Ep18 Addiction Treatment: Emotional Attachment Behavioral Therapy

Doug Smith Developer of Emotional Attachment Behavioral Therapy
===

[00:00:00] Boom, boom, boom, boom, boom.

Chris Langley: Hi, welcome to the Addiction Recovery Place podcast,

the podcast champion addiction treatment professionals around the world.

I'm your host, Chris Langley, and I'm pleased to introduce today's guest, Doug Smith from Oregon.

Doug has 20 years

of experience working in behavioral health services,

including serving as a direct clinician,

clinical director and director of clinical development.

He has a BS in psychology from Eastern Oregon University and is a Certified Alcohol and Drug Counselor Level Two.

Doug innovated many modern approaches to treatment services, including developing new patient centered treatment models.

He speaks nationally to professionals in the field around the positive outcomes of the emotional attachment behavioral therapy model, which he developed himself.

Doug is also the recipient of the Oregon Association of Addiction Professionals.

2023 Innovator of the Year Award,

as well as the 2018 Addiction Professional of the Year Community Service Award.

Welcome to the Addiction Recovery Place Podcast, Doug.

It's great to have you join us [00:01:00] and tell us about, tell our audience about the innovative work that you're doing with emotional behavioral therapy.

Doug Smith: Thanks, Chris. It's nice to be

Chris Langley: That's wonderful. I really appreciate your time and thank you so much for joining me today for the podcast, Doug.

So we're just going to,

we're just going to dive, dive straight in, shall we?

So tell us about your journey and how you started emotional attachment behavioral therapy.

Doug Smith: Great. first off, Chris, before I dive in, I just want to take a second and thank you also because, I appreciate the fact I've worked in this field for 20 years in the SUD field. And the fact that, you're giving a voice in an audience to, to professionals who work in this field, is something I really appreciate.

And, and so I want to thank you for having this forum available. for professionals like myself to get on and talk a little bit about, people who work in this field, we don't do it for the money, and we typically have a ton of passion and it's like being on the front lines of a battle zone to, to fight this disease on a daily [00:02:00] basis.

I just really respect what you're doing and appreciate, the efforts you're going to, give a voice to the people who work in this

Chris Langley: field.

Oh, wow. I really appreciate that, Doug. Thank you so much. And, I know our audience is gonna love hearing about the great work that you are doing. It's, it just sounds quite remarkable.

So tell us about how you started this.

Doug Smith: Yeah. so first off, just a little bit about my history. I grew up in a, household where substance use disorder was prevalent. And, my father, had difficulty with difficulties with alcoholism. So I know what it feels like to grow up in a household that substance use disorder is impacting. And then, as I grew up, I, I ended up, developing and having substance use disorder myself. And so I had my own difficulties with substance use disorder, and one of the things that I found through, my experience with addiction was that over the time that I was, struggling with [00:03:00] addiction, I was losing all the connections that I had in my life.

You know over time I lost contact with all of my friends that I had my whole friend group changed I lost contact over time with my family and ultimately I lost contact and connection even with myself, you know, where I was just completely disconnected from everything good in my life. It seems like as you're going, at least in my experience, as you're going through addiction, your world just keeps getting smaller and smaller, and everything that's good in your life starts to evaporate and all it becomes about is getting drugs or alcohol and using drugs and alcohol.

So that was my experience walking through it, and then as I got into recovery, and I currently have 24 years clean and sober, and I have lived experience with this disease, but, as I got into recovery, what I [00:04:00] found is over time, whether it be through individual counseling, group counseling through support groups that are out there 12 steps and things along those lines, I started to slowly rebuild connections in my life, right and some of that was repairing the connections that I could and building those back up. Don't get me wrong,

there were some connections. I was, never able to get back, but for the ones I could repair, part of my recovery was repairing those and getting those back, into an even better place than they were initially, but then also building new connections through recovery with, a lot of people I met through that process and surrounding myself with the right type of people and people who really cared about me as an individual.

So, I really learned through that process how important those connections are and, when I got into the field and started counseling, [00:05:00] one of the things I realized really quick working with clients was how important it was to build that type of a connection as a counselor with the client that you're working with.

And that's typically referred to as therapeutic alliance, and it's something that all counselors learn about, but, I was really passionate about what a foundational piece that was in the work that I was doing, that, all the, different assignments they could be doing or exercises or areas of focus were extremely important. But if I didn't have that solid connection with the client, that it wasn't going to work well. And also, being a group counselor for a lot of years, not only was it important that I had that connection, with the client individually, but that there was those types of connections within the group as well.

