Choosing a Treatment Center for Your Recovery Journey

Seeking treatment for substance abuse or behavioral disorders is a brave decision. Whether you or a loved one needs care, there are some ways to be certain you're selecting the right facility.

Integrated Approach

Working with professionals who have a philosophy of care that includes treating the whole person, not just a disorder or disease, creates an atmosphere of true, lifelong healing. The staff members at Cottonwood Tucson believe your wellness depends on full integration of physical, mental, emotional, and spiritual connectedness. This philosophy may already align with your core beliefs and desire to create a new life.

Drug or alcohol abuse not only affects the body, but also the mind and the spirit. Behavioral health issues, such as co-occurring disorders, mood disorders, and binge eating, may be rooted in trauma or grief. In the recovery process, it's not enough to simply remove someone from an unhealthy environment. It's important to address how each individual can heal from within.

Often referred to as holistic treatment, this approach allows you to create your own reality. You have the ability to consider sobriety and other aspects of recovery as an extension of a decision to deliberately foster health and wellness. Our individualized treatment methods help you acquire tools and techniques that inspire complete care for life. It includes:

• Medical management
  
• Evidence-based treatment
  
• 12-Step concepts
  
• Experiential, individual, group, and family therapy
  
• Nutrition counseling
  
• Eye Movement Desensitization and Reprocessing
  
• Mind-body and trauma therapy
  
• Equine-assisted therapy
  

With these and other applications, you have the opportunity not to fix what's broken, but reveal what's good and whole.

Qualified Personnel

There are aspects of recovery that, when unknown, may seem frightening at first. For example, someone seeking treatment for substance abuse may not understand what happens during detoxification. An individual suffering from traumatic experiences might have trouble trusting people outside of normal circles.

As you evaluate treatment centers, learn more about the staff. This collective of addiction professionals and clinical personnel will be instrumental in helping you regain wellness. They'll guide your path to recovery for a month, two months, or even longer. You have a right to be treated with dignity, respect, and kindness; and should expect privacy and confidentiality regarding all aspects of your care.

The members of our interdisciplinary clinical team include an extensive list of professionals:

• Board-certified psychiatrists and addictionologists
  
• Clinicians and nurses
  
• Psychiatric nurse practitioners
  
• Clinical psychologists
  
• Licensed professional counselors, social workers, and mental health workers
  
• Marriage and family therapists
  
• Registered dieticians
  
• Acupuncturists and massage therapists
  
• Exercise and recreational counselors
  
• Equine therapists
  
• Spiritual guides
  

This team ensures each resident receives caring and personalized comprehensive behavioral health care.

Cottonwood Tucson is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF). Our accreditations are in detoxification and inpatient treatment for adults. CARF is a non-profit organization that establishes standards of quality for organizations, and uses them to determine how well an organization serves its clients.

The Cottonwood Assessment Program (CAP)

If you or someone you love simply can't comprehend the depth of treatment required in the 

moment, finding a facility that can personally assess your specific needs before entering rehabilitation may help.

For example, Cottonwood Tucson has a four-day intensive inpatient program that assesses addiction and/or mental health threats and issues. The CAP is designed to personally address:

• Cases of differing and potentially complex diagnoses
  
• Individuals with mental health issues or substance disorders who aren't progressing in therapy
  
• Persons who experienced an intervention and may be open to receiving a comprehensive evaluation, without the intention of committing to a full inpatient residency
  
• People who would like a second opinion to a previous diagnosis
  
• Individuals who require a supportive and gentle yet firm process to move past denial of behavioral addictions, mental health issues, or substance abuse
  

The CAP assessment team is comprised of the same quality care personnel who would help provide guidance and methods designed for lifelong recovery.

To discover whether treatment is the right next step, try a self-assessment quiz.

Full Transparency of Fees and Services

Misunderstanding the scope of care and the costs of rehabilitation can sometimes prevent people from getting the quality treatment they deserve. During this critical time, it's important to know not only what you have to pay for, but how to pay for it and what you'll receive for your investment.

