It is a common myth that detox alone – or detox and a 30-day inpatient treatment stay – sufficiently rehabilitate the client to never drink or use again. In these cases, it is easy to say that treatment did not work for the client who subsequently relapses post discharge. It is all too easy to say that the client did not follow discharge instructions and therefore relapsed.
Recovery Continuation: Support, Accountability, and Responsibility
Beyond the myth, the truth: Recovery starts in treatment and continues with support, accountability, and responsibility.
The 5-year Continuum of Care model is the gold standard in treating professionals such as physicians, attorneys, and airline pilots. Among this population, the long-term recovery rates are approximately 82%. While it may be easy to say that these professionals are highly motivated to remain sober due to the fact that they could lose their license if they relapse – the fact remains that this model has merit and should be considered for all clients who enter into treatment.
The 5 Year Continuum of Care Model
The 5 year Continuum of Care model has multiple components that may be provided by multiple agencies. It often starts with a professional intervention followed by inpatient detox and residential treatment.
Either during, or at, discharge from the residential rehab facility – monitoring and coaching services begin that support the client and their family members through the continuum of care. The 5 year continuum model normally includes outpatient care in which clinical and medical services are provided as is appropriate for the client’s on-going needs.
The outpatient level of care requires safe and supportive housing. This may include sober living; or living at home with supportive family members. Following outpatient treatment, the client continues with monitoring and coaching. Also implemented is a continuing care plan that may include psychiatric care, counseling services, and participation in a 12-Step or other self-help programs; for as long as necessary to achieve lasting sobriety.
Recovery Monitoring and Coaching – Support and Incentive for Sobriety
The adage: “Whatever is measured improves” applies here. Monitoring and coaching add accountability and measurability to continuous client care. This is part of the reason for the 82% recovery success among impaired professionals following this model.
Recovery monitoring and coaching for impaired professionals includes regular reporting to the client’s licensing board. The licensing board has the power to revoke professional licensing. This is an important motivating factor for the client to remain in recovery. It is the consequence of losing one’s profession that plays such an important part in the 82% recovery success rate for impaired professionals. For non-professionals, consequences of non-compliance should be as motivating as possible; similar to losing one’s professional license.
A typical recovery monitoring program includes:
Regular and continuous contact with the client wherein the they self-report their compliance with the terms and conditions of the monitoring contract; and validation of the client’s report by the monitoring agency.
The parties of the monitoring contract include the client, the monitoring company, and the licensing board. In the case of a non-licensed individual, the board may be the client’s family, employer, and/or a probation officer.
Monitoring agreements typically include:
The frequency of 12-Step meeting attendance and meeting with a sponsor.
Random alcohol and drug testing.
On-going substance abuse and mental health counseling, addiction medicine and psychiatric care.
Those who receive reports from the monitoring company might include:
A probation officer
An EAP company
Consequences of breaking the contract, or a relapse, should be equivalent as much as possible to losing one’s professional license. This may mean:
Losing a job.
Losing financial support.
Losing the right to live at home, loss of a job, incarceration (if the client is on probation).
Anything or any event that might motivate the client to be compliant with the monitoring contract and avoid the consequences of a relapse.
Recovery coaching goes together with monitoring. Coaching services the often-neglected gap between clinical care and 12-Step sponsorship. Coaching may be weekly communication in the beginning and then gradually decrease in frequency over time.
Recovery Coaching Typically Includes:
Providing encouragement to the client and their family.
Helping and supporting the client with recovery goals as:
Returning home, work and/or school
Debt repayment plans
Living within a budget
Participation in a 12-Step or other self-help program
Acting as a sounding board when the client needs an objective point of view in making important decisions.
Assisting the client in finding and using resources to support their recovery.
Recovery coaching if often provided by telephone, but may also be in person if the coach and client live in the same vicinity. Coaching is sometimes provided by a monitoring company; or it may be provided by an independent coaching service.
Benefits of Recovery Monitoring and Coaching
Benefits of recovery monitoring and coaching include:
Improved self-esteem that comes from long-term recovery for both the client and family members.
Reducing the family’s anxiety about relapse.
Restoration of relationships, whether family, social and/or business relationships.
Improved physical, mental, and spiritual health.
Reduction in legal problems (it is not possible to get a DUI when sober).
Improved financial conditions from:
Elimination of fees for detox and residential treatment if the client remains sober
Elimination DUI defense attorney fees
Eliminating destruction of property, such as a car, due to intoxication
Costs for Recovery Monitoring and Coaching
Recovery monitoring costs vary upon the circumstances and the components of the service. Monitoring cost may range from a few thousand to many thousands of dollars annually.
Recovery monitoring fees vary depending upon services provided; and the individual who interacts with the parties involved.
For instance, a monitor or a coach may be a licensed therapist, in which case the fees may be higher than a non-licensed therapist. The service may be sponsored by the client’s residential treatment center that has negotiated rates with the monitoring and/or coaching agency. In most cases the treatment center will provide the client and their family with multiple monitoring and coaching resources.
5 Year Continuum of Care Model – Proven to Increase Long Term Sobriety
The disease of addiction is chronic and fatal. The 5 Year Continuum of Care model has been proven successful in helping recovering individuals achieve long-term recovery. The benefits far outweigh the costs.
With the proven success record of individuals achieving long-term recovery with the 5 Year Continuum of Care, why chose any other model?