So as a counselor, I was always looking for ways to emotionally connect clients in [00:06:00] processes. So if one client is sharing about something that's really impacted them, and I get them talking about their feelings around it. My mind's thinking about who else in the group has had similar things come up in their life and how can I create a connection between these two where they can relate to each other on an emotional level? And as you do that you start to tie these connections within the group and what I found is the faster those connections were tied within the group and with me as a counselor, the higher the success rates were of the clients I was working with and the research has definitely shown that to be true as well, that, that therapeutic alliance that we build, with clients and that clients build with their peers is so extremely important.

And in fact, that peer connection is so important that one of the most recent staffing areas that's had a huge increase over the last 10 years is peer support. [00:07:00] And

I think people realize that it's so important to have people that aren't an authority figure like a counselor that these individuals can connect with early on to help guide them through this process. And thankfully, peer support has gained a lot of steam in recent years, and it's doing amazing work as well.

Chris Langley: definitely.

Doug Smith: One of the things in terms of, developing EABT, Emotional Attachment Behavioral Therapy, one of my big passions, after being a counselor for a lot of years and getting into clinical leadership positions, one of my big passions was innovating new models of care.

I felt like at times, as much as I love the substance use disorder field, I felt at times like we could be stuck in our ways as an industry and that in some ways people like myself with long term recovery can make the mistake of thinking that what worked for [00:08:00] us 20, some years

ago is going to work for the client that we're looking

at

across the table today. And I think that's something that's affected us at times as an industry, and the reality is, over the 20 years that I've been in this career, clients are changing rapidly. The patients that we work with, the levels of acuity with mental health and other areas for them. The levels of trauma that they're impacted with the types of substances and how deadly those are, all of that stuff is increasing rapidly. And I have felt at times as someone working in this industry that the clients were changing a lot faster than than the staff was

or than we were in the industry. And so I was really passionate about wanting to push some of that stuff forward.

I've used things like cognitive behavioral therapy and dialectical behavioral therapy all of my career, and I've seen [00:09:00] the amazing good that comes from those models working with clients, but I also have seen some of the areas that I felt like I would like to see improved. And so all of that kind of formulated into me wanting to develop, this new model. I wanted to develop something that had a three prong effect to it.

I feel like with, CBT and DBT, one of the things they do really well, is they address immediate behaviors of concern. When clients come to us that are struggling with substance use disorder, they've got some behavioral stuff going on that's really impacting their life and threatening their lives in some ways, right?

It's, really important that we address those immediate behaviors. I think CBT and DBT do that really well, but at times I have felt like the core issues underneath those behaviors that led to some of those behaviors developing in the first place don't [00:10:00] get addressed as much as I would like to see them be addressed.

I wanted a therapy model that not only addressed those immediate behaviors, but also addressed the core issues that were underneath those behaviors. The other area that at times, would bother me working, with clients is I would see them change their negative behaviors that they came in doing, but they wouldn't replace the negatives that they removed from their life with positives in their life.

My belief is if you take a negative out of the equation, and don't replace it with a positive, you're leaving that void empty. And eventually the negative is going to fall right back into place. When I talk about a therapy model with a three prong effect, what I really was shooting for was something that number one, addressed those immediate behavioral concerns.

Number two, dealt with the core issues or started to work on those core issues underneath those behaviors. And [00:11:00] number three, improve the quality of the relationships in the lives for these individuals. I don't know that EABT does it perfectly, but I feel like it's really shown to begin to accomplish those things with the clients that we're working with.

I'm extremely excited about it. Another area when I was developing this model, as a counselor, pretty new in the field, at times I could receive the message that, when you're working with clients, don't worry about their feelings. Their feelings aren't important. It's their thoughts and their behaviors.

That's where we can make the biggest change with these clients. And that always bugged me a little bit because as somebody who had struggled with substance use disorder, the main reasons I used was to feel and not to feel like those were the two primary things that made me want to use. I felt there was just something intuitively when I would hear that's like that doesn't make sense to me, like I [00:12:00] feel like those emotions are really important.

I wanted something that was more emotion primary and there's a lot of similarities just to give a shout out to emotional focus therapy. I believe her name is Dr Sue Johnson, who actually recently passed away. Emotionally focused therapy was one of the first, therapy models to really focus on that.

It also incorporated some attachment stuff. So there's a lot I gleaned from what they were doing. I also really wanted to create a model that was self directed and empowering. I think one of the biggest changes I've seen in clients, especially over the last 10 years is, so much when I first got into this field was focused on 12 step facilitation, helping people see that they're powerless and work with them on their denial, all of those sorts of things.

