I get numerous calls from individuals concerned about their loved one’s drinking or drug use every week. For this post, I’d like to describe a recent call from Beth, a distraught mother whose 25-year old son, Jason, was arrested for driving while under the influence of alcohol.
OrangeCheckpointSign“Nothing like this has ever happened to him before,” she defended. “But there is a family history of alcoholism and I’m worried that he may be developing a problem.” However, she also went on at length about how Jason has a thriving business, a great fiancée and no other drinking issues, except that he can “go a little heavy on the holidays and other special occasions.”
I have friends telling me he should go right into a 28-day rehab… they say I should go to Al-Anon so that I stop ‘enabling’ him to drink like this. -Beth, Mother
When asked about next steps, Beth said, “I have friends telling me he should go right into a 28-day rehab and that both he and I are ‘in denial’ if he doesn’t. On top of that, they say I should go to Al-Anon so that I stop ‘enabling’ him to drink like this.” Still others are telling her not to worry about it, citing their own DUI mistakes and how they learned their lesson from the experience.
“The only thing I told my son,” Beth continued, “was that maybe he should go to an AA meeting. But he got upset and said, ‘No way, I’m not an alcoholic!’” Like many other parents I speak with, Beth knew that these options weren’t right for their situation, but she honestly didn’t know what else to do.
I get calls like this from concerned loved ones all the time – far more volume than I can handle alone. That is one of the reasons why I developed my Professional Recovery Coach Training Program. A Professional Recovery Coach can help people like Beth and Jason understand much more about the variety of options they have at their disposal. Even you may be reading this thinking, What else is there besides AA or rehab? Well, as helpful as those options may be for some people, there are many alternative approaches, especially if the condition is not a full-blown alcohol use disorder.
So, what can a Professional Recovery Coach do for Beth and Jason in this case? There are four primary components a Professional Recovery Coach can work on, including: 1. Navigation, 2. Engagement, 3. Accompaniment, and 4. Reduction of Relapses. In this first post, we’ll focus on Navigation.
Navigating Assessment & Treatment Options
Navigation involves helping a family member and/or a substance-involved individual understand and make good use of what is available in terms of professional assessment and treatment of substance-related issues. In the case of Beth and Jason, a Recovery Coach would first explain that, based on scientific evidence, there is a range of problems related to drinking. In other words, every problem related to drinking is not necessarily an alcohol use disorder, commonly referred to as alcoholism.
… every problem related to drinking is not necessarily an alcohol use disorder, commonly referred to as alcoholism. – Michael V. Pantalon
While the Recovery Coach I referred them to could not and should not diagnose Jason, he facilitated a process by which Beth and Jason came to understand: 1. The different categories of substance-related problems (from harmful or hazardous drinking to an alcohol use disorder); 2. The types of screening and assessment tools individuals can use on their own; 3. The types of healthcare professionals who can accurately label the issue; and 4. The types of evidence-based treatments available.
The Recovery Coach helped Beth understand the above by explaining that a single DUI, even combined with heavy drinking on occasion, does not necessarily mean her son has an alcohol use disorder, though it could. The coach gave Beth several resources for evidence-based self-screening and self-assessment tools that her son completed, to start getting a sense of how severe the issue is. This understanding is helpful to bring to a consultation with an addiction specialist.
The next step in the process was for the Recovery Coach to describe the range of addiction professionals with whom Jason could meet. While there are many different credentials an addiction specialist could have (e.g., Ph.D., M.D., MSW, CSW, RN, CASAC, CDAC, LMFT, the list goes on), the Recovery Coach helped his client understand the difference between those who use versus do not use evidence-based (i.e., scientifically-validated) approaches to assessment, diagnosis and treatment.
She had no idea that there was another way besides AA. She was even further surprised to hear that AA and NA are self/mutual-help groups and technically, not treatment. – Michael V. Pantalon
This was the part that came as a big shock to Beth. She had no idea that there was another way besides AA. She was even further surprised to hear that AA and NA are self/mutual-help groups and technically, not treatment. Her coach reviewed with her the addiction specialist options, after which she and Jason chose a Ph.D.-level psychologist, but it could have been any of the other credentialed addiction professionals who specialized in the assessment of harmful/hazardous drinking versus alcohol use disorders. After her son consulted with this person, he discovered that, at least at this point, he did not have an alcohol use disorder and that his pattern of drinking better fit “harmful and hazardous drinking.” This meant that a 28-day rehab was not necessary.
The coach motivated Jason to continue with this professional and to complete the course of treatment recommended. This led to a plan for staying within low-risk levels of drinking and a contingency plan for abstinence and more extensive outpatient treatment if Jason could not do this, or if it was too difficult to do this, on an ongoing basis, which is in line with the scientific literature. Finally, Jason agreed to check-ups every six months to ensure that he stayed on plan. It’s been over six months now that Jason has kept his drinking to low-risk limits and has not experienced any negative consequences from drinking.
Had Jason met criteria for an alcohol use disorder, the coach would have referred him to providers who offer longer-term, evidence-based psychotherapies and perhaps even medications to help abstain from alcohol.
But what if Jason did not follow up with the addiction specialist? What if Jason did not even want to speak with the coach? In cases such as these, a Professional Recovery Coach is trained to use evidence-based engagement and motivational coaching strategies to either encourage the substance-involved individual to seek out specialty assessment and treatment or to coach family members to use these strategies to motivate their loved one. We will turn to this part of Recovery Coaching in my next post.
For information on how to become or find a Professional Recovery Coach, visit centerforprogressiverecovery.com. And, as always, feel free to write to me at firstname.lastname@example.org with any questions.