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Addiction Treatment – Focus on the Wealthy

September 10, 2017 by Tailored Transitions  — Leave a comment


Let me start by stating that there is a tremendous problem with the lack of treatment options for the everyday person battling substance use and related addictive disorders. The average person suffering from addiction is either without insurance all together or they do not have the means to obtain an adequate insurance plan to cover the tremendous costs of a quality treatment facility.  It seems that quality professional care is reserved for those with financial means. In some cases, the individual’s loved ones are left covering the bill to send someone to rehab in attempts at saving their life. In the process, we see families over-extending themselves only to see the still suffering addict return to the same destructive illness. It is a problem. It is a problem. It is a problem. A problem macro level problem for another blog.

People see advertising for luxury rehab facilities that boast about their resort like facilities on beach front property and they get upset. Understandably so, as it seems everyone is susceptible to addiction, but only the elite class can afford to recover with the highest level of care. However, it is this author’s opinion that there is a lack of adequate treatment for the wealthy. Yes, we really need to focus on the affluent population struggling with addiction!

Recently, in a thread on Facebook I read a comment from an angry licensed master’s level clinician regarding the quality of services provided in some of some of luxury rehab facilities. The woman was employed at one such treatment facility and was expressing her concerns regarding the clients’ lack of accountability within the rehab, as clients were not required to make their beds, and would sometimes leave sessions to get pedicures or massages. She stated, “Treatment programs have to teach accountability…how can you learn accountability when you don’t have to make your F’ing bed!” And this author agrees wholeheartedly. Accountability is a necessary component in the process of recovery. Most clinicians working in treatment and individuals in recovery would likely agree.

The concern with accountability leads to many questions with the current treatment model within these plush rehab-resorts. If clients are lacking accountability with daily activities then how can they be accountable when it comes to more serious behaviors? Unfortunately, they can’t and they usually don’t. One might argue that these facilities don’t want the clients to succeed as the revolving door might create a steadier revenue stream. This author advocates for a more person-in-environment (PIE), live-in approach which teaches the everyday application of interventions.

“Hedonism should be replaced with altruism.”

Accountability, aside there are other serious core principles that are lacking with treatment models aimed at serving the elite class. At the heart of addiction, we see some common denominators such as: selfishness, self-centered, self-seeking, egocentric, and the constant longing for MORE.  Many believe that the substances are merely just a symptom of much larger ailment. Many in the recovery community feel as though selfless services is a key component to the process of recovery. Those that grapple with addiction are very much aware of the hedonistic lifestyle that leads to a constant yearning for more. Those that have recovered understand that part of the process to healing involves not only arresting the desire to take more, but the need to replace that with the desire to give more. Hedonism should be replaced with altruism.

If addiction is rooted in the greed, hedonism and selfishness, then we must examine ALL the ways in which a client is being influenced by these factors. Looking at it through this lens we can easily see that addiction bleeds over into another important area within this population. Money. With 1 % controlling 99% of the wealth, we see how greed, hedonism and selfishness are afoot. This population will never truly recover until they are taught that taking more will never fulfill that emptiness within. You cannot fill that void with money, power, drugs, sex, gambling, houses, fame, etc. You can try to supplement one for the other, but the end result is the same. You can leave the resort like facility with a fine pedicure, and go home to your mansion on top of the hill, but you will never fully recover from this disease until you discover the power of giving back.

This disease of addiction knows no boundaries. It cares not about ethnicity, gender, sexual identity, or socio-economic class. It runs through affluent communities and poverty-stricken ones alike. And when we examine the disease of addiction it may serve us well to think of it as anything that places us in a state of dis-ease.  This disease is not rooted in drug use alone. It wears many faces and infiltrates with no regard. It even impacts those operating the luxury treatment facilities. Yes, I’m speaking to those profiting off the $35 billion industry. You are taking money from a vulnerable population and you have an ethical responsibility to provide the highest level of services and assist people obtain the tools to sustain recovery. To profit off the sick and not give back to the needy puts you in the same greedy class as those you are serving, as you too, are focused on MORE. Teach your clients to give back to the community at large by setting an example through sponsoring those less privileged. Give back!

