About
I'm Timothy Harrington, Chief Empowerment Officer for Sustainable Recovery™, and for the last 10 years we've been developing an approach for sustaining one's recovery.
Our mission is to comprehensively identify and support the needs of an individual by creating a wraparound, scaffolding approach to address all aspects contributing to sustainable recovery.
We challenge two dimensions that most represent the acute care model: the concept of discharge (which may occur through “graduation,” administrative discharge, or client discontinuation of services) and either the lack of post-treatment support services or the utilization of only brief aftercare services.
We believe treatment clients would benefit more from “recovery support programs” that help them seek broader measurements of personal and social well-being such as wellness, quality of life, meaning and purpose, and citizenship. We also advocate abandoning the oft-espoused notion that “relapse is part of recovery” because “using again” is an expression of the disorder, not of the recovery process.
Among other things we...
Our mission is to comprehensively identify and support the needs of an individual by creating a wraparound, scaffolding approach to address all aspects contributing to sustainable recovery.
We challenge two dimensions that most represent the acute care model: the concept of discharge (which may occur through “graduation,” administrative discharge, or client discontinuation of services) and either the lack of post-treatment support services or the utilization of only brief aftercare services.
We believe treatment clients would benefit more from “recovery support programs” that help them seek broader measurements of personal and social well-being such as wellness, quality of life, meaning and purpose, and citizenship. We also advocate abandoning the oft-espoused notion that “relapse is part of recovery” because “using again” is an expression of the disorder, not of the recovery process.
Among other things we...
- remove family members from the role of monitor;
- maintain recovery momentum by offering a minimum of 300 points of contact per year, with the family and loved one;
- decrease the number of people “lost” from waiting lists to enter addiction treatment by setting up “prehab” ;
- enhance treatment retention and completion;
- increase post-treatment abstinence outcomes;
- delay the time period from discharge to first use following treatment (enhancing development of recovery capital, which is the sum total of all the personal, social, and community resources a person can draw on to begin and sustain his recovery from drug and alcohol problems);
- prevent lapses from becoming relapses;
- shorten the number, intensity, and duration of relapse episodes following treatment;
- decrease treatment readmission rates (slow the revolving door of treatment);
- decrease the time between relapse and re-initiation of treatment and recovery support services (preserving recovery capital and minimizing personal and social injury);
- result in readmission to less intensive, less expensive levels of care;
- reduce attrition in first year affiliation rates with AA and other sobriety- based support groups;
- enhance recovery capital (e.g., employment, school enrollment, stable housing, healthy family and extended family involvement; sobriety-based hobbies, financial resources) and self-defined quality of life.
What do leaders in the treatment field have to say about the state of aftercare?
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.”
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