Do I Need a Sober Companion?

Sober companions, also called sober coaches, are becoming increasingly popular in the United States. What do they do and is a sober companion the right choice for you?

Sober companions are individuals in recovery who assist someone struggling with addiction who is trying to get or stay sober. Sober companions are mentors or guides. They are not a friend, therapist, or 12-step program sponsor. They are not personal assistants, doing the client’s bidding. The main role of a sober companion is to encourage clients to make healthy choices, doing so by example. Jobs may last anywhere from a few hours to a year or more.

Almost all sober companions will work with any abstinence-based recovery model: 12-step, Refuge Recovery, SMART Recovery, etc. Most sober companions will work with a harm reduction model, if that’s what a client chooses.

Sober companions may do a variety of jobs. “Transport” is helping to get a person to rehab. Those suffering from addiction are frequently afraid to go to treatment and may need help getting safely to a treatment center. Often transport jobs require the companion to drive a long distance to a treatment facility with a client, if the client has no ID and cannot get on a plane. Some transport jobs require a nurse to give medication to a client, in addition to a sober companion.

Though transport jobs are common, most sober companions are hired to stay with an individual after they have finished a residential treatment program. A sober companion might help with the “transition” from treatment to home. In these jobs, sober companions may live with the client in their home or do 12-hour shifts (8am – 8pm, for example), to help an individual learn how to live a sober life in their community. These jobs usually start with a full sweep of the home, to remove any drugs or alcohol from the residence. Then, the client’s day is structured around all the activities that need to be accomplished – from grocery shopping and exercise to work and sober support that might include: psychotherapy, outpatient programming, or 12-step meetings. These jobs vary in length, but two weeks to a month is common.

Another short-term sober companion job has the sober companion travel with an individual for a particular event, such as a family reunion or a business meeting. These kinds of stressful events can cause relapse for individuals new in recovery. A sober companion helps an individual remain grounded and sobriety focused during the event and provides emotional support and encouragement in the high stress situation.

Other sober companions support people who are not in a position to go to treatment for addiction or mental health problems. These tend to be longer term assignments where companions will live-in or travel with a client for months or a year. Clients who choose this service might be on tour with a band, on location shooting a TV show for film, or living in a remote area where there is little support for a sober lifestyle. In these cases, the sober companion will generally work as part of a team, consulting with psychiatrists, addiction medicine physicians, psychotherapists, and others to help an individual maintain a focus on recovery.

Finding a sober companion is no more difficult than a web search. There are many sober companion companies to choose from. Though many sober companion companies are west coast based, most companions work nationally or internationally, wherever their clients need them. Treatment facilities, addiction medicine physicians, or psychiatrists often recommend companies or individuals they have worked with in the past.

Sober companion services are unregulated. There is no minimum sobriety or training requirement for companions in the USA. Sober companions can free-lance, though most are available to several placement agencies. Most reputable sober companion companies require that companions have a minimum of five years sobriety and a solid reputation for being unflappable in difficult circumstances. Liability insurance, CPR/First Aid certification, and a clean TB test are also common for sober companions. Because of the opioid overdose epidemic, many sober companions know how to use and carry naloxone, the overdose reversal drug.

Sober companion companies provide an extra layer of support and protection for the consumer. Though their services will cost more than hiring a companion directly, companion companies vet and support their sober companions. They provide case management and maintain relationships with a network of medical professionals. Sober companion companies train, monitor, and support sober companions. They also make travel arrangements and do all the bookkeeping for their sober companions, so that the companion can place 100% of their attention on the client. Sober companion companies also do their best to ensure that the client and companion are a good match for one another, and when needed, will send a replacement if the first match is not a fit.

The cost of sober companion services depends on the demands of the job. At a minimum, services run about the same per day as a mid-cost residential treatment program, plus the companion’s travel or living expenses. Insurance does not pay for sober companion services.

People who hire sober companions see it as an investment in recovery. While a sober companion cannot guarantee sobriety, they can help a committed individual navigate the difficulties of transitioning home.

To learn more about sober companion services for transport, transition, or other assignments, ask your addiction treatment facility or a psychiatrist/psychotherapist specializing in addiction who they recommend. Again, this is an unregulated field, so do your due diligence. Find out as much as you can about the sober companion company you want to hire. Make sure everyone involved is trained and insured. Discuss the role of the companion to be sure that your expectations will be met. While a sober companion cannot make a person get or stay sober, they can provide an important service to guide and support someone who’s new in recovery and needs assistance to navigate the world, clean.

