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  • How to Detox A Room

    I was called in by a neighbor to assist them with a problem with their daughter. The daughter, a 42 year old had come in to visit them during the week prior. They acknowledged that she drank, as they said, perhaps a bit too much. She had planned this visit because she was passing through New Jersey with final plans to relocate to Alaska (from South Carolina). This stop was one in a series of geographic cures (location changes that are supposed to help in sobriety) that had developed since the woman had split from her husband, leaving her two children with the spouse in Oregon a year ago. Her history included drug and alcohol use, a suicide attempt, a 14 day hospital stay after the attempt and a short term weekend hospital stay that was not clear to me if it was for detox or a mental health observation.

    During this past week, there was no visual confirmation that this woman was drinking or taking any drugs of any kind. However, the previous day the woman had spent a large about of time vomiting, and retuning to bed saying she had the flu. During my phone call with the father at 9am, the father acknowledged that the woman was convulsively shaking, grey in color and continuing to vomit, even though the woman had nothing to eat. I suggested the family immediately take her to the hospital, as she was experiencing all of the signs of alcohol detox. The family complied, yet, they continued to reaffirm their daughter had not been drinking during her stay.

    Once at the hospital, the woman admitted she had been drinking continuously during her stay and also taking whatever pharmaceutical drugs were available in the house. After over 8 hours in the hospital ER, the woman was finally admitted into the detox unit, and the parents came home…literally exhausted with a totally new perspective of their daughter.

    The next day was a Saturday, and I came to the house and I suggested we search the daughter’s room to see what exactly she had been taking. To search a room, an apartment or an entire house is an aspect of a recovery coach’s repertoire that is extremely important.

    My first experience in detoxing or sterilizing a room, I fortunately had the assistance of a professional Crime Scene Investigator teach me how to search a room. I just stared at a suspended ceiling in the basement bedroom of a 25-year-old client; I told my CSI friend that I imagined lifting every ceiling tile to seek out any drugs. I imaged the dust, the mess, the sneezing, moving the ladder not to mention the physical excursion! Very quickly, he showed me by lifting up one tile I could scan the entire surface of the tiles with a flashlight. He lifted another tile where the contraband was located and the search was over. It was less of a mess than I thought. Continuing to go through a search process with a Crime Scene Investigator is how I really learned how sterilizing a room is done correctly.

    To begin a search for contraband, you will need some tools:
    1. Rubber gloves, a box at least
    2. Baggies, zip lock variety, a sandwich size and a quart size at least two boxes per room.
    3. A wooden ruler
    4. Roll of Paper Towels
    5. Small Flash Light, with a directed hi beam
    6. A small multi head screw driver
    7. Notepad and pens
    8. Sharpie Marker
    9. Scissors
    10. Small ladder, or step stool
    11. A cardboard box, maybe 24” x 24” x 24” and a small show box sized box.
    12. A box of large plastic garbage bags, maybe two boxes for a home
    13. Clear packaging tape

    The legal requirements for collecting contraband are met when you can identify each piece of contraband, describe the exact location of the item when found, indicate when the item was collected (date and time of day) and be prepared to show a proper chain of custody and disposal.

    Be prepared to bag all prescription bottles, contraband like crack pipes, dime bags and liquor bottles empty or not. Bag each item separately. Write on a piece of paper placed inside the bag where the items were found, by whom, the date and time of discovery. Take a photo of the bag and the notes. Make all notes identifying the contraband, location, date and time found readable by the camera shot. Make similar notes in your log. By following the search procedures that follow law enforcement protocol, it will help you in the event the client turns against you and accuses you of theft.

    When first entering an area that you will be searching, walk through the room, home or apartment making mental notes on how you will handle the search. Taking photographs at this time is ideal. This walk through will give you an overview of the area. It will give you the first opportunity to identify possible contraband, good hiding places and your over all approach. Preferably, you should be the only person conducting this sterilization process, another person should be available to write notes documenting what contraband was found and photographing the contraband. If it is a large home, and if there are time restraints, you may designate two people to search each room. If it is a home, and only one client is actually suspected of hiding the contraband, the entire home must be searched, not just that person’s bedroom. It takes about three hours to search one bedroom-sized room.

