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What's the Missing Piece in Addiction Treatment? (Video)

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missing piece in addiction treatment

What happens when your addiction rehab just doesn't work?

“I [did both] a 12 step program and an aversion therapy program. Both, ultimately did not work for me …. It seemed like the most important thing to them was if your insurance covered you and your check would clear.”

Those words are from “J”, one of our past program participants. Sadly, J’s experience is typical for our participants. Most of them have been through one or more addiction recovery program before they arrive at our door. Every day, we hear stories of other programs that cared more about padding their pocketbooks than facilitating real healing.

It’s our belief that people struggling with addiction deserve compassionate, empowering help and respect. In the short video below our team member Caroline McGraw addresses the following topics:

  • What’s missing from most addiction recovery programs today
  • Why the traditional rehab success rate is so low
  • What dual diagnosis is, and why it matters in developing a treatment plan
  • How to integrate all four levels of self in a holistic recovery protocol
  • What to avoid and what to look for in a drug rehab program

Press play for a crash-course in what works and what doesn’t in rehab and recovery!


 The Missing Piece in Addiction Treatment

Here's a four-word spoiler alert: healing underlying core issues. That is the missing piece in modern addiction treatment.

What do we mean by healing underlying core issues?

We mean the reasons that people use drugs in the first place, the root causes, the bigger why, the reason behind the behavior.

Often addiction is actually what psychologists call a designated issue. That's a psychological term for a problem that covers up the real problem.

Doctor Martha Beck describes it this way:

"A designated issue dominates our psyche so that other troubles can go unnoticed."

That's pretty powerful. Addiction is a way that we turn our attention from our underlying core issues.

It might not start out that way, at least not consciously. People aren't thinking, "Hey, let me create this huge life-altering, awful problem for myself so I don't have to deal with my other problems."

No, we don't think like that. Normally we're thinking, "I feel awful. I feel like crap. I want to stop feeling awful for a little while."

That's how people get into addictive behavior.

They want to feel better or they want to feel less bad, and they want to avoid.

They want a buffer. They want to take a break from carrying around all the mental and emotional pain. That's very human, and that's nothing to be ashamed of.

How Traditional 12 Step Programs Fall Short

However, we also recognize that current addiction treatment paradigm often doesn't serve people very well. The current norm is to do the 12 Step program model or to do 12 Step groups.

Now, first let me say this really does work for a good many people. Many, many people have been helped by embracing 12Step programs, and that's great.

However, Harvard researcher Dr. Lance Dodes estimates that the actual AA rehab success rate is between 5 and 10%.

That means that for the other 90 to 95% of people there is a real need for a different treatment approach.

More specifically, there's a need for a treatment approach that addresses psychological conditions such as depression, anxiety, and trauma, also known as those underlying core issues we were just talking about.

Dual Diagnosis Treatment

We now know that most people who have addictions have what's called a dual diagnosis, which means that they have a substance abuse problem on the one hand, but they also have a mental health condition.


One in seven people in the US have some kind of substance abuse issue.

That is a lot of people, and the majority of them have a dual diagnosis. You can really see how the traditional 12 Step program model has left many people without success by focusing only on physical-level changes.

There are also addiction treatment programs that just look at behavior modification or aversion therapy. This is also just work on this physical level.

But in our experience, if you don't address the mental health issues that go hand in hand with addiction, then of course people aren't going to heal. They're not going to get better.

Why Holistic Addiction Treatment Works

It's encouraging to see more and more rehabs integrating mental level work into their addiction treatment programs. They're using proven psychological techniques such as cognitive behavioral therapy, CBT, mindfulness, all of these wonderful things.

This is really important because it teaches people to question their judgments and to question their limiting beliefs, and to work with some of the thoughts that are generating the anxiety or the depression. That's great.

However, human beings actually function on four levels of self. We have …  

  • The physical level, which is what we do
  • The mental level, which is what we think and what we believe
  • The emotional level, which is what we feel
  • The spiritual or the authentic self level, which is who we truly are.


You don't have to use the word spiritual if you don't want to, but the authentic self level is the part of you that goes beyond your mind and your emotions.

We have these four levels, and here again you can see the problem. If you have a program that's only focused on the physical level changes or just the physical and the mental level, you're missing two other levels of self.

From our experience, what we find is the most lacking is the emotional level support. You have a program like AA, they do operate on the spiritual level, but the emotional level support might be missing. You need to address all four levels for truly effective holistic addiction treatment.

There's a reason why a lot of programs lack significant emotional level support. Actually, there are four reasons, and I'll share them with you right now.

Why Most Rehabs Don’t Provide True Holistic Addiction Treatment

  1. Lack of well-trained and compassionate counselors.
    There are a lack of people who really understand how to do deep emotional work. Of the people who do understand and have been trained to do it, the demand far exceeds the supply of counselors that we have available. This is a good problem in the sense that we need more people to be able to do this work, but it's really challenging for the one in seven people, for the millions of Americans who need this kind of support. And we don't have sufficient trained providers to offer it.

  2. Real substantial emotional level work is time-consuming and expensive.
    Quality care requires means you're paying professionals to use their skills and to provide that support. A lot of drug rehabs will just do the state-mandated minimum number of counseling hours. That varies state to state. Depending on where you live, your state might only require an inpatient rehab program to provide maybe one or two hours of individualized counseling a week. That is not enough to deal with a serious addiction issue and a serious dual diagnosis issue.

  3. Non-supportive and chaotic environments.
    In most inpatient rehab programs, you have people coming and going constantly, people entering and exiting the program. You have court-mandated rehab. You have people who don't want to be there and who are being forced to be there instead of going to jail. That's not really an environment where you can relax or feel very vulnerable or ready to open your heart in an emotional level way.

  4. It requires very real willingness on the part of the participant.
    Emotional-level therapy is not something where you can just sit back in your chair and cross your arms and be like, "Yeah, whatever. I'm just listening to a lecture." No, emotional level work really requires that you participate and you be active and you engage with your own recovery.

What to Look For In a Non-12 Step Program

On the bright side, here are some things to look for if you personally are looking for an non 12 Step program.

First, look for a program that works on all four levels of self:

  • Physical - what you do;
  • Mental - what you think;
  • Emotional - what you feel; and
  • Spiritual - who you truly are

Ask what particular counseling strategies the program uses and research the efficacy of those strategies.

A lot of times you'll see websites that are very shiny and they look great, but they don't actually tell you what treatment modality is used. Make sure you get that clarified right up front.

Also look for a program that provides a safe space free of judgment and shame and guilt, and that encourages people to share with honesty and with vulnerability.

When I say safe space, I don't mean it has to be a luxury hotel. I do mean it needs to be a place where your privacy is protected, where you feel physically secure, and where your basic needs are met and honored.

You also want to look for a program that teaches you self-counseling strategies so that when you leave after 28 days or 30 days or more, then you are able to go home and take those strategies out into the real world and use them.

You want to be able to be your own best counselor and your own best advocate once you've gone through the program.

Of course, in our program we offer all of these things, and we invite you to check us out at theclearingnw.com. But, that said, we know that we're not a perfect fit for everybody.

Of course you're more than welcome to reach out to us for confidential calls at (425) 275-8600.

Ultimate Guide for Selecting the Right Addiction Rehab

Learn more by downloading our free guide to help you navigate the process of selecting the right addiction treatment program.



Caroline McGraw

This post was written by Caroline McGraw

In addition to her work as "the voice of The Clearing", Caroline Garnet McGraw writes about trading perfectionism for possibility at A Wish Come Clear. Visit and receive your free Perfectionist Recovery Toolkit today!

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