Seven Reasons Why Now is the Best Time to Go to Rehab

When is the right time to go to rehab? The simple answer is now. Here are seven reasons why this is the right moment to get online and find the treatment center that fits your needs to treat your addiction and if you have one, co-occurring psychological disorder.

Across the nation, treatment center censuses are low. A lot of people don’t want to go to treatment over the holidays. Even though family relationships might be strained, it’s no one’s ideal to be in rehab for Thanksgiving, Christmas, or New Year. This means that many treatment centers in all parts of the country have beds available. If you are a cash client, this can work to your advantage as some treatment centers might negotiate a lower price for you in order to fill a bed that would otherwise be vacant.

It’s the start of the insurance year. Insurance is tricky to navigate, but at the beginning of the year one thing is certain, all the previous year’s payments toward deductibles and annual caps are wiped clean. Get paying toward that deductible now, so that you can use the maximum benefits available to you this year.

You have the willingness. The best time to go to treatment is when you are willing to do so. If you or a loved one has any desire to get support for addiction or an eating disorder, the time to move on that is the moment that desire is voiced. Willingness comes and goes. Capitalize on the feelings and get help while the yearning is there.

Continuing to use can be deadly. With overdose deaths reaching more than 72,000 in 2017 and a similar number expected for 2018, every day of using is a day one flirts with death. At present in the USA, we lose more than 197 people to overdose daily. For those who don’t die, each day not in treatment is a day lost to addiction. You deserve a new and better life. You can start that life today.

Treatment works. Study after study shows that quality addiction treatment improves the chances that an individual will be able to create a quality, sober life. People who stay in treatment long-term have fewer relapses of shorter duration than those who do not seek treatment. If you want a new life, treatment can be a good place to start.

Treatment can be expensive. Addiction costs more. Many people get sticker shock when they see the cost of addiction treatment. It can be expensive. What costs more, however, is addiction. Set the direct cost of drugs or alcohol aside. There are also the costs of broken families, children placed in foster care, and trips to the ER. You can look at treatment as expensive or you can look at is as a way to get your, or your loved one’s, life back. People who successfully complete treatment and work on their recovery become useful and productive individuals who give back to, rather than take from, those around them.

Nothing changes if nothing changes. There’s an old saying that insanity is doing the same thing over again expecting a different result. Addiction controls lives, yours and your family’s. Change happens when you are willing to take the first step. For addicts, that’s picking up the phone and making a call to a reputable addiction treatment facility. It’s a frightening prospect, but you’ll be supported every step of the way.

Take your life back. If you need help with addiction, get it. You and your loved ones deserve it. It’s a new year. Make it a better one than the last.

Surviving Toxic Family Gatherings

Being with family can be stressful at any time of year. People who might not normally interact are thrust together at family gatherings. There may be alcohol thrown into the mix, increasing the potential for an unhappy event. What can you do to make your family events the best they can be? Here are a few tips:

You Don’t Have to Attend

Forget all the admonishments people give that “this is your family” and you “should” do this or that. Toxic is toxic. If it is dangerous or genuinely unhealthy for you to spend time with your family, don’t do it. If people are abusing substances at a gathering or are known to become violent, you are under no obligation to go or if the situation devolves, to stay. Your health and safety is paramount. Take care of yourself first. 

Find Something Meaningful to Do

If you choose not to attend a family gathering, don’t just sit at home. What can you do to bring hope and joy to others? If you’re in a 12-step program, go to a 12-step meeting so that others can benefit from your experience. Deliver meals to those who can’t get out. Shovel a neighbor’s driveway so they can get to their function. Make soup for the homeless. Visit someone who might not get many visitors. Sing holiday songs on the street corner. There are plenty of things to do that will help you and others have a wonderful day. 

Limit Interactions

If you go to a family event, at a larger gathering, it may be possible to limit your interaction with a particular person who rubs you the wrong way. This might not be a health and safety issue. Maybe your uncle’s political views rankle you. Perhaps your aunt boasts too much about your cousin who is doing “amazing things” or wants to show you 7,000 pictures of her cats. It’s OK to be polite, listen for a minute, and move on. It’s great to be courteous and interested, then hear about what other people in the family are doing. 

