Tough Love in Addiction Recovery Programs

How do we properly cope with the emotional distress that some staff members experience when called upon to dismiss residents for violating recovery program rules?

A. The Principle of “Tough Love” –  One of the keys to overcoming staff difficulties in this area is educating them in the important principles of “tough love.”  While it can be extremely difficult to dismiss certain people from a program, we really are doing what is best for them.  For those in denial about their problems, consequences can be their salvation!  People continue to abuse alcohol and drugs (and persist in dysfunctional behaviors) as long as they feel the benefits outweigh the costs.

Additionally, being dismissed can often serve as an important learning experience.  Such people may return to the program with a much better attitude, having had a chance to get a hard look at the pain and destruction in their old environments.  Someone once said, “It”s hard to go back to digging around in the garbage after you”ve been feasting at the King”s table!”

At times, people may have more problems than a program”s facility and staff are equipped to handle.  Except for this situation, there seems to be only one other reason for dismissing an individual from a program – resistance!  One manifestation of resistance is a refusal to abide by expectations and rules to which they initially agreed when they first entered your facility or program.  Keeping them around is both bad for them and unfair to those who do have a sincere desire for a new life.

Certainly, troubled people need a lot of love and compassion.  Yet on the other hand, like Jesus, staff members do need, at times, to confront people who are in sin and denial.  Truth is always uncomfortable to the hard-hearted.  People only recover when they learn to take responsibility (with God”s help) for their own actions and lives.  We cannot do this for them!

B.  Protecting the Sincere Client  Another important principle to remember in the application of “tough love” is the need to protect those residents who are sincerely trying to change their lives from those who are not.  Keeping hard-hearted and disruptive people around can be extremely discouraging to those individuals who are working hard at their own recovery.  It can be truly amazing to sense the dramatic change in the atmosphere of a program when one or two disruptive individuals are removed.  Sincere people can be further motivated and reassured if they know that their efforts toward recovery will not be undermined by disruptive, uncommitted, and dishonest people.

C. Consistent Application of Program Rules and Expectations  It is extremely difficult for a staff member to dismiss a resident for a rules infraction that another resident has gotten away with.  No one wants to play the “bad guy.”  To prevent this situation, whatever rules a staff establishes must be applied equitably to all who stay at the facility.  Furthermore, “bending the rules” leads people to conclude that the ministry”s staff members are not serious about enforcing any of them.  “Playing favorites” by exempting certain individuals from your established rules will certainly lead to resentment toward staff members and their “pets” by other residents in the facility.  It is also especially important that staff members are supported by their superiors who are not constantly over-ruling their disciplinary decisions. If there is a disagreement between staff members about such an issue, it must never be discussed in the presence of a resident.  Forgetting this will certainly undermine the authority of the staff member in the eyes of the residents, rendering him ineffective in disciplinary matters.

The most important element for successful application of program rules and expectations is a formal intake session for every individual before actually moving into the facility.  At this meeting, the rules and expectations that are conditions of staying at the facility must be clearly discussed with prospective residents. The best policy is to require them to sign a formal contract agreeing to abide by your expectations.  This way, with everything explained at the very beginning of their stay, staff members will not be accused of “making up rules along the way.”  It also means that residents cannot say, “I didn”t know about that rule.”

D. The Principle of Good Stewardship – Staff members must be assured that, if a program has limited space, they must practice the best possible stewardship of the resources God has entrusted to them.  This involves, at times, a commitment to not allowing their time and resources to be wasted on people who are closed and resistant to what they have to offer.  They must avoid turning away people they can work with because space is being taken up by those who are hardhearted and resistant.  Good stewardship can mean working with a smaller number of sincere people, rather than filling up their facilities with people who use and abuse often limited resources and have no desire to change their lives.

