by Troy C.

Support Programs help evolve acute addiction intervention into a more chronic approach.

The impact of the world on persons being discharged from inpatient treatment for alcoholism and drug addiction is tremendous. Many of them left dysfunctional and dangerous lives to be introduced to new concepts and ways of living that eventually gave them a sense of belonging and security. Many have not experienced security for a long time, if ever. Upon discharge many experience significant fear and anxiety regarding the dangers they had encountered in the past. Well-meaning family members are anxious about how to relate to their loved ones coming out of treatment centers. They often fall back on their habitual ways of relating and so resume enabling behaviors which foster attitudes which are not conducive to continued recovery.

In working with many individuals recently discharged from treatment, it appears that their chances of recovery are heightened by a treatment stay which is longer than the traditional twenty-eight day model. Treatment centers are recognizing the need for lengthier treatment stays and post-discharge care. South Padre Islands’ Origins Recovery Centers uses Austin-based MAP Accountability Services to extend their 90-day inpatient program to total eighteen months of patient care. After prolonged exposure to clinically-sophisticated treatment grounded in the Twelve Steps, discharged patients can benefit from support program staff who are clinically-supervised and grounded in their own recovery. This support, combined with care and encouragement, helps reduce the fear and anxiety of entering the non-structured world after treatment. Many persons experience a using episode within sixty days of leaving treatment. A continuum that leverages care coordination services like MAP provides a layer of structure and daily professional accountability early in recovery to help mitigate the risk of using as well as providing effective harm-reduction if they do use. Helping clients re-engage with intense step work, they can turn the using event into a therapeutic opportunity to redouble the depth and quality of their sobriety.

Post-discharge support services not only are effective with the recovering addict/alcoholic, it also serves to encourage and educate family members to go to Al-Anon and engage in their own recovery. Furthermore, post-discharge support services can act as "go-betweens" when past history makes effective communication challenging or impossible between family members.

Another function which post-discharge personnel perform is to assist the client with daily course correction. Computer systems combined with gut instinct help the Specialist detect early behaviors likely to result in using events. Early detection allows the encouragement of course-correcting strategies to be implemented so that the person in early recovery can avoid relapse. Such strategies may include an increase in the number of meetings attended, increasing the frequency of visits with a professional therapist, changing sponsors, addressing co-dependency issues, and changing residences. Early detection of co-dependency relapse can also be brought to the attention of family members and course correction strategies also implemented for family members.

Monitoring personnel can also keep clinical treatment facilities aware of relapse potentials and assist stakeholders in getting endangered addicts and alcoholics into appropriate facilities. By maintaining regular contact with families and alcoholic/addicts, the monitoring staff can rely on the trust that has been created to suggest corrective strategies and encourage follow-through.

Support personnel must be careful not to usurp the place of face-to-face sponsorship as the pre-eminent aid in working the Twelve Steps. What they can do is to guide and encouraging the newly recovering individual to secure a sponsor and to use that sponsor. In like manner, support personnel cannot allow themselves to be used as surrogates for the fellowship of the Twelve Step program of choice. Rather the support personnel can help the newcomer to overcome the initial shyness which often accompanies entering into a new twelve-step fellowship. As the newly recovering alcoholic/addict progresses in his recovery within a fellowship, he or she can use support personnel to reinforce and gain encouragement to actively engage in step work with responsible sponsors. When the addict/alcoholic has doubts about the quality of guidance that they are getting from sponsors, he or she can ask their support professional questions with which to qualify their sponsors. In like manner, support personnel can be quite useful in answering specific Twelve Step Group questions for the recovering person. There are innumerable quirks and idiosyncrasies in AA, CA and NA meetings and groups. Many of these can be addressed by knowledgeable support personnel who have personal history of sobriety in such meetings.

Support personnel can provide consistency while the discharged person changes location, moving from one recovering community to another. Many times newly clean and sober persons find that their old surroundings are no longer most comfortable, suitable or supportive of their recovery. Unlike the geographical moves of the past which were designed to enable continued use of the drug of choice, these relocations in early recovery can be beneficial. Support programs can direct the newly released person to resources he or she might find difficult to locate on their own.

MAP Accountability Services has been developing and maturing this model of care and support of persons leaving inpatient treatment with success on two levels. Firstly it has encouraged and seen the development of long-term quality sobriety and recovery firmly entrenched in Twelve Step fellowship among its cases. Secondly, and perhaps more importantly, it has guided persons who have had using events back into recovery in a kind and gentle way but with firmness. Use events have been quickly detected, course-correction has been firmly encouraged and many of these persons have renewed their recovery process with additional urgency and priority. There has also been the experience of the addict/alcoholic who has gone into longer term relapse, yet even they continue to be checked on the program and encouraged to renew their commitment to life.