Limiting interactions can also mean staying at a gathering for only a short period of time. Some families might have people drop in and leave throughout the day. If it’s comfortable for you to spend the day with your family, by all means enjoy your family! But if it is troubling to spend hours watching ball games or if tempers start to flare after an extended period of time, keep your time at the event limited. article continues after advertisement

Help Someone Else

Sometimes, we can get caught up in our own thoughts. The holidays are a good time to be of service. Ask whomever is hosting the function if you can help out in the kitchen or make a plate for an elderly person who is struggling. Does someone need to take the dog for a walk? Is there a child who wants someone to play with or would like to be read a story? Look for opportunities to be of service to those around you.  

Don’t Take the Bait

We all know people who want to bait us. If there is something about us that seems to upset another person, it’s our choice whether or not to get into an argument. It doesn’t matter what they say. We can change the subject. “I appreciate your opinion, Stewart. Jane, I hear that your nephew just earned a scholarship for his science project.” Defuse the situation whenever possible by not engaging with people who want to be negative. Walking away works too.

Stand Up for Yourself and Others

Changing family dynamics sometimes involves taking a stand. Did your nephew recently come out and someone in the family has a problem with it? Is your cousin conspicuously absent from the get-together because she’s in rehab? If someone is picking on a person present or bashing someone absent, respectfully and firmly step in. “I for one think it’s great that Debra is in rehab and doing her best to get her life together.” Part of being family — blood or otherwise — is providing one another with support. 

Family dynamics can be tough to navigate. This holiday season or any time of year, take care of yourself by setting boundaries and taking actions that will best serve your mental health. 

The Psychological and Developmental Benefits for Youth Involved with Horses

Now that spring is coming, our thoughts turn to outdoor activities. What do we want to do outside and how can we get our children outdoors? One outdoor activity that is always popular with children is horseback riding.


Except for children with certain kinds of physical disorders, riding is probably the least important part of being around horses for children. It is being in the barn and being responsible for the horse that has the most benefit for young people. Horses require a great deal of care and attention before and after riding. These needs can teach children to be responsible, on-time, compassionate, strong, resilient, and committed.


Here are some of the benefits of learning horsemanship and spending time with horses.




One can’t simply “ride” a horse. A person must develop skills and a relationship with the animal in order to be an effective team. This means working daily to improve communication skills. Horses respond to how a person uses body language to communicate with them. The best riders are those who can communicate effectively with a variety of horses. This communication takes years to develop and hone, but is priceless both in and out of the arena.




One of the most important things children learn riding horses is leadership. Horses are herd animals. They have a very strict pecking order in the herd. A rider gets a horse to respond to them by being the leader. Those great horse/rider teams – the one where the horse will challenge its own fear to do as the rider wants – come about because the rider has shown leadership to the horse.




Horses also teach children discipline. Horse have to be fed, watered, groomed and exercised. Their stalls and equipment must be cleaned. These are daily chores. Horses teach children to be disciplined and work hard. One can’t put off feeding their horse until “later” and then expect the horse to respond well. A good horseperson takes care of all a horse’s needs first and promptly, no matter what else they have going on in their life.


Conditional Affection


Horses give CONDITIONAL affection. They react to the emotions presented to them. If a person comes into the barn angry or stressed, the horses react to that. They are therefore very effective in therapeutic situations because they can help people see their emotional states.




A child who is taught horsemanship, which is different from simple riding, will learn humility. There is always more work to do and more to learn with horses. People working with horses will find their deficits and limitations. Those who learn from those experiences may dig deeper and push themselves harder. Horses can teach humans the real meaning of humility – to be modest and respectful – not just with horses, but with all beings we encounter.




Having an animal as large as a horse do what you ask it to do is a confidence-boosting experience. So many people are afraid of horses because of their size and the threat they pose. Someone who can get a horse to do what they want it to do will glow with confidence.


There’s also confidence in a job well done. Some kids don’t have terribly well-trained horses. They don’t win horse shows or go on to be lifelong horsemen/horsewomen. But they do gain confidence by setting goals and working toward them.


There is also confidence to be gained by cleaning your equipment well or running a personal best in a practice round for a rodeo or learning a difficult skill or helping someone else at the barn learn a skill you have mastered.




