampling

#principles of rational emotive behavioural therapy

#social club

#functional analysis of unhealthy and healthy behaviour

#recreational therapy

#couples counseling

#job retraining

Viola Davis quotes Anton Chekov at the start of her book. Psychiatrist Dr. Wiplove (Wip) Lamba didn’t realize who he was.

Anton Chekov is a famous Russian writer and playwright whom some argue is only second to Tolstoy in his acclaim. He grew up in poverty in an abusive household. Medicine was his main professions and he described writing as his mistress. He believed it was his role to share reality as it was and not provide answers and solutions, and that was clear in his stories.

Wip went through the audiobook and commentary for the proposal, the girl with the dog and the beggar. And interestingly, the beggar contained the major controversy in addiction treatment. The role of pushing for personal responsibility vs the value of compassion and serving the other.

Here is his Wikipedia page

https://en.m.wikipedia.org/wiki/Anton_Chekhov

Hindi review of the proposal for preparation for Indian exams

https://youtu.be/JlQt-NUpwT4

Play in Hindi for the proposal

https://youtu.be/n4jP44vG-uY

Summary cartoon of the proposal

https://youtu.be/CbexKBelE4M

The beggar audiobook

https://youtu.be/wtZ9mEdewt0

His most celebrated work, the girl and the dog.

https://youtu.be/e9QOcArzS58

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#russianwriters

#russian

#alcoholism

#Anton Chekov

Addictions case manager and former addict Jean-Paul (JP) Michael reached out to addiction psychiatrist Dr. Wiplove (Wip) Lamba this week, seeking info on CRAFT (Community Reinforcement, And Family Training). Seeing there was an audiobook, he started reading the version for family members.

For substance use disorders care, we usually focus on the individual. The family is kept separate. Robert Meyers, a psychologist and scientist out of New Mexico developed the CRAFT model so that the family member can help the loved one get sober. There are three main goals to craft.

1. Help reduce your loved ones substance use

2. Help move them towards treatment

3. Improve your life whether or not someone stops using substances.

People are sometimes so stuck waiting until “rock bottom” that they forget we can sometimes create an environment where it is easier for the person to move towards sobriety.

Here is the book:

https://www.amazon.ca/Get-Your-Loved-One-Sober/dp/1592850812

Here is the information for FAR canada. Families for addiction recovery. They have peer support workers who have been trained in ACT (acceptance and commitment therapy), CRAFT and MI (motivational interviewing) and are there to help family members.

https://www.farcanada.org

Here is the information for Al-Anon and Alateen, members share their own experience, strength, and hope with each other. You will meet others who share your feelings and frustrations, if not your exact situation.

https://al-anon.org/

Featuring addiction psychiatrist Dr. Wiplove (Wip) Lamba, addictions case manager and former addict Jean-Paul (JP) Michael, along with their guests discuss all things related to substance use, addiction, addiction medicine, psychotherapy, harm reduction, treatment and recovery. Wip and JP share their motivation, curiosity, and passion for their craft. JP works on a daily basis in a renown inner city hospital in Canada's largest city. This work is separate from Wiplove’s clinical and academic work.

The content should not be taken as direct medical advice or clinical instruction.

#Lived experience,

#PWID

#addiction

#recovery

#Captainhooked

#wiplove lamba

#jean-paul michael

#addiction medicine

#psychotherapy

#mindfulness

#Sobriety

#farcanada

#Al-Anon

#Alateen

#CRAFT

#harm reduction

#Self-care