And what I've seen over the last 10 years is that the clients coming [00:13:00] in to a treatment don't digest the idea of powerlessness as well as they did 10 years ago. I think their trust for large institutions has decreased a lot over the last 10 years. I think that's not just a substance use disorder,

I think that's a society type of thing where trust for large institutions, whether it be religion or the police force or the government or whatever, there's been a huge decrease in some of those trusts of larger institutions. The idea of a counselor immediately working with a client, on them accepting powerlessness and, and challenging their denial when you're working with a client that way, it's almost a top down approach where you're putting yourself as an authority figure and them in a submissive role,

and you're teaching them this stuff. Sometimes there's a degree of challenging that comes with it and stuff like that. What I've seen over the [00:14:00] last 10 years is a client's capacity to digest that and handle that while you're building a therapeutic alliance with them is decreasing rapidly, so I wanted something that was more, where the client was in charge of it was more self-directed like motivational interviewing has that component to it. It was more empowering where it lifted people up instead of you know focused on them accepting powerlessness for themselves. Those components were extremely important to me. Then, being a counselor myself, I wanted to create a therapy model that was for counselors to use. There isn't a lot of theoretical stuff behind my model as much as exercises and workbooks and curriculum.

When people purchase stuff, to use this model for me, they're quite often surprised that when they open the workbook, it's just filled with [00:15:00] exercises to do with patients. I'm a counselor and I created it for counselors to use with clients. When we rolled this out, I created this back in the end of 2020, early 2021.

When we rolled this out at the treatment center, I was working at in 2021. We were really amazed how quickly patients flocked to emotional attachment behavioral therapy. They all started asking if they could be in that group. We started off opening one group and within a short period of time we had to open additional groups.

The other thing that we were really amazed at, I was, the Clinical Director at that organization at that point. The other thing we were really amazed at is after the first year when we started to look at the data, it was pretty impressive how EABT compared to the other evidence based practice models we were using with 12 step facilitation.

So [00:16:00] all of that is how the journey of this began and, how, when it rolled out it was a real surprise, at least to me. Maybe it's just that when I create something, I can be a little insecure about what I'm doing, so I didn't know whether it was going to work or not. But, when we rolled it out, it was like, whoa, this is not only really popular, but it's showing a lot of effectiveness. And that was extremely

Chris Langley: exciting.

Wow. firstly, congratulations. That's such a journey that you've just explained to me.

In such a short space of time, what you've achieved with this new therapy model is, quite incredible, Doug. So, how does this therapy work and what's actually involved?

Doug Smith: Yeah. so, to try to boil it down in a nutshell with attachment theory, what they found, I was talking to earlier about connections and the founder of attachment theory is John Bowlby. He was a British psychologist back in the 1950s, and he described attachment as a lasting [00:17:00] psychological connectedness between the human beings.

So if you think about all the talk I was talking about with connections and how important those connections are, that's exactly how he described attachment in a nutshell. As a counselor who knew that connection was extremely important, attachment theory has always been something that's been near and dear to me.

I've tried to learn more and glean more from it and do research around it. So in terms of how this therapy model works, with attachment theory, after attachment theory was developed, they ended up discovering that people have different styles of attachment. So there's four different styles of attachment, and one of them is called "secure attachment," and the other three are all different forms of "insecure attachment." They were initially, titled as "ambivalent, insecure attachment, avoidant, insecure attachment, and [00:18:00] disorganized, insecure attachment." Those four attachment styles is a lot of how this model works. We simplified the names. To make it easier for the clients that we're working with.

So instead of "ambivalent insecure," we call that one "anxious attachment." Instead of "avoidant insecure," we just call that one "avoidant attachment." And instead of "disorganized insecure" we call that one "fearful attachment." But those four attachment styles that were actually discovered by a lady named Mary Ainsworth in a research study that she did in the 70s called the Strange Situation Study. That's the focus with this therapy model.

What we ultimately do is we help people to understand their attachment styles, and you know with attachment styles, it's not like there's four of them and you fit into one. You have a little bit of all

of these right and so you look at where am I on the scale? [00:19:00] And the other thing with these attachment styles is they're always fluid, right? So for instance when I was hitting rock bottom in my addiction, my attachment styles were in one place. But three years later in recovery, my attachment styles had improved, and I had talked about those connections starting to rebuild in my recovery. That's part of what, what happens, right? And so not only do we have a little bit of all four of these, but they're constantly fluctuating. I know people in my life who are extremely healthy, and their attachment styles are very healthy, and then something significant happens to them, like a death of somebody close to them that they love and i,t can really affect their attachment over a period of time.

