Managing Use:

Over the years, I have been highly interested in working with addictions, especially drug and alcohol dependency. During my forty-some years in the field, I have started and/or run five drug treatment programs:  The first involved running a Drug Diversion program through a community counseling center in the late 1980's for those referred by the San Francsico Superior Court; I later started a youth treatment program on-board a sailing ship for delinquent and disturbed Hawaiian kids and their families; while a staff psychologist at San Quentin State Prison, I ran the drug treatment program for the general population; later, working with those conditionally released from prisons, jail and the State mental hospitals throughout California, I ran a weekly group to help these patients deal with their addiction problems; and finally, for a decade, I spearheaded a family treatment program in San Francisco utilizing a level system and drug testing for teens. Family and individual therapy as well as emergency interventions were employed. Currently, in private practice, I have seen numerous individuals and couples who present addiction issues. Sampling not only my own practice but also the caseloads of the many trainees and interns whom I have supervised and continue to supervise, the problem of addiction - particularly drug and alcohol - seems to have effected most peoples lives in some way. In my studied opinion, if the problem of addiction is present and not taken off the table, therapy does not advance very far. Minimally, this means the client needs to get a handle on this issue, which I am more than willing and qualified to help them do. In some cases, harm reduction (i.e., reduced usage) can be effective, but for others abstinence is the only solution. Formerly, therapists and addiction experts referred to the client's resistance as denial. Far better now though, the client now is simply encouraged to ask him or herself the question:  "How is your usage working for you?" If an honest answer is given after weighing the pros and cons and there is problematic usage, we're on the road to recovery. Of course, there are psychological reasons a person uses, and the term "self-medication" is apt, but the sources behind addiction only become discoverable after use is under control. If you are overusing, it's a rough road ahead, but I'd like to help you move father down that road to health. I know this terrain fairly well.

The main modalities of treatment I employ in this area are individual counseling, couples counseling, family therapy, and theme-based groups. With individuals, I initially assess usage through various screening tools combined with my clinical judgment to arrive at the stage of use (pre-contemplative, contemplative, preparation, action or maintenance) using the Motivational Enhancement Therapy model. Depending on the persons's stage of use, I might suggest individual counseling, couples counseling, and/or family therapy. I might also help the person develop a relapse prevention plan, suggest a community support group (AA, NA, LifeRing, SMART Recovery, ACA, CODA, etc.), recommend participation in a theme-based therapy group, or utilize some combination of the above. If medications might seem helpful - and the client agrees - I will make a referral to a physician. And while any or all of these modalities might be helpful toward the client's gaining control over their usage in the beginning, all such "behavioral" techniques are stepping stones toward their finally uncovering and resolving the underlying reasons for their use.

If you think you might have an unmanageable drug or alcohol problem and would like to be assessed and/or treated, feel free to contact me in the ways listed on this site. If you require a higher level of care, I will attempt to put you in touch with programs or organizations that might best assist you.