Make sure to compile a comprehensive list of questions when researching facilities, and call each one to get answers. Ask:

• How rates are established based on length of stay
  
• What's included in the foundational rate, and what services have additional fees
  
• Accepted insurance plans and other forms of payment, including financing
  
• Costs of follow-up care and relapse prevention services
  

To learn more about what services you may be able to expect at a treatment center and what questions to ask, review Cottonwood Tucson's adult program and detoxification services.

Not Just for Now, But Always

There's a lot of uncertainty surrounding recovery treatment, but you don't have to go it alone. If you or a loved one decides to enter a rehab center, that's only one part of the process.

What's learned during an inpatient stay should be reinforced by a structured and individualized continuum of care plan, which often features lifelong resources to help you continue to be your best self. These touchstones may include sober and/or transitional living options, relapse prevention techniques, onsite and in-community support groups, facility alumni meetings, and other methods to ensure your wellness for life.

By Tracey L. Kelley

Creating Balance in Your Body After Addiction

One crucial component of recovering from addiction is to eliminate toxins from your body and enable its natural healing processes. It's not always enough to simply stop abusing drugs or alcohol: the body has to be restored with proper hydration, nutrition, immunity, pH balance, regular exercise, and good sleep hygiene.

Medical Detoxification

Medical detoxification isn't always necessary for some people. However, it may be mandatory if your substance abuse:

• Lasted for an extended period of time or was particularly intense
• Compromised existing co-occurring mental or physical conditions
• Involved daily use to help you function
• Involved multiple substances
• Reoccurred after a period of prior rehabilitation

This first step toward wellness is nothing to fear. Detoxification administered and supervised by certified medical personnel helps purge your system of harmful chemicals. This release will also enable your brain begin the process of relaying proper signals instead of those caused by the false stimuli of drugs or alcohol, thus improving cognitive function and behaviors.

Substance abuse often results in damage to your nervous system; vital organs such as the liver, pancreas, lungs, kidneys, and heart; metabolic and digestive processes; and cellular structure. Without a proper physical detox, it may be harder to help your body return to its normal regulatory ability and natural cleansing processes.

Does detoxification make you uncomfortable for a while? Sometimes, but only for a few days up to a couple of weeks. There are many variables that contribute to how you may differ in the procedure compared to someone else, but an evaluation by a clinical care team assesses your need and how the process should go. Under no circumstances should you attempt to detoxify your body after substance abuse without guided medical supervision.

If your addiction was quite severe, such as involving excessive use of narcotics or alcohol, your initial detoxification may be part of a series of components your care team will use to help you on the road to recovery. You may require additional medical intervention to recalibrate your system at various intervals to make sure you're returning to an effective position of physical wellness, especially if you have other major health concerns caused or exacerbated by substance disorder. This may mean you'll have more difficulty handling cravings or have an acute awareness of physical pains and other chronic health symptoms than you did before, but only for a short time.

Proper Nutrition and Hydration

We've written a number of articles about the necessity of proper nutrition in recovery in our blog, including:

• Using Good Nutrition to Support Your Recovery
• Why Substance Abuse Affects Nutrition
• Adapting to a Healthy Diet During Recovery

Scientific research supports wellness through a whole foods diet for everyone, not just people coming out of addiction. However, your body and mind need additional vitamins, minerals, antioxidants, and other nutrients to recover from the harm caused by addiction. This boosts your  immune system and provides greater wellness.

Whole foods nutrition also helps the body reduce the acidity caused by substance abuse. A low pH level due to fatty foods, artificial sweeteners and sugary substances, and processed meals, as well as drugs and alcohol, leaches vital compounds from muscles and bones while the overall physical system breaks down. This prompts excessive mood disorders and a greater risk for chronic diseases and pain. A more alkaline system, or a higher pH level, is supported by lean protein choices, leafy greens and other vegetables, low-glycemic fruits, healthy fats, and complex carbohydrates.

Cottonwood Tucson has behavioral health dieticians who work directly with patients to develop individual healthy eating plans. Our experts believe a moderated whole foods diet helps people:

• Regulate moods
• Have ample energy
• Improve concentration
• Deal with cravings more efficiently to avoid relapse

We have a comprehensive approach to nutrition designed to make it easier to feel healthier more quickly.

