Picking up the Pieces after a Relapse (Part 2)

Melissa Killeen

Sometimes a relapse is so severe, detox and residential treatment is advised. After a stay in a residential treatment center, maybe even for a second time, many clients don’t like the idea of going back to the very beginning of their recovery journey. In fact, going back into treatment can feel a bit like retracing their steps or “repeating a grade” as in elementary school.

The tendency is to think that they’ve already been there and done that. So what else is there to learn from a repeat visit to a treatment center? The answer is that your client will always pick up new pieces of information. They will learn new strategies for coping, how to deal with recurring issues and problems, how to incorporate healthier behavior patterns into their life and not allow stress to get them down. They will even learn how to communicate better. Research shows that people in long-term recovery may have visited a treatment center four to five times in the course of their life in recovery.

Relapses, severe and frequent, tell me there may be co-occurring elements that have not been discussed during the previous stay at a treatment center. I will suggest to the current facility (and the client) a referral to a center that features a co-occurring disorders program. A number of treatment centers offer this type of program as part of their addiction-treatment plan. If drugs and alcohol have been used as self-medication to disguise a mental health condition, a treatment facility with expertise in co-occurring disorders will recognize that both mental health and addiction problems should be treated during this client’s stay.

If the client has relapsed, gone back into treatment, relapsed again and continued with several additional stays in residential treatment, I will suggest the client go to a long-term residential facility. Such a facility offers the client a stay between 6 and 12 months, so they can re-learn how to live without drinking or drugging. Hand-in-hand with the long-term residential programs are psychiatric services to address any co-occurring disorders.

After a stay in a long-term residential program, a focus on assistance in entering back into “real life” is important and necessary and many recovery coaches are employed for this purpose. After 12 months in a residential program the client will often need to be reacquainted with such day-to-day tasks as driving a car or using an ATM. Just shopping in a Wal-Mart can be over stimulating. To ensure continued sobriety with support, a stay at a halfway house is the next logical step for a client leaving long-term residential treatment.

More and more halfway houses are popping up to cater to the older, more affluent recovering client. Some upscale halfway houses (or transitional housing environments) feature private rooms, live-in chefs, gym memberships and charge upwards of $10,000 a month. Others feature a more middle-class suburban environment and will charge $3,000 per month. The Oxford Houses, a nationwide not-for-profit organization, charges in the vicinity of $500-$700 a month. All of these halfway houses offer an environment where staying sober is seen as a requirement of living in the house and sobriety is monitored by frequent toxicology tests. The client must find a job or attend school within thirty days and frequent attendance at 12-step meetings is usually required. The length of stay in a halfway house varies, but it can be as long as one year.