It’s Not the Rehab—It’s the Relationships!
Individuals in active addiction sometimes say, “I don’t need another rehab, I could teach those groups.” Outpatient counselors sometimes say, “So-and-so isn’t doing well: S/he needs to go to rehab.”
The first position discounts the value of addiction rehabilitation by equating it with the content of psychoeducational groups. The second elevates its value to that of a panacea for faltering recoveries. Rehabs—and, for that matter, outpatient addiction treatment programs that incorporate similar elements—are neither of these.
Research has consistently shown that psychoeducation provides little or no benefit to those seeking addiction recovery. But interpersonal connection, such as an alliance with an empathic therapist, provides even more benefit than the actual method of treatment employed by the therapist. The wisdom of spirituality as well as the findings of science indicate that the way of recovery is not alone.
Essential tasks for those seeking addiction recovery are to make sufficient lifestyle changes that they no longer obtain and consume addictive substances in response to environmental cues and to cultivate resilience and self-acceptance by engaging in open, honest, mutually-respectful interpersonal relationships.
Many individuals with addiction require considerable structure and support to address these tasks. Residential rehabilitation centers and other addiction treatment programs often provide that—and empathic, pragmatic staff frequently make the essential tasks hard to avoid—but clients who simply attend these programs rather than engagein them are less likely to do well.
As is the case for structured addiction treatment programs, medications that treat addiction may be necessary but not sufficient for sustained recovery. These medications are like footwear that increases traction when walking on slippery or steep terrain. Travel is more secure, but the person in the footwear still has to take the steps.
So, those who “could teach those groups” may want to consider how honest and authentic they were with staff and peers when they attended rehab before, and whether it would be useful now to remove themselves from their current environment and get closer to people they can ask for support. Counselors and faltering clients may want to examine together how critical it is for the clients to leave their current environments and get closer to supportive people.
When recovery tasks are explicit and accepted, they can often be adequately addressed in a variety of settings. Validating interpersonal connections are available, for example, in mutual help gatherings (Alcoholics Anonymous, Narcotics Anonymous, SMART Recovery, Women for Sobriety, LifeRing Secular Sobriety, Celebrate Recovery…), individual encounters (psychotherapy, 12-Step sponsorship, recovery coaching…), and therapy groups (CBT, DBT, ACT…).
The people they need are out there. But persons seeking recovery must show up and be real.
The NCADD Addiction Medicine Update provides NCADD Affiliates and the public with authoritative information and commentary on specific medical and scientific topics pertaining to addiction and recovery.
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