Hydration is another important factor for creating balance in the body. Every organ, tissue, and cell needs water to function properly. Your entire system uses water to eliminate waste, maintain temperature, and keep joints mobile. It's not always necessary to drink the often-touted eight glasses a day, as everyone is a little different. But most people need four-to-eight glasses a day, usually about eight ounces each.

It's best to drink non-caffeinated, non-sweetened water when you first feel thirsty. However, you should also drink a few ounces before, during, and especially after a workout.

How can you tell if you're not having enough water? The first indicator is your urine. If you only visit the bathroom once or twice all day, and eliminate very little, that's a sure sign you're dehydrated. Also look at the color: the darker your urine is, the more dehydrated you are. Some people also experience symptoms of dehydration such as confusion, headaches, dizziness, or fatigue.

Regular Exercise and Good Sleep

These two wellness efforts often go together, because someone who exercises even three times a week develops better sleep hygiene, or healthy sleep habits.

In fact, the National Sleep Foundation indicates that a whole foods diet and as little as 10 minutes of some type of cardio exercise daily can "drastically improve sleep quality." Since many people in recovery frequently have trouble with insomnia in their first year, it might be good to create an exercise and sleep plan, and see how the two affect each other.

You don't have to become an Ironman triathlete—unless you find Todd Crandall's recovery story particularly inspiring—but you should dedicate 30 minutes a day to walk, jog, swim, strength train, play basketball, do yoga, garden, bicycle, or play Frisbee—whatever makes you happy to be moving. Keep a record of your activities and your sleep patterns for six weeks, and see what changes.

Cottonwood's Holistic Adult Program

Our experts can help you find new ways to recover from substance abuse through a variety of holistic approaches designed to treat your entire being. See what we can do for you.

By Tracey L. Kelley

Explaining Your Recovery to Relatives

Choosing to share your journey of addiction and recovery is probably one of the most personal revelations you'll have in life. It's important to remember that you decide what to talk about, what details are important, and how much to discuss.

When we're at family gatherings, we're often not sure who knows what. Since people are fallible, it's quite possible there's a bit of gossip involving any number of family members, their circumstances, and their actions. If you don't want to be part of the rumor mill, you may have to step forward and talk about your journey.

You're in total control of your narrative. To do this effectively, you may have to establish some boundaries, determine appropriate topics, and offer other resources to reduce myths and stigmas not only about your situation, but also addiction in general.

Establishing Boundaries

You're under no obligation to discuss your addiction and recovery with anyone. What someone else perceives of you isn't your concern—but that's a difficult concept for most of us to accept, even in the best of circumstances. If you decide it's fitting and helpful to talk about your experiences, however, you still have the right to make your boundaries clear.

Jennifer Rollin, a mental health therapist, wrote about boundaries for Psychology Today. She suggests three ways to establish boundaries:

• Tap in to your innate knowledge of yes and no
• Develop a way to tolerate others' reactions
• Continue to practice self-care

How might you put these methods into practice if you choose to explain your recovery to family members? Here's an example:

You decide you're going to talk to a small gathering of relatives about your sobriety. You ask everyone to take a seat, and you explain the facts: you once had a problem with substance abuse; you sought and completed treatment for it; and you appreciate their understanding when you choose not to partake in certain actions or events you feel compromise your decision to stay sober.

If people want to ask questions, you can answer the ones you feel comfortable with in whatever language and detail feel appropriate for you. If you choose not to answer particular questions, simply say, "I don't have an answer for that right now. Perhaps we can talk about it another time." This "I" statement is non-confrontational, maintains your yes/no boundary, and leaves the door open for discussion in the future so the other person feels heard as well.

If some people in the group have negative reactions, or start making comments of blame or shame, remember: those responses are more about them and less about you. You can redirect the conversation by saying something like, "I understand this news may initially be upsetting. I wanted to be honest with all of you. Maybe after some time passes and we've all had time to process this information, I can answer some of your questions." This "I" statement allows you to acknowledge their reactions without taking responsibility for them, and makes a point that you'll return to a more reasonable discussion without debating anyone in the heat of the moment.

