1. Revolutionizing Behavioral Healthcare Two Concepts, One Tool Impact Outcomes Facilitate Healing Copyright 2012 - Lighthouse Network 1

2. For if you remain silent at this time, relief and deliverance for the Jews will arise from another place, but you and your father’s family will perish. And who knows but that you have come to your royal position for such a time as this? Copyright 2012 - Lighthouse Network 2

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5. Statistics 1.Addictions leading cause of death in US 2.Suicide 38K - #2 in US with under-reporting counted 3.WHO – depression #1 cause of disability worldwide 4.Significant Substance Dependence – 15-25% 5.Pornography – largest internet business by far 6.Mood DO – 24% 7.Anxiety DO – 29% 8.Sexual/Physical Abuse – 36-43% 9.Adj DO – 27%, Personality DO 19-22% 10.Eating DO/Obesity – 31% Copyright 2012 - Lighthouse Network 5

6. Where We Stand Now Lots of people suffering Increased science and tx options meds, VNS, TMS, psycho surgery Better diagnostics and imaging, neurotransmitter testing Increased awareness Why is society getting sicker Why are treatment outcomes stagnating Copyright 2012 - Lighthouse Network 6

7. BH’s Biggest Obstacles We don’t have an integrated view of BH issues. – Compartmentalize MH from Addictions Don’t integrate spirituality into pathogenesis and treatment Copyright 2012 - Lighthouse Network 7

8. MH/Addiction Integration 1.Complicated Clinical Issue – Axis 1 and 2 2.Minnesota Model simplistic but entrenched 3.CAC, CADC, LPC skills 4.MH vs D/A – problem with specialization 5.Complicated Healthcare system – Insurance, Govt Agencies, Licensure/Credentialing – Programming Issues Copyright 2012 - Lighthouse Network 8

9. MH/Addiction Integration 1.Complicated Clinical Issue – Most difficult patient – Excuses/Lying/Manipulation – Underlying Core issues pt really wants covered up – Trauma – Brain damage, so cognitively challenged – Compromised resources Family, Relationships, Friends Money/insurance Job/Legal Health Copyright 2013 - Lighthouse Network

10. MH/Addiction Integration 2.Minnesota Model(Hazeldon) of D/A Treatment – Simplistic and outdated – But Entrenched as the Gold Standard – Alcoholism is involuntary – Primary Disease – Not Curable, but arrestable – Tx – spirit, psychological, social, medical – AA is essential component – Sometimes not approving of psychotropic medications for psychiatric issues Copyright 2013 - Lighthouse Network

11. MH/Addiction Integration 3.CAC, CADC – Front line treatment personnel – Often run groups – HS diploma or above – 270-300 hrs of training (Equivalent 6-7 college courses) – Often only 1-6 hour modules in not building depth of understanding – some supervised work in the field that is often unspecified and supervised by another CAC/CADC – One course is 45-55 hours is counseling Copyright 2013 - Lighthouse Network

12. MH/Addiction Integration 4.MH vs D/A – Which is primary – Not many therapists well versed in an integrated and practical addiction/psychological paradigm – Patient has to coordinate the 2 different treatment areas - Problem with specialization – Some rehabs won’t even accept psych meds – Trouble getting to the core issues underlying the addictive coping skill Copyright 2013 - Lighthouse Network

13. MH/Addiction Integration 5.Complicated Healthcare System – Voluntary vs. Legal Commitment – Third party managers – Insurance – PPO, HMO, UR – Level of Care (LOC) – Addictions treatment nebulous – Outcomes often poor – Stigma Lack of full disclosure by patient Wait to long to access treatment – Lack of clinicians understanding of illness and system – Lack of lay person understanding of illness and system – Lack of SMB Integration from either side – medical or church Copyright 2013 - Lighthouse Network