There are many biopsychosocial factors that contribute to the causes of addiction that can’t be covered in one blog. There are micro, mezzo and macro level systems at play. There are attachment issues that lead to a disconnect. To recover from this epidemic, we need to do this together. We need to be connected and attached to each other. We need to give more and remain altruistic. It helps us individually and collectively. It’s fine to offer services to the affluent, In fact, there’s a need for it. However, we need a shift in the model of recovery targeting that population. It should, if done correctly, serve the population at large.
Robert Freitas, MSW is the founder & CEO of Tailored Transitions and a therapist registered with the California Board of Behavioral Sciences. He is graduate from the University of Southern California (USC) and holds a Master’s in Social Work with a concentration in mental health. Robert is a passionate member of the recovery community who is dedicated to supporting those struggling with addiction and co-occurring disorders through an integrated approach. He is leading the paradigm shift in treatment through his clinical coaching model which combines recovery coaching with therapeutic modalities.

Weathering the Storms in Recovery


Imagine the surface of the ocean during a storm with strong gusting winds, rain pouring down, giant waves crashing, flashes of lightening, and deafening thunder. Sometimes that is like the surface of our lives. It’s chaotic, loud, and overwhelming. Now imagine for a minute that same ocean 30 to 40 feet below the surface -it’s calmness, stillness and silence. Sometimes we must drop below the surface of our lives, go inside, and find that peaceful place where our spirits reside. We hold ourselves gently like we might hold an infant. We ride the in breath and out breath with moment-to-moment awareness. We remember that we are exactly where we are supposed to be in this moment, and each moment to come. We accept this moment as if we hand selected it. We drop into acceptance. We give ourselves a break. We do not go within to check-out from reality, but rather, to check-in with ourselves. We stay there as long as it takes, or until we are ready to return to the surface, and ride the waves of our lives. The waves rise and fall, like our thoughts. A thought comes, we recognize its’ presence, and then it slowly subsides. We cannot stop the wave, nor can we hold onto it. We simply ride the waves of emotions as we weather the storm.

Stop and remember the worst storm of your life. Re-visit that time when you felt as though you were drowning in emotions, pain, and despair. Allow yourself to feel that again for a few moment. Now drop back into the present moment,…and be grateful you are no longer there. If you are not currently weathering a storm be grateful, but remember others around you may be struggling to keep their head above water. Reach out to them.

The storms of our lives inevitably come, as surely as the seasons will change in our lives. We cannot stop the storms, nor should we try. There is always a way to weather the storms of our lives, just as we endure the passing of a loved one, a broken heart, an episode of depression, or the despair of addiction. The grief, sadness, trauma, anxiety and depression can be likened to the conditions of the storm. The storms are of our lives sometimes feel as though they are going to kill us….and for some they do. That’s why it is important we do not weather the storm alone. If you or a loved one is struggling to weather a personal storm please remember that help is available. We’ll go to them, and stay with them until they are ready to return to the surface of their lives and back into your arms.

A Tailored Transitions, LLC Production

Becoming a Macoholic – Benefits of Malamute Therapy in Recovery

June 1st 2016, By Robert Freitas, ASW  — Leave a comment


Robert Freitas  Suffering from substance use and co-occurring issues was literally like walking through hell. The physical, mental, emotional and spiritual effects left me broken on a very deep level. I felt isolated from others, society, and from myself. I was disconnected from all that I once loved and adored. I spiraled down into a pit of despair, self-loathing, guilt and shame. It was an experience that only those who have known addiction can truly relate to. The road to recovery was rocky in the early years with several relapses, and failed attempts at traditional 12 steps programs. Returning to the “rooms” I felt judged and humiliated. Granted some of this was in my head as many members welcomed me back with open arms. Eventually, the tools of recovery took root and I have been slowly piecing my life back together as the years roll by. Recovery has been a journey that has involved dusting off old tools, and developing new ones. As a therapist, sponsor, CEO and founder of Tailored Transitions I have had the opportunity to share my tools and create options for people that are walking through the most difficult experience of their lives.