Once again, these are always fluid and stuff, but, in a nutshell with this therapy model, what we want is we want to assess your levels of attachment styles, and we want to see those three insecure attachment styles come down over time. [00:20:00] And we want to see that secure attachment style increase over

time. And that's exactly so far what EABT has been shown to be able to do which is extremely exciting. The other thing that we really want, with this therapy model is, it really focuses on, you know, when I talk about that therapeutic alliance or that connection between the counselor and the client, it really focuses on putting safety

first. So everything that we do with this model is around creating a safe environment for the clients to do this work. We train all of the counselors who are using this model how to create safety in their relationship with the client and also when applicable in the group therapy process, and we do that by teaching them what sort of environmental factors tend to lead toward creating secure attachment [00:21:00] for people.

They create that type of an environment for the client to do the work. And then the focus of the work is let's decrease those insecure attachment styles and increase your secure attachment styles. And in a nutshell, that's how this therapy model works.

Chris Langley: Wow, that's fascinating stuff. This is something I've not really come across in my work experience. And what,

yeah, this makes a lot of sense to me. And I can see how this really will work with,

the client groups that you work with.

Doug Smith: But just really quick too, Chris, just to say something. one of the top things I hear when I present, this model at conferences and stuff is people saying what you just said, which is this makes a ton of sense.

And I've never seen anything like this before.

Yeah, it's exciting that we can start to work directly on some of these

Chris Langley: areas.

Definitely Doug.

So what, are the, the client groups that you work with primarily? Or, what are the main client

groups you work

Doug Smith: work

Chris Langley: with.

Doug Smith: Yeah, one of the first, [00:22:00] EABT presentations I did, after the presentation was over, I had a counselor walk up to me and say, "you presented this for substance use disorder, but why is this only related to substance use disorder? Attachment theory is so foundational, it seems like this applies to a large, area of issues." I bring that up because over the last few years, I've really started to realize, even though I created it for this, that it applies to a lot of different areas.

That being said, it's still early in the development, right? So, currently the client groups that we're using it for are, are mostly substance use disorder.

We have an adult curriculum, and we use it with adult, populations with substance use disorder. It's showing a lot of success working with adolescents with substance use disorder. So that's another area, that we work with. I recently have rolled out a [00:23:00] new workbook for LGBTQ+ which is something I'm extremely passionate about.

That's a population that it's working with. And then, I mentioned peer support earlier and the great work peer support is doing. We have a peer support, curriculum that's just in the final stages. I think that should be ready in the next month or so to start to roll out. There's also a parents' curriculum for, parents, who have children that are maybe in adolescent programs or stuff like that, so there's a parenting curriculum that we're working on. And then I also have couples therapists who are using this model to research how it works with couples. To answer your question primarily what you're seeing right now, or what we're seeing is substance use disorder focus, but it's already starting to branch out into these other areas. I also have therapists [00:24:00] using this individually in different areas for things like trauma therapy and things along those lines.

Doug Smith: So I really feel like it's a foundational type of model, and it's going to be able to go in different directions, but currently substance use disorder is the main area that it's rolling out in.

Chris Langley: Excellent stuff. Excellent. Thank you for explaining that to us, Doug.

So what are the, what's the statistical data with EABT groups versus control groups? Can you explain the, statistics around this?

Doug Smith: Yeah. I mentioned earlier that when we rolled EABT out, it was extremely popular, and we were excited about how many patients were drawn to it. What we found, is over a 12 month period, we had a total of over 700 patients that we did a pilot study around, and some of them would choose the EABT group to go into and some of them would choose the [00:25:00] other evidence based practice models, which would be CBT, DBT, 12 step facilitation, things along those lines. And what we found over that 12 month period is that the EABT, patients had an 11 percent higher rate of completing their treatment experience than the averages of the other evidence based practice models. So that was extremely exciting. We also found, that, 13% more EABT patients transition to the next level of care than the other evidence based practice models.

So when it comes to treatment episodes, the most important things is that they stay there and that they complete their treatment. And that they, move on to the next level of care and that they follow through with continuing to work on this after they leave that treatment episode and both of those things showed substantial, significance over, over the other evidence based practice [00:26:00] groups. Atypical discharges is one of, the most difficult things that comes up for clients in treatment experiences and atypical discharges when they leave treatment early and sometimes they call that against clinical advice or against medical advice, but that's one of the number one things that leads to not having a successful outcome for a patient

because as you can imagine, the high majority of the ones who leave treatment early end up using again. We were excited to see over that 12 month period that the atypical discharges with EABT were almost half as many as, the other, evidence based practice models, which is just crazy.

