“At CMC, we are experts in potential and have built our practice on optimism—because it works. Research has shown that if you provide good options, give real encouragement, and respect people’s right to be part of the solution, things get better. One size does not fit all.”
— CMC:Berkshires website
When banker and sportsman Hildreth Kennedy Bloodgood purchased land in New Marlborough to build his Gilded Age “cottage” in 1906, he likely had no idea the 25-room stone manor would one day provide a place of respite and a path toward wholeness for people struggling with trauma and addiction. Its journey, however, was logical—from his family’s country home to a luxury spa named Mepal to the current Center for Motivation and Change, an alternative residential treatment center.
Set on 200 bucolic acres in the heart of the Berkshire hills, just three hours from New York City and Boston, CMC:Berkshires provides (per its website) “expert, collaborative, and compassionate evidence-based care for people struggling with substance use and other emotional problems.” The professional team at the helm is driven by optimism about people’s capacity to change, an understanding of how difficult the journey can be, and a commitment to the science of change. The stunning manor house is now a 15-bed facility (single rooms with private baths) and an additional wellness and therapy center offering clinical and wellness services (yoga studio, massage rooms, and fitness/sauna rooms).

For the past 10 years, CMC:Berkshires has been changing the conversation around adult mental health and addiction, one patient at a time, with over 1,200 admissions. Co-founder Carrie Wilkens, PhD, serves as the clinical director for CMC’s outpatient care providers—in New York City, Long Island, San Diego, and Washington, D.C.—and for CMC:Berkshires, the private inpatient/residential alternative.
“Something’s wrong here”
Wilkens’ interest in adults struggling with addiction and mental illness began while growing up in West Kansas. She describes it as a very rural and religious area where substance abuse struggles were met with stigma and shame. “Something’s wrong here,” she thought, which prompted more curiosity. She moved to New York City and eventually pursued a doctorate in psychology at Adelphi University, only to discover that many treatment providers did not adequately address substance use.
“I had been working with a young woman for two years under a supervisor who encouraged me to understand all of the woman’s current symptoms as an expression of her childhood trauma,” Wilkens recalls. “In my last session, as my patient told me how much I helped her with her trauma, she disclosed that she was drinking two bottles of wine a day. I had never been encouraged to ask about substance use, so it never came up in our work. I felt like I had failed her. I promised myself I would never let that happen again.”
Wilkens completed her fellowship in an addiction treatment program, further reinforcing her awareness of the deep split between psychiatry and addiction services. “If you had a substance problem, the mental health clinic would refer you to the addiction program to get sober before you could start therapy for your mental health issue,” she explains, adding, “When you got to the addiction program, the counselors could help you stop using substances but had no idea how to treat trauma or other mental health issues. Lots of clients suffered as a result.” She spent the next 20 years of her life trying to change that.
A radical new approach
During her fellowship year, Wilkens met her business partner, Jeffrey Foote, PhD. At the time, he was trying to bring evidence-based treatments, including Motivational Interviewing (MI), into the traditional abstinence-only addiction program where they worked. “Twenty years ago, there was one way to treat addiction. The goal was abstinence and engagement in 12-step. I would call to get authorization for a client’s insurance benefits, and insurance company representatives would ask if the client was attending AA meetings or whether they had a sponsor. There was no room for harm reduction goals (limiting the negative consequences of substance abuse),” Wilkens notes. While these programs helped many people, they failed countless others.

In 2003, Wilkens and Foote opened their outpatient program, the Center for Motivation and Change (CMC), in New York City. They staffed it with clinicians trained in evidence-based approaches for treating substance use and the mental health challenges that are usually present.
“We were all trained in strategies that help clients identify their reasons for changing and goals, which was a radical shift that allowed us to work with people at every motivational stage. If they wanted to abstain, we could help them learn to do that. If they wanted to try to moderate their substance use, we would teach them strategies to try to achieve that goal. We worked with you where you wanted to start,” describes Wilkens.
“While harm reduction is an accepted approach now, back then I had another treatment provider call me the antichrist. It was also not uncommon for other providers to say, ‘If you want your loved one to use, send them to CMC,’” she recalls, then clarifies, “We were never against abstinence—most of our clients will get there—but we wanted to work with people who were willing to start considering change but were not interested in or not ready for abstinence. We were also not against 12-step, but it doesn’t help everybody and, in fact, harms some.”
The clinicians at CMC understood that many people turn to drugs or alcohol because the substances work for them in some way. They decrease anxiety or physical pain and relieve depression in the short term, https://ryderclinic.com/klonopin-clonazepam/. “Their effect is reinforcing. When you understand that, you can get curious about what the client is trying to achieve by using substances and then strategically work to support and reinforce other, healthy, competing behaviors that will work for them instead of substances,” Wilkens states.
A new residential treatment program
Rising addiction and overdose rates led the U.S. Department of Health and Human Services to declare prescription opioid overdose deaths an epidemic in 2013, leading then-Governor Deval Patrick to declare opioid addiction a public health emergency in Massachusetts a year later. At the height of this crisis, Wilkens’ husband Will Regan, an investment banker turned hospitality entrepreneur, joined Wilkens and Foote to open CMC:Berkshires, one of the first residential programs in the country to provide clients access to life-saving medications for opioid use disorder.
The program was also unusual in the fact that it staffed clinicians who were mostly PhDs and able to treat substance abuse and the mental health disorders behind them. In addition to seeing their primary therapist four times a week, clients at CMC:Berkshires engage in three different group sessions daily and have a dedicated family therapist who also sees them weekly.
Intending to share evidence-based ideas with the larger public, in 2014, they published Beyond Addiction: How Science and Kindness Can Help People Change, offering family members a roadmap for how to help a loved one struggling with substance use. The book outlines an approach developed by Robert J. Meyers, PhD, known by the acronym CRAFT (Community Reinforcement Approach and Family Training intervention)— “an effective, nonconfrontational approach that can be used by concerned significant others (CSOs) to promote help-seeking and recovery initiation for a family member experiencing alcohol- or other drug-related problems.”

