By Jim Savage, LCDC
Family Challenges in Treatment
I’ve worked in the addiction field for over 30 years. One of the most significant periods was from 2000-2010, when I owned an adolescent outpatient treatment program.
During that time, I got a good education about what works and what doesn’t in addiction treatment, especially when working with young people. The two biggest takeaways for me during that time was realizing:
- How important the family is when it comes to treatment success
- It is hard for them to digest the vast amount of information they get with limited exposure to the actual treatment process.
And I became increasingly aware that one of the biggest challenges we face that directly impacts treatment success is simply that the families aren’t there in treatment 24/7 along with the clients!
That means that the clients are getting more education about addiction and recovery than the families are. And while many facilities have excellent family programs, the reality is that until we start checking families in along with the clients, there will always be gaps between the family, the client, and the treatment team. And those gaps are where important things fall through the cracks and become one of the biggest reasons for poor treatment outcomes.
So, I turned my attention to working specifically with families of treatment clients and began focusing on ways to bridge that gap. I eventually developed a RehabWorks Family Support Program—an online learning platform designed specifically for families to use while their loved one is in treatment.
When I was in the early stages of creating that program, I had an experience that opened my eyes concerning factors that can mean the difference between the treatment success and failure. And it had to do with making sure that the basic and essential elements of treatment education are effectively delivered—not just to the clients but also to the family.
Exposure to “The Problem” for the Whole Family
Here’s what happened. I had just completed the videos for the first Module of RehabWorks, and I was sort of excited about them. Module I is an introductory presentation on Substance Use Disorder—old school stuff I’ve been teaching for over 30 years. Nothing sexy. Pretty basic, disease model, ASAM definition of addiction kind of stuff.
I happened to have a family session with an 18-year-old client that day. He had just completed four months in a residential treatment program, and I was now providing aftercare support for him. He and his parents arrived at my office, and because I can be somewhat spontaneous and impulsive, I decided to show them the videos from my new module.
We went into the big group room and watched the modules that explained what it means to be diagnosed with a substance use disorder. As soon as we finished the last one, the dad looked at me and said somewhat dramatically: “That… was a punch in the gut.” He looks at the boy and says, “Was that not a punch in the gut?” And he went on, referring to a particular section that addressed the problem of not being on the same page as far as understanding the “problem.”
Who Defines “The Problem”?
“That’s exactly what we’ve been arguing about since the day we checked him into rehab.”
He was referring to the fact that the client’s drug of choice was opiate pain medication. But he also smoked a lot of marijuana. And he accepted that the opiates were a problem, but he didn’t believe he needed to give up the marijuana. And he and his parents had been going round and round, arguing about the definition of addiction, can you be an opiate addict but not addicted to marijuana, cutting down versus abstinence, etc.
After four months at one of the best programs in the country, things were a mess for this family since getting out of rehab.
But here we were. And after watching 45 minutes of some simple little videos where the parents were learning what I know the client had learned in treatment, they were like, “The jig is up; we’re done arguing about whether you can smoke pot or not.” And right before my eyes, I witnessed these parents move from what I refer to in RehabWorks as the “substitute teacher role” (“Oh, no Mrs. Johnson, our regular teacher lets us do that all the time!”) to becoming informed treatment supporters.
And suddenly, we had this beautiful thing we call treatment accountability. This turned the client’s entire treatment experience around because the family could now set some informed boundaries regarding treatment plan expectations.
Improved Alignment Enhances Treatment Outcomes
This story illustrates two important points concerning improving treatment outcomes:
1. Bridging the gap between the client, the family, and the treatment team: Not being on the same page about what it means to have a “problem” is an example of how important things fall through the cracks and can sabotage treatment efforts.
2. Back to basics: It seems that the trend these days is to keep coming up with new and increasingly sophisticated modalities with all sorts of fancy acronyms for treating addiction. However, my point here is:
a) Making sure the client accepts that substance use is a problem.
b) Do they understand what that means?
If a client doesn’t believe there is a problem—which should include understanding what it means to have a problem—there will be no motivation to follow a plan for overcoming the problem. And that’s where we run into the familiar power struggles of “why aren’t you doing what was recommended when you were in treatment?”
Ultimately, we get poor treatment outcomes. This story illustrates how creating alignment between the client, the family, and the treatment team is the shortest path to removing some of the most common barriers to treatment success.
Bio: Jim Savage
Jim Savage is a licensed chemical dependency counselor who has worked in the addiction treatment field since 1984. He specializes in working with adolescents, young adults, and families. After running his own adolescent outpatient treatment program for over ten years, Jim turned his attention to working directly with families to improve treatment outcomes through effective family engagement.
In 2014 he wrote Rehab Works! A Parent’s Guide To Drug Treatment, helping families navigate the road to successful recovery for a loved one. He created the RehabWorks Family Support Program, an entire online learning platform designed specifically for families to use while a loved one is being treated for Substance Use Disorder.
In addition to his clinical skills, Jim is an accomplished professional musician and producer dedicated to supporting recovery through the creative arts. He wrote a rock musical called The Journey: A Musical Story Of Transformation, in which he uses a treatment curriculum and a vehicle for carrying a positive message about recovery. The Journey is based on Jim’s own story of addiction and recovery but shows that as addicts, we all have essentially the same story. Ultimately, this is revealed to be the overall spiritual journey of life.
Jim lives in Dallas, Texas, with his wife, Laura. Jim is often found playing hockey at the local ice rink when he’s not writing, producing, or coaching families through RehabWorks.
Follow Jim on:
Substance abuse services:
- Treatment Consultant
Specializing in teens, young adults and parent support
Writing and recovery heal the heart
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