"I Don't Trust Those Rehabs"

I was with a family in a session one day, and we were getting to the point of saying. "It might be time to start looking at going to treatment" for their 22-year-old son.

The dad looked at me and said:

"I don't trust those rehabs. I don't think they work. I think they just want your money."

And it wasn't the first time I'd heard that.

It's understandable. How many of us know someone went to rehab and it "didn't work." 

A family member. 

A coworker. 

The kid down the street who's "been in and out of rehab and he's still getting in trouble."

Yet any substance use treatment professional knows that every day miracles are taking place in treatment programs all over the world:

Lives are saved. 

Families are healed. 

Parents get their child back. 

Marriages come out stronger than they ever could have imagined. 

Negative Public Perception → Self-Fulfilling Prophecy

The problem is, when we hear more about treatment failure than we do about treatment success, the public perception of rehab becomes tainted. And you can imagine how, in some cases this can even lead to a self-fulfilling prophecy:

A patient ends up in treatment, not happy to begin with. With an attitude of "I don't trust these rehabs," they may be quick to find fault with the program, and looking for ways to be contentious. In this case, the staff is already starting from behind the 8-ball, and the chances for treatment success are already compromised. 

What's Your Success Rate?

It's understandable that families are going to be concerned about treatment success rates. 

As the owner of an adolescent outpatient treatment program for many years, I used to get the question a lot: "What's your success rate?"

I sort of enjoyed looking the family right in the eye and say:

"Our success rate is lousy."

And I would just let that sink in for minute. 

I would go on to say, "Is that because we have a bad program? No. To the contrary, I think we have a really good program. But the truth is, adolescent substance use treatment success rates can be pretty lousy." 

Again, I would sort of let that sink in. Then I would go on to share my formal view on our success rate:

"Our success rate is either 0%, or it's 100%. It depends on the individual."

Then I would share with them the line that has became the thesis of my book Rehab Works!, and is the premise of all the work I do with families today:

"Treatment success is an interactive process in which the family has much more to do with outcome than is generally realized."

From this premise, I suggest to families that they take proactive role in their loved one's treatment by learning everything they possibly can about substance use disorder, how it is treated, and what recovery looks like—not just for their loved one, but for the entire family. 

Don't Become The Substitute Teacher!

Learning everything they can about substance use disorder and recovery—in other words, learning what the clients are learning in treatment—is what helps families avoid what I call the Substitute Teacher phenomenon. Here's what that looks like:

a. Clients are in treatment 24/7. Families are not.

b. Clients are learning a heckuva lot more about addiction and recovery than families are. 

c. Families end up out of the loop when it comes to understanding whether the client is following treatment recommendations or not. 

For example, the family may observe their loved one engaging in an activity that would not seem to be a good idea for their recovery. If they ask about it, they don't know if they're getting a straight answer—not unlike the substitute teacher confronting students on questionable behavior in the classroom:

"Oh no, Mrs. Johnson, our regular teacher lets us do this all the time."

 Don't be the substitute teacher in your own home.

Until we start checking families into treatment along with the clients—which I don't see happening anytime soon—there will always be inherent gaps between the client, the family, and the treatment. And those gaps are where:

1. Important things fall though the cracks that compromise treatment efforts.
2. Put the family in a compromised position of not knowing what to expect, what boundaries to set, or if the treatment plan is even being followed. 

In next week's post I'll introduce you to the Educated Consumer—the role families can step into that is the opposite of the Substitute Teacher role—and is the best thing they can do to improve their loved one's chances for treatment success. 

 

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Need help now?

If you're navigating this with a family member right now — and you recognized yourself somewhere in this article — I work directly with families in exactly this situation. Feel free to reach out: 

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