Who I am and what I do

The primary focus of my practice for the past 30 years has been helping people achieve recovery from substance abuse. I use a collaborative, motivational approach, rather than confrontation, and work with people on setting and achieving realistic and healthy goals for their problems. I believe, as did Bill Wilson (the founder of AA) that there are many paths to recovery; each person must work on a program that reflects their unique needs and assets. I encourage people to explore their resources, their obstacles and their values in setting goals and in working a positive program.

Most people with substance abuse problems have struggled unsuccessfully to control their use, and feel demoralized and shameful. My initial goal is to restore a sense of hope and defuse the shame the often prevents a person from seeking help in the first place.

I have trained professionals nationally and internationally, including psychologists, psychiatric residents, counselors and other human service professionals. I have written a book (“A Clinician’s Guide to 12-Step Recovery” (WW Norton) and several chapters and articles, including a recent chapter in the “APA Handbook of Clinical Psychology” published by the American Psychological Association. I remain active in helping to train professionals to expand their skills into this neglected area. I have been on the Board of the Society of Addiction Psychology, a division of the APA, and am on the Board of the Philadelphia Society of Clinical Psychologists.

I have a Ph.D. in Clinical Psychology from Temple University and have had postgraduate training in family therapy. In addition to my clinical work I have held faculty positions at several local universities and medical schools; I have consulted with various agencies, and have held supervisory and administrative posts in psychiatric and substance abuse programs throughout the area. My experience has given me an excellent understanding of how people work and how social systems operate.

My office is comfortable and private, insuring confidentiality. I am conveniently located in Chestnut Hill in Philadelphia, with easy parking and near public transportation. I can provide invoices to submit to insurance companies for reimbursement.

Feel free to contact me by phone or email if you have questions, or would like to discuss your situation confidentially.

How I work

We begin with a thorough psycho-social evaluation. I review your current substance abuse and history of use, consequences and related issues. I also get a family history, placing the current problems in the larger context of your life. Psychological functioning is the next area, and possible co-occurring disorders are assessed. Your own understanding of your problems and your goals become key elements in developing a plan of action. I am interested in learning about you as a person, not just about your disease.

At times, in addition to the individual assessment, it is quite helpful to include the input of other concerned parties, including spouses, family members and friends. This is always done with your consent.

After the evaluation is completed, I share my impressions and thoughts with you and solicit your own opinions. Together we develop a plan for your recovery. This may include individual work with me, family therapy, referral to a more intensive outpatient program or to a different outpatient clinician, or referral to residential treatment if that is warranted.

I am happy to work with people being discharged from residential programs who need continuing care support. I also work with family members of those with addiction problems, even if the other parties are not yet interested in treatment or recovery.

My style is based on the various traditions in which I’ve had training and experience. These include psychodynamic therapy, family therapy, 12-Step tradition and general systems theories. I have been influenced as well by humanistic and motivational theory. I feel that it is best to base our work on your goals and strengths and work toward solutions that will be effective for you. While I do not hesitate to offer recommendations and suggestions, I recognize that you are the person who must live by your decisions.

At times it may be appropriate to refer you to a psychiatrist or physician who specializes in addiction treatment to provide ancillary medical care. This may be relevant to provide help for an outpatient detoxification or to provide medical support for recovery. At other times, psychiatric care is important to help deal with related psychiatric problems, such as depression or anxiety. I will discuss this with you collaboratively and an appropriate referral can be made.

What is addiction?

There is a great deal of confusion about what constitutes “addiction”. The Diagnostic and Statistical Manual of the American Psychiatric Association does not use this term at all. The professional term for these problems is “Substance Use Disorders”. In the old system (DSM-IV), a distinction was made between “abuse” and “dependence”. “Abuse” meant you were having problems as a result of your substance use. “Dependence” meant you also had signs of biological adaptation and true loss of control. In this view, either you had the disorder or you didn’t.

In the current Diagnostic Manual (DSM-5), this distinction between “abuse” and “dependence” is erased, in favor of seeing these disorders as one disorder with a range of severity – mild, moderate and severe. This is a more realistic way of looking at the problem.

Many people ask, “Is addiction a disease?” There is a lot of emotion on both sides of this question. The more severe the level of the addiction, the more likely that the term “disease” applies. For these people, the biological components of the illness (brain and cellular adaptation) have taken over and are clear. For those who have struggled to attain and maintain abstinence and have been unable to do so; for those who are unable to say “no” to that first drink; for those who have been to rehab multiple times – for these people the ability to control their use is compromised or absent by disease factors. And with the acknowledgement of the disease comes a responsibility to do something about it; rather than a cop-out, this acknowledgement requires a commitment to a new way of living and thinking.

