Ten Things I Wished I’d Known Before I Sent My Brother Off to Rehab
Almost 10 years ago, my brother was sinking fast, in the grip of cocaine and pot. My family asked me to find him help. I was not a substance abuse specialist, just a therapist, but I started looking. I stepped on a lot of landmines along the way, and since then I have learned a lot. And finally, my brother is doing pretty well. I want to share some of what I learned, in the hopes that you won’t have to step on as many mines as I did.
1. Interventionists measure their success rate by the number of people they get into treatment. But that doesn’t mean that your family member (or you) stays in treatment. Even if they leave the day after they arrived, the interventionist counts it as a success.
2. Most interventionists have financial relationships with a few favored treatment programs. Those are the ones they will try to funnel your family member into regardless of whether it is the best match or not. Based on the latest U.S./NESAC research, 98% of the residential and outpatient programs in the U.S. are inappropriate for 85% of the clients they admit.
3. When you call to speak with somebody at a treatment center, you nearly always are talking with the marketing department. They are selling their program and they lie – about everything, except the price.
4. Admission criteria? How much money can you be conned or bullied into spending?
5. The program you pick may have a Program Director and/or Clinical Director with impressive credentials, but they are not the people who will be delivering the treatment or therapy. Treatment is generally delivered by poorly trained Chemical Dependency Counselors with only high school educations, who are nearly always former clients trying to stay sober by working in a treatment facility – or who are simply afraid to leave.
6. 30 days away is nice but it doesn’t “fix” anybody. – With rare exceptions the 30, 60 or 90 days away is just a break. It can Ayahuasca ceremonies in+ USA put a floor in, if you are spiraling down ever further, but mostly it is just a strange vacation or a luxurious jail, depending on your point of view. The problems leading to substance abuse generally lie in your everyday life and if those are not fixed, nothing else much matters.
7. Most of what clients do while in residence at a rehab center has little to do with rehab and a lot to do with filling time. Let’s face it – people are there 24 hours a day, and there is only so much time anybody can spend eating, sleeping and “in group”. Consequently, rehab facilities have come up with all sorts of creatively labeled time-fillers like equine therapy (playing with horses), canine therapy (playing with dogs), ropes courses (playing with ropes), hikes, massages, and “step-work”, since they are all (98%) 12-step programs (and they frequently lie about that too).
8. Treatment is mostly delivered in a group setting – not because it works (mostly it doesn’t), but because it’s cheap and doesn’t require expensive staff with real skills.
9. Spouses will be excluded from participation. As the most important person in the substance abusers day-to-day life, how do you think that’s going to work out when they go back home? Don’t be fooled into thinking the optional 2- 3 day “family program” will be something where you are working together. It isn’t. It is all about indoctrinating the family into the 12-step philosophy. And they charge extra for it, too!
10. The hard work really begins when you or your family member goes home from rehab and there is little or no ongoing support – just “don’t drink, go to AA” (90 meetings in 90 days, for starters). Nobody really wants to acknowledge this. Rehab center staffs want you to believe that they can magically cure you while you are staying with them. After all, it helps justify the tens of thousands of dollars they charge and close the sale and because they rarely offer any meaningful follow-up. But the truth is that the hard work is just beginning when somebody goes home. Substance abuse problems arose and exist within the context of everyday life and that is where people need good ongoing support. Thirty days (or 60 or 90) away is just the beginning, not the end, of effective treatment.