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What is the Addictions Recovery Measurement System?
As I climbed 15-feet on a wooden ladder to the top of an old platform, next to this wall of leathery gray flesh, I caught a good whiff of fresh animal dung that immediately cleared my sinuses. Attempting to hide my fear from my wife with a poker face, and already feeling a little queasy, we were then advised by an old man who held a hammer in his right hand, to step into a shaky bamboo cradle seat atop of this seemingly gentle 8000 lb mammoth giant. As the sweat dripped off my forehead, I knew there was no turning back from the plunge into the humid jungle while perched on an elephants' back that we had so enthusiastically planned. At last, we were elephant trekking in Thailand. Apart from the slow bumpy ride, and my thighs being chafed on the course sides of this enormous peaceful beast, the serene walk through the forest with its' beautiful and unique flora on top of one of the strongest ancient animals alive, was an unforgettably pleasant experience for both of us. Recently, as I was daydreaming about elephant trekking in Thailand, I began to think about an old video that is used in the addictions' field entitled, "The Elephant in the Living Room." This is a rather silly story of a family that pretended to function normally with a real life elephant walking around in their living room. It exemplifies the dynamics of the co-dependent, dysfunctional family that continues to enable the alcoholic family member and deny the presence of alcoholism in the family. Try to imagine having some quality family time - conversations, watching television, or just relaxing all together when the elephant continues to tramp around the living room, bumping into things and knocking them over. It smells bad, eats a ton of hay and bananas daily, it takes up half the living room space, and it makes loud trumpet noises all day long. Then try to imagine convincing your children, friends, and other family members to keep it a secret, or that the elephant does not really exist. The idea is that if you just pretend long enough that it's not really there, and it's not really an elephant, that it may just go away by itself. Some things like the common cold, poison ivy, and stress headaches usually due subside with time. Chronic diseases and life-style addictions (e.g., alcoholism, drug addiction, obesity, gambling, etc.) on the other hand continue to progress with time. Just ignoring a chronic problem rarely makes it go away for good, because of the continued negative consequences that effect everyone involved. My initial purpose in writing this article is not only to proclaim that the elephant is real, but that it won't be ignored despite our best efforts to do so. Lying about it makes the elephant bigger and stronger, and it will continue to dominate the house. If we admit and acknowledge its' existence, we can take the first step out of denial and onto the road to recovery. The "it" that I am referring to is what I call "Poly-Behavioral Addiction." Secondly, I want to introduce the Addictions Recovery Measurement System (ARMS) as a progress tracking measurement tool for clinicians. In a sense, this system simulates the old elephant masters' steering instructions to me. "Dig your heels into the elephants' neck, and hold on to its forehead, kick right to go right and left to go left, and if the elephant stops to eat bananas, you must use the hammer on his head, because with his thick skin, nothing else will get his attention." Behavior medicine experts and health psychologists must take into account the biological, psychological, and socio-cultural influences when considering an individual's health. They have long emphasized the role that multidimensional life experiences (e.g. traumatic life events, the negative effects of stress on the immune, endocrine, gastrointestinal, and cardiovascular systems, unhealthy/ hazardous life-styles, and poor health choices in regards to adherence to preventive regiments, etc.), play in the occurrence, maintenance, and prevention of physical illness. In 1990, 50 percent of the mortality (over 1-million deaths annually) in the United States from the 10 leading causes of death was linked to addictive behaviors such as tobacco use, poor dietary habits and activity, alcohol misuse, illicit drug use, and risky sexual practices, (McGinnis and Foege, 1994). Some experts in the medical field are presently purporting that America's number one health problem is no longer heart disease or cancer, but a deadly condition labeled "Syndrome X". This condition is described as a combination of several metabolic problems such as being overweight, having high blood pressure, being insulin resistant, and/ or having abnormal cholesterol levels that are all related to a poor diet and a lack of exercise. The sum is greater than the parts in this syndrome. Each metabolic problem is a risk for other diseases separately, but together they multiply the chances