Organizing the Addiction Counseling Process Index

Photo by Alan Cleaver

In 1997, I wrote a series of articles appeared in five consecutive issues of RESCUE, the journal of the Association of Gospel Rescue Missions. The focus was to give counselors some guidance that would help them more effectively work with homeless addicts.

Here are the five articles:

Organizing the Addiction Counseling Process – Part 1 When I see a man in a recovery program I like to ask, “How is he doing?”   I usually just get a pat answer like, “Well, he’s been with us for six months.”   The problem with this answer, of course is that a sober, healthy lifestyle is not automatically picked up just by hanging around the mission for a certain length of time. The only way to really know is by keeping accurate written records that show how we are meeting the individual needs of the people in our programs.   A formal needs assessment process is needed.   The information that is gathered provides the foundation for a written recovery plan.

Organizing the Addiction Counseling Process – Part 2 In this installment, I would explore a very basic question; “Just what can we expect to accomplish in the life of a homeless addict during their stay at a rescue mission program?”   The answer comes from recognizing some basic needs that need to be addressed so those we work can develop productive, satisfying sober lives.   The goal of a written recovery plan is to set down these goals, in order of priority, and then develop a strategy for working through them while in the program.

Organizing the Addiction Counseling Process – Part 3 I recommend a program for homeless addicts that is based totally on accomplishing a set of treatment goals – instead of one based on the calendar.   Still, there are some special considerations for the first 30 days of sobriety to which we need to pay special attention.   If we make a special effort to help a newly recovering people through them, more of them will stay around longer and go forward in recovery.

Organizing the Addiction Counseling Process – Part 4 Most rescue recovery programs for homeless addicts have no trouble filling up their beds. Yet, it is better to have a smaller program with committed participants than to have a large one filled with people who are not serious about changing their lives. A well-organized long-term recovery program is – “A planned, organized, and systematic delivery of services — using both internal and external resources— with the goal of meeting the unique needs of each individual.”

Organizing the Addiction Counseling Process – Part 5 In our last installment in this series we discussed, briefly, the importance of meeting the needs of each individual in the recovery program. To do this most effectively, a process of documentation is essential, using paper forms or computer-based data collection.   In residential recovery programs for the homeless, it is also important to adopt a team approach to working with our clients.

What to Do When Program Graduates Relapse

relapseWhat should we do with graduates who turn to our recovery program after they have relapse?

At addiction recovery programs, addicts spend several months to a year or more in a relatively safe, drug- and alcohol-free environment. While involved with the program, they are introduced to Christ and learn the principles of a sober lifestyle. Despite all this help, many, if not most, graduates from solid programs with caring, competent staff will use alcohol and drugs again. Relapse is normal part of the recovery process. For many, it can turn out to be the key to gaining a deeper commitment to Christ and to a program of personal recovery. So, we must help program graduates who fail to use failure in a constructive manner.

Let’s take a look at the main reasons recovery program graduates relapse:

A. Denial — Addicts who are not fully convinced that they are powerless over alcohol and/or drugs will withdraw from support groups, counseling, and other activities intended to support them in recovery. They usually end up experimenting to see if they can, in fact, handle drugs and alcohol.

B. Relationship Issues — Romantic involvement with a dysfunctional person is one of the most common reasons newly sober people relapse.

C. Isolation – By failing to make new friendships and to stay in touch with a support network, in another big reason. Failing to adequately deal with broken past relationships can also be a setup for relapse.

D. Financial, Legal & Vocational Issues — Not finding or keeping a job, not paying their bills, and unresolved legal problems lead to major stress, especially for program graduates on probation or parole. Too often, they end up dealing with this stress by using alcohol and drugs.

E. Spiritual Issues – 1 Cor. 10:13 is a simple warning — “Let him who thinks he stands take heed, least he fall.” Success, itself, can result in an attitude of pride, which in turn leads to a neglect of the very disciplines that brought the success in the first place. Commitment to rigorous honesty is the foundation of recovery. Newly sober addicts must remain committed to their relationships with God and His people.