If this initial reveal triggers you in some way, stay calm. Deep down, you probably expected this, especially from people who don't know you well or see you often. They may need more time to accept what you've told them, process it, and see you in a new light. Again, this isn't your concern or responsibility, which is why you need to maintain your approach to sobriety in all the meaningful ways you've used so far.

Determining Appropriate Topics

Just because you've dealt with substance abuse and are now in recovery doesn't mean your life is the proverbial open book. Again, you can choose to be as open as you like. However, if there are family members who were involved somehow before your treatment or after, it may be necessary to have a frank talk with them about what happened and where you are now.

Here are some reasons why:

• Making amends. If you're using a 12-Step program to help maintain sobriety, acknowledging your wrongs and righting them if possible is a critical component of this process.
• Continued recovery. As part of your wellness journey, you may have to address causation factors such as abuse, dysfunction, neglect, and other conflict that may be part of the family history and require healing.
• What you need from them. Whether it's support to avoid triggers or distance to reduce negative influences, this conversation is critical to address your needs in a direct and rational manner.

Be prepared for people to offer all sorts of opinions and advice. Try to stay gracious and understanding, but be open to discussion. However, you're under no obligation to do anything outside of what your treatment plan outlines.

Offer Other Resources

It may be helpful to encourage your family members to learn more about addiction without you being the only source. This neutralizes the topic a bit more, eliminates some of the stigma surrounding addiction, and helps all of you find more common ground. Some books that may help include:

• Beverly Conyers' Everything Changes: Help for Families of Newly-Recovering Addicts
• Debra Jay's It Takes a Family: A Cooperative Approach to Lasting Sobriety
• Al J. Mooney, Catherine Dold, and Howard Eisenberg's The Recovery Book: Answering All Your Questions About Addiction and Alcoholism and Finding Health and Happiness in Sobriety

Also consider directing loved ones to qualitative scientific sites that discuss facts regarding addiction and recovery.

Find More Resources Through Cottonwood Tucson

While Cottonwood Tucson doesn't endorse specific companies or programs, it offers an extensive list of resources you can use to enable clear communication with members of your family.

By Tracey L. Kelley

Equine Therapy and How It Helps Recovery

A frequent remedy for mental health issues is to be in a situation where you're not being judged and you have the opportunity to express your true self. However, talk therapy may not initially be the best course of action for someone if he or she has difficulty accessing deep feelings with other people.

Animal-assisted therapy changes this dynamic: you have a chance to simply love and be loved. The interplay between you and your animal companion is one of pure spirit, as two beings find their way to each other. The animal senses your energy and emotions, and this may pose a challenge at first to connect. 

The animal will also continue to exist in its own way, and there's little you can do about this behavior. But each encounter allows you to overcome your fears, change your perceptions, and gain confidence by stepping into a caregiver role and doing what you can to put the animal at ease and understand its nature. As trust develops, the animal responds with an open heart. This connection helps guide you along your healing process.

For someone in recovery from substance abuse, learning to trust, share feelings, recognize a surety in the present moment, and make valuable connections are just a few benefits of animal interactive therapeutic treatments.

Equine Therapy for Healing

One of the most successful forms of this process is equine therapy. Mounting scientific and anecdotal evidence points to the success of this experiential therapy method: a more hands-on approach for working through negative thoughts, feelings, behaviors, and experiences by doing enjoyable activities. For example:

• A study sponsored by the Animals and Society Institute revealed that individuals participating in equine-assisted therapy "reported significant improvements in psychological functioning immediately following [this therapy] program, and these changes were stable at a six-month follow-up."
  
• In a 2018 report by CNN, equine therapy experts relayed information about its success with a number of individuals, including those with autism, chronic pain, PTSD, depression, and other conditions.
  
• Psychology Today referenced nearly 50 studies that indicate benefits from working with equine and other animals in therapeutic settings include emotion stabilization, improved socialization and communication skills, better self-regulation or impulse control, reduced depression and anxiety, realignment of stress responses while doing something pleasurable, and increased feelings of calm, comfort, and safety.
  
