Choosing the right treatment program for you and your family
The information contained in this article is a compilation of research materials reviewed by the author and is presented for educational purposes only. This information does not constitute medical advice, not should it be
relied upon as such. Please consult a professional health care physician before pursuing any course of treatment.
By Beverly Rayfield, Administrator, Neuro Assisted Recovery
The first step is deciding to quit. That’s the easy part since most of us decided to “quit” (smoking, drinking, eating, procrastinating) a dozen times or more before we can actually make it “stick” The second step is often the hardest part. It is deciding what type of treatment program is going to give you your greatest chance of success for your self and your family.
Just say NO! It was a great little slogan, and it worked for former First Lady Nancy Regan. A number of people, I am told, are able to look at their final shot of vodka or glass of beer, and just say no to sipping another one. For most of us, however, stopping or controlling alcohol consumption is not a simple matter of “willpower”.
If you have been drinking for a good many years, and now have found yourself abusing for a good many years, it is not so easy just to push yourself away from the table and just say no. “doing it on your own” is without doubt the hardest way to gain sobriety but it can be done and is done every day.
The body may be willing to quit, but the brain has developed a taste for alcohol—it is called “craving” - and it is not so willing to give up without a great deal of help and motivation.
Motivation comes in may forms. At one time, there was only one option available for the chronic alcohol abuser: a 2\3– day inpatient stay in an inpatient detox facility (or even jail) when absolute abstinence was started. You didn’t have any problem “saying no” because it (alcohol / drugs) wasn’t there. You were expected to learn “the rules” and follow “the steps” once you left the relative safety of the treatment center / hospital / jail and went home.
Home is where your drinking buddies are waiting, where the problems you left resurface, where the bottle is hidden. Logically it is thought that inpatient detox and daily groups allow individuals to focus on “the problem”. There were, and still are real compliance problems with short-term detox treatment. The recidivism (return_ rate to this treatment can be as high as 97%.
The 28-dat treatment modality (or a 14 to 30 day, or the 3,6,9 month variation) is used frequently by those people whose health insurance provides this coverage, or individuals who can afford the $9,000 to $30,000 cost. The Betty Ford Clinic, Hazelton Clinics, and Carter Hospitals are amount the best known of the upscale clinics.
These days it appears this type of treatment is being reserved for those individuals who are dually diagnosed, or have multiple substance abuse problems, or those who have been “court ordered” prior to or instead of going to jail, typically, a court order is a result of committing crimes to support their drug / alcohol problem, or a punishment following their second or third DUI.
There are other treatment models available from which to choose that do not require lengthy stays in locked facilities and have differing rationales and procedures. Finding the one protocol that “feels right”, and most importantly, is one that you and your family will agree to is of paramount importance.
First, you need to know that most programs have a “one size fits all” policy. Each individual molds to the program: the program does not “flex” or “stretch” to accommodate the individual. You need to find a treatment program that treats you, and respects you, as an individual. You need a program that understands what services you most have to insure the greatest chance for meeting your sobriety goals.
Secondly, because alcohol (and other chemical / drug) addictions are often chronic and always complicated, it’s best when spouses, partner or supportive family members are involved in deciding what course of action to take. Admittedly, this is not always realistic because human pride comes into play preventing us from always admitting to our family / partner that we have “failed
Third, treatment options are only realistic when they match the person’s stage of addiction. A person who has just swallowed a fifth of vodka, and does it on a regular basis, is in no shape physically or mentally for outpatient counseling that occurs once a month.
The same can be said for an indifferent person who has been hauled into counseling by an irate spouse under threat of divorce. Of course, this is a threat that our alcohol abusing spouse is not taking seriously because it has been said so many times before, and, “everyone” is expecting that our friend is not going to seriously start an abstinence program and stick with it; after all how many other programs has he or she started? They are expecting failure—hard and fast—from the very beginning.
As the kids, we need to get real!