Instead of traditional “interventions,” which often contribute to shame, anger, distrust, and relationship breakdowns, CRAFT trains family members in the approaches the clinicians use, including communication skills, reinforcement, and natural consequences. Compared to Al-Anon meetings and traditional interventions, CRAFT is more successful in engaging individuals in treatment and decreasing their substance use. It also improves the mental health of the family member trying to help.
Ensuring positive outcomes
Treatment at CMC:Berkshires is evidence-based and includes Motivational Interviewing (MI), Cognitive-Behavioral Therapy (CBT), Dialectical-Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT), Community Reinforcement and Family Training Therapy (CRAFT), and Invitation to Change (ITC). CMC asks, “What skills do we need to help you develop so we can help you approach (rather than avoid) the things in your life that are challenging? What skills do we need to help you develop so you feel healthy and well?” The minimum length of stay is three weeks (six weeks minimum for trauma treatment), and the average length is five weeks.
In addition to helping clients address substance use and other compulsive behavior problems, CMC:Berkshires stands alone among residential programs in providing evidence-based assessment and treatment of trauma and Post-Traumatic Stress Disorder (PTSD). Using specific trauma protocols such as Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), Skills Training in Affective and Interpersonal Regulation (STAIR), Dialectical Behavior Therapy–Prolonged Exposure (DBT–PE), and Eye Movement Desensitization and Reprocessing (EMDR), CMC helps clients heal from the traumas that drive their substance use. Clients who have completed treatment for PTSD with CMC:Berkshires experienced an 85 percent reduction in symptom severity as measured by the Post-Traumatic Stress Disorder Symptom Scale Interview (PSSI).

Most importantly, the entire CMC team focuses on helping clients develop the skills they need to sustain positive change once they leave by providing them with ongoing exposure to and practice in life-enhancing activities. These include exercise, yoga and meditation, outdoor adventure, nutrition and food preparation, and recreational and cultural activities in the community.
Limited beds but far-reaching impact
“Because we can only treat 15 patients at a time, we vet incoming clients pretty hard,” Wilkens admits. “We’re very clear about the structure and intensity of the treatment. We treat a lot of trauma, so we have to protect our community in residence and create safety.”

Most patients seek them out for that purpose. The intensive therapy and reparative experience includes goal-setting, community meals and celebrations, and the joys and comforts of living in the Manor House. Patients are taught mindfulness and self-compassion in an environment recognizing that change takes a long time and rehab is one step on the journey.

While running the treatment programs, Foote and Wilkens began collaborating with Partnership for Drug-Free Kids to staff a hotline to help connect parents seeking advice to other parents trained in CRAFT. Wilkens notes, “We started to train parents how to coach other parents—because it can be incredibly healing to hear from another parent who has walked in your shoes.” The partners went on to start their non-profit, the CMC:Foundation for Change, because they wanted to be able to share strategies shown to be effective in helping substance users with an ever-expanding network of family members and treatment providers.
“Our foundation, which enables us to share the Invitation to Change (ITC) approach, grew out of our desire to get all of these effective strategies into the hands of family members,” Wilkens continues. “It’s where we wanted to start, but we had to prove ourselves through the for-profit program first. There were all of these effective, proven strategies, and traditional addiction programs were not using them. We launched ITC—my favorite CMC child—so we could share all of these strategies with anyone trying to help someone struggling with substance use at no or low cost.”
Along with Dr. Ken Carpenter, Wilkens and Foote developed the Invitation to Change Approach, a unique blend of evidence-based strategies and practices (including kindness) that helps encourage positive change in a loved one. Its expanding network of professionals and family members trained in the ITC approach is changing the conversation around addiction by leading groups, bringing the ITC into their communities, and advocating locally for more compassionate and effective approaches to substance use. As one family recovery coach shares, “This stuff works! And it brings families together rather than pulling them farther apart…I’m so excited to bring this to more and more parents who truly want to do things differently.”
In addition to the books, workbooks, and free trainings, CMC has developed a video series highlighting each concept in the ITC Approach, which it shares on the website and social media sites. Wilkens joined Rev. Jan Brown in a six-part podcast series, “Rethinking Rock Bottom,” where they shed light on the impact shame and stigma have on those struggling with addiction and those who care about them. They offer ways to approach the helping process that are grounded in the latest science, and their guests share how real change happens for a family and the community around them.

Labor of love
“We’re privileged to be able to do this. And we’re trying to make it so that professionals can use the most effective treatments regardless of where you go for help,” Wilkens states. Thanks to CMC’s efforts, the landscape is changing.
What lies ahead? “We are developing grief support groups for family members,” she says. “The reality is addiction and mental health struggles end lives. We want to be able to provide family members with the support they need when they face those losses. That will be the final frontier.”
You can explore the ITC Approach in The Beyond Addiction Workbook for Family and Friends: Evidence-Based Skills to Help a Loved One Make Positive Change (New Harbinger Publications, 2022). All proceeds of the book go toward scholarships for family members and professionals to attend ITC workshops. You can also find free and low-fee ITC groups on CMC:Berkshires’ website.