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This coach gets down to business

Issue Date: Addiction Professional-January-February 2010,

This coach gets down to business

by Gary A. Enos, Editor
Dave Lindbeck recalls that when he was rising in the banking industry in his 20s, he was the sort of person who would say whatever occurred to him, no matter its impact on others. He says that during his active addiction, he gave friends and colleagues plenty of reason to abandon him, only to receive patience and understanding instead.
“Thank God I didn’t get what I deserved,” says Lindbeck, now 50. One positive influence he lacked, however, was someone with whom he could discuss his career goals and how to keep them in balance during his recovery journey. Later in his banking career he would find himself playing that advisory role for others who somehow would find their way to his office, and he discovered that this put him in a comfortable place.
Lindbeck would leave his job to start a career as a business and life coach, and soon that would evolve into a specialty assisting individuals in recovery as they pursue their professional goals in all types of fields.
“The majority of my folks happened to be on the road to recovery, so I figured, ‘Why not focus on that?’” says Lindbeck, whose InStep Coaching unit of his company (http://www.instepcoaching.com) assists individuals in recovery. “I would hear clients in recovery tell me, ‘You understand me on a level that others aren’t going to.’”
Importance of balance
The name “InStep Coaching” sounds like a reference to 12-Step recovery, but Lindbeck says that’s not where the name originated. “The reason for the name is that my head as a banker was going one way, but my heart was going another,” he explains. “I wanted to see how to keep those in step.”
Likewise, he assists his coaching clients in maintaining balance between their professional and personal lives. “They need to keep their business goals in balance with personal growth, not trading one for the other,” he says.
His approach with an individual client might depend greatly on the person’s stage of recovery. Someone who has been in recovery for more than five years is well on the road and probably needs to talk mainly about maintaining balance, while someone with less than a year of sobriety might still be running into conflicts with work colleagues who remember the recent past and expect their colleague to behave in a certain way.
The presence of an employee in recovery can present numerous challenges in a workplace. A boss might be fearful of what could happen and might be more prone to micromanage. The employee might lack the maturity to deal with certain situations and could adopt a victim mentality. Lindbeck can discuss these scenarios frankly with clients. “Companies are just a big dysfunctional family,” he says.
Lindbeck, who is based in the Phoenix area, conducts his coaching sessions over the phone. Sometimes he will work with someone for whom one conversation will suffice, while others have developed a long-term professional relationship with him. Even in these cases, however, he makes sure that while he serves as a resource the client doesn’t become too dependent on the relationship-and he clearly points out that he is not serving as a sponsor. His work emphasizes the client’s professional life and goals.
“Sometimes I can be coaching the owner of the company and the top employee, and some of the challenges in the company are between the two of them,” Lindbeck says.
Experiences in youth
Lindbeck describes a somewhat familiar scenario in discussing his own progression into harmful substance use, from starting to drink in a public park in junior high school to attending keg parties with football teammates in high school to discovering drugs in college. A couple of important events occurred in his 20s. First, his alcoholic father committed suicide. He says he became determined not to be like his father, although his substance use and some of the bad behavior to colleagues that accompanied it would continue for some time.
Then, in his mid-20s, he and a colleague took a new hire to lunch. When the moment came to order drinks, and Lindbeck prepared for business as usual, the new employee said he didn’t drink and discussed openly his addiction and recovery. It was an epiphany for Lindbeck, who saw what his life had become and observed someone who had taken another path.
The employee would end up taking him to his first 12-Step meeting. It has all led him to defining his own helping role, now in the unique position of helping executives who are in recovery. “I wish I had had somebody with whom to have these kinds of conversations,” Lindbeck says.
Addiction Professional 2010 January-February;8(1):40

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For Addiction Help, Hire a ‘Sober Coach’

These specialists practice tough love. Some move right in. But standards are nonexistent
By Angela Haupt
US News and World Report, Posted: December 21, 2010