of life-threatening illness such as heart disease, cancer, diabetes, and stroke, etc. They indicate that up to 25% of adults presently have Syndrome X, and the ranks are growing considering for example that 30.5% of our Nations' adults suffer from morbid obesity, (100lbs., or more above ideal weight, or BMI = 30 >), and that two thirds or 66% of adults are overweight (BMI = 25>). Considering that the U.S. population is now over 290,000,000, some estimate that up to 73,000,000 Americans would benefit from some type of education awareness and/ or treatment for a behavioral addiction. This fact does not take into account the 25% addicted to nicotine, the 13.4 % (NIMH) with alcoholism, and the multiple millions of others who are addicted to mind-altering substances, and other behavioral addictive disorders such as pathological gambling, pornography, and extreme religious addictions, etc. To compound this healthcare crisis, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and the Commission on Accreditation of Rehabilitation Facilities (CARF) both continue to seek verification of quality healthcare, as healthcare disciplines typically have no common ruler that standardizes outcome measures. The outcome measurement research data in their comprehensive medical center inspections therefore, remain a primary focus. In many states, outcome evaluations are legislatively mandated with future appropriations tied to the demonstration of treatment program effectiveness. To add to the confusion, there are differences in the definition of outcome that relate to two paradigms:(1) Our present healthcare system is set up to focus on acute care rather than chronic illnesses. It focuses on a Unitary Syndrome model in which the sole marker of treatment response or success is specific symptom-reduction.(2) Healthcare consumers are increasingly advocating for a Multidimensional model that takes into account an array of life-functioning domains that influence patient treatment progress. Evidenced-based meta-analysis studies also purport the prognostic power of life-functioning variables to predict outcome as well as their importance for treatment planning over a unitary model that has had little empirical support. My goal in writing this article is not only to educate and make others aware of these complex issues, but also to offer strategies and practical tools for clinicians to utilize in attacking these problems. The Addictions Recovery Measurement System (ARMS) was developed in an effort to help healthcare providers to: 1. Provide the highest quality of patient care that improves patients' overall health 2. Document health risk reduction effectiveness and medical care cost reductions 3. Comply with the U.S. Preventive Services Task Force's evidence-based prevention assessments and recommendations for early detection of diseases 4. Support the U.S. Department of Health's Healthy People 2010 national initiatives 5. Comply with JCAHO and CARF standards for outcome measurements 6. Help change the current health care system from a traditionally symptom-reduction focused model to a holistic multi-dimensional prevention model 7. Maintain treatment efficacy and integrity for healthcare program viability The ARMS is a standardized multidimensional integrative program that offers a combination of twelve primary clinical and innovative assessment and measurement tools to assist providers and consumers of healthcare services with the following seven objectives: Initial Intervention Diagnosis Prognosis Treatment Level of Care Recommendations Progress Management Discharge Determination and Outcome Measurement. The ARMS patient progress tracking system also includes a performance based holistic health and wellness non-confrontational point system. It provides a uniform administrative device to impartially screen, monitor, and re-assess a patients' initial bio-psychosocial medical condition for prognostic indicators, treatment progress indicators, and subsequent treatment outcome indicators. This motivational measurement system can track patient progress in six (PD) Progress Dimensions from admission to discharge to coordinate continuity of care given to the patient by multiple providers simultaneously. The ARMS incorporates a comprehensive prognostication system of instruments with a treatment progress and outcome measurement system that visually displays a patient's journey from enrollment to recovery. The goal of treatment outcome measurement is to yield more effective, targeted, and clinically validated treatments to match individual patient needs through continued research. The Addictions Recovery Measurement System is equipped with an arsenal of assessment tools and prognostic, progress, and outcome measurement instruments to help you fight the War on poly-substance and behavioral addictions. We must consider that over 440,000 Americans are dying each year from nicotine addiction alone, (e.g., that's 1205 daily, etc.), costing $75 billion in direct medical costs. We must