One of the things we found, working with Oregon Research Institute, who is our research partner, that we're working with, is that the levels of engagement and the levels of retention with [00:27:00] this model were very high compared to those other models. I think a lot of it is, first off, creating that safe environment that I talked about beforehand, where the counselor focuses on safety first on everything they do and create an environment that's really safe. It made patients feel safe and welcomed coming into the group, and it made them want to stay in the group and not want to leave, which was great. There's actually a 15% higher length of stay with EABT than the other evidence based practice groups because a lot of the patients wanted to extend and stay longer and do the work, which was extremely exciting. Anyone who's in the treatment field, like I mentioned earlier, the levels of acuity with the patients that we're working with are just constantly increasing, right? When I first got into treatment, or I'm sorry, when I first got into the treatment field 20 years ago, we didn't talk a ton about, [00:28:00] mental health and co-occurring disorders, but now it's the norm that everybody has co-occurring disorders, and you rarely see people that don't. One of the things that was extremely exciting through the pilot data that we looked at with EABT is, the majority of clients today coming into treatment. have some form of trauma in their past, and especially coming out of the pandemic.

The pandemic had so much trauma just worldwide going on for people that, I personally still don't think we've fully seen the ramifications of the pandemic on things like the substance use disorder field. I think it's still coming to pass to some degree. Trauma is something that is constantly impacting the clients that are coming in and working on their substance use disorder, and we've done a good job in the last 10 years of trying to become more trauma informed. I think as mental [00:29:00] health and substance use disorder have combined forces and started working together better over the last, 10 or 15 years, we've become more trauma informed on how we treat our clients and stuff like that.

But with EABT what we found is that clients with a history of trauma had an 18% higher success rate with this model than they did with CBT or DBT, so that's huge. Arguably one of the most high risk populations, in the treatment field is people that are, the ages of 25 and under tend to be really high risk, and EABT showed a 21%higher success rate with people in that age group than, than with the other evidence based practice models, and, like I mentioned, that's led to us doing more work with adolescents, One of the, one of the organizations that I've been working with, [00:30:00] working with adolescents, we had, after a, 10 week period, we had them retake the attachment style quiz, which assesses where their attachment styles are, and all of the people in that group, their insecure attachment styles were coming down and their secure attachments were increasing. When I got the results of it and was looking at the graph and stuff like that it was an emotional thing to see those types of results because that's exactly why I developed this model in the first place. I'll also mention that, this is all pilot data, so there's more research to be done, right?

Oregon Research Institute and myself, are applying through the National Institute of Health for a larger grant to be able to do a five year longitudinal study. We want to work towards this being an evidence based practice, so there's a lot more to [00:31:00] study and a lot more to look at, but for initial results, those are really good. I also wanted to ask Chris, do you mind if I go back and spend just a minute talking about what the primary objectives of EABT?

Chris Langley: Of course,

Doug Smith: and, explain that for people. So with EABT, we have eight primary objectives and the first one is learning about your attachment style.

So we teach everyone who comes into this group about. What the four attachment styles are, and then we have them take the attachment style quiz. Which I referenced just a few minutes ago, and the attachment style quiz lets them know what their different attachment styles are and what their most prominent insecure attachment characteristics are because those types of characteristics can impact us and our stress levels a lot and on a daily basis.

The second, [00:32:00] primary objective is identifying, their core attachment stressors and what we mean by that, I was talking earlier about the three prong effect and wanting to work on. The core issues underneath those behaviors for people, the core attachment stressors when it comes to EABT are partially your environmental factors that have impacted you over the course of your life, and it's also partially how those environmental factors led to unmet needs. So let's say for instance that I grew up in a household with an overly strict, parent in my household, that would be an environmental factor that can affect my attachment styles to some degree, and the research has shown this. That there's certain environmental factors that lead towards certain attachment styles, and so if I had an overly strict, parent, let's say, that environmental factor can lead to unmet needs for me where maybe I don't feel safe, or I don't feel secure, or I don't feel supported or things [00:33:00] like that.

And so what we really work on with EABT is identifying what those environmental factors are that impacted you the most. And what unmet needs correlate with those for you. And as we move forward with the EABT, we really focus on what those unmet needs are and starting to work on meeting those needs for yourself and how to change some of that.

