Addiction and Mental Health

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Posts Tagged ‘Moderation Management

Making Changes in Recovery, Step-by-step

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Making Changes in Recovery, Step-by-Step

by Julie Myers, PsyD, MSCP

Licensed Clinical Psychologist in San Diego;


Have you ever wanted to make changes in your life, but felt so overwhelmed by the situation that you didn’t know where to start?  Sometimes it helps to break the change down, working through the situation step by step using pencil and paper.  (A useful worksheet can be found at  First, think about why you want to make the change and then work through the steps you will need to get there. As you do this, you may find that the change you want to make really requires more than one significant change.

For example, let’s say you want to start exercising in the morning. As you work through the steps, you find that to do this, you will have to leave earlier in the morning, which means that you need to be more organized in the morning, which requires that you go to bed earlier, which means that you need to leave work earlier, which requires that you have lunch by noon.  Too many major changes means overwhelm!

Instead of becoming frustrated, break each of these steps into a different change plan, starting with the easiest change (such as having lunch earlier!)  By doing this, you will feel less overwhelmed, be more successful, and will feel better about your ability to make changes. With thoughtful forethought, you will be amazed at the changes you can make!

– Julie Myers, PsyD, MSCP


Think Before You Drink!

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Think Before You Drink!

by Julie Myers, PsyD, MSCP

Licensed Clinical Psychologist in San Diego, California

One of the first steps to changing a behavior is becoming (really and truly) aware of the behavior.

Often, addictive behaviors are driven largely by habit, which people engage in without much thought.  For example, someone may arrive home after a hard days work and automatically reach for a beer (which then automatically leads to the next beer).  This may be as much habit as it is a true desire to drink.

When you “turn-on” your brain and become more mindful of your automatic responses, you will be better able to begin to change your behaviors and habits.   The next time you reach for your drug of choice, pause and think…. you may be surprised!

Julie Myers, PsyD, MSCP

Licensed Psychologist, MS Clinical Psychopharmacology, Master Addiction Counselor, Board Certified Biofeedbac  

Internet Services to Help Problem Drinkers

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Internet Services to Help Problem Drinkers

A Review by Julie Myers, PsyD, MSCP

Licensed Clinical Psychologist in San Diego

“Can targeting nondependent problem drinkers and providing internet-based services expand access to assistance for alcohol problems?   A study of the moderation management self-help/mutual aid organization”

by K. Humphreys and E. Klaw

There has been a call for alcohol programs to broaden the base of alcohol intervention, reaching out to those who do not normally seek treatment (Tucker et al., 1999.)  By offering programs targeted to nondependent drinkers and by using electronic media, those who do not normally seek treatment may be included.  In this study, Humphreys and Klaw surveyed members of the self-help group known as Moderation Management (MM) to determine if the group has reached this underserved population.

Moderation Management is a non-12-step based self-help group, which helps those who wish to moderate their drinking.  Although there are other non-12-step based sobriety programs – such as SMART® Recovery, Rational Recovery, and Women for Sobriety — the authors claim that MM is the only self-help organization to target nondependent problem drinkers and to allow moderate drinking rather than abstinence.

The authors examined the characteristics of members of the group through survey self-reports.  The survey included demographic characteristics, alcohol consumption patterns, life functioning, religious tendencies, and participation in other self-help groups. It also explored the participation in the group via internet-based resources to determine if members in these groups differed from members involved in face-to-face meetings.   177 surveys were returned, which represented a large proportion of surveys given out in face-to-face meetings and an unknown proportion of electronic surveys.

The results showed that those in MM tend to be white, employed, college educated, not strongly religious, and early middle-aged.  Those returning the online surveys were more likely to be female, more educated and atheistic, and have greater markers for dependency.  Few respondents were likely to have other drug dependencies.  Overall, MM does not attract those who are highly dependent, who would more likely benefit from an abstinence approach.  For those who attended online meetings, their stated reason for using the electronic resources were its availability and ability to access the resource at any time of day, the privacy afforded, and because they found it easier to write about their feelings than speak about them.

This study brings to attention the need for and availability of alternative alcohol self-help groups.  However, the study was clearly limited in its ability to conclusively determine characteristics of the self-help group members.  This was largely due to the experimental design, which used self-report measures.   Also, the surveys returned clearly biased the results in favor of those who were highly motivated to return the surveys (or who really needed the $20 payment!)   It is likely that those who were more highly educated and who preferred writing about their problems were more likely to complete the survey.  It would be interesting to conduct a survey with a randomly selected sample population, something unlikely with such a small organization of voluntary members.

In my opinion, the authors did not seem particularly knowledgeable about other self-help groups, often misrepresenting them.  They state that other self-help groups have claimed a “niche” market.  SMART® Recovery, for example, is a broadly-based group that includes members with a wide variety of addictive behaviors and socio-economic backgrounds.  The only niche that I see in this group is that it is not Alcoholics Anonymous (AA).  The authors also include Rational Recovery in their discussion of self-help groups, even though they have not existed as a self-help group for some time and are not abstinence based.

The authors propose that one reason that more women use the online self-help group than men is because men may be more dedicated to abstinence.  This is highly speculative and does not seem very well informed, in my opinion.   There are many more plausible explanations for this, including the greater likelihood that women completed the survey and the social climate of AA, which is the most well attended abstinence based self-help group.  Women are more likely to have a strong social network then men, thus they are less likely to rely on a self-help group for social contact; men tend to have fewer social contacts, especially those that do not use alcohol, and thus may seek out the social support of AA.   A random sample would help tease this out.

Also, I believe that men are more likely to receive court-appointed treatment than women, thus they are more likely to be mandated to abstinence-based programs.  As far as I know, MM does not comply with court mandates for treatment.  Mandated treatment is a significant reason why people attend self-help groups.  It would be interesting to ask members why they are attending treatment in further surveys.  It would also be interesting to ask if their ultimate goal was abstinence.

The authors stated purpose was to explore how services could be tailored to non-dependent drinkers and to those wishing to use the internet.   It would have been interesting if the authors speculated about how this group could have been tailored to meet that need.  Given the data collected, how could MM attract more members or a more diverse group of members?

– Julie Myers, Psy.D.



Humphreys, K. & E. Klaw (2001) Can targeting nondependent problem drinkers and providing internet-based services expand access to assistance for alcohol problems? a study of the moderation management self-help/mutual aid organization.  In Journal of Studies on Alcohol: 62(4), pp. 528-532.

Moderation Management, February, 17, 2007.  <;

Tucker, J., D. Donovan, & G.  Hiarlati (Eds.) (1999), Changing Addictive Behavior: Bridging Clinical and Public Health Strategies, New York: Guilford Press.