Horses can teach children patience and to learn from their mistakes. Horses have minds of their own. A rider has to work with the horse to get it to perform as desired. It is a partnership, and one that doesn’t always go well. Children learn that they don’t always win the horse show. Their horse may be lame when they want to go riding. They will be frustrated when the horse won’t do for them what it will do for their trainer. These are all learning opportunities. And they are worthwhile.

Get Kids Outdoors to Improve Mental and Physical Wellbeing

Children are increasingly spending time indoors engaged with various forms of electronic devices: phones, computers, tablets, televisions, and gaming consoles. Parents and educators are often concerned that too much screen time is damaging to children. One study suggests that children can spend an average of seven hours per day in front of screens. While not all screen time is created equal, there are benefits to using media in educational settings, for example, there is no argument that children on the whole spend too much time engaged with electronic devices to be healthy.


What’s the solution? Get kids outdoors to improve their mental and physical health.


There is significant data indicating that time spent outdoors, whether in play, outdoor education or recreation, or even gardening, can have a real and positive impact on mental and physical well-being. Outdoor experiences included as adjuncts to classroom learning improve classroom performance. These types of experiences can also improve communication and social cues. Parks with green spaces and urban hiking areas promote creativity through play. Gardening teaches children about the food cycle and nutrition, provides important life skills, and creates opportunities for children to learn competence, resilience, and community building.


How can busy parents, who may themselves suffer from too much screen time, help kids get outdoors? Here are a few suggestions:

GardeningJunior Master Gardener programs can be integrated into school curricula or be used at home or in religious youth groups. Children’s gardening programs ignite a passion for good food, provide opportunities for people of all ages to work together, and develop important life skills that can lead to a lifetime of healthful choices. Food produced may be used in home or school settings, canned for use in the off season, and excess donated to local food banks.


ScoutsBoy Scouts and Girl Scouts are values-based movements that each have an underpinning in outdoor programming. While certainly not all these groups do – they have science and community service activities among others – scout organizations often own or have access to outdoor properties and professionals that children would not have an opportunity to experience in other ways. Outdoor programs have a deep tradition within scouting and are offered in age-appropriate ways for the youngest and oldest scouts.


State and National ParksState and national parks offer a wide variety of outdoor activities for youth and families. These are not necessarily just hikes or camping, but interactive wildlife activities, archaeological activities, storytelling times, and much more. The park service often coordinates activities with various scout groups too and provides special programming for youth groups from a variety of agencies and organizations. There are also free access days to National Parks that you can find out about online.


Agricultural Groups – Groups like 4H and Future Farmers of America (FFA) teach agriculture skills using project-based activities. 4H is the nation’s largest youth serving organization, providing leadership and skill building opportunities for youth and their communities. FFA is a school-based activity giving students a foundation in agriculture education.


Don’t allow children to trap themselves indoors spending mind-numbing hours watching screens. Take them to the park for unstructured play time. Give them chores that include working outdoors. If you live in a place where those kinds of activities are unsafe or you want your children to develop leadership and communication skills in addition to spending time outdoors, consider any of the organizations listed above or local groups that give children outdoor experiences.


By teaching children about gardening, ecosystems, and wildlife and giving them opportunities to work in a team with others, you will equip them with experiences and skills that will help them live healthier, more well-adjusted lives in the years to come. Outdoor experience often creates resilience – and we can all use much more of that.

Get Outside: One Difference that Makes a Difference for Improving Life Satisfaction

We’re three weeks into the year and most of us have already given up on our resolutions. But giving up on resolutions should not mean giving up on leading healthier, more fulfilling lives. In fact, now is a great time to consider reasonable, pleasurable activities that will help us be fitter and happier.


Perhaps the easiest thing to do is to spend time outdoors.


There is mounting evidence that almost any outdoor activity will decrease stress and improve life satisfaction. Improvement in both mental and physical health can be attributed to spending time outdoors. Even something as simple as outdoor play can lead to positive health outcomes.


There are simple steps you can take to benefit from being outdoors. Why not try:


Gardening: The time to plant a spring garden is fast approaching. Check out gardening websites for your area or find a Master Gardener group. Even if you live in a densely populated city, you can grow plants indoors, use window boxes, or find neighborhood green space. Many food pantries around the nation have land plots where people can garden. Whether you grow food or flowers, putting your hands in soil will have positive mental health benefits.


