What is Sustainable Recovery?
It's a process by which I offer customizable strategies, that recognize a family's uniqueness, hopes, wishes, dreams and aspirations, and meets their very specific needs. It's a modern, out-of-the-box, coaching model, a leadership model, a care model, an empowerment model, an inspiration model and a change model.
The Old Model
- One size fits all
- Minimum to no continuing care or ongoing empowerment
- Medication management means you're not sober/in recovery
- Deficit based. Focusing on what you did wrong.
- Minimal long term family support services.
Poor Outcomes of Old Model *
- Less than half of admissions (42%) complete treatment
- 40% of court-ordered do not complete treatment
- 60% resume use in 6 months
- 45% are readmitted within 12 months
What does the research say?
There is an implicit assumption within prevailing models of addiction treatment that family health improves spontaneously upon recovery initiation of the addicted family member. That assumption is evident in the paucity of family-oriented treatment models and the lack of post-treatment monitoring of family functioning and family member health.
Stephanie Brown performed a great service when she referred to the impact of addiction recovery on the family system as the “trauma of recovery.” Her work underscores two critical truths: 1) recovery can be destabilizing to families whose roles, rules and rituals have become organized around active addiction, and 2) family members and family units need sustained support through the recovery process. - William White
Stephanie Brown performed a great service when she referred to the impact of addiction recovery on the family system as the “trauma of recovery.” Her work underscores two critical truths: 1) recovery can be destabilizing to families whose roles, rules and rituals have become organized around active addiction, and 2) family members and family units need sustained support through the recovery process. - William White
Why Do We Need a New Model?
Janelle Wesloh, Executive Director, Recovery Management, Hazelden: "We need to keep doing what we’re doing, but do it better in regard to the things we do with people after treatment. In many cases, it’s horribly difficult for a person leaving treatment to return to their home environment. Things that were messy and awful when they left are still there. If they don’t have the support that they need, any continuing care plan goes in a drawer because life hits them full in the face.
If someone’s not calling them to connect, check if they’ve made appointments, and ask if they’re meeting up with alumnae, all the things we did in treatment were a waste of time. I know that’s a provocative thing to say, but you spend all this time doing all this great work in treatment, then basically throw them to the wolves.
We need to set them up in a supportive way and not leave them to figure it out for themselves. We don’t want to set up barriers for our clients, we want to remove them. That’s where we’ll see our outcome rates change because these things do make a difference. But we need to figure out ways to make it work, ways to get reimbursed for it—especially for treatment centers that don’t have as many resources."
Sure Haven admissions director, Elizabeth Perry: Putting someone in a program for 30 days and removing all outside contact, and then setting them loose doesn’t do much for long-term recovery. You structure their days for a month, and then say, ‘Time for sober living, good luck,’ [that] just sets people up for failure. Reintegration serves as the program’s cornerstone, says Perry. I know from my own experience that stopping drinking and using was difficult, but learning how to live without it was a lot harder. You have to relearn life skills.
William Miller of the University of New Mexico: ... it’s easy to feel like you’ve got it licked while you’re in a secure residential facility, but ultimately you have to deal with it all back home.
Mike Early, Executive Vice President/Chief Clinical Officer, Caron: We’ve done a great job of selling treatment over the last number of years, but we haven’t done a great job of selling recovery. It’s a chronic disease and people are beginning to talk more and more about that. And that’s what I believe this next generation needs to focus on; you need to be talking about the recovery process, not just treatment. I have a lot of hope based on what I’ve seen that we will see a return to addiction being treated as a chronic disease.
Phil Herschman, Chief Clinical Officer, CRC Health Group: “I’ve been in this business for 30 years, and virtually the entire time we’ve been talking about chemical dependency as a chronic disorder. But we don’t treat it as such on a regular, consistent basis. We talk about it, we give it lip service, but we don’t do it. The next evolution of treatment will be an increased focus on what happens post-discharge.”
Tim McLeod, Senior Alumni Coordinator, Sierra Tucson: “People talk about budgets to go toward alumni relations, and it’s frustrating. It can be an uphill battle. What I’d like to see in 10 years, or hopefully sooner, is that as much money that’s spent on the front end is spent on the back end. We talk about how hard it is for that individual when they come out of treatment and how we can support them. But doesn’t have to be a fight to offer that support.”
Anne M. Fletcher, “Inside Rehab”: “— about twenty controlled research studies have been conducted since the late 1980s to examine the various types of help available following the completion of residential or outpatient treatment. They suggest that interventions lasting at least twelve months or in which greater efforts were made to reach and engage clients—for instance by visiting the home, approaching clients by telephone calls, use of incentives such as money, or involving significant others—appeared to be the most effective. And two studies showed that “recovery management checkups” can help get people back in treatment when needed and significantly increased days of abstinence following treatment.”
If someone’s not calling them to connect, check if they’ve made appointments, and ask if they’re meeting up with alumnae, all the things we did in treatment were a waste of time. I know that’s a provocative thing to say, but you spend all this time doing all this great work in treatment, then basically throw them to the wolves.