14. MH/Addiction Integration 6.Programming Issues – Heterogeneous Population – Admitted on different days – Patchwork program – pt has to integrate and organize – Not enough programming each day – Not enough Homework or practicing skills – Not enough experiential implementation – Skill set of staff limited – Not addressing core issues because of above limits Most is behavioral mod and not insight oriented – Minimal practical equipping Copyright 2013 - Lighthouse Network

15. Lack of Spiritual Integration 1.Patients desire it – Holistic approach 2.Clinicians are afraid of it 3.What is it. 4.Science supports it 5.Outcomes improve with it 1.Infusing it 2.Matching pt’s it with therapists it Copyright 2012 - Lighthouse Network 15

16. Resiliency Factors Optimism. Altruism Having a moral compass or set of beliefs that cannot be shattered; Faith and spirituality Humor Having a role model. Social supports Facing fear (or leaving one's comfort zone); Having a mission or meaning in life; Training Copyright 2012 - Lighthouse Network 16

17. Basic and Spiritual Yearnings/Desires Self Ability Relationships Consistency – predictable, makes sense, hope Adoration - Value Security Meaning/Purpose Copyright 2012 - Lighthouse Network 17

18. What is Addiction? Copyright 2013 - Lighthouse Network

19. DSM 4 TR… Substance Abuse One or more of the following 4: Failure to fulfill major obligations at work, school or home Use when physically hazardous Recurrent legal problems Recurrent social or interpersonal problems Copyright 2013 - Lighthouse Network

20. DSM 4 TR… Substance Dependence (Addiction) Three or more of the following 7: High or increased Tolerance Withdrawal Consumption of larger amounts over longer period of time than intended Copyright 2013 - Lighthouse Network

21. DSM 4 TR… Substance Dependence (Addiction) Three or more of the following7 (cont): Unsuccessful efforts in cutting down Significant time spent obtaining, using, thinking about or recovering from the substance Substance time replaces social, occupational, or recreational activities Continued use despite adverse consequences physical, psychological (spiritual) Copyright 2013 - Lighthouse Network

22. DSM 5: Substance Use Disorders Not using the word ‘addiction’ Behavioral Category – gambling(was Impulse DO) Considered Sex, Eating, Caffeine, Internet Internet Gaming and Caffeine Use DO will be in the appendix Use same 11 Criteria but: – Dropped Legal Issues, Added Craving 0-1, 2-3, 4-5, 6+ Copyright 2013 - Lighthouse Network

23. American Society of Addiction Medicine  Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry.  Dysfunction in these circuits leads to characteristic biological, psychological, social, and spiritual manifestations.  This circuitry and resultant manifestations lead to the individual pursuing reward and/or relief by substance use and other behaviors. Copyright 2013 - Lighthouse Network

24. 5 Levels of SA/Addiction EXPERIMENTAL USE: trying substance once or twice. RECREATIONAL USE: using a substance socially, only with friends or at a party CIRCUMSTANTIAL USE: using a substance to escape or avoid personal problems or life circumstances OR using a substance to get through a challenging situation (e.g.: taking caffeine-laced pills to stay awake to study for exams). INTENSIFIED USE: increasing over a long period of time. This describes the regular user who experiences on-going symptoms because of their drug use (physical, psychological, emotional, spiritual). COMPULSIVE USE: True addicts who can’t “voluntarily” give up their substance abuse. They can no longer choose not to use, and suffer significant life and heath disruption because of their addiction. Copyright 2013 - Lighthouse Network

25. Bible Definition Exodus 20:3 You shall have no other gods before Me. Exodus 20:4,5 You shall not make for yourself an idol, or any likeness of what is in heaven above or on the earth beneath or in the water under the earth. You shall not worship them or serve them; for I, the Lord your God, am a jealous God, Copyright 2013 - Lighthouse Network

26. Real Addiction Rom 7:15 For what I am doing, I do not understand; for I am not practicing what I would like to do, but I am doing the very thing I hate 17So now, no longer am I the one doing it, but sin which dwells in me. 18For I know that nothing good dwells in me, that is, in my flesh; for the willing is present in me, but the doing of the good is not. 19For the good that I want, I do not do, but I practice the very evil that I do not want. 20But if I am doing the very thing I do not want, I am no longer the one doing it, but sin which dwells in me. Copyright 2013 - Lighthouse Network

