WHY I DON'T NEED A SOBER HOUSE
It's rare for young men to willingly accept the recommendation of transitional living after treatment. Most of the time, families will have a healthy debate on their hands once the primary therapist makes this recommendation. Many times the family, as well as the young man in treatment, will have ambivalence about this recommendation. It makes sense. Treatment is a jarring event.
Families find out all sorts of truths about their loved one that cause hurt, anger, fear, and shock. Even when a family suspects a great deal of the truth was hidden; hearing that all your fears are true is overwhelming. The young man is trying to wrap his mind around the concept of abstinence for life, and so, oftentimes, is the family.
It is easy to believe the counselor is making off-the-cuff suggestions, but in good treatment centers, the recommendation for transitional living post treatment is a clinical recommendation based on your family member’s diagnosis.
Generally speaking, the recommendation comes as a result of multiple clinical supervision team meetings discussing your family member’s prognosis. Because of the sometimes informal feeling of therapy, it can be easy to misunderstand the seriousness of this recommendation.
The clinician knows what a massive commitment it is to leave treatment and forego returning to familiar ground, and instead go out of the young man’s comfort zone to live with strangers. The reality is that ongoing care post-treatment works. Research suggests that the longer a patient stays engaged in clinical services after primary treatment, the better their chances of maintaining recovery. Like any other medical service, continuing care is the key to the service providing lasting relief. Common sense tells us that not following the continuing care recommended drastically increases the chance of relapse.
As much as the clinicians in the substance abuse treatment field realize that all of the above is true, it is still a difficult decision to make. If you have decided to consider following the continuing care plan, prepare yourself for the debate.
Here are some of the objections that you are likely to hear from your family member:
“They tell everyone to go to a halfway house. They have to say that. I don’t need it.”
⁃ Not true. It is typical for clinicians to recommend some form of continuing care for those leaving primary treatment. But not everyone was recommended to the sober house you were. This is a manipulation, and avoids the conversation your family could be having about how it feels to be in this situation. A patient telling you that the clinical team is making life-changing recommendations with no basis for that recommendation should raise significant flags. Please seek out the counselor and ask about the rationale for that recommendation.
“It’s not the real world. How am I going to learn if I am not out in the real world?”
⁃ In some sense, this is true. Sober living situations are not going to be long-term living situations for anyone. The benefits in this case outweigh the argument that sober housing is not real-world experience. Being surrounded by peers in a similar situation, all of whom have followed a continuing care plan from their treatment center, and all of whom are struggling with the consequences of their past, creates a unique growth experience. The young men here watch their peers in different stages of success or struggle. They are able to see what works and what doesn’t work, and, perhaps most importantly for young men, they stand shoulder-to-shoulder with their peers and work toward a common goal. Relapse potential is considered when making recommendations. Relapse potential for a young man immediately returning home, or back to school or work, is high. Taking time to build the “muscle memory” needed to create long-term abstinence is key.
“You guys already spent so much money. I can do this at home for free at meetings.”
⁃ This is my favorite. Yes, anything is possible, but that doesn't mean it's likely. First, going to meetings is just one small piece of recovery. Also, I would ask you to consider where this newfound concern about your finances is coming from. It is possible that your family member was always considerate about money, and even in that situation, this is a myopic statement. Young men who are truly aware of the complexity of a substance-use disorder, and have accepted their diagnosis, are also aware of just how hard it will be to return home and wouldn't want to do so without the necessary support. While there is nothing better to hear for families than a young man showing passion and drive for their recovery (assuming it is sincere), this is ultimately a misguided passion and highlights the lack of awareness of just how hard the struggle will be.
“Sober houses are a scam. The treatment center gets a cut for sending guys there.”
⁃ Unfortunately, in rare cases, this is true. However, these situations are the exception, not the rule. That type of financial arrangement is called “patient brokering” and is a felony. Ask yourself what the underlying issue is in this situation. Why is this young man making this argument? As a counselor I heard this statement hundreds of times. I worked for years at a nonprofit treatment center that primarily referred to a nonprofit transitional living house. I would show the patients how to pull up the financial statements for both agencies. No one ever did so. The truth is that while all situations have the potential for fraud, the important question is whether or not your family member needs ongoing care, and if the treatment team at his center is recommending it, this argument should be discussed with the counselor present.
“I will be surrounded by drug addicts and drunks. Everyone will be using.”
⁃ This statement pulls in so many parents. Your family member will be surrounded by recovering addicts and alcoholics that are actively seeking an entirely new way of living in a structured environment with a great deal of oversight. Sober living situations utilize drug tests, room searches, and, most importantly, regular community meetings and off-site clinical support to maintain the health of the home. Again, being surrounded by other young men trying to better their lives, and some who are failing, is one of the most powerful learning opportunities for your family member. This is a team effort. Football players practice with other football players; otherwise, they can't progress.
The entire list of objections is much longer and more creative than the short version we provided. Sober housing, in conjunction with therapy, works. It is a critical piece in the continuum of wellness that your family began when you sought help. Conversations about the objections are healthy. As a counselor, I was most concerned about the young man who did not initially fight the recommendation. The fight is honest, and honesty begets honest feedback. Early recovery is hard. The drugs and alcohol are gone, leaving raw nerves and a brain that cannot find the homeostasis that substances provided. These young men are off-balance and emotionally fragile. They will probably present less like a fragile man, and more like an angry or overconfident man, but know that they are raw and frightened.
If you are struggling with the recommendation, seeking support from the clinical team at the treatment center where your family member is receiving care is critical. If you have a therapist, discussing your ambivalence with them is also critical. Continuing care works, and long-term recovery for young men is possible.