“When the student is ready, the teacher will appear.” – Buddhist Proverb

Before I could be a teacher, a therapist, and a recovery coach…I needed to become a student. And as the Buddhist proverb goes, “When the student is ready, the teacher will appear.” There have been many teachers along the road to recovery. Part of the journey involves remaining teachable. One of my greatest teachers has been, and continues to be, the Alaskan Malamute (specifically Balou & Timber – seen above). When I felt stigmatized by friends, family, and society my Mals showed me unconditional love and acceptance. Their smiling faces were always ready to greet me at the door. They didn’t care about the mistakes I made. It was (and still is) for them – irrelevant. My process has been one of learning to channel my obsessive nature into more productive and spiritual outlets. I have grown to recognize obsession as a strength rather than a weakness, but it must be focused on things that bring joy, love, and purpose to a person’s life. In some sense, I have ex-changed one addiction for another. In a way I went from alcoholic/addict to a Malcoholic!


(Artwork by Robin Twete of Rockin Da Shirts)

Pet-assisted therapy is nothing new to mental health or substance use treatment. The benefits have been well documented and it continues to be useful in hospitals, prisons, and rehabs alike. Different variations of pet therapy (i.e. equine, wolf therapy, etc.) are proving to be valuable with individuals struggling with a variety of presenting problems ranging from medical conditions to mental health disorders. Some of the benefits of pet-assisted therapy with those recovering from substance include but are not limited to:

  • Increased ability to connect
  • Increase in empathy
  • Learning to be present (mindfulness)
  • Unconditional love
  • Learning to be of service (i.e. walking, feeding, grooming, etc.)
  • Self-soothing effects decreasing stress/anxiety
  • Increased self-esteem
  • Increased attentiveness
  • Selflessness
  • Increased ability to socialize
  • Decrease in physical pain
  • Increased sense of spirituality
  • Release of endorphins

These benefits are not just useful in early recovery, but can be extremely valuable with maintaining long-term recovery and relapse prevention. They teach us accountability, uplift our spirits, prompt us to exercise, model mindfulness, show us the meaning of selfless service, and love us when we are struggling to love ourselves.  They increase happiness for pet lovers. They change the way we feel without the need to put substances in our bodies. It’s a simple solution to complex problems. The commonly used cliché of “keep it simple” applies and is relevant.

I try to use the tools that have worked for me and incorporate them into treatment plans for others. I frequently ask myself, “what am I doing in my daily life that keeps me happy, joyous, and free from active addiction?” I take real life tools and apply them to clinical models to help people overcome the grips of addiction. There are applications of Malamute therapy that can be applied to live-in recovery approaches and inpatient facilities alike. Not everyone can bring a horse home with them to continue their equine therapy. Similarly, wolves (although beautiful) are not domesticated animals that can be legally brought into the home to continue wolf-therapy after inpatient treatment. Malamutes have the same majestic, free spirited temperaments while being amazing pets for those that aren’t afraid of hard work, grooming, and a lot of fur!

The Alaskan Malamutes are referred to as “gently giants,” and have unique malamute smile that can uplift a person’s mood. They are family dogs and welcome us as part of their pack. The application of malamute therapy through a live-in recovery approach can teach a person very specific tools that can be carried over after a formal treatment program. They become a part of your life and apart of your recovery.

Timber (Timber)

It should be noted that Alaskan Malamutes, dogs, and pets in general are a tremendous responsibility. Pet-assisted therapy is not a standalone solution to recovery, but should be used in conjunction with a variety of therapeutic, self-help, and traditional approaches. Those in early recovery must be solidified in their recovery process and able to care for their pets or have support in doing so. Addiction is ruthless and can quickly lead to animal neglect. The idea is to not neglect yourself, your pets and/or your loved ones any longer, but rather to find things in your life to nurture and love. We get back what we put into things. If you put love and affection into your relationship with your pet (or anything else for that matter), then you will get love and acceptance in return. And love, is at the solution to many problems…including addiction and mental health!

Alaskan Malamutes (and other dogs of course) are available for rescue. For certain individuals, this is an opportunity to save another life and help save yours in the process.


Twete, R., (2015).  Rockin Da Moots & Rockin Da Shirts. “Malcoholic” Image retrieved from:




20160208_Robert_Freitas-SELECTS_0075_WEB  Robert Freitas, MSW is the founder & CEO of Tailored Transitions and a therapist registered with the California Board of Behavioral Sciences. He is graduate from the University of Southern California (USC) and holds a Master’s in Social Work with a concentration in mental health. Robert is a passionate member of the recovery community who is dedicated to supporting those struggling with addiction and co-occurring disorders through an integrated approach. He is leading the paradigm shift in treatment through his clinical coaching model which combines recovery coaching with therapeutic modalities.