consider that 300,000 adults a year are dying from obesity (e.g., that's 822 daily, etc.), with $117 billion we spend on obesity related diseases annually, (National Health and Nutrition Examination Survey, 1994). We must also consider the 100,000 deaths annually related to alcohol use (e.g., that's 274 daily, etc.), with the 184.6 billion we spend for this problem, (Tenth Special Report to the U.S. Congress, June 2000). Just these three lifestyle addictions mentioned alone are causing 840,000 deaths annually (e.g., that's 2301 daily, etc.), with total costs of $376.6 billion annually to the U.S. taxpayer. We must conclude that we can no longer afford to ignore the "elephant in America's living room," the multidimensional problems related to individuals suffering from multiple behavioral addictions. A call to "ARMS" is in order to fight and stop the top killer of Americans: Poly-behavioral Addiction. For more info: http://www.geocities.com/drslbdzn/Behavioral_Addictions.html James Slobodzien, Psy.D., CSAC, is a Hawaii licensed psychologist and certified substance abuse counselor who earned his doctorate in Clinical Psychology. He is credentialed by the National Registry of Health Service Providers in Psychology. He has over 20-years of mental health experience primarily working in the fields of alcohol/ substance abuse and behavioral addictions in hospital, prison, and court settings. He is an adjunct professor of Psychology and also maintains a private practice as a mental health consultant.
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Alternative Medicine Metaphors of the Mind (Part II) Storytelling has been with us since the days of campfire and besieging wild animals. It served a number of important functions: amelioration of fears, communication of vital information (regarding survival tactics and the characteristics of animals, for instance), the satisfaction of a sense of order (justice), the development of the ability to hypothesize, predict and introduce theories and so on. The End of Psychotherapy In two articles entitled "We Are Not Our Personalities" and "Eliminating The Past" I make the point that it is now possible to "dismantle" all the life experience that is stored in the human bio-field, i.e. in our consciousness , with all its ensuing consequences. The Essence of Being Human What does it mean to be Human? Well if you reflect on your thoughts and behaviors and those of the individuals around you on this planet since the beginning of our existence here I think you will likely come to the conclusion that to wear the label Human is not exactly endearing or desirable. What are the 4 Brainwave Patterns and How Do They Effect Your Health WHAT ARE BRAINWAVES? HypoManiacs Often Misunderstood Are you a Hypomaniac? If you are you have some definite advantages over others. Hypomaniacs are often superstars in their fields, but they are often misunderstood by those who work so hard to profile personalities and put individuals into neat little boxes. On Empathy The Encyclopaedia Britannica (1999 edition) defines empathy as: Insighting Human Behavior thru Gravity Wave Simulations of the Moon Every police officer will tell you that when there is a full moon, the natives are restless and it will be a long night, with lots of arrests and paperwork? This is a known fact one which cannot be dismissed so easily after such basic observations. An evolutionary theorist would say this is because on moonlit nights our ancient ancestors went on night hunts or that the Sabertooth tigers came to hunt us? Some say these things date back to our Tree Shrew ancestry, all of which Darwin might agree is plausible. Other more spiritual folks might say it is a special time, which brings out human emotion and spirits? Sounds cool to me. I could go for that one? Whatever the case is Lunar Cycles and full moons cause or help along Earth Shift movements of Tectonic plates, coincide with ocean wave actions and indeed cause the behavior shift of many life forms on the Planet's surface. Could this be from an interaction of gravity waves between Earth and Moon? If so does it affect the resonance of mother Earth's 7.89 Hz or heartbeat? Cult De-Programming? The following good work from a person engaged in trying to free people from cultish programming is far better than most. It demonstrates the person is aware of mind control techniques employed in influencing people. Having said that I will now try to show how this piece is in fact an evidence of SPIN or influence that the person engaged in doing it might not even personally realize. For example Catholic exorcists are taught incantations and rituals to use that they may not or usually will not understand either the derivation or history thereof. Nature VS Nurture - Theories of Personality in 21st Century Nature vs Nurture theories have wasted a lot of energy of human beings. Plato is considered first to realize that you are made of not only flesh but also an intellectual soul. Time Out of Mind Let us first consider