Because what the research has shown is for a lot of people with substance use they're using to get those, unmet needs

met. So if I don't feel connected to people, or if I don't feel safe, I can use drugs and alcohol. People will refer to alcohol as social lubricant at times where it's like, it creates that sort of safety and social situations. A lot of times the reasons people are prone to using drugs and alcohol is to meet those needs and the research has absolutely shown that those insecure attachments [00:34:00] that people develop are strongly correlated with developing substance use disorder down the road. Number three for EABT, we focus on what your attachment stressors or triggers are.

We, have people learn when those buttons get pushed, those old attachment, core attachment stressors get pushed for them. How does that manifest into physical, emotional, and mental symptoms of trigger activation? So we really want them to learn when those buttons get pushed and they go into a cycle, how can they identify that cycle faster when it's coming up for them? What new coping skills can they work on to intervene on that cycle? You know the way a lot of us in substance use, have been coping with it is through the use of drugs and alcohol. We want to teach them new coping skills, and that's taking components of CBT and DBT and bringing it in with this attachment lens.

Even though this model is [00:35:00] designed to have some differences to those, there's also parts of CBT and DBT that we use with this model as well. It's still definitely like an amalgamation of, different things. And then, we want people to look at, how these core attachment stressors affect how they think of themselves, how they think about other people, how they view the world, all those negative core beliefs that come from those core attachment issues.

We want them to learn about those and begin to work on that. We want to look, we want them to really look at how this is an intergenerational thing, and we do exercises where you look at what were your parents' attachment styles or your caregivers' attachment styles. For some of us it may not be parents, it may be step-parents or grandparents or things like that really had an impact on us when we were children. But what were their attachment styles, and how does that lead to what our attachment styles are? How does it lead to our choice and partners and what their attachment styles are?

So we want people to [00:36:00] see like the wider context and how this is a cycular type of thing. That for them to be able to work on and it's actually been really neat. One of the concerns I had chris when I developed this model was that if we're focusing on environmental factors from the past that it could lead people with substance use disorder to just like blaming their parents for all their problems. And it actually hasn't worked out that way. What we've found with people is by learning how this is a cycle that's passed down from generation to generation. It actually gives them more empathy for the fact that their parents inherited this from the generation before them, and so it tends to lead to more empathy around the people in that cycle with them and more motivation to wanting to be one of the people that's breaking that cycle for the next generation.

So that part's been extremely cool. And then the last two primary objectives with the EABT, as I mentioned before, we do all this focus [00:37:00] on insecure attachments and how they impact us in different ways. But we want to increase the levels of secure attachment as well. That's extremely important. So we do a lot of different exercises focused specifically on secure attachment, and how we can increase that. Anytime with substance use disorder, relapse prevention is an extremely important focus.

We do a lot of relapse, cycle exercises through the attachment lens and through EABT to look at your attachment relapse cycle. And how to intervene on that if it comes up. So I appreciate you let me

go back and go over a

Chris Langley: couple of things.

I appreciate you explaining that to me because that's incredibly remarkable. It really is. And I'm learning so much from this already,

Doug. So thank you very much indeed.

Tell us about the group training that you offer and how this is accessed.

Doug Smith: Yeah. what I'm doing currently, and once again, this model is still building and growing as we speak,

what I'm doing currently [00:38:00] is people that are interested in, bringing this model to their organization, I provide a certification training. That group training is two days and it's 16 hours long. It's certified by, NAADAC, or it's accredited by NAADAC. So anywhere in the nation, I can go and provide this training and, provide CEUs to all the people who participate in it, but it's 16 hours long. In that group training, I've. being in clinical leadership roles. I've done a lot of trainings with clinicians and people coming into the field and all sorts of stuff. And one of the main things I've learned from training experience is that the best way people learn is experiential. It's not by just listening to me for 16 hours.

No one wants to listen to me for 16 hours,

Chris Langley: I don't know.

Doug Smith: But it's the way they're going to learn the best is by practicing

some of this stuff. So I [00:39:00] really set up the group training where there's a short introduction process where I go over what EABT is and all that for the first hour or so. But then the rest of it is the clinicians completing the exercises that the clients actually do and practicing what it feels like to do that work and present that work to somebody and pair up with other clinicians in the training and take turns presenting it to each other. So they're each getting practice on what it feels like to be in the client's shoes, and they're each getting practice on what it feels like to be the clinician walking that person through that.