E. Internal Struggles of Staff Members  When staff members are struggling with their own codependency-related problems, it can be very difficult for them to take disciplinary measures with program participants.  Staff workers must be committed to being part of the solution and not a part of the problem.  Their own unresolved issues will inevitably hinder their ability to minister effectively to others.  It is only proper and fair to those they work with that staff members seek out the right sort of help for themselves.  (The “Wounded Warriors” recorded lecture has more insights on this topic.)

 

Excerpts from Rescue Magazine, Fall 1993. Journal of the AGRM.

Presentation to the Kansas City MO City Council

Right Length for a Residential Recovery Program?

addiction-recovery-programAwhile ago, I was asked by a staff member of a rescue mission, “We want to lengthen our drug/alcohol program from ninety days to 42 weeks. Is this too long a time to expect a man to stay on a program?”

Unlike programs that rely on government or insur­ance funds, rescue missions have no funding constraints to restrict how long an addict can remain in their programs. There is no set formula that we can use to determine how long it will take people to put their lives back together. Therefore, it is best to avoid setting definite time limits for pro­grams. When a program has a set 90 day length, often on about day 80 the residents’ minds and hearts are already out the door. Even though we might feel they need more time in the program, when graduation day is not far off, it is extremely difficult to convince them to stay any longer.

A. Goal Oriented vs. Time Oriented – Instead of limiting programs to a certain number of days or months, it is best to divide them into definite phases that are goal oriented rather than time oriented. Some mission programs use three phases based on the Twelve Steps: Phase I – Steps 1-5, Phase 2 – Steps 6-9, Phase 3 – Steps 10-12. Others use different activities or accom­plishments to determine when residents move to the next phase. This approach creates a sense of movement, with genuine bench­marks of achievement for participants to work toward. A string of such successes can promote greater self-esteem and commitment to completing the program.

B. The Key to an Individualized Program – Personalized goals and objectives are best developed after an in-depth intake and assessment process. Taking time to identify par­ticipants’ needs in this manner communicates that the program staff is committed to really knowing them and will work with them on a personal basis. With this type of system, how long an indi­vidual will stay in the program can be addressed by saying, “We ask all those who come into our program to make a commitment of at least 90 days. Most stay anywhere from 6-8 months.” We can say this because people grow at different rates. Some can accom­plish their treatment goals and objectives in a shorter time period, while others with more issues in their lives to work on may need a longer stay.

Here’s a few other responses were I got from other program staff and directors:

“When a man receives Christ, he is a new creation, but he still carries a lot of baggage from the old life. To quote Jerry Dunn, author of God Is For The Alcoholic, you can get rid of the stinking drinking in two days (detox), but it takes two years to get rid of the stinking thinking.”’ (Michael Fishback, Bakersfield Rescue Mission)

“I have come to the conclusion, after 22 years of observa­tion, that programs must be custom designed to the individual. Some need 6-8 months and others need one year or more. Alert case workers [manage] the process of moving the client into the next phase of recovery… either a job, college or trade school and! or private living conditions outside the mission.” (Frank Jacobs, Miami Rescue Mission)

“The rule of thumb at Mel Trotter Ministries is one month of treatment for every year of addiction.” (Bill Dodge, Grand Rapids, MI)

“Our program is 12 months long and is divided into 4 phases, each one goal driven with a specific minimum time required. This is about a minimum for an addict/alcoholic to reach middle to late recovery, and have established a relationship with Christ, and The Body. About 60% of all men who enter our program stay to completion. I think one of the keys is to make the program increasingly challenging, and rewarding, so the program member stays alert, and interested.” (Bill Roscoe, Redwood Gospel Mission, Santa Rosa, CA)

“We increased our minimum time on the program to ten months. (The maximum time can be tailored to the individual.) Increasing the length of time on our program brought fewer gradu­ates for a while, but the quality of graduates increased tremen­dously, and the number of relapses and returning clients decreased.” (David Ganzert, John 3:16 Mission, Tulsa, OK)

I would appreciate your feedback on this question!

March/April 1997