Whenever someone come for help with the misuse of mood altering substances (or behaviors), they are already aware that there is a problem. However, they rarely agree with caring family members or helping professionals about the nature of that problem. Usually this disagreement result in a press to convince the person that they are addict or alcoholic with the hope that recovery and healing will follow. Pressure to acknowledge, admit and accept is enormous. In most treatment settings, this pressure alone will cause a person self-identify as an addict or alcoholic. Unfortunately, this labeling, while accurate in most cases, implies a level of agreement between client and helping professional that rarely exists.
Tom was admitted into an inpatient treatment setting after a driving under the influence arrest. He admitted that he had long standing problems with the over use of alcohol. While in treatment he admitted that he was alcoholic and was very compliant with all treatment protocols. He was referred to me for follow up therapy after treatment. His inpatient counselor reported that Tom had “done very well” and that he expected good follow up and results. During Tom’s first session with me he stated that he did not believe himself to be alcoholic and had doubts about the aftercare plan. He reported that the he immediately saw that the only way to get through treatment was to admit and comply. He also reported that he went along because he knew he had a problem of some kind and that he really did not have another plan. However, he knew that he was unlikely to follow through with 90 meetings in 90 days, sponsorship and most other aspects of the follow up plan. While anecdotal, Tom’s case is not unusual.
In this case, the label addict or alcoholic, while accurate, is not helpful because it implies a level of agreement about the nature of the problem that does not exist.
The most important and first part of MMRP is that we will not enforce a definition of the problem. Instead, we will provide state of the art information that includes our best scientific information. Each individual will define their own problem, using this information and we will seek agreement with each other. Only after we have agreement and understanding can we have any hope of moving for with a plan that can be successful.
The recovery plan is based on the agreement. It is based on the options and information that has been provided, but it may include personal aspects that each individual may bring to their own process. Therefore, each plan is very individualized. Each plan may include very traditional components including 12 step facilitation and counseling. It may also exclude those methods and utilize Refuge Recovery, SMART Recovery, Mindfulness-Based Relapse Prevention or other methods. It may include some components of all of these or none of these. What each person needs is enough quality information to make their own decision and plan. The MMRP staff’s job is to provide information and facilitate the formation of that plan.
Both traditional wisdom and recent research support the idea that recovery requires support. This support has traditionally been found in some sort of recovery community. That is not the only way. Each individual has to find the level and setting for their own support. The components that seem to be most helpful are intention and caring. My recovery support community has to understand my problem, plan and intention and then care about me and my outcomes. Some people find this easily within the anonymous 12 step fellowships. Others do not. Some have become discouraged and give up on the idea of community support.
At The Intensive, we provide a community space called “C3” for Caring, Conscious, Community. It is designed to be an ecumenical recovery community where all modes of recovery are equally welcome. This community currently supports SMART and Refuge Recovery, Parents Affected by Loved Ones (PALS) and other community based groups.
Everyone’s recovery plan changes over time as we get results (good or bad) and as we grow and change over time. What we need is consistent methods to measure our own results and the modify our plan as needed. Each person who uses the MMRP is called upon to have a method to evaluate and modify their own recovery plan.
ARF will being conducting ongoing surveys, and qualitative interviews with each individual to assess and modify the MMRP as it is implemented. This is a research based model that will be evolving as it moves forward. The plan is for this to be flexible and as new evidence becomes available the model will change according to new information.