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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Lloyd I. Sederer, MD: Addiction: America's Most Neglected Disease
Michael Hodin: Adults On Social Media: Facebook's Untapped Value
David R. Hamilton, Ph.D.: Are Healthy (And Unhealthy) Habits Contagious?
One of the problems, when referencing addiction-related experiences or information in Facebook or Twitter is that all your followers can see it ... and you've essentially just outed yourself to them. I work with people who struggle with sexual behaviors (some at the level of addiction, some not), and this is an especially tricky issue for them. Many people are hesitant to post things that relate to sex or sexual struggles, because of the shame attached to having problems in that area. I know this is true with other addictions as well - some more so than others. just one quick example: I have a Facebook fan page that deals with recovery, and I know that some people are hesitant to "like" it, because that will show up on their wall, and might raise questions from friends and family members.
Obviously, there are ways that people can use social media that limit their exposure. Some technologies are better at this than others. As it stands right now, Twitter seems to work best for broadcasting information -- sending messages that identify the user is verbotten (at least for me). Facebook really doesn't seem to work too well on this front -- Google+ seems better, with its use of circles. Any other thoughts?
With an online correspondent, though, can you establish that level of trust and acceptance? Mightn't there always be a doubt about whether others are who they say they are? Or that google/facebook, et. al. aren't trolling the web to identify advertising targets to sell to treatment centers? How do you evaluate whom to trust in cyberspace? And does the quality of support suffer as a result?
Neuroscientists say one of the reasons social support is beneficial is because having an understanding human connection boosts dopamine. But I don't believe I've seen any research studies comparing in-person support to online support.
Any thoughts on the effectiveness of online versus in-person support or referral to studies on the subject would be greatly appreciated.
Steve Castleman
AddictScience.com
I am happy to say I am not alone - there are also other professionals and organisations doing the same - and there are many, many recovering addicts helping each other via Social Media.
There is also a variety of support - not everyone follows a 12-step approach. There are coaches, counsellers and some very nice people out there showing that recovery is possible and offering a bit of social support from all corners of the globe.
Look out for hashtags #xa #recovery #addiction among others on Twitter - I have some lovely followers and I very much enjoy hearing about their progress and offering an extra safety net during tough times - sometimes a Twitter chat can really help, just knowing that there are people out there who care, who want to help, are going through the same thing, or who have been where you are and recovered.
Also, please know that there are other organizations that are responsible for the long-term sobriety of thousands of people since the mid seventies. These include LifeRing Secular Recovery, SMART Recovery and Women for Sobriety!