And then we also do group practice in the training as well so that you're getting practice on what does it feel like when you're running a group process and somebody is presenting one of these exercises. I definitely believe doing a lot of that experiential stuff is really important to be able to, learn this stuff. And the [00:40:00] really cool thing, every training I do, I, start off talking about the three primary objectives of the training, which in a nutshell is, learn EABT, learn what the client experiences, and learn how to counsel, somebody through it. But I always tell every training there's a bonus fourth objective that I hope that most trainings will receive, and that is by doing this two day training and actually working on these exercises together and doing some personal work and sharing it with your co-workers, you actually tend to see these teams get more connected and close, which is super cool, especially coming out of the pandemic.

I think all of us, felt our teams being impacted over the course of the pandemic. So having a training that not only teaches this new model, but increases the connections between, your team as well, is really cool. And, for people that are interested in, learning more about the [00:41:00] training, they can go to my, my website, which is www.learneabt.com. They also can reach out and contact me at my email address doug@innovativerealities.org. yeah, and, hopefully we'll include, some of those links, with us.

Chris Langley: We'll have all the links below this video. Don't worry about that.

No problem at all.

Doug, you were featured in the United States largest association for addiction treatment professionals, NAADAC,

for their national webinar series.

Can you tell our audience about this and where they can find this presentation?

Doug Smith: Yeah, first off, when I got the email from NAADAC that I'd been selected to present, it was like Christmas morning for me. You know, I think I must have acted like a little kid. I called my wife right away. I was so excited because you know, the first year or so a lot of my presentations, you know living in Oregon, I was focused on this region and going around and you know talking to [00:42:00] organizations or going to conferences here in the state of Oregon, a little bit in the northwest in general. But that was like my first opportunity to start to take this more to a national stage, which was extremely exciting.

And I was so honored that an organization as prestigious as NAADAC, chose to have me present. The day before when I was meeting with them, and they told me how many people were signed up, and how many people were attending the presentation and stuff, it was well over a thousand, and it was it was pretty exciting. You know I gotta say I'm glad I was doing it over the computer and not in person because I don't know how I would have responded to talking to that many people in one room at one time, But it was nice over Zoom. I could just zone in on my presentation and forget that there was all these people watching it, but it was such an exciting opportunity and being able to talk to people [00:43:00] all present to people all around the nation. Then when I got done with the presentation, my email box just started to blow up, where all these people are reaching out to me from different states. It definitely was a pivotal moment in the development of this model, where it felt like it took it to the next level. That's when I decided, to make, the continued development and implementation of this model nationwide, a hundred percent of my focus. the organization I was with was extremely supportive of,

Chris Langley: can imagine.

Doug Smith: me in, going and, focusing on that. yeah, so I left an organization I'd been with for 20 years and went off on my own and started doing this which is super exciting. To anyone who's interested in seeing that NAADAC presentation, if you go to NAADAC's webinar, [00:44:00] page www.naadac.org/innovative-behavioral-health-treatment-webinar but if you look up, NAADAC webinars online, it'll pop up and, emotional attachment behavioral therapy is on there. And, that was, gosh, must have been six months ago or something like that. And, I still am having people reach out

to me every week who are, watching that webinar, so

yeah, it's been really exciting and I hope to continue to present for NAADAC

Chris Langley: I'm sure.

I'm sure that's real recognition of the great work that you're doing, Doug. And it's, It's very inspiring. And as I said, I'm, learning so much

just from this hour that we're spending together. And it's very, this is so exciting for me as well to hear how things are progressed.

And we've got such great people doing the work that, that you're doing as well. This is, amazing stuff. So

thank you very much indeed.

Last couple of questions, Doug,

For anyone looking for help for their addiction or mental health.

and is interested in contacting you, how can they get in touch with you?

Doug Smith: Yeah, first [00:45:00] off, if you go to my, my website, it's got a contact, page, that, you can, that goes straight to my email. And so the website once again is www.learneabt.com/contact-us. The other thing I'll mention really quick is, I talk about the attachment styles and the attachment style quiz on our website.

Any of you can take the attachment style quiz on the website. So if you want to learn what your attachment styles are and what characteristics you know would be good for you to continue to work on or whatever yeah go on there and try it out. It's pretty fun getting to check it out and see what your attachment style is, and then another way to contact me directly is through my email address which the name of my organization is Innovative Realities. And so my email address is doug@innovativerealities.org. Contact me either way, and I am always open to [00:46:00] spending time, talking with people, to get the word out more about this model.

Chris Langley: Fabulous. Thank you very much indeed for that, Doug.

Last question.

Have you a message for anyone suffering from an addiction or mental health issue that you'd like to

say?

