RE: Relapse
Ed wrote:
> Today most addiction treatment programs are based on the disease,
>psychosocial learning, cognitive behavioural, or family systems models. Some
>, at times it appears many, seem very reluctant to accept NLP as a
>legitimate therapy and method of effectively coping with substance abuse
>problems. Not that long ago, a few months, other substance abuse counsellors
>and I were discussing the various therapies available. When I inquired re:
>what they knew about NLP and its use in addiction, most of the others
>reported it as pop psychology, it did not create lasting change. I inquired
>to there experience with this therapy and how they reached that decision.
>When they all reported knowing little and never having any personal or
>professional experience with NLP, I realized that we were dealing with
>limiting beliefs about effective treatment.
>
> Have others encountered similar problems with treatment agencies? If so,
>what is it that we can do to alter these limiting beliefs?
>
>p.s. It also came out in the discussion that I had the lowest rate of drop
>outs among all those involved in the discussion. Any possible link??
>Ed Westlake B.Comm. I.C.A.D.C., C.C.S.
>Substance Abuse Counsellor
>London, Ontario
In my experience mainstream substance abuse treatment have a very narrow
world view: that the 12-step, one day at a time, total abstinence, disease
model is the only one that works. In actual fact AA/NA and 12-step based
treatment programs all have lousy success rates. Last reliable stats I heard
were that only around 30% of people entering 12-step programs stay in the
program through one year of abstinence/sobriety. Of those 30% only about a
third get to 5 years. This gives an overall 5 year sucess rate of 10%.
Of course, we have no stats on those who come into a 12-step program, drop out
and deal with their substance abuse problem through some other method. One
of the hardest things I have to deal with in school is keeping my mouth shut
on the ineffectiveness of 12-step programs in discussions with recovering
counsellors who are in school with me.
Sometimes I think that many of these recovering counsellors are counsellors
because they cannot adapt to a sober life in the real world. They become
counsellors because that way they can eat, sleep, breathe and shit recovery.
The disease model is of itself extremely limiting: If one has an incurable
progressive disease and is therefore powerless, there is no scope for
change. All that can be done is crisis management. You build up a wall of
sandbags to hold back the inevitable tide, but if you stop building, the
floodwaters will overtop the wall and drown you. In this model there are
only two positions to be in: recovery or relapse. Now, that's not a bad
model to get someone sober enough to understand what's going on. But when
they've dried out enough to be able to understand, then it's time to move
out of crisis mode and into long-term change and reframing. That's where the
12-steppers fail, and it's people who don't want to live their lives in
perpetual crisis who drop out, either to stay sober in their own way, do
some work in therapy (if they're lucky), or go back to active substance abuse.
The most difficult part of changing the way substance abuse treatment is
handled is getting the recovering counsellors (who like to live their lives
in crisis mode, or they wouldn't be where they are) to recover from their
dependence on crisis as a way of functioning and themselves move on to a
more mature phase of recovery.
As a metaphor: it's really hard to get a unversity education when all your
teachers only have 3rd grade educations. If you're lucky you can learn up to
3rd grade from them, but most will only be able to teach you to 1st or 2nd
grade. Beyond that you're a) on your own and b) the teachers won't support
your efforts because it makes them look less competent.
Looks to me like Ed's better stats (got anyt &s BTW -- I'd be very
interested) are the result of his clients getting more than a 3rd grade
education <grin>
Blessings,
Jenni