6 Benefits to the Live-In Recovery Approach

May 28, 2016 by Robert Freitas, ASW — Leave a comment


banner-161x161   Obviously substance use disorders is a highly prevalent and expensive public health problem in the United States and in other industrialized countries all over the world. The United States Department of Health and Human Services (USDHHS, 2012) estimates 22.2 million Americans 12 years and older meet the criteria for a formal substance use disorder. Unfortunately, of those struggling with addiction only approximately 1.5 million (0.6%) Americans have reported being treated for drug addiction in the past year. Not only are people dying in staggering numbers, but we are shelling out billions (over $600 billion) to combat this epidemic. Something is definitely not working efficiently and we are in desperate need of alternative approaches to treat people effectively. One of the newest and fastest growing approaches is the live-in, recovery coaching models of care. At Tailored Transitions, we would argue that this innovative practice, when done properly, has some excellent benefits that are leading to successful outcomes and long-term recovery. Some of those are as follows:


The client-centered approach originated with the humanistic psychologist Carl Rogers in the 1940’s and 1950’s. Rogers was regarded as one of the most influential thinkers of the 20th century and affirmed that people are inherently good and have an actualizing tendency to reach for their potential. The client-centered approach is a non-directive form of interaction in which the client drives the treatment based on their intrinsic desire for self-actualization. Both therapists and recovery coaches alike are moving toward a client-driven treatment plan with client-driven goals and action plans. This is now accepted as a best-practice by most clinicians working in recovery and mental health. It requires that the therapist, counselor or recovery coach remain empathetic, non-judgmental, accepting, genuine and collaborate with the client with unconditional positive regard. Through a live-in model of care, clinicians are able to see the client in every facet of their life. They see them at home, work and in the community. They see them engaging in interpersonal relationships. They see them in their natural environment on good days, and bad. This allows them to show acceptance of the client’s mood, behaviors, and emotions in a way that is not available in an inpatient rehab or intensive outpatient program. Not to say that clinicians cannot, or do not remain client-centered in those settings, but obviously doing this in a person-in-environment approach has additional therapeutic benefits.


This is a phrase so over-used in mental health and treatment. However, it is still regarded as a “best practices” approach to recovery and therapy. Many times it is referred to in relation to the Transtheoretical (TTM) or Stages of Change Model (Prochaska & DiClemente, 1983). According to this modality, a person falls within one of six stages. It is our job to coach them, cheer them and guide them through the stages. However, we must accept where they are in this process. We must accept where they are when they enter treatment. We must accept what their goals are and what they wish to achieve. It’s not our job to decide this for them, but rather to “meet them where they are at” in their process and help them make thoughtful decisions about how to get where they want to be. This is a practice implemented in therapy, IOP’s and inpatient rehabs. However, they are limited to the extent that they are able to meet the client where they are at. They have removed the client from their natural environment. Through a live-in, PIE approach clinicians are able to literally meet the client where they are at in every sense of the phrase. We go to them, and stay with them 24/7 for the duration of services. We meet them where they are at physically, mentally, emotionally & spiritually in every moment throughout every day. We meet them through a client-centered, strength-based approach and gently coach them in the direction of self-actualization in a way virtually impossible through traditional methods of treatment, therapy and recovery.


For many reasons a holistic approach to recovery is regarded in the profession as a best practice. It has many definitions and is usually referred to in relation to treating multiple facets of a person’s ailment (i.e. mind, body & spirit). It affirms that a problem (such as drug use) cannot, and should not, be treated as separate, but rather, must be viewed in relation to the person as a whole. For example, it is commonly understood that to sustain long-term recovery you must not merely focus on just the substance use, but the co-occurring issues that lead to the desire to alter one’s state.

“Characterized by comprehension of the parts of something as intimately interconnected and explicable only by reference to the whole.”


“Characterized by the treatment of the whole person, taking into account mental and social factors, rather than just the physical symptoms of a disease.”

