The Daniel Plan
Earlier this year in an excellent HuffPost blog, "How Social Networks Control Your Health," my colleague Dr. Mark Hyman wrote, "The power of community to create health is far greater than any physician, clinic, or hospital."
Hyman was of course referring to his wildly successful healthy eating program, The Daniel Plan, created with Drs. Mehmet Oz and Daniel Amen. Hyman formed the idea for the plan while having dinner with then-overweight pastor Rick Warren, leader of the 30,000-member Saddleback Church in Southern California. During dinner Warren described to Hyman his extraordinarily successful experiment for sustained personal growth and change -- based largely on encouraging his enormous congregation to form 5,000 small groups, one for every six members, which met every week in their local communities to study, learn, and grow together. As dinner progressed and Warren complained that he wasn't the only member of his congregation with weight-related issues, Hyman envisioned using those small groups to help the Saddleback congregation get religious about health.
Shortly thereafter, on Jan. 15, 2011, The Daniel Plan, named after the biblical character Daniel, who resisted the temptations of rich food and was healthier for doing so, was launched. Within a week, over 15,000 people -- more than half the congregation -- had signed up to participate in small groups, track their progress, and be part of a research study. The groups were supported by a weekly curriculum, learning objectives, videos, webinars, seminars, and online support. In the first year, the 15,000 participants lost over 250,000 pounds, with drastically improved overall health and well-being. Many participants reported both fewer doctor visits and a reduced need for pharmacological intervention in treating hypertension, diabetes, and heart problems.
The power of community trumped the power of medication!
Does The Daniel Plan Work for Addiction?
The success of The Daniel Plan may have surprised many in the scientific and medical communities. However, members of 12-step support networks such as Alcoholics Anonymous were not surprised at all. After all, AA has been espousing The Daniel Plan's philosophy since the 1930s -- with the results to back it up. As members of AA are wont to say, "I can't stay sober, but we can."
In the more than 70 years since AA was founded, literally hundreds of offshoots have sprung up -- dealing with everything from other addictive drugs to eating disorders to compulsive gambling to out-of-control sexual behavior. All of these hundreds of programs have (no surprise here) 12 steps, and the first word of the 12 steps in each and every program is "we."
"We admitted we were powerless over..."
No matter what substance or behavior addicted individuals are battling, the path to lasting sobriety begins with support from other individuals recovering from the same addiction. No medical doctor, no therapist, and no pharmacological intervention can guide an alcoholic or an addict to lasting sobriety as well as another individual trudging along the same road to recovery -- a person who is dealing with the same thoughts, cravings, and life-issues. As AA and other 12-steps groups have proven, when dealing with addiction, the community is the best treatment.
But what happens when the community disappears? What happens when an alcoholic, 30 days sober, leaves an intensive inpatient treatment setting filled with supportive staff and others in early recovery? And what happens when an addict, six months clean, gets a new job in a new city? Or when that person's sponsor gets a new job in a new city? Sadly, when a support network is not stable, or when it disappears altogether as sometimes happens when a recovering person leaves the supportive cocoon of a treatment center and returns to whatever region of the country he or she is from, the potential for relapse increases significantly.
Social Media to the Rescue
These days, virtually everyone owns a computer, smartphone, or other mobile device. Digital interaction is an integral part of our everyday routine. We check emails and texts, update our Facebook page, fire off a Tweet or two, and then finish our morning coffee. Digital interconnectivity provides endless new opportunities to support our very human needs for community and social interaction. Facebook, with over 800 million users, and Twitter, with over 300 million users, now allow real-time interactions with an increasingly wider and more diverse group of people. Best of all, friends and family too distant for regular contact just a few years ago can now be intimately folded into our lives.
This rapidly growing interconnectivity is a godsend for those in recovery. An individual leaving a treatment center in California can return to his home in New Jersey and remain in close contact with his brothers in recovery no matter where they live. If he has a good Twitter network -- and he should by the time he leaves treatment -- he need only tap "I'm standing outside the liquor store" into his smartphone to round up the digital rescue posse. An AA grande dame with a dozen sponsees can post daily affirmations on her Facebook page, providing inspiration with a personal touch no matter where she or her sponsees are. And these days, the addict with six months clean who gets a great job in a new city needn't forsake his recovery support network. Instead, he can stay in regular contact with his sponsor and recovery buddies via emails, texts, tweets, and phone calls while he develops his new in-person support group, greatly reducing his odds of relapse.
As AA and other 12-step programs have long been aware, the power of "we" in recovery cannot be overstated. So anything that helps us to stay connected, especially in real-time (as we see with Twitter, texting, etc.) can be a powerful implement in the recovering individual's toolbox. The time has come for treatment centers and clinicians to recognize and embrace this, perhaps even integrating social media training into treatment programs. Furthermore, in person treatment can now be supported, like The Daniel Plan, with online videos, webinars, and social support.
David Sack, M.D., is board certified in psychiatry, addiction psychiatry and addiction medicine. He is CEO of Elements Behavioral Health, a network of addiction and mental health treatment programs that includes Promises Treatment Centers, The Ranch outside Nashville, The Sexual Recovery Institute, and The Recovery Place.
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