The Five Most Powerful Words In Substance Use Treatment

Some parents I've been working with had a family therapy session at their adult daughter's treatment program recently. The purpose of the session was to discuss discharge planning. The treatment team was recommending that their daughter go to an extended care program that included sober living and PHP treatment. 

Going into the meeting, their daughter was adamantly opposed to anything other than returning home to live with her parents and perhaps continue in weekly outpatient counseling. When she stated her position in the session, the family said one simple thing that changed everything:

"What's the treatment team's recommendation?"

Those five words are perhaps the most powerful words a family can say in working towards a successful treatment outcome. 

One of the biggest factors that contributes to poor treatment outcomes is not following treatment recommendations. And while the responsibility ultimately rests with the client (at least with adult clients), this is where the role of family engagement in the treatment process can make or break a case. 

When families are left out of the process, they may have no idea how the treatment process works, or more specifically, what the treatment recommendations are for their loved one. Important details fall through the cracks, and in the end, treatment efforts are compromised. 

But it doesn't have to be this way. 

EFFECTIVE FAMILY SUPPORT

In this case, when the family simply asked—in front of the counselors—what the treatment recommendations were, everything changed. Because along with that specific question was the implication of "we're going to support the treatment team's recommendation." By the end of the session, the client—who entered the meeting dead-set on returning home and relying on her parents' support—was fine with going to the extended care program that was being recommended. 

But what took less than two minutes in the family session to completely alter the dynamics was actually the result of lots of hard work these parents did behind the scenes. They had been meeting with me since the day their daughter admitted to treatment, learning about:

1. how treatment works

2. setting boundaries

Prior to beginning our work, they had a sense that it would not be right for their daughter to return home following a few weeks in residential care. But they didn't possess a) the knowledge of why this was correct, and b) the fortitude for enforcing the seemingly drastic decision of not allowing her to return to their home. Through education about these various treatment factors, and then helping them apply this through their role as treatment supporters, these parents changed the course of their daughter's treatment by uttering five simple words:

What's the treatment team's recommendation?

LESS IS MORE

I've been introducing families to the power of this phrase for years. But the other important point I make with this is that they don't need to say anything more.

They don't need to try to convince.

They don't need to explain.

They don't need to argue.

They simply suggest they support whatever the treatment team is recommending. 

But there is definitely more going on here than meets the eye. The power is in helping the family understand why it makes sense to set boundaries that support the treatment plan—even if it means rocking the boat and disrupting the status quo of family dynamics prior to treatment. I frequently tell families:

"It's like the tectonic plates deep below the surface of the earth have shifted, and your loved one feels it."

They know something's different. The family has thought it all through, played out all the scenarios, and they understand that the boundary they are setting is indeed healthy and is the most productive thing they can be doing to support the treatment process. 

I told these parents that even without saying anything, the way they interacted with their daughter let her know something had changed. And when the moment came in the family therapy session, all they had to do was deliver the message—with five simple words:

What's the treatment team's recommendation?