Treatment is not a quick fix

If I got a dollar for every time a parent asked me how “quickly” their young adult could get the help they needed, let’s just say I’d have a lot of money. To cut right to the chase, treatment is not a quick fix. And it's not a thing to be "fixed." We need to understand that, but in order to do so we need to learn a little history behind the treatment world and where the mindset for quick fixes in treatment originated from.

From what I’ve heard anecdotally and read, the 28-day model of getting help was created by Daniel Anderson in the 1950’s to divert addicts from remaining in jail. He created the “Minnesota Model” that was a 28-day curriculum in getting care. Scientifically, there is zero basis behind 28-days being effective. Then, insurance companies decided they liked the Minnesota Model, mostly because there wasn't much else out there with evidence saying otherwise. Collectively, insurance companies started to pay for 28-days of treatment. And so, created a widespread industry of treatment across the US and a timeline that is unfounded. Those of us working in the behavioral healthcare or addiction treatment industries know that by the time someone reaches 30 days, they are only just at the tip of the iceberg in contemplation. And that's if they're even in contemplation!

To follow that metaphor, a life of stability, sobriety, and recovery takes at minimum a year. Now, most of the programs I refer to ask for a 60-day minimum commitment, but have research and evidence showing their graduates who stayed for 90 days and who went on to a continued care program had a much higher percentage of remaining sober. Young people aren’t meant to be “fixed.” That implies they are broken. What we need to consider saying instead is that it’s their time to grow. Growth is dependent on a number of factors. Nutrients, light, water can all be translated to therapeutic modalities, community connections, sense of service, and learning that you can have sober fun. Everyone's path is different, and yet there is also an equation of programs and supports that translate to healthier, sober lives.

You can take the “addiction” out of the mix here and replace it with mental health. There is still a period of recovery. Going to a program for two weeks will do nothing for the longevity of the well-being of your loved one. Again, we are only just experiencing the tip of the iceberg.  Or, we can talk about it as if it were a race. This is a marathon, and they’re in the beginning stages of their training. This will take months, long before they’re ready to run the race. They will have days where they feel amazing. There will be days where they don’t even want to lace up their shoes to go outside. We must support them either way when they show up. This is often the hardest thing for a parent to do.

The last example I’ll use is around study habits of the college students I used to work with. I’d love to bring up their age. For someone who was 18 years old, they’ve been training their body and brain to slowly shut down once they lay on a bed. That was something they practiced daily.  So, when they lay on their bed in college to study how likely is it that they’ll be able to remain awake to study? Eighteen years of daily routine tells us they’re fighting a losing battle. The same goes for someone who has been struggling for years with mental health or addiction. This is not thing that we can snap our fingers and will be miraculously cured in 14 days. Anyone who thinks otherwise is sorely mistaken.

Most parents really want to see their young adult get better and never struggle again. Most importantly, they want to see results immediately. Is that realistic? Absolutely not. We are human after all. We’re biologically wired to have ups and downs. To laugh, to contemplate, and to feel deeply. Sometimes those feelings are light and sometimes they are heavy. Getting treatment is about being able to acknowledge when you’re going into a dark place and making sure you get help before it’s too late. The progress is sometimes hard to see in real-time. I’ve recently enjoyed the idea of saying that young adult treatment can be a glacial process. From the outside we are staring and waiting for the glacier to change, but it doesn’t appear to be moving at all.  Even to the point of holding your breath in the off-chance that you see movement. These changes may not visible. Significant movement is happening, especially below the surface. But because we’re just watching and waiting for it, we may subscribe to the belief that no work is being done. Progress takes time.

Thinking about talking about treatment with your young adult? Consider stopping at the door with your agenda and timeline. The clinical team in the program they enroll in will be the ones who can make the recommendations around appropriate timelines. They are looking at the long-term for your loved one. Your sights may still be set on the short-term (i.e. college enrollment, a sibling’s wedding out of state, etc.), but we need to acknowledge that the expectations we have need to be let go. We need to learn to accept that treatment is a process. It’s not a short-term solution, or a "quick fix."  As soon as you can get on board with that, the more likely your loved one with advocate for longer care for themselves.

For questions or comments contact Joanna.

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