    To make things simple for this book, I am going to describe the process as if I am searching one room. Simply multiply these techniques for an apartment or a home.
    Bedroom #1
    1. After your initial walk through, place the tools just outside the door of the bedroom. Invert the cardboard box to create a small table to hold your baggies, markers, ruler etc
    2. Turn on all of the lights. If you have not taken any photographs, do so now. Take a few shots of the dresser top, and include any of the table top objects that may be there.
    3. Look at the room, to decide if you will start from the left of the door and go clockwise around the room or start at the right of the door and go counter clockwise around the room. Once this choice is made, do not deviate.
    4. Look at the walls. In your search method everything 36” and below will be completed in the first sweep of the room. This means you will start at the floor and search up to 36”.
    5. In the second sweep of the room, everything 36” and above will be searched (e.g. taking down mirrors, picture frames, looking behind them, looking above drapery valances, dismantling light fixtures, etc).
    6. The suspended ceiling will be last area to investigate
    7. Set this plan into your head, and/or write it down in your notebook. Note the date & time your search begins. Put on your rubber gloves
    8. In the case of bedrooms, dining rooms and living rooms, there is usually a very large object in the center of the room that can also be used as an examination surface. So this is where you will begin.
    9. In this case it is a bed. Go to the bed, take off all of the linens, remove the pillow cases, search for anything in the pillow by pressing them flat (not fluffing them up!), ensure there is nothing in the mattress pad lining, remove all linens and take out into the hallway.
    10. Inspect the top mattress carefully, run your hands and eyes along the sides and seams, looking for cuts in the fabric. Push the mattress to the edge of the bed, and rest it standing on one edge and lean the mattress against the wall to examine the underside of the mattress.
    11. Inspect the box spring the same manner. Box springs are often great hiding places because of the rigid sides. Look and feel for tears in the fabric, use of fabric adhesive, tape etc.
    12. Push the box spring to the side of the bed, and place up against the top mattress, inspect the underside of the box spring
    13. While the mattresses are standing against the wall, look at the space that was under the bed(s).
    14. Run your hands along the bed frame and the underside of the bed frame. If there is a head board or footboard, inspect both with your hands. Move the frame and the headboard away from the wall, and inspect the area behind the headboard.
    15. Once confident the bed area has been thoroughly searched, return the box spring and mattress to the bed frame. Using the bed as your ‘desk’, begin your search of the rest of the room.
    16. As stated previously, start at the door, to the left or right and continue around the room.
    17. Look behind the door.
    18. Look for wall to wall carpet edges that have lifted, if there is an area carpet; lift a corner as far into the room as possible, look for inconsistencies in the wood floor.
    19. Let us say the first object is a trashcan. Spread one of the black garbage bags on top of the mattress, and empty the trashcan contents onto this black bag that is flatten on the bed. Handle and inspect all contents. Open all discarded bottles or jars. Any empty prescription bottles, liquor bottles, and/ or contraband retain. Place each item of contraband in its own baggie; clearly making all notes identifying the contraband, readable by the camera shot. Place the contraband baggies in the smaller box. Take the four corners of the garbage bag, with the trash can contents within, tie the four corners of the garbage bag and discard out into the hall, preferably into another garbage bag.
    20. Next, could be a dresser with six drawers. Take the two bottom drawers out completely. Empty one drawer onto the mattress. Inspect the underside of drawer and all exterior and interior sides. Now inspect the contents. Unroll socks, feel thoroughly all legs of pants, sweaters etc. Return folded items back into drawer. Do not refold the clothes perfectly neat, but be mindful that if you stay neat in this process, it takes much less time returning the room back into its original state.
    21. Repeat with the second dresser drawer. Set both bottom drawers to the side of your working area (the bed)
    22. Remove the middle two drawers, place on bed. Repeat search process with these drawers and set aside.
    23. Remove the top drawers, and repeat the search process. Before placing all drawers back into the dresser, search dresser’s interior.
    24. Look inside the case of the dresser, feel along the base, and reach back to the back of the dresser. Use the flashlight to illuminate your view. If you cannot reach, use the wooden ruler to inspect along the interior case of the dresser.
    25. Move the dresser away from the wall, to look at the wall and the back case of the dresser. Inspect the carpet. If a mirror is attached to the dresser, search behind the mirror and wall. If not, leave it for the second phase of the search. Move dresser back against the wall
    26. Replace the lower, middle and top drawers into dresser
    27. When finished, all the drawers and contents should be in the same drawers and positions in the dresser.
    28. When inspecting the top of the dresser, photograph it first. If you have not photographed any room or surface, photograph this one. Pull up a chair, boxes of baggies, and the roll of paper towels. From right to left, inspect the contents of the surface of the dresser. With liquid filled bottles, open them up and smell the contents. Mouthwash? Taste. Jar of moisturizer? Stick your finger and probe inside the jar. Powder? Open the powder container and empty the contents into a quart-sized baggie. Do not replace powder into the original container. Ensure the powder is not contraband and discard the baggie and the container. Open anything with a lid, inspect it, smell it, taste it, and feel it.
    29. Prescription drug bottles may be in this area, as well as in a bathroom medicine cabinet. Open the bottle to confirm the contents are of the same prescription identified on the bottle. Use a Physician’s Desk Reference (apps are now available for your smart phone) to confirm the contents are the contents on the label. Confirm the label on the script bottle is your client and set aside the verified prescription drugs allowed by the client’s physician. Do not destroy any verified prescriptions until you have a conversation with your client on the validity of these drugs.
    30. All prescriptions not meeting the above guidelines are considered contraband.
    31. Lift any trays, baskets, or cloth protecting the surface of the dresser. Inspect the bottom of said items. Do not re-arrange the surface, leave it as it was. Photograph top of dresser when you are done. If there is a large amount of jewelry of value, identify, and bag these items. Clearly make all notes identifying the jewelry, location found, date and time found readable by the camera shot. Make notes in your log. Leave all jewelry bagged, on the dresser.
    32. Now there is the clothes closet. Use the same rule you determined for the room either right to left, or left to right, inspecting the closet 36” and below in the first sweep. Go for the shoes!
    33. Try to be neat but quick, look in all shoeboxes, feel inside boots, sneakers, but do not dump all the shoes on the floor and then inspect them, inspect as you go, keeping shoes in the boxes. Be glad you have rubber gloves on.
    34. If the closet is a complete and utter disaster, open a large garbage bag inside an empty cardboard box and toss the shoes, clothes, etc inside this garbage bag as you search. Then tie the bag up, generally identify the contents with a label on the bag, take this bag out into the hall, place a new bag in the box and continue until you see the bottom of the closet.
    35. Using your flashlight, visually inspect and feel along inside of closet door frame.
    36. Thoroughly inspect floor of closet for trap doors, loose floor panels, etc.
    37. Continue sweeping the room until you reach the door where you started.
    38. When you finish the first sweep, regroup with new materials if needed, new gloves and begin the second sweep of the room, starting 36” and above.
    39. Remove all picture frames, mirrors, posters off the walls, inspect back of frames, then re-hang the pictures back on the wall
    40. Use your step stool to reach to the top of valences and drapes. Run your hand along any valence or crown molding close to the ceiling.
    41. If any lights do not work, look at these closely, unscrew them from the wall look inside in shell, unscrew the stem of the lamp, inspect the shades etc.

