Saturday, March 15, 2014

Filling in the Workplace Gaps with Web-Based Treatment and Support for Addiction and Mental Health Issues

Rehab Matters 2013 pg. 14-15

The internationally awarded Life Recovery Program is  featured in Rehab Matters, which is part of the Vocational Rehabilitation Association of Canada (VRA Canada).  It is the leading national organization representing and advocating for vocational rehabilitation professionals.

You can see the original article here

The Life Recovery Program: Filling in the Gaps with Web-Based Treatment and Support for Addiction and Mental Health Issues
By PaulRadkowski, MTS(PC), OACCPP, IAAOC; Monique Peats, MTS(PC), OACCPP, MSW, RSW

Today, there is increased awareness about addiction and mental health issues—people are starting to be more open about their experiences with depression and anxiety.  But while awareness is on the rise and words like "absenteeism" and "presenteeism" are becoming part of the workplace vernacular- we still have a long way to go before these issues are adequately met.

In terms of some of the service gaps in the current health system, a majority of people don't seek help, often citing access issues to treatment, financial reasons or because they're afraid of the stigma associated with treatment and fear the repercussion of what their friends, family or employer might think  

One U.S. study found that the delay between the first onset of symptoms of a mental health issue and when people seek and receive treatment can be as long as decades. The study found that because 75 per cent of lifelong mental illnesses start before the age of 24, many people adopt unhealthy coping strategies, including using substances. This means that addiction issues are high among this population group. This can lead to other problems, such as loss of job and home, destroyed relationships, and even death.

Research is increasingly backing the use of online programs to provide treatment for mental health and addiction issues. Such programs are easy to access, avoid the stigma associated with in-person treatment, and let the individual make progress at their own pace.

John A. Cunningham and colleagues (2010) affirm that trials of computer-based interventions for different health behaviours and interventions provide “significant evidence for their efficacy.” A meta-analysis also suggests that minimal contact, computer-delivered treatments—that can be accessed online—may represent a cost-effective means of treating uncomplicated substance use problems and related issues (Rooke, et al).
Web-based Treatment and Support

The Life Recovery Program (LRP, is an internationally awarded online, video-based program that provides trauma-informed, psycho-education and support to people with addiction and mental health issues, as well as to their friends and family.
Life Recovery Program 
The program is aimed at persons with issues such as substance abuse, behavioural or process addictions, self-cutting, disordered eating, gambling, toxic relationships, anger, managing chronic stress, trauma, and impulse control issues.

It’s informed by the latest research and integrates materials and resources used by many inpatient addiction treatment centres. It also takes a holistic approach to the individual’s needs, and looks at the biological, spiritual, and psychosocial influences of addiction.

Paul Radkowski, CEO/Clinical Director of the LRP, came up with the concept of an online recovery program while working as a psychotherapist in the Northwest Territories, where traditional support for mental health and addiction issues was very difficult to access.

How the Program Works
The Life Recovery Program defines addiction as any behaviour a person can’t stop, resulting in destructive consequences. This can mean substances as well as behaviours or processes, such as self-cutting, disordered eating, gambling, toxic relationships, even anger.

The program is based on cognitive behavioural therapy (CBT) approaches and other evidenced informed modalities that have been proven to reduce symptom severity. This includes the use of various self-regulation skills training resources, all of which are foundational for recovery. The web-based format allows people to access the program anytime, when they need it, wherever they are.

Throughout the program, clients download homework that allows them to practice and review new coping strategies for their mental health and addiction issues. They also receive weekly emails that encourage actions such as finding an accountability partner, summaries and reminders of key messages from the latest lesson, and videos.

They can also join an interactive peer-support forum that allows participants to interact anonymously with others in the program. This clinician-moderated forum is a way for people to find support and resources for the mental health and addiction issues they’re facing.

The program uses the most recent research findings in the field of neuroscience and neurobiology to help explain to clients the effect that addictions, stress, and impulse/control issues have on thoughts, feelings, and behaviour.

Challenges: Misconceptions About the Program
There’s a misconception that LRP is providing e-counselling and live video exchange with a counsellor, but this online program doesn’t aim to replace traditional treatment options. It’s designed to fill current service gaps—not to replace existing treatment approaches.

The Life Recovery Program can be used by a variety of people for many different purposes, such as support for someone waiting for treatment, those who want anonymity, or who are unable or not ready to have face-to-face treatment. It can be used to prevent relapse or as support for someone coming out of treatment.

The Outcomes
A content analysis of the LRP peer-support forum revealed that more than 80 per cent of participants were able to view their lives differently, regulate their moods, and developed new ways of coping to stop or decrease their addictive behaviours. Among active members, 27 per cent chose to sign up and pay to go through the entire six-month program (which remains available for one year) for a second time, decreasing their likelihood of relapse.

Participants also noted that they increased their use of alternative resources, such as support groups and therapists.

Paul Radkowski has been speaking with Employee Assistance Providers, insurance organizations, government agencies, and treatment centres that are looking for a more cost-effective way to address these issues. "It's a ‘more for less’ model, which provides more bang for one's buck. It's different than e-counselling, so it makes it even more cost-effective. These are 24/7 issues requiring a 24/7 solution; and as it turns out, the Life Recovery Program can improve lives while saving money," explains Radkowski.