Walking: The simplest activity anyone can participate in is going for a walk in a green space. Walking by yourself or with others can be both physically and emotionally invigorating. Walking can decrease your sweet tooth and improve your creativity. Walking outdoors, particularly in a natural setting, can help to put our problems in perspective. It can take our minds off the pettiness and smallness of so many of the issues we face. And let’s tell the truth – parks and nature trails smell nicer than the indoor track at the gym.


Outdoor Play: The benefits of outdoor play for children cannot be understated. Studies have shown that outdoor play can have a significant positive impact on children’s brain development. Unstructured outdoor play can help children develop social and problem-solving skills. As with adults, being outdoors has a positive mental health impact and reduces stress and anxiety. Whether playing with other children or with the family – walking, hiking, or bike riding – being outdoors together builds family and social bonds.


Chores: Yes, even outdoor chores can have positive mental and physical health benefits. Instead of seeing snow shoveling or garden watering as a bummer, make a game out of your outdoor duties. Shoveling off the sidewalk in front of an elderly person’s house will give you exercise and help you feel good about yourself. Chores are an opportunity for service.


Stargazing: This might not be the most fun in the dead of winter, but getting out of the light polluted city and going someplace truly dark where you can really see the stars is breathtaking and awe-inspiring. The universe is an incredible place to behold. Grab a telescope and thermos of coffee and take off to see the moon and beyond.


State and National Parks: Our state and national park systems are one of the treasures of this nation. To find local resources, search “state parks near me.” For our national park system, search for the National Park Service. At many locations, there are professional rangers or volunteer docents who will share with you the magic of our beautiful parks.


Don’t allow yourself to become a screen addict and a couch potato. Get outdoors and reap the many mental and physical health benefits that come from enjoying our beautiful planet.



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Go Where It’s Green: A New Year’s Resolution You Can Keep

One of the problems with New Year’s resolutions is that most of us who make them aim too high. After at least a week of merry-making, starting with events before Christmas and culminating with New Year’s Day binges of sports and food, we suddenly expect ourselves to turn our lives around. We vow to go to the gym five days a week or switch to a paleo diet. We want to lose fifty or a hundred pounds and get in shape for summer. The reality, however, is that these changes are too drastic for us to be successful. Instead of expecting radical change in an instant, why not focus on smaller changes that can create big differences in our lives?

A resolution that is easy to implement and will have a significant impact on your life is to spend more time in green spaces and natural settings. According to the US Census Bureau, more than 62% of Americans live in cities and the trend is growing. Part of the reality of urban life is that most of us are not spending a lot of time outside or in green spaces; we go from home to transportation to work to other buildings and home again. This is a shame, because spending time in natural areas can have tremendous positive health benefits.

Research on the benefits of spending time in green spaces, especially for those who live in urban areas and may not have innate opportunities to be outside, is extensive. The International Journal of Wellbeing published a study indicating that regularly connecting with nature is a key activity in having a flourishing life. The Journal of Landscape and Urban Planning shared research showing how simply walking in a park can have a significant positive impact on well-being and encouraged the development of more green spaces in urban areas. Frontiers in Psychology published a study that found that spending time in nature or green spaces can help those with a variety of psychological disorders including but not limited to anxiety, depression, and attention deficits. Research in the Alternatives Journal concurs about the mental health benefits of spending time in green spaces and natural settings. That article even goes so far as to suggest that physicians and psychotherapists might do well to prescribe time outdoors for patients suffering from anxiety, depression, and many other mental health disorders. A study in the Journal of Environmental Psychology found that, “Being outdoors was associated with greater vitality, a relation that was mediated by the presence of natural elements.” There is no scientific dispute; spending time in parks and wild spaces makes us feel better.

What does this mean for New Year’s resolutions? Foremost, it means that we can make substantial improvements in our lives by making small changes. Set yourself up for success by making minor modifications to your lifestyle that you’re willing to stick to. While you might not be likely to go from junk-food-junkie to raw food vegan in one fell swoop, you are likely to be able to keep a commitment to take a walk in the park or eat your lunch under a tree on your break. You probably will take your kids for a bike ride or do a little gardening in the yard. Even these little changes can have a big impact. Then, as you begin to feel better, you can begin to tackle the larger issues you might want to address in your life.