The call of drugs and alcohol to substance abusers trying to kick their habit never goes silent. For someone who has relapsed repeatedly, a new specialist—the “sober coach”—has emerged. They are paid at least $200 an hour to work one-on-one with recovering addicts, sometimes moving into their homes at more than $1,000 a day to fulfill a 24-7 role. They are motivators and cheerleaders, role models and mentors. They don’t sugarcoat their words. And they resort to the unconventional to break a client’s addiction cycle.
A coach might go grocery shopping with his client until that person learns not to stop in the wine aisle. He’ll police an alcoholic’s morning coffee routine to ensure no rum or brandy is added. And if there’s a slip up? “I’ve used everything from ‘Shut up!’ to ‘Do you want to become a person or remain a dope fiend?’ ” says Doug Caine, founder and president of Sober Champion, a sober coaching company that has offices in Los Angeles, New York, and London. “I’ve asked, ‘Is smoking crack the best way you can serve your children?’ Every client requires a different motivating tool at a different time.”
Tough love is central to sober coaching. “We don’t do hand-holding or babysitting jobs,” Caine says. “Coaches and clients develop an intense, bonded relationship. If you’re not willing to do some work, if you won’t go to any lengths to stay clean, you’re going to have a tough time benefiting.”
Working with an outsider who is not emotionally invested in an addict’s case can be more helpful than turning to a friend or family member. “High-risk situations are not always predictable, and having someone there 24-7 is helpful,” says William Zywiak, a research scientist with the Center for Alcohol and Addiction Studies at Brown University. But it’s not for everyone, and should be complemented by other types of treatment, such as therapy sessions or support groups. “It’s a poor fit for clients with a dual diagnosis, like a mental health issue,” Zywiak says. “Coaches are experts on sobriety, not other conditions.”
Coaching sessions follow no set curriculum. Unlike Alcoholics Anonymous sponsors, coaches are not confined to a 12-step program, and services are customized to fit clients’ needs. Michelle Hirschman, a sober coach based in Santa Monica, Calif., provides 24-hour phone crisis support and meets with clients three times a week, typically for six months to two years. She helps clients learn to deal with free time by mapping out schedules with hour-by-hour activities. She also focuses on exercise, meal planning, career guidance, budgeting issues, and ways to have sober fun.
But there’s no evidence that sober coaching works. Studies of effectiveness don’t exist. And the specialty has no formal structure or discipline—coaches are not overseen by a governing body, they are unregulated, and there is no standardized or accepted training. Some coaches are recovering addicts drawing from their own struggles with addiction. Others are trained drug counselors, social workers, or psychotherapists, or have worked at residential treatment centers. “Sober coaches don’t necessarily have a sophisticated education—and because of the amount of money they’re charging, one would expect some sophistication,” says Westley Clark, director of the U.S. Department of Health and Human Services’ Center for Substance Abuse Treatment. “It becomes a matter of what are you buying, what do you get?”
Before signing on with a coach, do a credentials check—supervised training, affiliation with public and private treatment programs, and references. Ask the coach about his successes and failures, years in the field, and experience with similar cases. If the coach has an addiction history himself, inquire about her own recovery process, and how long he’s been sober. A well-qualified professional, Clark says, will be knowledgeable about the science of addiction—and about self-care, community resources, conflict resolution, and crisis intervention. He will also be respectful of confidentiality and sensitive to cultural differences.
“Anytime you have an intense one-on-one relationship, it’s a delicate situation,” Clark says. “Between the money and that intensity, boundary issues can start to surface—a client is essentially buying his treatment provider. That’s why we recommend this approach be combined with other recovery services, which can offer support and backup to both the coach and the client.”
[Drugs and Alcohol and Your Kids’ Music]
Copyright © 2011 U.S.News & World Report LP All rights reserved.

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Should Sexual Addiction be in the DSM V?

Should Sexual Addiction Be in the DSM V?

By Robert Weiss LCSW, CSAT-S

What do you think?