Program graduates must know that if they fail, returning to the for help is an option. Help can be provided through on-site counseling, referral, or coming back to live at the facility. If the third option is chosen, keep these thoughts in mind. Once the returning individual has completed the essentials of the first phase for a second time, he or she can progress through the remaining phases at an accelerated pace. This should be based mainly on the successful completion of the required tasks for each phase.

A. Focus on Forgiveness and Humility – People who relapse get stuck in shame and become discouraged. We need to help them recognize that their failure was anticipated by Christ at the cross. It can be used to motivate them to avoid the sort of self-reliance that got them into trouble.

B. Start Them At The Beginning – In a multi-phased recovery program, the initial phase should focus on addiction education and overcoming denial. A refresher in these principles is important, since the relapse is proof that he or she either forgot them or never believed them to begin with. Reviewing the essentials of the spiritual life is also a good idea.

Once the returning individual has completed the essentials of the first phase for a second time, he or she can progress through the remaining phases at an accelerated pace. This should be based mainly on the successful completion of the required tasks for each phase.

A. Map Out the Relapse – Relapse is too often thought of as the actual act of ingesting alcohol or taking drugs. It must be viewed as a process that begins with certain types of thinking, attitudes and behaviors. The objective of a “relapse map” is simple: to help addicts recognize their patterns and, then, to develop strategies for circumventing them before the actual use of alcohol and drugs occurs.

B. Aftercare Planning – Before the individual leaves the program for the second time, they must work with a staff member to develop a detailed aftercare plan. It should include concrete activities in which he or she will participate in order to avoid falling into patterns that were identified in the “relapse map”. It may also be helpful to schedule follow-up sessions with a program staff member in order to build in a level of accountability.

This copyrighted article originally appeared in RESCUE Magazine, published by the Association of Gospel Rescue Missions, December 2004   Reprinting without permission is prohibited

Recovery Support Groups in the Church

1groupHow do “support groups” help church members who are struggling with addiction and other life issues?

A. “Support groups” are not a new idea for the Church — John Wesley’s “Rules for Small Groups,” written in 1816, is an outline that embodies “the Method” from which the name “Methodist” came. This method resulted in one of the greatest revivals the world has ever known. Believers gathered together in small groups, sharing honestly, becoming accountable to one another, asking probing questions, praying for one another with a deep knowledge of their mutual needs and struggles. Any believer can benefit from this type of gathering. It can be a tremendously healing and encouraging experience for those in recovery.

B. Benefits of church members participation in support groups — Ideally, a good support group is, first, a place where recovering addicts will find true acceptance and a sense of what unconditional love is all about. It is a safe, non-judgmental setting where they can express struggles, thoughts, ideas, and feelings without fear of rejection. Hearing the stories of others with similar difficulties and how they overcame them, gives the struggling addict great encouragement to go on in a life of sobriety. Healthy support groups can provide a sort of “family” atmosphere that stimulates the hope for a better life in all involved. Because addiction wreaks havoc upon an individual’s relationships with others, a good support group is a wonderful place for recovering addicts to begin the difficult and painful process of re-connecting with other people.

C. How to identify a good support group — Overcoming the lingering affects of addiction and moving into the fullness of the abundant life is an involved, long-term process. Fortunately, in recent years we have witnessed the growth of Christian support groups. Those who use the Twelve Steps originally developed by Alcoholics Anonymous seem to be the most effective. In many ways, support groups are like churches – all are not the same. Some are very closed and even hostile toward Christianity. Others are very open. Actually, there are even many AA groups meeting throughout the country that even call themselves “Christian AA groups.”

Before people from recovery programs attend a particular AA meeting or other support group, a staff person should make one or two personal visits to the meetings. A list of approved meetings that program participants are encouraged to attend should be developed. When a support group will be meeting at a local congregation, it is important for the pastor or someone in senior leadership to meet personally with those who will be leading the group. It is critical that they have confidence in the maturity, sobriety, and spiritual commitment of the group’s leaders. It is also important to set down guidelines for conducting the group in the church facility well before the meetings begin.