Doug Smith: Yeah, that's interesting. Part of that encompasses, my experiences, in recovery myself and also part of it encompasses how I've seen things change. Over the last, 20 plus years, that I've been involved in this stuff. So I guess the first message I would give to people is that you're not alone.

you know as I mentioned before when I was towards the end, of my substance use disorder and hitting rock bottom, my world was getting smaller and smaller. And the smaller your world gets, the more you feel like you're all on your own, and nobody will help you or nobody wants to help you and nobody can help you or whatever. And I guess I would, I [00:47:00] just want people to know that you're, not alone. There's a lot of people out there that can relate to what you're going through and there's a lot of, of different opportunities, for you to get help. The other thing I would mention is that, message I would have is you're not a bad person.

The number one thing I see people have difficulty with when they're trying to get into recovery is the shame that comes from everything that they went through while they were in their substance use disorder. I definitely had a lot of shame around some of the things that I had done, and in my substance use disorder.

I think it's really important that, people learn as quickly as possible that, they're not a bad person. This isn't t a measurement of moral character or anything like that. You're [00:48:00] a person with a disease who needs help, and I'll say this too, Chris, and i don't know if you can relate, but you know over the course of my recovery over the last 20 years some of the absolute best people I've ever met in my life are recovery and substance use disorder, individuals. There's just something about somebody who pulls themselves up from the bottom and builds their life back up

Doug Smith: that,

It's just, it takes so much fortitude, and I have so much respect for, for the people who accomplish that.

And I think, I think there's something about going through all these experiences that if you can come out the other side and start to work on it, you'll realize that, you're an amazing person and you can accomplish anything you want.

And then the last message I would give is just that there's a lot of paths to recovery.

I think, and this goes to what I was talking about [00:49:00] before. I think one of the mistakes that happens in our field at times is people will give newcomers the message that there's only one way to get out of this and that you know if you want to if you want recovery you've got to do a b and c and the reality is more and more we're realizing in this field that first off what is recovery? Recovery can be defined a lot of different ways for individuals.

What recovery might mean for me might be different than what recovery might mean for you

and so there's a lot of different definitions of recovery and there's a lot of different ways to to access recovery

There's a lot of different tools at your disposal and and professionals that go, that use different models and different directions.

I would just encourage everybody to know that there's, a lot of different paths for you.

Chris Langley: Thank you very much indeed for that, Doug. And thank you for everything you're [00:50:00] doing for people

experiencing trauma and addiction. And this has been a really interesting hour. And I'm sure the people listening to this have learned an awful lot.

This is something very new.

And I love it. I'm a big fan.

I'm a big fan. and I'm truly honored that you came onto the podcast today

to speak to me and thank you for everything you're doing. And, maybe we can have you go on again in, six months or a year to see how this is developing. Cause it seems that this is going to be going and going for a

very long time. I'm really excited to hear the journey. So

thank you very much indeed,

Doug.

Doug Smith: Chris, do you mind if I mention one last

Chris Langley: do.

Doug Smith: I guess the last thing I would like to mention is I take a lot of pride in the fact that, as I was developing this model, one of my biggest insecurities that came up is because, I only have a bachelor's degree, but I've got 20 years of experience working on the front lines in this field. I would feel at times like I didn't have the right to [00:51:00] innovate new things that was for, PhDs and people with a lot more letters after their name than me, and granted, I'm partnered with a lot of those types of individuals, and they do amazing work. But I guess I really would like to also just get that message out that we need more frontline workers who've got years of experience knowing what it feels like to work with with clients struggling with this to innovate new things and create new things.

I feel like at times all of that innovation comes from people who, who may not have that same level of experience. And I really hope that, if I could ever do be any type of a support, if you're out there and listening to this podcast and you've got innovative ideas, and you want somebody to be the wind in your sails and give you some support along the process because I'll tell you even though this idea is great and it's really [00:52:00] blossomed and I'm excited about it, it would not have happened if I didn't have the level of support around me. Innovative ideas, crash and burn if there's not a group of people supporting them, and if I could be support for anybody out there with innovative Ideas who's been a frontline worker? I would love to be a part of helping with that.

So I just wanted to share that message as well.

Chris Langley: I can't think of any better way of finishing this conversation. And thank you very much indeed for your time today. I really, appreciate it. And as I said, we'll

love to have you back on again in the next six months or a year to hear where this is going. It's really exciting stuff. So thank you very much indeed, Doug.

Much appreciated.

Doug Smith: That sounds great. Thank you Chris

Do, do, do, do, do.