On the other hand, many people with mild or moderate levels of impairment have often been neglected in treatment settings; it was assumed that any symptom of addiction meant that the only resolution was complete abstinence and strict lifelong adherence to AA or NA. Research seems to suggest that this may not absolutely apply to those with mild or moderate levels of disorder.

In contrast with older schools of treatment, which provided a “one-size-fits-all” approach, it has become clear that different levels of problem require different kinds of interventions. It is also important to consider the degree to which a person is ready to acknowledge the problem and make changes about it.

Regardless of the diagnosis, my treatment philosophy begins with the assumption that you are the primary person who can define what goals you want to establish and develop a plan to achieve these goals.

A few important considerations:

The symptoms of addiction appear to have strong biological, genetic roots. They are not signs of poor character, psychological disorders, or weak moral fiber. This is important to understand, as so many people avoid getting help out of shame over their condition.

Not everyone has all the symptoms of addiction. For example, some people may never actually get drunk, but they may never go a day without drinking. Another person may not use cocaine for weeks at a time, but when they do they are unable to stop or limit their use.

The more severe the addiction, the more likely that complete abstinence from all substances will be necessary for stable recovery.

Addiction is a chronic disease. It doesn’t go away over time. Like diabetes, it requires ongoing responsibility on the part of the patient to lead a stable life. Like diabetes (or asthma or other chronic diseases) you didn’t create it, but without doing something about it, your life will gradually go downhill. The recovery rate for substance use disorders is similar to that of most chronic illnesses, and depends on your compliance with a program of recovery.

What is recovery?

For many people the term “recovery” conjures up negative images of grimy, smoky basements with people talking incessantly about their problems. These are usually people who have never been to an AA or NA meeting, or have seen movies which portray it in this manner. The term “recovery” is, in fact, usually linked with the Twelve-Step program of Alcoholics Anonymous, although it doesn’t necessarily mean that this program is the only path. However, for the majority of people suffering from the more severe or more progressed forms of the illness, Twelve-Step programs offer a very positive and effective plan for re-gaining stability in your life.

The idea of recovery from addiction has been around for a long time, but crystallized with the work of Bill Wilson and Dr. Bob Smith, who co-founded Alcoholics Anonymous. This program has been so successful that many of the practices and terms of the program have become household terms. “Thanks for sharing”, “One day at a time”, the Serenity Prayer, have all been popularized by Twelve-Step programs. Despite what some rumors say, there is abundant research that AA/NA can be powerful tools to help people find and maintain sobriety, and to transform their lives.

Is AA for everyone? In many parts of the recovery world, any objection to AA is seen as “denial” or “resistance”. In a lot of cases, in fact, this is true. Too many people reject the Twelve-Step method without ever having attended a meeting. Shame, negative stereotypes (particularly about the “religious” aspects of the program), fear of being “outed” and other factors have prevented many from taking part in a supportive, caring community.

On the other hand, not everybody can benefit from AA or is ready for it. For those, there are other pathways for achieving sobriety, which are also valid. Although AA and NA are the most commonly known programs, other programs (Women for Sobriety, Rational Recovery, Smart Recovery), are also available, although a bit harder to find than AA/NA.

One definition of recovery is: “The process of making changes to lifestyle, thinking and values in support of maintaining sobriety. It is usually characterized by an increased level of humility, honesty, interpersonal connection and spiritual grounding”.

In order to maintain abstinence from addiction, it is usually necessary to make changes in lifestyle, thinking and attitudes. Any method that works on achieving these goals can be effective. Bill Wilson has written that AA has “no monopoly on recovery”, and he continued to seek other paths to recovery to help more people. If AA is truly “not for you” I am happy to work with you to develop your own plan of recovery.

What is Treatment?

Many of us know someone with a drinking or drug problem who has simply stopped using. Perhaps they just swore it off, or have successfully cut down, or have found their way into an AA or NA meeting without professional help. They can point to their lives being better and their improvement is usually apparent to others as well. These people might also be proud that they were able to accomplish this without needing treatment.

On the other hand, we may know someone who has been to rehab multiple times and still has not maintained stable sobriety. Such situations create a cynical view of the entire treatment enterprise, and there is substantial rumor that such treatment “doesn’t work”, that recovery rates are terrible, or that these cases are “hopeless”.

Given these poles, why do we need treatment?

Some people simply have a more difficult time achieving sobriety than others. Whether this is due to the severity of the illness, psychological problems, deeply ingrained habits, social variables, personality characteristics, or unknown factors, simple recovery is just too difficult to accomplish. For people who seem to be stuck, outside assistance is usually needed.