START WITH A PLAN IN WRITING. WRITE SMALL WORDS IN BIG PRINT.
One of the first things that anyone who is entering a first class treatment program goes through with an admitting clinician is a complete physical, mental, and family assessment. This is called a “biopsychosocial” and is a review of where that patient has been mentally and plans to go with their alcohol abuse, interactions with their family, and goals, It covers the biological, psychological and sociological components of a person’s life.
However, even before you seek outside help, it is a really good idea to develop your own family plan of action. This is the first step that the patient and spouse / partner / family should think about before they commit to a treatment procedure. Review why you drink, what worked in the past to maintain sobriety even for a short while, and examine the present “who, what, where. When, and why” of the current drinking pattern.
Talk realistically about what you want in the way of short and long term goals. Conflict is sure to come if the alcohol abuser is thinking “moderation management” while the spouse is thinking total abstinence with no liquor in the house, ever, ever, again. These are totally different and clashing philosophies. Someone is going to end up very unhappy. Unhappy, and probably drunk or very angry.
As a couple or a family, put down in writing what everyone’s expectations are on the one day. Keep it very simple. Stick to the present and don’t go dredging up past transgressions. (This, I know, can be very hard, just do it!) Keep it relatively simple with 2 or 3 or at the most 4 goals, and the expected outcomes, with a defined timeline. Let it be THE PLAN that everyone buys into be affixing his or her signatures.
Bring this with you when you interview that treatment provider—see if your goals are realistic and can be accomplished within the treatment provider’s policies and procedures.
Remember that to be EFFECTIVE for the LONGTERM, the TREATMENT must match the person’s “STAGE FOR CHANGE”. How serious is the craving? How long are the periods of sobriety? Also remember that addiction can be deadly. Undiagnosed heart or liver disease combines with rapid detox can have serious side effects so choose a treatment program as carefully as you would if you were seeking treatment for cancer or heart surgery.
STOP THE CHAOS: What kind of treatment do I need?
Sometimes trying to decide on the right provider and the right treatment feels like ordering from the Chinese menu or shooting dice at a game of craps. Do you choose…
Outpatient or inpatient?
Inpatient or in-home detox?
Abstinence or Special drinking?
Individual or group therapy?
AA or specialty support groups?
Non-12 step counseling?
Clear your thoughts. Try to make an objective assessment of where you are in your drinking stage. Many community mental health centers, like Neuro Assisted Recovery, offer free or low cost alcohol screening assessments. This consists of a short interview with a therapist who can provide you with treatment options. In fact, during the first week of every April—usually the first Thursday—is national Alcohol Screening Day. That’s an excellent, non threatening starting place to learn more about alcohol consumption and resulting problems and which agencies are the best community providers.
Don’t be afraid to ask a lot of questions. Ask about recovery statistics both short term (less than 6 months) and long term (3 years and greater). Ask about the professional credentials of the providers. Not every doctor is qualified to treat alcohol abuse patients and not every licensed clinical person has the skills needed.
Also, don’t be afraid to seek out a counselor who goes completely against the “norm” of the treatment provider that you have had in the past. What I mean by this is, if in the past you have had middle-aged counselors who were in recovery themselves, and can be very sympathetic to your “falling off the wagon” or perhaps, overly critical, next time seek out a therapist who is recently graduated from college, very energetic, and has a passion to help you succeed. Draw from their enthusiasm to rekindle those same feelings of “I can do anything” that you had when you were younger.
Don’t be afraid to try a holistic approach to controlling your alcohol consumption. Some people swear by acupuncture. Sometimes it is as simple as changing your diet and eliminating sweets, sugar, yeast products—you would need to have a physical and see an allergy specialist. If the old way of controlling your alcohol consumption hasn’t been working—try something new.
If you would like a free confidential alcohol assessment or are interested in learning more about Neuro Assisted Recovery’s programs please call 941-330-2929