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.

Motivating Addiction Recovery Program Participants (Part 2)

 

Chapel services at KCRM

When I came to Kansas City in 1990 and my focus turned from direct involvement to training people to become addition counselors and helping them to manage more effective programs. However, I’ve stayed in touch with the “hands on” dimension of recovery work by volunteering at local rescue missions and for other organizations that help addicts and their families. Conducting chapel services for program participants and interacting with them is something I always look forward to doing.

One local mission, the Kansas City Rescue Mission, where Joe Colaizzi serves as executive director, is an example of a rescue mission recovery program that is doing a lot of things right. Their recent follow-up efforts reveal that for three years running, 70% of their graduates are still sober for year or more after leaving the mission. This is a very good rate of success. So, what are some of the things they are doing to promote such success?

A. They have a well-organized program — A “program” is best defined as “the planned, organized, and systematic delivery of services — using both internal and external resources— with the goal of meeting the unique needs of each individual.” The key words are “planned” and “systemic.” This means that everyone – staff, administration, volunteers, and clients — are all “reading off the same page.” At the Kansas City Rescue Mission, everyone knows what is expected – what staff members expect of residents and what residents can expect of staff members. Their daily schedule is clear and events begin on time. Their rules, which kept to a minimum, are well established and upheld equitably. Since sobriety is rule number one, any use of intoxicating substance leads to immediate dismissal with possible readmission after a predetermined time, 30 days in most cases. Being well organized means minimizing external distractions and “game-playing” and keeps people focused on working on themselves. The Kansas City Rescue Mission has achieved something very special — the men in the program are so committed to recovery that it is “self-regulating.” As a result, people who do not want to recover don’t stay. And, the staff members are spending most of their time helping people instead of enforcing rules.

B. They are not “re-inventing the wheel” — To assist our member missions, when I worked at the Association of Gospel Rescue Missions, we published a resource in 1993 called A Guide to Effective Rescue Mission Recovery Programs. The principles contained in this 12 tape staff training tool are well established and proven to work in the treatment and rescue mission recovery field. (available free online here) The Kansas City Rescue Mission has fully implemented our suggestions. They use regularly updated written client recovery plans. Their classes include relapse prevention and other addiction-specific topics, along with Biblical. And, they have well-defined phases through which participants progress. These phases are not simply time-based, but are instead based on residents attaining specific recovery-oriented goals, as contained in their written recovery plans, if they are to move into higher stages of the program. Program people are motivated by instruction and activities that “get right down to where they live”. If we are dealing with the real, pressing areas of need in their lives, they will be more committed to the process. This is how we show them we understand them and are, ourselves, committed to helping them to become all God wants them to be.

C. They help program participants to recognize their progress and celebrate with them over it. – One of the most important duties of mission staff members is to maintain an environment that encourages people to make changes in their lives. A big part of this is rewarding people for making good choices that lead in a godly direction. I saw this in practice during a recent program chapel service at the Kansas City Rescue Mission. Every month they recognize those who have some months of “clean time” by giving out AV chips during their chapel services. And, those who are moving to a higher phase in their programs receive a printed certificate to recognize and acknowledge their progress. Program participants are always more motivated when we give them “benchmarks” by which their progress can be measured. They need to feel they are getting somewhere and not just biding their time at the mission. Developing written recovery plans with regular reviews and updates will accomplish this. And, just as KCRM does, we need to reward them for attaining them. More than anywhere on earth, rescue missions ought to be filled with the type of joy and celebration we see in the father of the prodigal son. He exalted over his son who was lost and now is found. A simple little plastic coin or computer-printed certificate given to them in front of their peers may not be a fatted calf or golden ring. But, they can mean a lot to someone who has been experiencing nothing but failure for years on end. Let’s be sure to find creative ways to recognize and celebrate even small changes and right decisions.

(Most of this article originally appeared in Rescue Magazine January/February 1997 AGRM)

See also Part 1   and   Part 3 of this series.