• Counseling Today shared an in-depth story of one equine therapist's experiences helping children and teens with mental and behavioral issues.
  

A lot of drug and alcohol rehabilitation facilities use some type of equine therapy. As herd animals, horses frequently need to create bonds and form new relationships. If an individual in recovery has attachment or trust issues, working with a horse helps him or her acknowledge these circumstances, and learn to move beyond them in a healthful way. Additionally, a horse's innate hypersensitivity is the perfect mirror for someone's verbal and nonverbal communication. Therapy experts believe the way a person interacts with a horse is an indicator of how he or she is with humans. This awareness can be a pivotal point to explore later in group or individual counseling.

Aspects of an Equine Therapy Session

There are usually three types of equine therapy programs:

• Therapeutic riding: Considered a recreational activity guided by a non-therapist instructor who helps someone learn to control a horse while riding. Often used with people to build self-confidence and work on communication skills.
  
• Hippotherapy: Incorporating the expertise of physical or occupational therapists, language and speech pathologists, or recreation therapists, this practice uses a horse's movements to help a rider improve sensorimotor systems, balance, coordination, and other aspects of movement. Frequently a course of treatment for people with cerebral palsy, autism, or brain damage.
  
• Experiential interactivity: Although sometimes riding is a component, most engagement is conducted through ground exercises such as grooming, massaging, leading the horse in a training circle, and a variety of human/horse activities that may be metaphors for what a person is feeling or experiencing. This is the most common method used at drug and alcohol addiction treatment centers.
  

What people learn during experiential equine therapy for substance abuse treatment may include:

• Evaluating addiction and its impact
  
• Addressing trauma-sensitive issues
  
• Improving self-esteem and confidence
  
• Using grounding methods to help manage triggers, depression, and anxiety
  
• Establishing better relationships and defining necessary boundaries
  
• Trying mindfulness and other stress-relieving or coping techniques
  

What's more, individuals learn that other creatures suffer, too—and that it's within their ability to ease their pain and help them recover. The award-winning documentary Buck follows the life and experiences of trainer Buck Brannaman and how his humanity, vulnerability, and compassion helped him find new purpose, overcome past trauma, and change the lives of hundreds of horses. Watch the captivating movie trailer here.

Cottonwood Tucson's Equine Program

As part of our holistic recovery services, we offer equine-assisted therapy as a means to help an individual develop a better sense of feeling alive in the present moment, and to regain peace and connectivity.

The horses in our therapy team are retired from previous careers, and demonstrate the importance of second chances. Each relationship between horse and human starts on the ground with various activities and exercises to foster trust and communication. A horse can easily detect human emotions, and provide biofeedback to help people establish new ways of understanding their behaviors, perspectives, feelings, and beliefs.

By Tracey L. Kelley

Getting Treatment for an Eating Disorder

Sometimes, we know the truth, even if it's hard to face or we don't know where to turn. With so much focus in society on weight gain, weight loss, and model-perfect images in social media and on magazine covers, it's no wonder problems with eating disorders often are overlooked—and sometimes dismissed.

But, if you feel certain behaviors are harming your health, and loved ones or friends express concern about these behaviors, it might be time to consider treatment.

The National Institute of Mental Health (NIMH) defines eating disorders as "serious medical illnesses marked by severe disturbances to a person’s eating behaviors. Obsessions with food, body weight, and shape may be signs of an eating disorder. These disorders can affect a person’s physical and mental health; in some cases, they can be life-threatening."

NIMH clarifies that anyone can suffer from an eating disorder, regardless of gender, body weight, ethnic or racial background, or age. At any time in life, someone can develop an eating disorder, and there are many contributing risk factors, including biological, genetic, psychological, behavioral, and environmental.

The National Eating Disorders Association (NEDA) estimates 20 million women and 10 million men have experienced eating disorders. Someone struggling with an eating disorder has a health condition which NIMH categorizes as biologically-influenced. It's also quite common for these conditions to be co-occurring disorders with other mental health issues or substance abuse.

