All Things Substance Podcast
Treatment & Recovery Episodes
The Skill to Help You Thrive Instead of Burning Out
Episode 142 Learn how to THRIVE while treating trauma & substance use! Tired of feeling limited in your practice? We've got you covered! Hi, we’re Betsy Byler and Jenny Hughes and between us, we have 30+ years of treating trauma and substance use under our belts!...
The Intersection of Trauma and Substance Use
Episode 141 Want to treat trauma and substance use with confidence? We've got you covered! Hi, we’re Betsy Byler and Jenny Hughes and between us, we have 30+ years of treating trauma and substance use under our belts! Today we’re joining together in this episode to...
Gambling Addiction Treatment
Episode #140 Gambling addiction treatment and the gambler brings to mind a certain image for many of us. We might think of a man looking downcast with his hand on his head and a drink in front of him. Some might think of someone spending hours in front of a slot...
You don’t want to miss this…
Episode 132 Normally, when I make an announcement it’s a brief thing. Perhaps a few sentences and then we move onto the main topic. However, today is a little different. My announcement needed some more context, so today’s episode is going to do just that. When I...
The Power of Secondary Gain
Episode #138 Secondary gain is a powerful thing. It impacts behavior in ways that we wouldn’t think of, but when it comes to substance use it’s an important factor in making long lasting change. Behavior is so complex sometimes. So often people want to stop a behavior...
Re-post Why Readiness to Change May Be the Biggest Factor
Episode #137 (Repost of Episode 109) People change because they want to or because they have to. When neither of those things are true, change isn’t going to happen. When clients come to us, we have to focus on what they bring to the table. If they come to change a...
Re-post Harm Reduction and Abstinence
Episode 136* Repost of Episode 12 What does abstinence mean in the context of addiction? What is the difference between harm reduction model and abstinence? Is the harm reduction model and abstinence mutually exclusive? In the addiction treatment world, abstinence and...
Is Willpower Enough?
Episode #134 Just say no. You should just quit. So and so just stopped doing it, so can you. Some people believe that willpower should be all someone needs to overcome addiction. Willpower is a part of how people make change and make new habits. But willpower isn’t...
Psychiatrists and Therapists
Episode #133 Therapists and psychiatrists want the same thing: for our clients to be well. We don’t always get the chance to work together. I wanted to see what we could do to bridge the gap between us. I interviewed a psychiatrist friend of mine, Dr. Jess...
You’re Invited! Doors open to my new substance use training program for therapists
Episode 132 Normally, when I make an announcement it’s a brief thing. Perhaps a few sentences and then we move onto the main topic. However, today is a little different. My announcement needed some more context, so today’s episode is going to do just that. When I...
Liability and Risk When Treating Substance Use
Episode #131 People are complicated creatures. We work with people when they are confused, hurting, anxious or generally distraught. Sometimes that can impact our work with people and how they feel about us and their lives. We mean well and we work hard to give people...
You Can Work With Substance Use! Let’s Look at What Substance Use Treatment Entails
Episode #129 I’ve been suggesting that regular mental health therapists can work with substance use. But what does that mean? Doesn’t treatment have to be some specific techniques, length of time and process? What is treatment really like? Substance use treatment is...
Recovery: Process of Change
Episode #127 What is recovery? People talk about recovery with a capital “R”. But what does it mean? Is it something that happens over time? Is it possible to finish recovery? Recovery really is, at its core, the process of change. It is a living and active process...
Triggers and Cravings
Episode #125 Triggers and cravings are a huge key to what helps addiction develop. It makes sense then that recovery is going to need solid ways to manage triggers and cravings. Triggers aren’t something we control. They are developed when we pair reinforcement with a...
What 20 Years Has Taught Me
Episode #124 Adding substance use to your scope of practice means that you will want to have a source for good information. How do you know who to trust? Why am I the right person for you to talk with and listen to? Over the last 20 years of my career, I have been...