The Life Recovery Program is unique in its delivery and customizability. Some agencies have expressed interest in customizing the Life Recovery Program into mini-programs. This would enable clients to choose their topic of interest from a treatment menu addressing issues such as: healthy relationships, anger management, stress management, grief, boundaries, self-esteem, anxiety, depression, trauma or PTSD, and relapse prevention. Radkowski goes on to explain, "These are some of the more common reasons why people seek counselling."

Radkowski further justifies an online offering by asking, "Einstein said the definition of insanity is doing the same thing over and over and expecting a different outcome. Historically some of the gaps in the mental health system result in people waiting for services. Some of these people may also be dealing with issues of stigma, lack of support, and not getting the help they need resulting in them falling through the cracks. Sadly, according to CAMH, only one third of those who need help actually receive it. It's time to explore all options and provide alternative and more cost-effective approaches."

The Life Recovery Program has been peer-reviewed and recognized by the International Association of Addictions and Offender Counselors’ (IAAOC) for its comprehensiveness and innovation. In 2008, it received the Outstanding Addictions Professional Award from the IAAOC. The program was also awarded the very first Outstanding Mental Health Award from the Ontario Association of Counsellors, Consultants, Psychometrists, and Psychologists (OACCPP) in 2011. The Life Recovery Program is also featured in CAMH’s “Fundamentals of Addiction” textbook and cited as the example of an effective online program in a chapter called “Digital Future.”

  1. Wang, Philip S., Patricia Berglund, Mark Olfson, Harold A. Pincus, Kenneth B. Wells, Ronald C. Kessler. “Failure and Delay in Initial Treatment Contact After First Onset of Mental Disorders in the National Comorbidity Survey Replication.” Archives of General Psychiatry. 2005; 62(6): 603-613. Available at:
  1. Cunningham, John A., T. Cameron Wild, Joanne Cordingley, Trevor Van Mierlo, Keith Humphreys. “Twelve-Month Follow-up Results from a Randomized Controlled Trial of a Brief Personalized Feedback Intervention for Problem Drinkers.” Alcohol Alcohol. 2010 May-Jun; 45 (3): 258–262.
  1. Rooke, Sally, Einar Thorsteinsson, Anne Karpin, Jan Copeland, David Allsop. “Computer-Delivered Interventions for Alcohol and Tobacco Use: A meta-analysis.” Addiction. 2010 August; 105 (8): 1381-1390.

Tuesday, December 10, 2013

Five Ways to Prevent a Holiday Heart Attack

Always a timely post for this time of year.  While the holiday season is associated with the indulgence of food, spending, festivities and the "spirit(s) of Christmas" (i.e. something involving frequent visits to the liquor store), it can have its downside as well... a little cheer disturber called stress. Perhaps it would be more accurate to say the "stress of indulgence".

According to the alcohol industry watchdogs, 25% of the annual profit for liquor sales occurs between late November and January 1st, between American Thanksgiving and the New Year (Distilled Spirits Council of the United States, 2007).

That's right, one quarter of the annual sale of alcohol occurs in just over a month's time. Perhaps even more disturbing is the increase of cardiac arrest that occurs within this window of time as well.

In fact, coronary deaths are 33% higher between December and January than they are from June through September (L.A. Times, December 17, 2007). While this spike of heart attacks during this time period has been known in the medical field for years, it was at first attributed to people who would possibly overexert themselves by shovelling snow and have a cardiac event. Not so, as folks in southern and warmer regions (no snow available) are equally effected.

The two riskiest days for heart related deaths... Christmas day and New Year's (December 25 and January 1).

Such things as: alcohol, increased intake of rich (salty and fatty) foods as well as the all too often Christmas rush of getting from one social obligation to the next; not to mention the family tension and concerns that occur, for example, when you might wonder if "uncle Fred will go off at the mouth again" after having too much of the spiked eggnog, are all contributors to making the next party, possibly your last.

Your Five Holiday Heart Attack Survival Tips:

1) Avoid excessive eating of salty foods

2) Avoid excessive eating of rich/creamy/fatty foods (avoid excessive eating period!)

3) Avoid excessive alcohol consumption (depends on age, weight, gender, history etc.)

4) Maintain some level of physical exercise or activity throughout the holidays i.e. go for a walk, take the stairs vs. elevator etc.

5) If social obligations require you to be around difficult family members, have a boundary of how long you will stay at the event, take your own car if you feel the in-laws will act up again and/or have another "out" in terms of being able to leave the event.

Perhaps the most important tip: if you or someone you care about feels a shortness of breath, chest pain and especially for women, symptoms such as indigestion, sleep disturbances, or weakness in the arms, etc. Don't just ignore it and think "another drink should fix that".

Listen to your body and get medical attention. This information could save a life.

Do take care over the holidays. Be mindful of excessive drinking, eating and over exerting or stressing yourself with too many social "obligations". The greatest "obligation" you can have is to a long and healthy life where you are there for your loved ones for years to come.

Season's Greetings, best wishes and best of health!
Paul Radkowski