Is Relapse a Normal Part of the Recovery Process?

Doesn’t saying “relapse is normal part of the recovery process” give clients the ability to abdicate responsibility for behaviors that lead to using –practically giving them permission to relapse?

People who work in the addiction recovery field pour their lives into troubled people day after day.   Nothing is more discouraging than to see these efforts met with little or no long-term results.   When an individual who is a graduate of a long-term residential program falls back into drugs and alcohol, those who have been helping him or her often take it quite personally.   For these people, it is important to remember that a temporary or occasional “slip” does not mean that all their time and efforts were wasted.

I would almost say that the real test of how successful we are with graduates is not whether or not they use alcohol or drugs again. What happens when they do relapse really shows whether they have, indeed, started on the path to recovery. The main issue is to make sure that they don’t stay stuck in a downward cycle of destruction, but, instead, get back on the road to recovery.

So, how can we help newly recovering people to use failure as a “springboard” to successful recovery?   Here are a few points to keep in mind:

A. Don’t Condone or Project — Prepare! —Without condoning relapse, or even expecting them to fail, every program graduate needs to know that it is not uncommon for newly recovering addicts to relapse.   We need to let them know that we will not be shocked or disappointed by a failure to remain sober.   The doors of the mission are always open to them — whether that means returning to the program, seeing a counselor on an outpatient basis, or being referred to another program for help.   The last thing we want is for them to end up full of shame, think they have let us down and not reach out to us in their time of need.

B. Help Them “Own” Their Own Choices —Failure to stay sober is always a consequence of the individual’s own actions and choices.   He or she must be held accountable.   Returning to alcohol and drugs after a period of sobriety is evidence that there are still significant issues in the realm of denial that need to be addressed. He or she probably needs a lot of help to “connect the dots” in order to make sense of how these decisions and behaviors came together to cause the relapse.   That is the purpose of creating a detailed “relapse map.”

C. Keep Quitting — For most addicts, staying clean and sober is not a “once and for all” proposition.   Few people with long-term sobriety “got it” right the first time they made an initial resolve to forsake alcohol and drugs. I like to use Jerry McAuley, who founded America’s first rescue mission in 1872, as an example of this principle.   We know that Jerry backslid over seventy times before he finally found lasting sobriety. The key to his eventual success — and his tremendous legacy as a servant of God – he “kept quitting.”   The Lord always honors an attitude of humility coupled with godly perseverance.

D. Never Waste a Good Crisis! —This was some of the best advice I have ever received from a fellow counselor.   When are people most likely to change?   It’s in the midst of a crisis when they are bewildered, and full of self-doubt and pain.   It’s basic human nature to keep doing what seems to be working as long as it seems to be working.   So, give the person lots of time to sort through all the feelings associated with the failure.   Then, help him or her to use that pain as a motivation to renew a commitment to sobriety.   If viewed correctly, the crisis of relapse will create a healthy sense of self-doubt that leads the addict to admit in his “heart of hearts” that he is powerless over his “drug of choice.”   This acknowledgement is the where the road to successful recovery begins.

 

 

Taking Care of Staff Members

How can we be sure we are taking care of the needs of the program staff members?

 

Most people working at rescue missions don’t view their work as simply a “job.” They consider it a ministry or, more precisely, a “calling.”   As a result, they tend to be highly motivated employees. Yet, by keeping a few simple human resource management principles in mind, rescue mission leaders can do a lot to encourage them and help them to be even more happy and satisfied in their work for the Lord.

Why people “burn out” – Working with troubled people can be very stressful and makes rescue mission workers very susceptible to “burn out.”   In her 1994 IUGM Annual Convention Seminar, in Denver CO, Cindy Stutheit, Program Director of Denver Rescue Mission’s Champa House, noted some of the factors that cause burn out for mission workers:

Lack of communication

Frustration

Emotionally draining

Too much responsibility

“Losing people, souls & lives” versus “losing an account”

Physically taxing

Poor boundaries and codependency

Tyranny of the urgent–daily rut of routine and poor crisis management

Poor training

Heavy workload

Inexperience and unrealistic expectations

No personal space

24-hour job for live-in staff

Establishing a set of priorities for meeting staff members’ needs will help them avoid burn-out and will inspire them to high performance in their work.

Meetings Their Basic Needs – Everyone is concerned about meeting his or her basic needs for food, clothing, and shelter. These basic needs are satisfied through wages and job security. Staff members must know   that as long as their work is satisfactory, their job will be secure. Secondly, rescue missions must offer adequate wages if they are to attract and keep good staff members. When their basic financial needs aren’t being met, it becomes impossible for them to remain motivated and to perform their work satisfactorily.

Meeting Their Social Needs – Rescue mission workers need and enjoy small talk among themselves and group interaction. They enjoy telling about weekend trips, family needs, hopes and dreams. An effort needs to be made to set time aside for wholesome, informal group gatherings.

Meeting Their Ego Needs – The ego needs of the workers are met through esteem and self-fulfillment. At the rescue mission, this need can be met by encouraging acceptable job performance, ethics, dress, language, and also by periodic evaluation for merit and for promotion. In other words, by making sure that each staff member knows that her or his work is appreciated.   Secondly, dead-end jobs are seldom satisfying. A promotion can be as rewarding as a raise. A title is a status symbol, a name indicating a job position, an important status symbol, even in the rescue mission. Some thought needs to be devoted to developing a “job entry career ladder system.”   Staff members must have the opportunity for career mobility.   They need to be able to move upward as they gain experience and training, and as new positions become available.