the role of time in our lives, then let us consider that role in terms of mental illness. Buddhists and Hindus, among others, propose that time does not actually exist. The Western world, however, with its dependence on clocks and deadlines, scoffs at such a notion, relying upon sayings such as "Time is money" and "Time is of the essence." The Joan of Arc Complex Sometimes I think that I have a mental health problem and that at any minute the pharmaceutical companies are going to develop a cute little green star-shaped pill to cure me of my ailment. I call it my Joan of Arc Complex. You see, I hear voices that I'm pretty sure aren't mine and they tell me to go out and do these stupid save the world projects. I call them THEY or THEM because they refuse to give me a more accurate name to call them. So, I must be crazy. The Iron Mask - The Common Sources of Personality Disorders Do all personality disorders have a common psychodynamic source? Psychological Tips for Effective Studying STUDY STRATEGIES Fairies and Mental Health Schizophrenics hallucinate alternate realities. People who claim to have been abducted by aliens are accused of having Fantasy Prone Personalities. So what about those of us who claim to be conversing with angels, fairies, and spirit guides? Are we nuts? Absolutely yes! If we weren't crazy before we started chatting with the divine, we soon will be. Just the constant questioning of one's sanity can drive a person insane. How do you know if you are really talking to spirits or if you are losing your mind? Artificial Intelligence - What Have We Learned Through Natural Ignorance? During the late '80s and early '90s, I had the opportunity to work with expert systems in real-time production environments. I found artificial intelligence, or AI, to be thoroughly intriguing. I even went so far as to write an expert system package, under Microsoft Windows, called WindExS. However, as I continued my work, and expanded into other areas of knowledge management and, eventually, remote viewing, I began to find some unusual inconsistencies in the AI world and the desires to create "truly intelligent" and "thinking" machines. The Special Secret of Intuition The limbic system Emotion is a Reaction to the Influence Each one of us is linked to the emotions whether by protecting self values or deep affectionate involvement to the objective. The "sense" is a gift to us to analyze the values of the personality and behave in accordance. Sense creates sentiment that helps to avoid harm to the values possessed deep in the personality. We avoid action or reaction to what is not related to our values. Our Endeavour is to retain our values unharmed is a method to maintain the identity intact but when lost, we loose emotionally means lost everything. Emotion is a reaction to the influence of attraction that contacts our personality. Unknowingly we get attached to others and their objectives; the attachment is due to the influence of the attraction. We become affectionate, friendly, begin involving deeply and etc; are the reactions called emotional attachment but when hurts that becomes emotional breakup. Our social action and reaction relates of our emotional attitude. The emotional attitude is the reflection of the values possessed deep in the personality and the reaction is in accordance. Our sense works on the basis of the quality we possess that reflects the attitude. I sense emotion in three philosophical features; one is Identity emotion is the Endeavour to protect self values secondly sentimental emotion is submission that involves acting in affection and thirdly Effectual Emotion leaves effect of impression on our personality: What's the Problem: Introducing Solution Focus Pt 2 Again, many of us think we listen, yet we don't always "attend" to the person who is speaking to us. We are too busy doing other things! We are not being 100% attentive. The following attributes of good listening are suggestive of the skills needed. There is some overlap between the various attributes, but each suggests something different. Narcissism, Substance Abuse, and Reckless Behaviours Pathological narcissism is an addiction to Narcissistic Supply, the narcissist's drug of choice. It is, therefore, not surprising that other addictive and reckless behaviours workaholism, alcoholism, drug abuse, pathological gambling, compulsory shopping, or reckless driving piggyback on this primary dependence. Animal to Animal Telepathy There has been much study on Telepathy in the animal kingdom. Many have experienced telepathy from human to human. Some have experienced telepathy from pets, both sending and even on rare occasion receiving. There are so many studies that show it is not coincidence or explainable by probability. In fact the statistics are so strong that after reading only a few studies and pitting that against your own observations in your ego-centric life experience that any normal human would have to agree.
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