This New Year, make a resolution that you are going to keep. Commit to spending at least twenty minutes a day outdoors in a green space. You might read a book, take a walk, practice tai chi, drink your coffee – whatever activity you choose is fine – just get outside and enjoy the beauty the world has to offer. You’ll feel and be better for it!


Do you want to learn more about changing your life? I invite you to follow me on Twitter @ConScharffPhd and join me on Facebook.

Seven Tips for Enjoying a Family Thanksgiving Celebration

Family gatherings can be difficult. All the emotional baggage and hurt feelings of the past can simmer beneath the surface. If allowed, these feelings can erupt in ugly ways. Here are a few tips to keep calm and help all family members enjoy their Thanksgiving dinner.


  1. Do not discuss politics. No one’s mind is going to be changed over dinner, but families can be permanently broken apart. Even if your politically-polarizing relative chides you, politely change the subject. Do not take the bait. There is nothing to be gained by discussing divisive topics.


  1. Do something nice for someone else. Show up Wednesday afternoon to help your grandmother put the leaf in the table and get the extra chairs from the attic. Drop off that old coat and knit hat at a collection place on your way to the airport. Make a donation to your local food bank or homeless shelter. One way to bring joy and give thanks for what you have is to help others who may not have the same gifts and blessings.


  1. Create a tradition of sharing gratitude. It might sound hokey, but having everyone share something for which they are grateful can sometimes put difficult family relations in perspective. It can also be an ice-breaker for those who are not accustomed to talking about their feelings. Reflecting on your blessings will improve your outlook and your patience.


  1. Lock up all medications. Millions of families are dealing with substance abuse and addiction. Unfortunately, Thanksgiving is a time when lots of people are in one place, which gives addicts an opportunity to steal medications. If someone at your Thanksgiving dinner has a problem with substance abuse, make sure all medications are locked away and are not accessible.


  1. Consider making your event alcohol free. Some people can’t imagine Thanksgiving dinner without alcohol. Others don’t really care one way or another. What is certain is that the more alcohol is involved in holiday gatherings, the more likely there are to be harsh words and broken relationships. Also, if you have someone in your family struggling with addiction or in early recovery, having an alcohol-free event can show your support for their recovery.


  1. Don’t judge. OK, so your great uncle is a loudmouth. Your niece’s boyfriend behaves in a way that is entitled, rude, and disrespectful. Your daughter is on some crazy diet and won’t eat anything you slaved over the stove for three days to make. Take a deep breath and remember why you are gathered. Focus on what is good instead of the irritations.


  1. Keep the visit brief. You are not required to spend the entire day with your family. If Thanksgiving is difficult, join the family for the meal and perhaps a short chat after and move on. Most people can be pleasant for an hour or two. Spend your time with those you rarely get to see, especially the elderly or the ill – and ask them how they are, instead of focusing on you.


I invite you to follow me on Twitter @ConScharffPhd and join me on Facebook.

To Honor Our Veterans, Let’s Keep Our Commitments to Them

As an addiction treatment professional, it goes with the territory that we lose people, good people who maybe needed a little more help or time or who simply made a regrettable choice. Veterans are often among those lost to substance abuse and suicide.


My first and most devastating loss was of a young Marine, Scott,* who had returned to the US from multiple deployments in Iraq and Afghanistan. He was 23 and handsome, classic good looks – blonde hair, blue eyes, solid chin and impeccable manners. I like working with veterans and active duty military because I have yet to meet one without impeccable manners. When I knew Scott, he was living at a VA facility in California. Scott and I spoke often. He liked to watch me needlepoint. I understood Scott because although we had very different stories, we had both self-medicated our symptoms of post-traumatic stress. We were in a way, kindred spirits.


Scott had hoped for a career in the military, but had been wounded during his last deployment and could not continue in military service. He walked with a cane and was clearly in pain. Scott had a wife and a child that was only a few months old. He sought treatment at the VA for alcohol abuse related to post-traumatic stress disorder (PTSD).