    If you have discovered any contraband, as stated earlier; bag it, mark it as to where you found it, what it is, and photograph it. Ensure the notes are readable in the photograph, and place the baggies into the cardboard box for destruction. Review the list duplicating these discoveries that were made in your notebook. It is important to be sure you verify you did not use the contraband for your own purposes. You have to protect yourself, by documenting the discoveries by following the same procedure the law enforcement officials have established.

    Place all bed linen, the bag of shoes back into the room, and close the door. Mark the time this search ended.The next step is taking the box with the contraband and in the presence of a witness, destroy the contraband. The witness should be the individual that helped you document the search process. In order to discard these contents, it is very important to have a witness. However, if you think the witness could be your client, you are wrong. Do not ask the client. A parent of the client, a therapist of the client, will do if you do not have an assistant. Because of anonymity, do not ask a neighbor, janitor, or property owner.

    Even after several years of sobriety, I find it very disorientating handling drugs, bags of marijuana, crack pipes, etc. I am fearful driving my car with the contraband in it. Let us say you are pressed for time, if you do not have an assistant, cannot find a witness and you have to get rid of this stuff fast, placing it in the client’s garbage is not a good idea. Drive to a public place, like a convenience store. Write down the address, photograph the location, and toss the bag in a commercial dumpster. If you really have the guts, ask someone to photograph you doing so. Self-care is important here, so get rid of this stuff so it will not haunt you.