Just as concrete and predictable diagnostic criteria help medical professionals determine whether your burning stomach pain is a case of chili-induced heartburn or appendicitis, so do categories of well-researched mental health symptoms provide the scientific underpinning for the identification of psychiatric and emotional disorders. New mental health diagnosis are not arbitrarily determined, but come about as consistent sets of reliable sample data are codified through years of repeatable clinical research and study. This is the science of diagnosis. The Diagnostic and Statistical Manual of Mental Disorders or DSM, renewed or revised in sporadic 10 to 20 year increments is, as every trained psychotherapist knows, the diagnostic ‘bible’ of mental health. In 2013, the American Psychiatric Association (APA) through their various working groups and committees will deliver a shiny new DSM 5, the formal guide that will differentiate and re-standardize our definition of mental health for at least a decade to come.

Like it or not, there is no single work more important to the daily practice of mental health diagnosis and treatment in America than the DSM. Though some clinicians consider the book demeaning as it purports to apply broad labels to the behavior of individual human beings, the DSM remains the authoritative guide to mental health diagnosis and its influence cannot be underestimated. The codification and language of the upcoming DSM 5 will come to establish not only what is considered mental health from pathology, but will also help determine and re-categorize our systems of insurance reimbursement and legal casework along with the content and organization of counseling psychology education for a generation to come.

Although the words Sexual Addiction first appeared in the DSM III, offered as a way to describe certain types of sexual disorders, those same words were removed from the subsequent DSM IV and IV-TR reportedly due to a lack of research. Unfortunately when persistent emotional and psychiatric problems lack a formal name or diagnosis, they can quickly become the stuff of subjective moral judgment. Without a diagnostic category sex addicts can just as easily referred to as perverts, binge eaters called fat and lazy etc. Had we not arrived at a workable diagnosis for alcoholism alcoholics might continue to be considered ‘bums’ and judged as the ‘amoral’ people they were thought to be only a generation ago. Clear diagnostic criteria allow us to view alcoholism and drug addictions to be the treatable symptoms of predictable psycho- biological disorders, now managed as the chronic illnesses they have proven to be.

Below are the proposed criteria for the DSM 5 for a disorder most commonly known as Sexual Addiction – being considered for the DSM 5 by the name Hyper-sexuality. As a specialist in the treatment of compulsive and addictive sexual disorders for over 20 years and having founded two of the sexual addiction treatment programs currently designated as research sites for this proposed diagnosis, the Sexual Recovery Institute (SRI) in Los Angeles and the Center for Sexual Recovery (CSR) at The Ranch in Tennessee, I am eager to learn how others view both the potential reintroduction of this disorder as a formal mental health diagnosis and the criteria proposed below. Comments are very welcome …

DSM 5 PROPOSED DIAGNOSTIC CRITERIA FOR HYPER-SEXUAL DISORDER

A. Over a period of at least 6 months, recurrent and intense sexual fantasies, sexual urges, or sexual behaviors in association with 3 or more of the following 5 criteria:

Time consumed by sexual fantasies, urges or behaviors repetitively interferes with other important (non-sexual) goals, activities and obligations.
Repetitively engaging in sexual fantasies, urges or behaviors in response to dysphoric mood states (e.g., anxiety, depression, boredom, irritability).
Repetitively engaging in sexual fantasies, urges or behaviors in response to stressful life events.
Repetitive but unsuccessful efforts to control or significantly reduce these sexual fantasies, urges or behaviors.
Repetitively engaging in sexual behaviors while disregarding the risk for physical or emotional harm to self or others.

Provided A: That there is clinically significant personal distress or impairment in social, occupational or other important areas of functioning associated with the frequency and intensity of these sexual fantasies, urges or behaviors.
Provided B: That these sexual fantasies, urges or behaviors are not due to the direct physiological effect of an exogenous substance (e.g., a drug of abuse or a medication)
Specify if: Masturbation, Pornography, Sexual Behavior with Consenting Adults, Cybersex, Telephone Sex, Strip Clubs, Other

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