A Snapshot of the 12 Steps and 12 Traditions of AA
Episode #123 The 12 Steps of Alcoholics Anonymous have brought many into recovery and saved lives all over the world. Most people know that there are 12 Steps, but they don’t know what the Steps are and most haven’t heard of the 12 Traditions. Today we’ll be covering...
What’s a Recovery Meeting Like?
Episode #122 Recovery meetings can be a giant help to people as they move through recovery from all kinds of things. If you’ve never been it can be hard to know what happens at a meeting and to know how your clients would benefit from attending recovery meetings....
Sex and Recovery
Episode #120 Sex is a vital part of who we are as humans. It’s a way to connect with others. A way to have pleasure. Research tells us that sex is super beneficial for our health and well-being. Experiences vary wildly depending on the people and the circumstances....
Addiction Myth: People Have to Hit Rock Bottom to Get Sober
Episode #117 People have to hit rock bottom before they can get sober. It’s a really good thing that this isn’t true. If people had to find the very bottom before they could get clean, there would be so much more misery. People get sober at all different times of...
Substance Use Decision Tree-Explained
Episode #116 Sometimes we have to make decisions pretty quickly. I remember being floored when I was out of school and had to diagnose in the first session. I had held onto charts because I wasn’t ready to do the diagnosis. I got in “trouble” with the three support...
Why Readiness to Change May Be the Biggest Factor
Episode #109 People change because they want to or because they have to. When neither of those things are true, change isn’t going to happen. When clients come to us, we have to focus on what they bring to the table. If they come to change a particular behavior, then...
When is Outpatient Therapy the Right Fit?
Episode #108 When therapists think about working with substance use, they may envision a meth addict or a heroin addict. They worry that someone will overdose and die. They are concerned that the person’s use will be more than they can handle. The great news is that...
Eat, Drink and Be Merry: Holiday Skills
Episode #106 Substance use is our problem. By “our” I mean mental health therapists. The subfield of substance use isn't big enough to be its own thing. It's just a further specialty. Like other specialties such as eating disorders, sex therapy, OCD treatment, trauma...
Charting the Course is Here!
Episode 105 This is the program you need in order to feel competent and confident in addressing your clients’ use of alcohol and drugs. You don’t need to go back to school or refer out. The majority of clients who are using substances problematically don’t meet the...
You Don’t Need Personal Experience to Work With Substance Use
Episode 103 One of the things that gets in the way of a therapist deciding to step into substance use work is this belief that if they aren’t in recovery, then they aren’t going to be able to work with this population. As therapists, the imposter syndrome can be all...
Substance Use and Mental Health Are Under the Same Umbrella
Episode 102 Substance use is our problem. By “our” I mean mental health therapists. The subfield of substance use isn't big enough to be its own thing. It's just a further specialty. Like other specialties such as eating disorders, sex therapy, OCD treatment, trauma...
Stop Referring Out: You Can Work With Substance Use Clients In-House
Episode 101 I remember hearing the advice “refer out” in my early career. It was usually around substance use or personality disorders. I remember feeling like there must be a piece I was missing. Why were these seasoned therapists saying to refer out? If they don’t...
You Don’t Need to Get Certified or Specialize to do Substance Use Work!
Episode 100 I’m so excited to talk about today’s topic because I think it's one of the main things that pop up when we think about adding substance use to things we are willing to work with. The question that comes to mind is some form of “Are we allowed to work with...
Recreational or Problematic? Signs that Use May be Moving from One to the Other
Episode 99 We don’t want to be wrong about what’s impacting our clients. We try really hard to assess what is happening in a client’s life that is getting in the way of their success. We ask all sorts of questions, compare it against all the information in our heads...
The Reason That Gets a Client Sober, Won’t Be Enough to Keep Them Sober
Episode 97 Love of others, the law, nor the hope of a good future are enough to keep someone sober long term. Great way to start us off right? I know it sounds like a real downer, but I promise if you stick around it’ll get better. People start working on reducing...
Where do Mental Health Therapists Fit Into Substance Use Recovery?