    Then go about working with your client as a recovery coach. Inform them of what you found and discarded. Anticipate they will ‘freak’ out, about being caught with this contraband and the addict will kick in and want their ‘fix’ back. Verify the prescriptions confiscated from the scene are still to be used by the client. Lastly, place copies of the documents and photos in the client’s file. If you are a contractor for a recovery coaching referral agency, ask if the firm wants a copy of these records.

    In total it took me about three hours to sterilize this woman’s room. We discovered several prescription drug containers that were someone else’s, we discovered a barbiturate tablet in Tylenol PM bottle, empty methamphetamine baggies in her makeup bag, and we discovered an empty whiskey bottle in the closet. When the parents saw this particular empty bottle; they recognized it from their liquor cabinet. Going to the liquor cabinet in the living room, they discovered sixteen empty liquor bottles. Subsequently, they went to the basement and discovered a case of wine that was given as holiday gift, was also empty. A year later, after walk around the perimeter of the parent’s property, these empty wine bottles appeared under piles of leaves and lawn cuttings.

    Even though the sterilization of the room had the purpose to find out what the daughter had been using, it was a grim reminder to the parents that the non drinking behavior they thought they saw in their daughter, was not the truth surrounding their daughter’s alcohol or drug use. Participating in this search was a better reinforcement of reality than if I had not had them in the room with me.

    This is one of the chapters from “Guide to Coaching People in Recovery from Addiction” a book written by Melissa Killeen and available as an eBook in February 2013 on Amazon.com
    Another Chapter will be posted next week

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  • 15 Common Signs of Love and Romance Addiction

    Are you a love or romance addict? Recovering love and romance addicts who have worked on themselves in therapy and 12-step programs like Sex and Love Addicts Anonymous (SLAA) can relate to the idea of having used a well-rehearsed repertoire of manipulation to find and hold on to sexual and romantic partners.

    Jose, a 32-year-old IT administrator put it this way –

    I was always hunting in one form or another to find the special attention and sense of importance that only the right girl might make me feel if I could get with her. I figured I could make it happen with someone if I just wore, said or did the right thing or was good enough in bed, etc. In recovery it was necessary for me to recognize all the manipulative strategies I used to employ to attract and seduce women. As I slowly began to cast these aside, with the support of 12 step members, friends and therapy I actually began to learn my own value and real human worth, which over time has helped to remove the powerful and empty fantasy life that I lived in for so long.

    Unlike the kind of partnership and dependency that many of us seek to compliment our lives, the love and romance addict searches for someone outside of himself to provide the emotional stability he or she lacks within. Working hard to catch someone who can to fix them, rather than learning about and growing beyond their own emptiness, they can become fixated on troubled or emotionally unavailable partners, often providing others with the very love and security they themselves most desire. Ultimately as the love addict’s own emotional needs remain unmet, they may himself act out through verbal or physical abuse of a current partner or though excessive spending, sex addiction, affairs or drugs, experiences that will ultimately reinforce their underlying sense of shame, self hatred and loneliness.

    For those seeking a long-term a relationship, healthy romantic intensity is the catalyst that brings about the bonding necessary to sustain love and attachment. The beginning stages of a potential love relationship are the most exhilarating because that emotional state helps us bond and attach. This is when how HE looks, walks, talks, eats and thinks is the subject of endless fantasy, excitement and late night phone calls.

    Romance itself, with or without sex, does encourage personal growth when we are open to learning. Then each new relationship can offer insight and self-awareness. Most people easily relate to that “rush” of first love and romance; the stuff of endless songs, greeting cards and fantasy. More than romantic intensity or great sex, true long-term intimacy is an experience of being known and accepted by someone over time. Loving relationships develop in part as those first exhilarating times together form a foundation of a deeper, long-term closeness. It is that deeper closeness which ultimately feeds our hearts and keeps us content; long after the rush of new romance has passed.