27. Real Addiction 21I find then the principle that evil is present in me, the one who wants to do good. 22For I joyfully concur with the law of God in the inner man, 23but I see a different law in the members of my body, waging war against the law of my mind and making me a prisoner of the law of sin which is in my members. 24Wretched man that I am! Who will set me free from the body of this death? Copyright 2013 - Lighthouse Network

28. Real Addiction Why Addiction: coping skill to ‘help’ deal with life/stress – Circumstantial Use – deeper than brain or behaviors We all have behaviors to help us cope with life/stress that qualify as addictions that grow out misguided coping skills Benzio Definition of Addiction: – Choosing or pursuing something other than God (or Him + the healthy solution He provides) in a habitual, patterned, or repetitive way to get a particular need/needs met – A Coping mechanism, repetitively used, not focused on God Comfort We’re ALL addicted to ……….. Comfort Copyright 2013 - Lighthouse Network

29. Real Addiction Addiction Role = Coping skill for stressor management Addiction Goal = COMFORT Addiction Object = the element we turn to thinking it delivers the comfort we desire – Usually a process rather than a concrete object Treatment: Needs to get at the root issues that cause discomfort – Trading addictions Copyright 2013 - Lighthouse Network

30. HELP! I prayed, took meds, and love my mother! I’m DYING Psychological Defect- Tell me about your mother! Sin- Have more Faith! Disease- Take your MEDS! Copyright 2012 - Lighthouse Network 30

31. Your wish is my command!

32. The Most Important Spiritual Discipline: Copyright 2013 - Lighthouse Network

33. Karl’s Story Why did I become a psychiatrist? Copyright 2012 - Lighthouse Network 33

34. Karl’s First Beer Copyright 2012 - Lighthouse Network34

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36. Goal: Mind of Christ! Jesus’ Brain = Perfection! 1.Perceived everything from a Godly perspective 2.Responded with Biblical skills Copyright 2013 - Lighthouse Network

37. BrainWorks – My Brain Based on new scientific research, my brain does 2 things 1.Perceives 2.Responds Copyright 2013 - Lighthouse Network

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40. HARDWARE! Copyright 2013 - Lighthouse Network

43. S.P.E.C.T. Scans Single Photon Emission Computerized Tomography A sophisticated nuclear medicine study that looks directly at cerebral blood flow and indirectly at the brain activity (or metabolism) All of the following slides are used with permission from “Images Into Human Behavior - A Brain SPECT Atlas” by Daniel Amen, M.D. © Copyright 2000 Copyright 2013 - Lighthouse Network

44. Normal Brain-Top Copyright 2013 - Lighthouse Network

45. Normal Brain-Bottom Copyright 2013 - Lighthouse Network

46. Normal Brain-Active Views Copyright 2013 - Lighthouse Network

47. Motorcycle Accident Copyright 2013 - Lighthouse Network

48. Alzheimer’s Disease Copyright 2013 - Lighthouse Network

49. 25 year Heroin Addiction - 39 yo Copyright 2013 - Lighthouse Network

50. 16 Years of Daily THC (Tetrahydrocannibinol) Use 32 yo Copyright 2013 - Lighthouse Network

51. 10 Years of Mostly Weekend Marijuana Use 28 yo Copyright 2013 - Lighthouse Network

52. 2 Years of Frequent Cocaine Use - 24 yo Copyright 2013 - Lighthouse Network

53. 8 Years of Heavy Methamphetamine Use 28 yo Copyright 2013 - Lighthouse Network

54. 17 Years of Heavy Weekend Alcohol Use 38 yo Copyright 2013 - Lighthouse Network

55. 17 Years of Heavy Weekend Alcohol Use 38 yo Copyright 2013 - Lighthouse Network

