My Conversations with Tom and Kent
Tom Johnson (Clinical Director of the Recovery Council) asked me to change some of the technical language and use more BB and 12 & 12 references. I am convinced that Tom is right and believe that it will benefit the clients. The average person on the street is unfamiliar with CBT jargon. If you did a "man-on-the-street-interview" to survey the average person's working knowledge of CBT jargon (e.g. "cognitive reconstruction", "collaborative empiricism", "maladaptive schemas", "functional analysis", "socratic questioning", etc) you would get a lot of "I-don't-know" responses. Could they learn the jargon? Absolutely! They could read the literature, see a counselor or join a group that uses CBT. But the likelihood of that happening is slim. How many CBT Groups meet in your hometown? None in mine. But there are a lot of AA meetings. There are thousands of AA/NA/CA meetings all over the country. There are millions of AA members and it is free!
The integration of evidence based therapy and 12 Step Recovery is effective but we need to align some (not all) the language of CBT will AA. Counselors need to be familiar with language in the literature but it needs to be presented in user-friendly AA terminology. To my knowledge, this has not never been done before - at least, not in any comprehensive way. It is certainly not in the research literature. There is a large body of research on the efficacy of CBT and a substantial amount of research on 12 Step Recovery but very few studies combine the two. Controlled studies are designed to compare (not combine) the two. Experimental research that compares 12 Step Recover to CBT requires protocols to maintain the purity of each approach so that the results are not contaminated by mixing the two. This is one reason efficacy research on substance abuse treatment is manual-driven. The largest study to date is Project MATCH which was a 5-year multisite clinical trial of patient-treatment matching sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The Three manuals used in Project MATCH were —Cognitive-Behavioral Coping Skills Therapy Manual, Twelve-Step Facilitation Therapy (TSF), Motivational Enhancement Therapy (MET). Therapists were prohibited from mixing CBT with other treatment approaches and the purity of approach is maintained by local and national supervisors who review videotapes of the session.
This does not mean that CBT cannot be combined with 12 Step Facilitation and/or Motivational Enhancement Therapy (MET) in clinical settings. In fact, Margaret Mattson ( Project MATCH Staff Collaborator Project MATCH) wrote, " The general therapeutic principles underlying CBT can be applied in many other ways than those delineated here. Under ordinary circumstances, the number, duration, and distribution of sessions could be flexible. Significant others might be involved in all sessions or none at all. The goals of therapy might be more flexible, and cognitive-behavioral procedures could be intermixed with other therapeutic strategies. The specific prescriptions outlined in this manual are imposed for purposes of standardization and separation of treatments in Project MATCH.
Kent and Tom are helping me with this.
I had a great conversation with Kent Montgomery (the clinical manager of the Recovery Council in Chillicothe Ohio) yesterday. He knows the Big Book better than many preachers know the Bible. People call him "Big Book Kent." His has a wealth of knowledge. I asked about five or six questions and he quoted the passage and page number. He carries his BB everywhere. The next time I am in Chillicothe I am going take my BB so I can copy his handwritten notes. Kent has highlighted and underlined important concepts, principles and inspirational passages. He has helpful notes and corresponding BB and 12 & 12 page numbers written in the margins. Yesterday, after clinical supervision, Kent skimmed through his Big Book and 12 & 12 teaching me. I was eager to learn from him. I need his expertise because I am trying to tailor the language of the my CBT counselor training materials and client handouts so that they match what most clients hear in AA meetings.
In addition to Kent and Tom's help, I am using two other resources: 1) The AA Concordance and 2) 164 and more.
Kent recommended two books by Dr. Paul O and I just purchased them on Amazon - "You Can't Make Me Angry" and "There's More to Quitting Drinking Than Quitting Drinking"
The integration of evidence based therapy and 12 Step Recovery is effective but we need to align some (not all) the language of CBT will AA. Counselors need to be familiar with language in the literature but it needs to be presented in user-friendly AA terminology. To my knowledge, this has not never been done before - at least, not in any comprehensive way. It is certainly not in the research literature. There is a large body of research on the efficacy of CBT and a substantial amount of research on 12 Step Recovery but very few studies combine the two. Controlled studies are designed to compare (not combine) the two. Experimental research that compares 12 Step Recover to CBT requires protocols to maintain the purity of each approach so that the results are not contaminated by mixing the two. This is one reason efficacy research on substance abuse treatment is manual-driven. The largest study to date is Project MATCH which was a 5-year multisite clinical trial of patient-treatment matching sponsored by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The Three manuals used in Project MATCH were —Cognitive-Behavioral Coping Skills Therapy Manual, Twelve-Step Facilitation Therapy (TSF), Motivational Enhancement Therapy (MET). Therapists were prohibited from mixing CBT with other treatment approaches and the purity of approach is maintained by local and national supervisors who review videotapes of the session.
This does not mean that CBT cannot be combined with 12 Step Facilitation and/or Motivational Enhancement Therapy (MET) in clinical settings. In fact, Margaret Mattson ( Project MATCH Staff Collaborator Project MATCH) wrote, " The general therapeutic principles underlying CBT can be applied in many other ways than those delineated here. Under ordinary circumstances, the number, duration, and distribution of sessions could be flexible. Significant others might be involved in all sessions or none at all. The goals of therapy might be more flexible, and cognitive-behavioral procedures could be intermixed with other therapeutic strategies. The specific prescriptions outlined in this manual are imposed for purposes of standardization and separation of treatments in Project MATCH.
Kent and Tom are helping me with this.
I had a great conversation with Kent Montgomery (the clinical manager of the Recovery Council in Chillicothe Ohio) yesterday. He knows the Big Book better than many preachers know the Bible. People call him "Big Book Kent." His has a wealth of knowledge. I asked about five or six questions and he quoted the passage and page number. He carries his BB everywhere. The next time I am in Chillicothe I am going take my BB so I can copy his handwritten notes. Kent has highlighted and underlined important concepts, principles and inspirational passages. He has helpful notes and corresponding BB and 12 & 12 page numbers written in the margins. Yesterday, after clinical supervision, Kent skimmed through his Big Book and 12 & 12 teaching me. I was eager to learn from him. I need his expertise because I am trying to tailor the language of the my CBT counselor training materials and client handouts so that they match what most clients hear in AA meetings.
In addition to Kent and Tom's help, I am using two other resources: 1) The AA Concordance and 2) 164 and more.
Kent recommended two books by Dr. Paul O and I just purchased them on Amazon - "You Can't Make Me Angry" and "There's More to Quitting Drinking Than Quitting Drinking"
posted by Unknown at 3:00 AM
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