    Love and Romantic addiction are not defined by gender or sexual orientation. The men and women who suffer from these challenges do however have underlying attachment, trauma and/or personality based issues that will require a period of healing to work beyond. It is strongly recommended that love and romance addicts both attend 12-step sex and love addiction meetings and therapy with a specialist trained in behavioral addictions. Hope and change are highly possible – but first the addict has to fully withdraw for some time from the active dating/sex/love game, while being guided by others toward self-reflection, grieving and improving social (non-romantic, non-sexual) peer relationships.

    15 most common signs of love or romantic addiction:
    1. Frequently mistaking intense sexual experiences or romantic infatuation for love

    2. Constantly searching for romance and love

    3. Using sex as a means to find or hold onto love

    4. Falling in love with people met superficially or solely online

    5. Problems maintaining intimate relationships once the initial newness and excitement has worn off

    6. Consistent unhappiness, desire to hook-up or anxiety when alone

    7. Consistently choosing abusive or emotionally unavailable partners

    8. Giving emotionally, financially or otherwise to partners who require a great deal of care-taking but do not or can not reciprocate what they are given

    9. When in a long-term relationship most often feeling detached, judgmental or unhappy, when out of a relationship, feeling desperate and alone

    10. Making decisions about what to wear, how to look, what to say etc., based on how others might perceive you, rather than on self-awareness, comfort and creativity.

    11. Using sex, money, seduction, drama or other schemes to “hook” or hold onto a partner

    12. Missing out on important family, career, recreational or social experiences in order to find, create or maintain a romantic relationship

    13. Giving up – by avoiding sex or relationships for long periods of time to “solve the problem”

    14. Being unable to leave unhealthy or abusive relationships despite repeated promises to self or others

    15. Returning to previously unmanageable or painful relationships despite promises to self or others not to do so

    Editor’s Note: If you think you may be a Love and/or a Romance Addict consider visiting the following sites:
    http://www.slaafws.org/

    Home

    http://www.itsallaboutlove.com/quiz_3.htm

    http://loveaddicts.org/kindsofloveaddicts.html

    http://www.piamellody.com/

    http://recoverytradepublications.com/

    http://www.huffingtonpost.com/mastin-kipp/addicted-to-love-part-1_b_652919.html

    We welcome the return of our guest blogger, Robert Weiss, the Founding Director of The Sexual Recovery Institute and Director of Sexual Disorders Services at The Ranch Treatment Center and Promises Treatment Centers. This post, originally published in February 2012, was this year’s top read blog post. I am re-posting this as my New Year’s Day blog post. Happy New Year to all of my 17,000 readers and thank you for joining me this year!

    This blog was written by: Robert Weiss, Founding Director of The Sexual Recovery Institute and Director of Sexual Disorders Services at The Ranch Treatment Center and Promises Treatment Centers. These centers serve individuals seeking sex, love, romance and codependency addiction. Follow Robert on Twitter @RobWeissMSW

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  • FOUNDATIONAL THINKERS IN THE RECOVERY COACHING COMMUNITY

    Phillip Valentine

    In the past few weeks, I have been presenting brief biographies of people that have been instrumental in developing the recovery coaching industry. As a field, recovery coaching had an odd path of growth. In the 80’s no MBA’s or PhD’s set forth to devise this new industry of recovery coaching. But a few people saw this as a bona fide profession. Yes, some of these Foundational Thinkers were drunks, dope fiends and ex-cons, like Bob Timmins. Others were dedicated professionals in the field of addiction recovery that saw there was a gaping hole between a client leaving treatment and achieving long term recovery that needed to be addressed. How does a person leaving a treatment center find, embrace and develop their recovery? The answer was for the client to find a 12-step meeting, find a sponsor, and pray to a higher power.   

    Picture this, open the door of a treatment center, and send the client back into the environment that placed them into treatment in the first place, with these instructions “don’t drink (or pick-up, act out, or drug etc), find a meeting and get a sponsor” and with no other guidance except a list of 12-step meetings. Those in recovery know how hard that path is. For those who choose not to believe in a higher power or that could not find a sponsor or whose addiction did not fit into the typical AA or NA meetings, what should they do? Well, most likely, 80% of these people relapsed.            