56. 27 Year Daily Heavy Cigarette and Coffee Use 45 yo Copyright 2013 - Lighthouse Network

57. PolySubstance Abuse and then 1 yr Clean Copyright 2011 - Lighthouse Network

58. Depression Copyright 2013 - Lighthouse Network Before Treatment After Treatment

59. PTSD, Depression, and Anxiety Before and After St. John’s Wort and EMDR Copyright 2013 - Lighthouse Network

60. Images of PMS Copyright 2013 - Lighthouse Network Day 2 of Cycle (Worst Time) Day 10 of Cycle (Best Time)

61. Hardware Summary Disease Aspect Our brains are dynamic organs Our brains can be injured or diseased easily Our brains can be strengthened or renewed Not just born this way Copyright 2012 - Lighthouse Network 61 Hardware Summary

62. BrainWorks Research Skin GI / Cardiac Panic Disorder Study Copyright 2012 - Lighthouse Network 62

63. Heart of Transformation: Decision-Making No biological Intervention But Brain Chemistry Improved/Renewed Decision-making is exercise for brain Good decisions = stronger brain Bad decisions = injured brain Copyright 2012 - Lighthouse Network63

64. What determines accurate Perception and Response? Values, Authority, Plum Line determine the standard DM: Science and Faith Meet Integration and DM are Key! Copyright 2012 - Lighthouse Network 64 Mind SpiritBody Decision-Making = Spirit, Mind, & BodyIntegration

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66. Holistic, Not Primary Disease, Approach Like an ED model WHY do you use – faulty coping skill Not 12 Step More psychological Getting at core issues Customized Less behavioral mod and more transformational in goal and communicated approach Lots of room for Christian integration Curable

67. 1.Don’t separate MH and Addictions 2.DM is the most foundational tool/strategy for life success – gets to core and sees all BH on a continuum Copyright 2012 - Lighthouse Network 67 My Challenge To You

68. 3.Improve your Spiritual Radar 4.Bring Spirituality into Treatment 5.What set of principles determine clear perception and healthy responses – Guide your life – Offer to others to guide them to healing Copyright 2012 - Lighthouse Network 68 My Challenge To You

69. Lighthouse Network Helpline Finds addiction and MH treatment options. Expertise about all elements of the system Free to client Saves the clinician incredible amounts of time We find great options for struggling people 877-562-2565 x:101 Copyright 2012 - Lighthouse Network69

70. Lighthouse Network Resources Within Reach: Disciplines for Real Life Change – 10+ Hours of DVD – 140 Page Workbook Edging Forward: Godly Decision Making Shattered Silence – Documentary for teens/young adults Can Psych Meds Help Christians? (DVD) Addiction: Sin vs. Disease DVD kbenzio@lighthousenetwork.org www.LighthouseNetwork.org Stepping Stones Daily Devotional - Free

71. Any Questions? Copyright 2013 - Lighthouse Network

72. 12 Steps of AA 1.We admitted we were powerless over alcohol—that our lives had become unmanageable. 2.Came to believe that a power greater than ourselves could restore us to sanity. 3.Made a decision to turn our will and our lives over to the care of God (as we understand Him) 4.Made a searching and fearless moral inventory of ourselves. 5.Admitted to God, to ourselves, and to another human being the exact nature of our wrongs. 6.Were entirely ready to have God remove all these defects of character. Copyright 2013 - Lighthouse Network

73. 12 Steps of AA 7.Humbly asked Him to remove our shortcomings. 8.Made a list of all persons we had harmed, and became willing to make amends to them all. 9.Made direct amends to such people wherever possible, except when to do so would injure them or others. 10.Continued to take personal inventory, and when we were wrong, promptly admitted it. Copyright 2013 - Lighthouse Network

74. 12 Steps of AA 11.Sought through prayer and meditation to improve our conscious contact with God (as we understand Him) praying only for knowledge of His will for us and the power to carry it out. 12.Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs. Copyright 2013 - Lighthouse Network