Through a live-in approach, clinicians are in an optimal position to treat the person as a whole and implement holistic practices that focus on a variety of signs and symptoms impacting a person’s overall wellness. Live-in counselors, therapists and coaches can work toward assisting the client develop and utilize tools that improve physical health (i.e. nutritional & fitness), mental and emotional regulation (i.e. self-soothing techniques, cognitive reframing, etc.), and spirituality. Furthermore, when approached through a ecological systems theory the live-in model can start addressing not only the client as a whole, but micro, mezzo and macro systems impacting the individual. For example, the assigned therapist/coach can collaborate to address family issues or interpersonal relationships at work on a mezzo level.


For those well-versed in addiction, or those that have been directly impacted by substance use, it is common knowledge that it is not just the addict suffering, but the entire family. Co-dependency, unmanageability, legal/financial matters, interpersonal relationships, anger, fear, confusion, sadness and health issues plague the entire family unit. The family unit is in need of coping skills to adequately walk through the storm without relapsing on behaviors. Traditional rehabs and IOP’s incorporate family sessions into their treatment plans to address these issues. Similarly, live-in models of care serve the entire family when done correctly.

Recovery starts and ends at home!

The live-in approach to recovery and wellness allows the staff insight into the family’s presenting problems and supports them in their home as conflicts arise. Each family member will have unique challenges that call for a tailored action plan or linkage to resources to recover. Live-in recovery programs allow staff to be there moment-to-moment to assist them implement tools or conduct sessions as problems arise. Developing connections among family and maintaining peace and serenity in the home is essential for recovery starts and ends at home.


Inpatient rehabs also offer 24 hour, moment-to-moment care which can be beneficial under certain circumstances. However, the live-in approach to treatment/recovery offers a person-in-environment (PIE) value that will not be available in a rehab environment. Person-in-environment PIE is based on a model developed by social workers in attempts to move away from the dual construct of either being completely person-focused or environment-focused.  PIE bridges the gap and examines the interaction between the person and his/her environment while specifically addressing problems and highlighting strengths in categories such as:

  • Social Roles in Relationships with Others
  • Social Environment
  • Mental Health
  • Physical Health

There is no better way to address the interaction between a person and his/her environment then by stepping into that environment. This gives the assigned clinician a unique insight into the interplay between the two constructs which gives them the ability to gain more thorough and accurate assessment information. A more accurate and thorough assessment will lead to a treatment plan that is more individualized or tailored to the client’s needs. Live-in, 24 hour care in a person’s environment gives the client access to strategies, interventions and support as stressors, triggers and cravings arise moment-to-moment in their everyday lives. Rehabs may educate clients on tools during their inpatient stay, but they are not with them when they need to use them after they are back at home. This is a problem because all it takes is one moment for a relapse to occur in early recovery.


It should be noted that this author is a member and avid supporter of traditional 12 step communities. A sponsor and support group developed in programs such as AA/NA are extremely valuable for many people (including myself). However, within the literature and meetings you will hear it stated that some people need outside help. A sponsor is not a licensed therapist, certified recovery coach, drug and alcohol counselor, psychologist, or psychiatrist. Although life experience is a valuable asset, it does not give one the formal education necessary to support someone with mental health or co-occurring disorders. A reputable live-in recovery coach company such as Tailored Transitions provides certified, licensed and competent staff to address clinical needs that may be impacting the likelihood of success. A person’s treatment plan should include trained staff with the credentials to treat the client based on the level of severity of the presenting symptoms. In many cases, this may mean assigning a therapist to act as a clinical recovery coach or having a therapist work in collaboration with a licensed mental health clinician. It is important to ask the company who’s services you wish to obtain if their staff is licensed, certified AND if they are acting under clinical supervision to assure best practices and the highest level of clinical care. There are evidenced-based practices (EBP’s) that have been proven to effective in treating substance use and related disorders. Therapeutic modalities that are tailored to a person’s presenting problem can only be offered by those working within the scope of their practice. The live-in approach allows the staff the ability to extend evidenced-based interventions outside of the therapy session or inpatient facility and into a person’s natural environment. As soon as insurance companies recognize this, the benefits of this model of care can be more readily available to a wider population of people in need.