    William White’s model of a volunteer peer recovery coach began to fill that hole between treatment and long term sobriety. Treatment centers are now calling this model an aftercare program, and hiring recovery coaches to help their client through this transition period.  The outcome is that both of these models work and both use a recovery coach to assist the client on the path of recovery. There is, as you will read below, a discussion as to the efficacy of a coach that gives their time for free and a coach that is compensated. Is one right and the other wrong? Is the other type of coach is not trained well enough? Is one more legally liable than the other? In the next few posts, not only will I introduce these leaders of the recovery coaching field, but I will also feature their thoughts on this topic.

    One individual, Phillip Valentine, chose the William White recovery model and began one community recovery support center in Hartford and has grown the Connecticut Community of Addiction Recovery into a nationally recognized leader in developing recovery support centers and recovery coaching training.

    Phillip Valentine is the Executive Director for the Connecticut Community for Addiction Recovery (CCAR). He has been an integral component in this recovery community organization since January 1999. He is recognized as a strong leader in the recovery community and in recovery himself. Valentine is on the Board of Directors of Faces and Voices of Recovery in Washington DC; the nationally-recognized voice of the organized recovery community. In 2006 the Johnson Institute recognized his efforts with an America Honors Recovery award. In 2008, Faces and Voices of Recovery recognized CCAR with the first Joel Hernandez Voice of the Recovery Community Award as the outstanding recovery community organization in the country. In 2009, the Hartford Business Journal named him the Non-profit Executive of the Year. Currently, he is spearheading CCAR’s effort to build a statewide network of Recovery Community Centers that feature innovative peer recovery support services like Recovery Coaches, Telephone Recovery Support, All-Recovery Groups and Recovery Works! –which is an employment services component to the recovery community centers.

    In an interview with William White, as part of Perspectives on Systems Transformation: How Visionary Leaders are Shifting Addiction Treatment Toward a Recovery-Oriented System of Care, published by the Great Lakes Addiction Technology Transfer Center (ATTC), Valentine describes what he sees as the difference between peer-based recovery support services, treatment services and recovery coaches that are compensated:

    White: How would you distinguish between peer-based recovery support services and treatment services?

    Valentine: I see treatment as more sterile, professional, hospital-like, staff-focused. Treatment can be real effective in initiating recovery, where recovery support services are more focused on maintaining and enriching recovery. Recovery support services aren’t bureaucratically bound—at least not yet—by mountains of rules, regulations, and paper. Recovery support services are more free and unencumbered to sustain a focus on whatever it takes to support recovery. We’re trying to escape the coldness you feel when you walk into a place that seems only concerned with forms and money—the feeling that you’re just one more person in the assembly line, one more of the addicts or alcoholics coming through the system. It’s hard to be seen as a person in such coldness. Recovery support services are the warmth that can heat you back up. They’re the antidote to people being paid to be your friend. Frontline counselors are often warm and wonderful people, but they are constrained by the burdens placed upon them.

    White: Are your recovery support services being provided by people in volunteer and paid roles?

    Valentine: The vast majority of our recovery support services are provided by volunteers, and that’s the way we hope to keep it. That being said, if a director of a center is a very strong, powerful personality and very visible, people will be drawn to that person for recovery coaching. What we try to do is to get such people to train others so that we can expand the pool of recovery support resources.

    White: Do you see a danger in the trend toward paid recovery coaches? Might we drift toward that same clinical coldness you described earlier?

    Valentine: It’s always about the heart. There’s a real spiritual component. Some recovery coaches can get paid and handle it well and others cannot. Getting paid in this role elevates the level of authority and responsibility. I worry about the ego. I worry about coaches aspiring to that kind of life-and-death influence over others. That kind of authority can mess with a person’s recovery and humility. The longer I’m in recovery, the less I know. When you’re a paid recovery coach for a while, you think you’re starting to know all the answers, and that’s just not true. There’s always gonna be clients who are gonna teach you more than you teach them, and I hope we stay open to the lessons of such people. There are new ways to deal with things. The volunteer piece works in part because you have a whole network of other volunteers that you bounce things off of. With volunteers, the individual is served by a community of people—the volunteers being the welcome wagon of that community. What a difference it makes on the soccer fields! I’ve had six years’ experience as a travel soccer coach. I wouldn’t dream of getting paid. I love it, and I do it because the kids are so much fun. The sport’s great. I have something to contribute. Why do we think that a recovery coach should be any different than that? (White, 2006) http://vtrecoverynetwork.org/data/Recovery_Symposium/GLATTCInterviewValentine.pdf

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