Meeting Their Self-fulfillment Needs – Most staff members need to be creative in order to attain some measure of self-fulfillment. To be creative in the rescue mission context means that when a staff member has new and practical ideas, they are used whenever practical. Rescue missions have many staff members who are imaginative and like to solve difficult problems. Some want to take part in management decisions. Since the staff members are the people closest to “the action,” they often understand the operation better than those in leadership do.   Many constructive changes have originated with a staff member’s suggestions and recommendations. By listening to their views, experiences, and suggestions, wise rescue mission managers will motivate and encourage such a staff member to do bigger and better things.

Personal rewards are also effective in motivating. For example, if a staff member suggests an idea or method that is cost saving, a bonus would be appropriate. Citations, public acknowledgment and the conferring of certificates of distinguished service or appreciation are also valuable. Recognition in the mission’s monthly newsletter or magazine is another good way to reward the creative staff member and to stimulate others in this direction.

Meeting Their Spiritual Needs – Prayer and the Word of God are a part of everyday life at the rescue mission.   Still, apart from their service at the rescue mission, it is vital that staff members participate in the life and body of a local church.   They need the fellowship of believers where they can find encouragement and inspiration. They need interaction with people who are not looking to them to meet their needs, but rather minister to them.

In summary, five important motivating factors for rescue mission workers are:

Keep them informed.

Give them some control over their actions.

Challenge them with work that can lead to recognition for their efforts.

Provide them with the opportunity to achieve and advance in their career.

Encourage them to find spiritual and emotional refreshment outside of the rescue mission.

  

February 1999

A Few Thoughts for Chaplains and Counselors

Good chaplains and  counselors start “working themselves out of a job” when they first get involved.   They truly succeed when the troubled people they help no longer need them.   The opposite is what I call “missionizing” – the rescue mission version of institutionalization.   It is possible to teach needy people to function successfully while staying in the mission, but not prepare them to live a healthy, sober life after they have left.

There are a few ways to avoid this.

A. Equip people to help themselves: Discover each program participants needs and help him/her to own these needs for themselves.   Telling people what they need does little good if they don’t eventually “own” those needs for themselves.   Sometimes needy people expect us to “fix them.”   However, successful recovery begins when addicts take responsibility for their own lives.   This begins by bringing them to a saving knowledge of Christ — taking responsibility for their own eternal destinies.   We need to create other essential “confrontations with reality” for each individual with whom we work.

For instance, it might be obvious to you that an individual has a drug problem.   Some may even verbally agree.   But until this truth is accepted in his “heart of hearts,” he will not be motivated to change.   Education about addiction, support groups, one-on-one counseling and fellowship with other addicts who are in recovery all can work together to help such an individual to begin to recognize his own need.

B. Help them access community resources: Identify resources in the community that address needs that cannot be met in-house (e. g. legal aid, medical services, vocational training and self-help groups).   No organization has all the resources in-house to meet the needs of all those who look to them for help.   A community referral book listing resources available in the local community — complete with phone numbers and contact persons — should be a fixture in each chaplain’s office.

People become homeless when they don’t know how to access resources that are available to them.   So, we need to help people learn how they can access these resources as they encounter problems in their lives after the rescue mission program.

A special note of caution: Never refer without a follow-up contact to the agency.   This helps build relationships with referral resources and gives us a direct line on the services that were provided instead of relying on information from the person we sent to them.

C. Establish benchmarks on the road to success: Help program participants to evaluate their options, to see progress and establish “benchmarks” for measuring growth.   A sober, healthy lifestyle is not automatically picked up just by hanging around the mission for a certain length of time.   A formal, written recovery plan (or discipleship plan) should be developed for each individual in a mission’s long-term program.   The purpose of such a document, which should be reviewed and updated often, is to help program people think through their options, to identify their own needs, and to determine which specific actions they must take to get their needs met.   This should be developed in the form of a checklist with target dates for taking the predetermined actions and the actual date they were done.

Providing solid benchmarks for growth gives program participants a sense of movement and a way to evaluate their own progress in the journey to a new and sober life. Creating a situation where they experience a series of small successes that lead to stability in their lives is a great self-esteem builder.

Model a healthy godly lifestyle.   Be an example in word and deed of the principles you hope program participants will adopt.   It is critical that we help mission program participants learn to walk with the Lord, to listen to their consciences, and to make personal prayer and Bible study a part of their daily lives.   It is also important that the mission’s staff members remember that they may be the first examples of real Spirit-led Christianity that many of the people we work with have ever observed.   Our attitudes and actions speak about the nature and heart of the God we serve.   May we always be a reflection of Him to those in need!

D. Assist them to get the right, healthy people in their lives: Help program participants to develop new personal and social resources that will contribute to a positive life style.   Even after people graduate from the mission program, they have a real need for ongoing support to succeed at life on their own.   I would say that we are wildly successful if people leave our programs as struggling baby Christians!   Therefore, it is absolutely essential that we help them to become integrated in two communities while they are with us, so they will have time to make them an ongoing part of their lives after the mission

First, they need to make new, positive relationships with other believers.   The lack of support and meaningful relationships with other people is essentially why they became homeless in the first place!   Secondly, because recovery from chemical addiction is not a “do-it-yourself” proposition, they need to be connected with the recovering community.   This is best accomplished by making participation in outside support groups a vital component of the latter stages of a mission recovery program. (A word of caution: be sure that you have visited the support groups yourself before sending mission program people to them.)

 

Portions originally appeared in the April 1999 edition of RESCUE, the journal of the AGRM