The last time I saw Scott, he had arrived at the meeting hall earlier than normal. He sat in his usual chair at the end of the first row. He was shaking. I walked up to him right away and asked what was wrong. He told me that he had just come from therapy and was very upset. To treat trauma, the VA often uses exposure therapy. In this type of therapy, the individual recounts, and very often in their mind relives, the most traumatic experience(s) of their lives. Exposure therapy is the “gold-standard” for PTSD treatment, according to the VA.


Exposure therapy can be an effective tool for overcoming trauma-related symptoms. For example, if a woman was raped in a park, she may have a fear of going to a park – and this might prevent her from having a full relationship with her young child who likes parks. By reviewing the traumatic event in the park, the woman may be able to become desensitized and recognize that the trauma stems from an event, not from parks.


Unfortunately for some, there is no catharsis in reliving the worst moments of their lives. For these individuals, there is no desensitizing that goes on with exposure therapy. In fact, the therapy may exacerbate their PTSD symptoms. Scott did not benefit from exposure therapy. He did not tell his therapist that his PTSD symptoms were worsening. Rather than feeling he was a failure for discontinuing therapy or relapsing on alcohol to relieve his PTSD symptoms, Scott chose suicide as a way out of his pain.


Scott died nearly a decade ago. I didn’t know him well, but he was precious and he was pained. I think of him often, particularly on Veterans Day.


Could Scott have been saved? I don’t know. The VA certainly does its best. However, the staggering number of veteran suicides, now 20 per day down from 22 per day earlier in the decade, should indicate that we are not doing enough. Our services are either incomplete or inadequate, or not in the right places or veterans cannot or will not use them. Whatever the cause of the deficit, it is our responsibility to keep our promises to our wounded warriors of all types and do a better job of providing re-entry into our communities. We owe them a debt. We need to pay it.


*Not his real name.


Another Affordable Care Act Repeal Effort: The GOP’s Rosh Hashanah Prayer for American Deaths

It is clear with the latest healthcare proposal, the Senate’s Graham-Cassidy bill, that the GOP has no interest in genuine healthcare reform that would provide higher quality or less expensive health services to Americans. The proposal unremorsefully would decimate the quality of healthcare for millions of Americans, raise premiums, and make access to health insurance impossible for at least twenty million citizens. The Graham-Cassidy bill, which Senators hope to push through by the slimmest of votes, serves the purpose only of trying to eliminate Obama-era policies without any regard for the well-being of Americans. It is a heart-breaking effort most precisely because there is a chance that it could pass.


Today is Rosh Hashanah, the Jewish New Year and the beginning of a ten-day period of intense introspection that culminates with the holy day, Yom Kippur, the Day of Atonement. During this period, many Jews believe that the Book of Life is open. We pray to be inscribed for a good life and to be shown how we can live better. On Yom Kippur, when the Book of Life is sealed, we hope that our prayers and efforts to make important improvements in the way we live, will grant us mercy and strength to implement those changes through the year. It is not lost on me that the deadline for the Graham-Cassidy bill’s passage or defeat is also the day when our collective fate is sealed.


Bernie Sanders and his cohort have put out the call, again, to fill the phone lines with calls to Senators, demanding that they vote against this bill. No leading medical group supports the legislation. The medical groups I belong to are urging me once more to be sure that that my Senator votes against this legislation. Hasn’t the fact that similar proposals have failed twice already sent that message? It should have.


The Senate knows that Americans do not want this bill. I would rather, during this spiritually important period, devote myself to the charity work that calls so loudly – to evacuating people and livestock from the wildfires plaguing us here in the West; to collecting gift cards to support those devastated by hurricanes; to the food and coat drive that my synagogue runs to help our community as winter rolls in. I am frustrated. If our Senators can’t see that this is a deadly proposal, we need not waste our time showing them the fallacy of their ways. We need new Senators.


It is clear that the President’s base doesn’t like Obama. I completely understand that repeal of the Affordable Care Act was a rallying call for that base. We certainly can do better than the ACA, but until we can improve it, we cannot return to the days of pre-existing condition exclusions, annual or lifetime caps on coverage, enormous premium hikes, and lack of access to care for millions.


As I go to the synagogue to pray for a good year, I pray not only for myself, but for those who have no one to speak for them. I pray for the mentally ill and the addicts, the people I work with, who aren’t registered to vote and don’t have the ear of a Senator. The Torah commands that we choose life. It is for life, and for healthcare, that I pray. Senators, kill this bill before this legislation kills us.


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