Anorexia Nervosa

Anorexia nervosa involves actions such as eating extremely small quantities of food, avoiding food, eating miniscule quantities of certain foods, and restricting food in a severe manner. There's also a misconception about body image: many sufferers feel they're grossly overweight when they're often underweight to the point of compromising physical health.

This condition includes two subtypes: restrictive, which is when people limit the kind or amount of food they eat to an extreme level; and binge-purge, which includes restriction as well as behavior that involves laxatives, vomiting, and diuretics as a form of food elimination.

Common symptoms of anorexia nervosa include, but aren't limited to:

• A heightened fear of weight gain, including refusal to maintain a normal weight for body type and style
• Intense thinness, often to the point of emaciation
• Patterns of excessive exercise and food restriction

Initially, anorexia nervosa causes mild health problems such as brittle nails and hair, constipation, and constantly feeling cold. A prolonged condition of starvation weakens muscles, compromises heart function, manifests brain damage, and can result in failure of major organs. NIMH reports anorexia has a greater death rate than any other mental health condition.

Bulimia Nervosa

Bulimia nervosa is defined by eating excessively large quantities of food and not having control over this behavior. Quite often, sufferers maintain a normal weight or may be overweight. They also follow patterns of food elimination similar to anorexia nervosa, in addition to a tendency to exercise too much.

Frequent symptoms and health concerns of bulimia include one or more of the following:

• Gastrointestinal issues and acid reflux
• Side effects of laxative abuse, such as intestinal problems
• Inflammation and swelling of the throat, neck glands, and jaw
• Teeth issues, including loss of enamel, sensitivity, and decay
• Serious dehydration and electrolyte depletion from purging or intense exercise
• Heart attack or stroke brought on by excessive binging and purging

Binge-Eating Disorder

Binge-eating disorder is different from bulimia nervosa in that sufferers may still binge, but they don't exercise, purge, or use other methods for food elimination. Consequently, they're often obese or morbidly obese.

Binge-eating is classified by three or more recurring symptoms:

• Eating excessively in a short timeframe, such as one or two hours
• Consuming food quickly during one of these episodes
• Eating even when not hungry or when feeling full
• Experiencing intense digestive issues
• Brain fog and confusion
• Stealing or hoarding food
• Hiding during episodes like these, or the evidence of the amount of food consumed
• Experiencing feelings of shame, guilt, stress, or embarrassment about this behavior

Once someone develops a pattern for binging, it becomes a compulsion, similar to alcohol or drug abuse. Additionally, people with bulimia nervosa and binge-eating disorders are at greater risk for medical complications and suicide.

Getting Help for Eating Disorders

To help determine if you have a problem, NEDA provides a screening tool and a guide on how to start a conversation with a mental health professional about treatment.

Causes for eating disorders vary considerably, so an individualized approach is a must. There is a range of options available to address the underlying reasons for a condition, such as:

• Acceptance and commitment therapy
• Cognitive behavioral therapy
• Dialectical behavioral therapy
• Interpersonal psychotherapy
• Family-based therapy
• Eye Movement Desensitization and Reprocessing (EMDR)
• Body-oriented applications such as yoga, somatic experiencing, and biofeedback

Levels of care that may be recommended include:

• Inpatient treatment, if an individual suffers with medical complications, testing reveals acute risk factors, or symptoms are rapidly worsening
• Residential treatment, if someone doesn't require serious medical treatment but may have a psychiatric impairment
• Partial hospital treatment, if a person's health is stable but they are having trouble functioning in daily life, such as working or going to school; or are still engaging in potentially harmful behavior such as fasting, purging, or binge eating
• Intensive outpatient treatment, if an individual is psychiatrically and medically stable, doesn't require monitoring, and doesn't have compromised daily functions

The intent of eating disorder treatment is to help someone regain a healthy relationship with food, a more realistic perspective of body image, and stronger emotional and mental balance.

Eating Disorder Treatment at Cottonwood Tucson

To help people suffering from eating disorders, our facility provides specialty treatment so they may change their relationship with food from an additive concern to one aspect of a healthy lifestyle. Learn more here.

By Tracey L. Kelley