We need to set them up in a supportive way and not leave them to figure it out for themselves. We don’t want to set up barriers for our clients, we want to remove them. That’s where we’ll see our outcome rates change because these things do make a difference. But we need to figure out ways to make it work, ways to get reimbursed for it—especially for treatment centers that don’t have as many resources."
Sure Haven admissions director, Elizabeth Perry: Putting someone in a program for 30 days and removing all outside contact, and then setting them loose doesn’t do much for long-term recovery. You structure their days for a month, and then say, ‘Time for sober living, good luck,’ [that] just sets people up for failure. Reintegration serves as the program’s cornerstone, says Perry. I know from my own experience that stopping drinking and using was difficult, but learning how to live without it was a lot harder. You have to relearn life skills.
William Miller of the University of New Mexico: ... it’s easy to feel like you’ve got it licked while you’re in a secure residential facility, but ultimately you have to deal with it all back home.
Mike Early, Executive Vice President/Chief Clinical Officer, Caron: We’ve done a great job of selling treatment over the last number of years, but we haven’t done a great job of selling recovery. It’s a chronic disease and people are beginning to talk more and more about that. And that’s what I believe this next generation needs to focus on; you need to be talking about the recovery process, not just treatment. I have a lot of hope based on what I’ve seen that we will see a return to addiction being treated as a chronic disease.
Phil Herschman, Chief Clinical Officer, CRC Health Group: “I’ve been in this business for 30 years, and virtually the entire time we’ve been talking about chemical dependency as a chronic disorder. But we don’t treat it as such on a regular, consistent basis. We talk about it, we give it lip service, but we don’t do it. The next evolution of treatment will be an increased focus on what happens post-discharge.”
Tim McLeod, Senior Alumni Coordinator, Sierra Tucson: “People talk about budgets to go toward alumni relations, and it’s frustrating. It can be an uphill battle. What I’d like to see in 10 years, or hopefully sooner, is that as much money that’s spent on the front end is spent on the back end. We talk about how hard it is for that individual when they come out of treatment and how we can support them. But doesn’t have to be a fight to offer that support.”
Anne M. Fletcher, “Inside Rehab”: “— about twenty controlled research studies have been conducted since the late 1980s to examine the various types of help available following the completion of residential or outpatient treatment. They suggest that interventions lasting at least twelve months or in which greater efforts were made to reach and engage clients—for instance by visiting the home, approaching clients by telephone calls, use of incentives such as money, or involving significant others—appeared to be the most effective. And two studies showed that “recovery management checkups” can help get people back in treatment when needed and significantly increased days of abstinence following treatment.”
A New Model
My coaching will:
- Encourage successful entry, for a loved one, into treatment (if required or desired)
- Encourage successful completion of treatment (coach while in treatment, meet them at treatment if kicked out or when they are leaving)
- Create close collaboration between (insert treatment center here) and myself: working side-by-side throughout the entire process
- Drive a seamless transition from primary to secondary levels of care
- Support continued participation in self-help activities
- Introduce the family to various mutual-aid groups
- Guide the family in setting goals and identifying how to take steps to achieve them
We will develop a long-term, comprehensive & customized, action plan:
- WRAP - Wellness Recovery Action Plan
- Investigate Mutual Aid Support Groups
- Trauma Education
- Seek Family Therapy
- Family Coaching
- Seek Couples Therapy
- Pharmacotherapy or Medication-Assisted Treatment Education - Topiramate, Naltrexone, Suboxone, Campral, Baclofen, Nalmefene (Europe only)
- Mindfulness Practice
- Look at Food and Mood Approach
- Seek Physical Exercise Training
- Complement and Reinforce Prescribed Continuing-care Plans
Sustainable Recovery™
Timothy Harrington
323-804-5555
Timothy Harrington
323-804-5555
* References: The National Center on Addiction and Substance Abuse at Columbia University. Addiction Medicine: Closing the gap between science and practice. Published June 2012. http://www.casacolumbia.org/upload/2012/20120626addictionmed.pdf. Accessed August 9, 2013.
White WL. Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices. Philadelphia, PA: Northeast Addiction Technology Transfer Center, Greater Lakes Addiction Technology Transfer Center, Philadelphia Department of Behavioral Health/Mental Retardation Services; 2008.
White WL, McLellan AT. Addiction as a chronic disorder: Key messages for clients, families and referral sources. Counselor. 2008;9(3):24-33.
White WL. Recovery Management and Recovery-Oriented Systems of Care: Scientific Rationale and Promising Practices. Philadelphia, PA: Northeast Addiction Technology Transfer Center, Greater Lakes Addiction Technology Transfer Center, Philadelphia Department of Behavioral Health/Mental Retardation Services; 2008.
White WL, McLellan AT. Addiction as a chronic disorder: Key messages for clients, families and referral sources. Counselor. 2008;9(3):24-33.
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