Although live-in recovery models of treatment can be used in lieu of traditional approaches, they can also be used in collaboration with them as pre-care or aftercare programs. There needs to be a variety of individualized programs to meet the needs of the clients. We cannot expect to remove one from their environment and then return them to that environment without the support they need to walk through the most challenging process of their lives. As mentioned, there are many benefits to stepping into the real life situations faced by individuals in the grips of addiction. It allows for a more realistic and higher quality of care which increases the likelihood of successful outcomes. Through this model of care, multifaceted issues can be addressed including biopsychosocial presenting problems and systemic issues. There are added benefits to the clinician, as well as the client and their families. Addiction can feel like being lost in the dark. Through a live-in approach, clinicians are able to act as a beacon, lighting up a path to limitless horizons and potentiality.

20160208_Robert_Freitas-SELECTS_0075_WEB Robert Freitas, MSW is the founder & CEO of Tailored Transitions, a member of the Board of Directors for the International Association of Addictions Professionals (IAAP), and a therapist registered with the California Board of Behavioral Sciences. He is graduate from the University of Southern California (USC) and holds a Master’s in Social Work with a concentration in mental health. Robert is a passionate member of the recovery community who is dedicated to supporting those struggling with addiction and co-occurring disorders through an integrated approach. He is leading the paradigm shift in treatment through his clinical coaching model which combines recovery coaching with therapeutic modalities.

A Message to the Still Suffering Parents

A Message to the Still Suffering Parents

December 21, 2015, Tailored Transitions  — Leave a comment


The language of saying no is simple. It goes like this – “No!” Addiction is rooted in selfish, self-centered instant gratification. Those suffering from addiction learn to get what they want, when they want it. It starts at an early age usually long before drugs enter the equation. It carries into adolescence and adulthood. When you tell a child “yes,” and constantly give them what they want you are contributing to the problem, compounding the issue at hand, and enabling the behavior. You are setting yourself and your child up for failure, heartache and pain. You must learn to create boundaries.

Recovery starts and ends at home. It is a family disease. It is not a spectator sport…eventually the whole family gets to participate! This means, as parents, you must learn new tools as well. Parents must learn to say “no,” and if your child is over 18 and refuses help for his/her addiction then “no” must be replaced with “you gotta go!” It is a harsh reality, but it is essential to creating an environment that is NOT enabling or compounding the presenting problem. Repeat after me:

“No, you can’t have more money!”

“No, you cannot borrow the car!”

“No, I will not pay for your cell phone!”

“No, I will not bail you out again!”

“No, you cannot live in my home if you refuse help for your addiction!”

Parents have maladaptive thoughts that lead to unwarranted guilt. If you are not giving into your son/daughter and providing them with everything their heart desires, then you feel as though you have failed as a parent. These beliefs could not be further from the truth. Your child has learned to manipulate and play off your emotions to get exactly what they want. And getting what they want is a core issue with addiction. This form of “tough love” may not settle well with you as you watch your child throw tantrums, yell, and accuse you of being a terrible parent. Please remember, that they cannot see clearly in their current state. All they can see is their next pill, drink, or fix. Just because they are unable to say “No” to themselves, does not mean you are incapable of learning to say “No” to them.

Please do NOT misunderstand me and think this article is blaming you for your son/daughter’s addiction. Addiction is a multi-faceted problem that extends well beyond parenting, family dynamics, and household rules. Addiction is a mental, spiritual, emotional, and physical illness that is created through micro, mezzo, and macro systems. The blame does NOT fall entirely on parents or their lack thereof. Similarly the blame does NOT fall entirely upon the still suffering individual inflicted with addiction. Our society, our systems, and our environment may play pivotal roles in this disease. However, either you are a part of the solution or you are a part of the pollution.

Grant me the serenity to accept the people (your child) I cannot change,

The courage to change the one I can,

And the wisdom to know that person is me!

You cannot change your child. You can offer love, support, services, and guidance, but you cannot change them. You must focus on the only person you truly have control over, and that person is yourself. Sometimes what you have control over is whether or not you say “yes” or “no.” This may sound like common knowledge, but I assure you it is NOT common practice. You must find it within yourself to learn the language of saying “No” to your child and say “Yes” to yourself. And if you are struggling (as many parents are), then find the services for yourself. As stated previously, recovery is a sport the whole family gets to play which means services and coaching exist for parents too! Don’t hesitate to reach out for help. We do NOT recover alone!

Sending love and prayers to those struggling with addiction.