Category: Recovery Coaching

  • Relapse

    In the course of most recovery coaching assignments, there is a relapse. The client often 30–60 days into their sobriety becomes confident that they have this “recovery” thing down pat. They may conclude that their problems are over, and that there is no need to do anything more to maintain their sobriety. They feel good and can now handle the world.

    The pink cloud of recovery can sustain some or it can allow others to slide down that slippery slope. It depends on the client and how they react to various triggers. Perhaps, there is a bit too much euphoric recall on how the drug or drink made them feel, sparked by a bottle of Xanax found in the luggage, or a whiff of scotch while enjoying a dinner out.

    Relapse is inevitable. I know a relapse has happened when a coaching call is missed or, say, a commitment to a homework assignment is not kept. The usual reason a relapse occurs is that the individual stops putting enough effort into staying free of addiction. They start ignoring their problems and stop asking for help.

    In fact, as a coach I am prepared for relapse to happen. Once identified, the beginning of a relapse-prevention plan can be put into place. Such a plan allows for introspection, the looking inside oneself and trying to figure out “why I picked up.” A focus is placed on the healthy fear of the consequences of a relapse and is pivotal to a client’s understanding of why they “slipped.” Indeed, my own personal fear of the pain of withdrawal kept me sober for years. A relapse early in recovery for clients can be devastating, with such results as an angry spouse, mandatory discharge from an Inpatient/Outpatient Program (IOP), a night in jail or a visit to the detox. These consequences can be positive influences on the client’s recovery process.

    I look for the signs that the client has obtained a small level of humility. As a result of the relapse, does the client recognize they are neither God, nor the son or daughter of God? They are human, with the basic frailties and insecurities that every alcoholic/addict has. The first slip is a good time to examine who this client is. Is there still an air of superiority, the “I can beat this addiction” mentality? Or has a spiritual component started to appear in their conversations, such as “Higher Power” or “Your will not mine?”

    Post-relapse is the best time to write a relapse-prevention plan. Ensuring the client has a week or two sober, I pull out the book by Mary Ellen Copeland, WRAP-Wellness Recovery Action Plan, or print out the template on the NAMI website[i] and hand it to my client. During the next week, the client uses the experience of a relapse to create their relapse-prevention plan. The following week, we both meet and review their plan, and discuss how to integrate it into their overall recovery plan and their life.


    [1] The pdf version of the WRAP plan with authorization by Ms Copeland to reprint. Blank WRAP Forms

     

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  • Consequences

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    Melissa Killeen

    It is a good sign when a client can see the consequences of his or her drinking, drugging, gambling or acting out sexually. The consequences include a spouse that is mistrusting, a mother that cries a lot, a bank account that is overdrawn or a friend that won’t stop by anymore. When the fog begins to clear and a client becomes more conscious, it seems that the subject of consequences comes up.

    I am always very happy when I hear the client speak about their remorse and sadness over the consequences of their addiction. Even better to let the client talk on, bringing all of this remorse into the light. The coach can sit back and just listen. Talking about the consequences drives home the insidious nature of the addiction while validating that the client does not want to go down that path again. The client can see their addiction has hurt the people they love the most: their spouse, their family and their friends. When I hear a client talk about consequences, then I know he or she is really starting to “get it,” truly grasping sobriety and the benefits of clarity.

    A discussion on consequences is a great opportunity to bring forth the ambiguity of how addiction obliterates one’s moral compass. One client went on talking about his compulsive lying. He lied to everyone. He lied about using. He lied to avoid conflict or arguments. Soon he lied just because a lie rolled off his tongue easier than the truth. He lied for no reason at all. Of course, in time, these lies started to catch up to him. He regretted the loss of trust he had with his wife and his best friend, because of his compulsive lying.

    This client also regretted the loss of his commitment to his wife. Under the influence, he slept with other women. He now fears taking an HIV test. He knows that if he was not using, the situation would have never presented itself. He loves his wife—she is everything to him. He fears if she finds out about his lack of commitment to the marriage, she will seek a divorce. Should the results of the HIV test prove positive, his marriage will be equally threatened.

    The discussion of consequences can be very difficult for a client. Often, the client will cry, express guilt, admit to being ashamed. They may discuss their feelings of powerlessness. As a client meeting ends, it is a very good time to reframe the discussion into a positive message. If the client realizes that they don’t want to return to their addiction, remind the client to keep these thoughts in mind, and as “green” as possible. A client can journal about the consequences, refer back to the journal when thinking about picking up again. Also, while the remorsefulness is fresh, it is a good time to mention that in the future (not now), they will be able to complete a ninth step with the people he or she has hurt and make amends to them. This will bring the client into a state of hope.

    Lastly, discuss that feeling of powerlessness. I interject the 12-step mentality of having a higher power, that your higher power always has your back. I also mention that I firmly believe in the Buddhist philosophy of surrender. If a client has any doubt about how surrendering will help their sobriety, I hand over a small card with this quote:

    “Doubt comes from the absence of surrender” –Ramana Maharishi

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  • My First Meeting with a Client

    Melissa Killeen
    Melissa Killeen

    I know every client is nervous, unsure, and very vulnerable when they first meet their recovery coach. A typical client has just been discharged from an inpatient treatment center. It may have been the outpatient coordinator that suggested the client work with a recovery coach. Or maybe it was the therapist that the client employed after discharge. A coach can be there for a client during this incredibly difficult time. Of the clients discharged from rehab, 80% relapse in the first year. Of this number, 30% relapse in the first month. Those are some distressing numbers.

    Not every client can walk into an AA or NA meeting and select a sponsor. Many have to wait a week before they even see their therapist for the first time or move into an Intensive Outpatient Program. Wouldn’t it be nice if someone was there to support this client as they move from the safe environment of an inpatient treatment center back to the very scary environment that they may blame for sending them to treatment in the first place.

    My first meeting with a client is focused on establishing trust. Yes, hoping the client has trust in me as a coach, but also for me to establish the level of trust I have in that client. I ask the client to tell me the story of when they first picked up a drug or drink. I ask them their first childhood memory. We talk about expectations, and deliverables. How they think coaching will help them, and what I expect of them.

    Many of those expectations are the business side of the recovery coaching relationship. For example: Don’t be late for an appointment; if they miss an appointment they pay for it. Other expectations are stated to establish firm boundaries, such as every face-to-face meeting I have with them will include a toxicology screen. The client must email or text me every day and call me when they are scheduled to call since the client has prepaid for this. I also lay out the ramifications if the client slips. I ask them outright what they think will happen if they slip.  Every client thinks I’ll drop them, cold, if they slip. I tell them that a slip is a learning experience and research shows that everyone will slip. But it is the full blown relapse we want to avoid. That’s why I will stick with the client through thick and thin. Asking, what have they learned? How will they change? Next time, what will they do differently?

    After the tox screen I give the new client a Life Orientations Survey, which is a behavioral analysis. This is so I have a sense of what kind of behavior the client will display. I also request a spouse or partner take the survey. I request that the spouse take this behavioral survey so I can coach the client on how to deliver messages to the spouse in a way that the spouse can hear them.

    After finishing up the negotiations on the monthly schedule and fees, I usually exit within an hour or an hour-and-fifteen minutes with a check for prepayment of next month’s coaching engagement.


    If you are interested in purchasing Melissa Killeen’s new book, click below.

    Recovery Coaching
    A Guide to Coaching People in Recovery from Addictions

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