Here, too, negative stereotypes abound. For many people, the image of treatment involves humiliation, petty punishments, boot-camp-like conditions and such. It is true that some programs have operated like that, although those programs are in a distinct minority nowadays. The value of coercion has been recognized to be minimal. While some may benefit from such a strict program, the vast majority of people need help which is more empathic and motivational than confrontational. In fact, one of the most consistent research findings is that therapist empathy is the strongest predictor of outcome.

Similarly, in many minds “going to rehab” is a prerequisite for recovery. Certainly, there are some who require that level of intensive treatment, and a separation from a dangerous environment, to get sober and learn to stay sober. For others, however, outpatient treatment can be quite effective, and does not require the dislocation of going away for 30 or more days.

For me, treatment is a cooperative process. It begins with your own goals and expectations, and involves my input to help mold these goals into a workable plan. While I certainly have specific expertise in this area, this is your journey, and I respect your preferences in working with you. And if I do disagree with you, or think your plan isn’t reasonable (or is dangerous), I’ll certainly tell you so.

Myths and Realities

Many people avoid getting treatment for their alcohol or drug problems, due to misconceptions about what is involved in getting help.

Myth: Treatment for addiction involves confrontation and humiliation.
Reality: The old model of working with addicts involving relentless confrontation only increases guilt and shame and does little to help address the real problems of addiction. I work to help increase your own internal motivation to change.

Myth: You must “hit bottom” to be ready for help.
Reality: You can get help at any point. It is, in fact, easier to be helped before the problems have gotten too serious.

Myth: Treatment is useless if you are not “ready to change.”
Reality: Recent innovations in treatment suggest that people can benefit from treatment even if they are not sure they are ready to quit, or even if they are not sure if they have a problem. The primary ingredient is a willingness to talk about your concerns.

Myth: There is only one way to get clean and sober.
Reality: There are numerous methods that can help you achieve your goals, whether those goals are to cut down on your use or to quit altogether.

Myth: Making up your mind – willpower – is all that is necessary to quit using and drinking.
Reality: Making up your mind is not usually enough to make a lasting change. (Think of how many times you have changed your mind!) Nowadays, there are many adjuncts to treatment that can help you establish and maintain a more productive life.

Myth: The only person who can help you is you.
Reality: It may be true that nobody else can “make” you get better. However, it is quite clear that many people who recover from drug and alcohol problems are greatly helped by seeking support and/or professional help.

Myth: Having an addiction is a sign of poor character, moral failing or an “addictive personality.” 
Reality: Most people with an addictive disorder feel guilty and angry at themselves for negative choices they feel they have made. However, it is increasingly clear that addiction has a significant foundation in disordered brain chemistry, which results in disordered behavior and poor judgment.

Myth: Calling addiction a “disease” is just a way of copping out and avoiding responsibility for my behavior.
Reality: Having a disease does not excuse you from the responsibility for acting to manage your disease; for example, if you have diabetes it is still up to you to manage your diet and take your medications. Addiction, like many chronic disorders, requires your active involvement in getting better and staying better.

News

2018 
Dr. Schenker was honored to receive the Presidential Citation for Distinguished Service from Division 50 (Addictions) of the American Psychological Association.

2017
Dr. Schenker was the opening speaker for the Northeast Family Association Conference on Opiate Disorders.

2017
Dr. Schenker was honored with the “Addiction Professional” Award for 2017 given by Caron Treatment Centers, one of the leading treatment programs in the country. The citation reads, in part, “Dr. Schenker is not only a gifted clinician and a strong leader, but has spent his 30+ year career in advancing the knowledge and practice of addiction treatment…He is a valued resource to the psychological community in the entire Delaware Valley”.

2017
Elected to be a member of the Board of Directors of the Philadelphia Society of Clinical Psychologists, the largest organization of psychologists in the Delaware Valley.

2016
Invited to write a chapter on “Addiction Treatment Settings” for the APA Handbook of Clinical Psychology. This landmark 5-volume reference work was published in Fall 2016.

2016
Dr. Schenker founded and manages a monthly Clinical Webinar for addiction treatment providers on behalf of the Society of Addiction Psychology (SoAP – APA Division 50). We have had many notable presenters and have had participants call in from all over the country and Europe. This is an ongoing service of SoAP and all clinicians are invited to participate.

2014
Invited to provide a column on rehabs.com, and to moderate a forum for professionals on the integration of Twelve-Step principles into practice. The blog can be found at here

2014
Invited to give a presentation at the annual Harvard Medical School “Treating the Addictions” Conference, He presented on an integrated model for substance use disorders. A month later, he co-presented a workshop at the Pennsylvania Council of Mediators on assessment and management of substance use problems in the mediation process.