Episode 95 Substance use treatment isn’t just about dealing with the substance. That would be like treating a cavity but not dealing with underlying disease. People in long-term recovery know that their mental health is a vital part of their recovery and needs to be...
Addiction Myth 2: People Choose their Substance Over their Love Ones
Episode 94 We have witnessed the impact of substance use on the loved ones of the person who is using. It can feel like the person who is using substances is either oblivious to the pain they cause or at worst, that they don't care about hurting their friends and...
How to Repackage Your DBT Skills to Work with Substance Use
Episode 92 Therapists love tools. We love learning new ways to help our clients live more skillfully and have more ability to manage their symptoms. There is no shortage of tools either. We can choose from a multitude of modalities from every kind of theoretical...
Understanding Client Choices: Why People Choose a Certain Substance
Episode 91 Client’s use lots of different things to cope with life. Sometimes those things are good and some things aren’t as adaptive. When people are using drugs or alcohol to cope with life or mental health issues, it gets in the way of the work we are doing with...
Addiction Myth: You Can’t Force People to Go to Treatment or it Won’t Work
Episode 90 It’s a common thing people say about addiction: You can’t force someone to go to treatment. Well, sometimes adults can get forced to go to treatment. Sometimes as therapists we get clients who are mandated to see us. For a lot of therapists that feels bad...
Treating Chronic Pain
Episode 88 Treating chronic pain is difficult on a good day. After the over-prescribing of opiates in the 90’s and early 2000’s, it's become more challenging. Opiates used to be the treatment of choice, but the medical community has more research and information that...
Helping An Addicted Loved One
Episode 82 Helping an addicted loved one can be really difficult. What should a person do? What shouldn’t they do? I had an opportunity to talk with Dr. Kate Watson of the podcast Only Trying to Help about this very thing. This is our second podcast together and for...
Good Therapy-Protecting the Therapy Hour
Episode 81 Good therapy depends on both us and our clients. We need to show up ready to work, but our clients need to show up ready also. Substance use can get in the way. There are two ways that substance use interferes with our work. One is when a client’s brain and...
Shame and Addiction
Episode 77 Shame and addiction cannot be separated. The deeper someone goes into their addiction, the more things happen that they want to keep hidden. So many things are “normal” when a person is stuck in active addiction. Things that “normal” people who shake their...
Client Responses That Impact Assessment
Episode 73 We can ask all the perfect questions, but sometimes a client’s answers aren’t as clear as we’d hoped. There are lots of reasons for why a client might not want to share about their use of substances. Today we’ll discuss the most common responses and how to...
Medication Assisted Treatment Explained
Episode 25 What treatment options are there for opiate addiction? What is medication assisted treatment? What’s the difference between agonist, partial-agonist and antagonist options? What is the therapist role in treating opiate addiction? The opiate epidemic is all...
A Recovering Opiate Addict’s Perspective
Episode 24 How does opiate addiction start? What does progression look like in opiate addiction? What keeps people stuck in a cycle of opiate addiction The opiate epidemic is all around us. We hear about the deaths and the dangers. Most of us know a bit about it, but...
The Harm Reduction Model and Abstinence
Episode 12 What does abstinence mean in the context of addiction? What is the difference between harm reduction model and abstinence? Is the harm reduction model and abstinence mutually exclusive? In the addiction treatment world, abstinence and harm reduction can...
Effects of Substance Abuse-Progression
Episode 11 What are effects of substance abuse? What does progression mean when talking about addiction? How does progression relate to the DSM criteria? What addiction criteria shows up most often? Progression is the key to addiction. It’s not about choice or...
Addiction: Stages of Addiction and Use
Episode 10 What stages of addiction and use are there? How do I know which level of use my client is in? Do people bounce around in use stages or move in a linear fashion? Stages of use are helpful in assessing your client’s use and determining when you should be...
Addiction: Protective Factors
Episode 9 What reduces the risk of addiction? Will changing environmental factors help or is it just up to genetics? Is prevention only for kids? This episode looks at the protective factors for addiction. Genetics isn’t the only factor and much can be done to help...