2012
Dr. Schenker was appointed as a Member-At-Large for Practice to the Board of Directors of the Society of Addiction Psychology (Division 50 of the American Psychological Association), the largest organization of addiction psychologists. The next year, he was elected to that position for a three-year term.

January 2012
The practice was relocated to Chestnut Hill, from Lafayette Hill, PA. This new location affords easy access by car and public transportation (the Chestnut Hill West SEPTA line stops around the corner), and the new office is comfortable and private.

2011
Dr. Schenker consulted with a team at the Treatment Research Institute, in Philadelphia, and became a co-author of the Handbook for their Twelve-Step Curriculum Toolkit.

May 2011
Dr. Schenker was invited back to the annual conference of the Society of Psychotherapy Integration, in Washington DC, to present a workshop on the use of 12-Step programs in dealing with addiction.

Spring 2011
Dr. Schenker made several presentations to professional colleagues this spring. He spoke on various topics to the Pennsylvania Psychological Association, the Deleware Valley Group Psychotherapy Association and the Philadelphia Society of Clinical Psychologists.

January 2010
Dr. Schenker published a chapter entitled “The Disease Concept: Controversies and Integration” in David Brizer and Ricardo Castaneda’s textbook, Clinical Addiction Psychiatry, published by Cambridge University Press.

March 2009
Dr. Schenker was invited to present a workshop on addiction treatment at the Psychotherapy Networker Symposium in Washington, DC. This is one of the leading psychotherapy conferences in the country, with over 3000 clinicians attending. That same month, he wrote a column in the Psychotherapy Networker magazine on the role of AA in treatment.

January 2009
Dr. Schenker has just published a book for mental health clinicians on the Twelve-Step program. “A Clinician’s Guide to Twelve Step Recovery” has been published by W.W. Norton in New York. The book is in keeping with his efforts to help mental health professionals understand the nature of addiction and recovery, and to help them to utilize this traditional modality. Although the primary audience is mental health clinicians, there is much useful information for persons in recovery and the lay public as well. The book is available on Amazon.com or directly from the publisher. Reviews in the national and international press have been uniformly favorable.

April 2006
Dr. Schenker was invited back to lecture on addictions work at the Massachusetts School of Professional Psychology in Boston, MA.

November 2005
As part of a series on working with sexual offenders, Dr. Schenker conducted a workshop on countertransference issues with this population. The audience included mental health clinicians and criminal justice professionals.

October 2005
Dr Schenker did a training for psychologists at the annual convention of the Pennsylvania Psychological Association in Exton, PA. Later that month, he also presented on family dynamics in recovery at the Berks County Council on Chemical Abuse Conference in Reading, PA

May 2005
Dr. Schenker made two significant presentations this month. He conducted a workshop on integrative models of addictions treatment in Toronto Ontario, at the Society for the Exploration of Psychotherapy Integration Conference International Conference. Later in the month, he did a training on innovations in addictions treatment at the United States Psychosocial Rehabilitation Association (USPRA) in Pittsburgh, PA.

January 2005
Dr. Schenker trained psychologists and other professionals at a workshop sponsored by the Philadelphia Society of Clinical Psychologists at Chestnut Hill College in Philadelphia.

May 2004
Dr. Schenker presented to rehabilitation professionals at the International Association of Psychosocial Rehabilitation Services (IAPSRS) Conference in San Diego, California.

November 2003
Dr. Schenker will presented a workshop on Alternative Approaches to Addiction Treatment at the National Employee Assistance Association (EAPA) meeting in New Orleans in November 2003. This is the largest meeting of EAP professionals in the country, and will allow the dissemination of new approaches to a wide audience.

May 2003
Dr. Schenker was invited to speak to the staff at the Montgomery County Emergency Service on the topic of working with addicted patients.

January 2003
Mark Schenker, Ph.D. was invited to appear on Channel 6’s “Weekend Live” show hosted by Wally Kennedy. Mark appeared opposite Dr. Joseph Troncale, M.D., the Medical Director of the Caron Foundation, the nationally-known addiction treatment facility in Wernersville, PA. Much of the discussion centered on the use of naltrexone in facilitating controlled drinking on the part of alcohol abusers.

December 2002
Dr. Schenker was featured in the December 12, 2002 issue of the Chestnut Hill Local. The writer, James Sturdivant, emphasized the multifaceted approach to recovery that we offer.

December 2002
Dr. Schenker’s work was featured in Philadelphia Magazine, under the heading “Medical Miracle: An Alcoholism Cure You Can Drink To”. The focus of this piece was on the use of naltrexone to pursue moderate drinking goals.

Links

Dr. Mark Schenker, Ph.D

215-264-5412

8506 Germantown Avenue

Philadelphia, PA 19118