Autism and Addiction
A person with an Autism Spectrum Disorder (ASD) diagnosis struggling with Addiction is the hardest population to treat. And with this population growing, there is a higher need for support now, more than ever. Professionals working with this population cannot make a recommendation solely to a program that supports clients with ASD, and you cannot solely focus on the addiction. It’s a conundrum, and a gap in the treatment industry.
You cannot make a recommendation to just any addiction recovery program. Although they might tell you that they can support someone with an ASD diagnosis, you learn that the program has an aggressive 12-step model and does a lot of groups. For someone with social anxiety, rigidity in thinking, or who struggles with nonverbal cues, placing them in a group could be harmful. Their anxiety can play out looking like anger outbursts, leaving the room during groups, or breaking rules, which can be viewed as non-compliance from a program perspective. For a program that says they can work with someone with an ASD diagnosis will learn very quickly that this profile of a person can be disruptive to the overall community and thus, will ask the client to leave.
You cannot make a recommendation to a program that works with adults with ASD, specifically focused on their launching into adulthood. Although they might say during an admission call that they could work with this client, once the client arrives and is substance-seeking, the program will quickly discharge the client to a higher level of care. Their structure was not tight enough, and although they could work with the client’s potential rigidity, the program either does not understand addiction or is not willing to work with this client profile. With this, we are back to square one.
This conundrum exists at the residential-level of care, as well as extended-care levels. Families are left scrambling to find treatment that will work after failed attempts with treatment programs; programs that said “absolutely we can help your adult child!” on the front end without truly understanding the depth of their neurodiversity, or addiction. Don’t be fooled by an approachable Admissions representative. For this particular client profile, you will most definitely need to work with a professional to help filter through programs and supports that can truly help your young adult. It’s not easy, and it definitely won’t be cheap. If you want your young adult to get the help they truly need, it’s important to have a professional by your side.
For questions or comments contact Joanna.
Skipping Steps in Treatment
When someone goes straight from a residential level of care to an outpatient level of care, often that patient falls flat on their face. To go from the highest level of supervision and structure to the lowest level of supervision and structure provides too much opportunity for someone just coming out of treatment to backslide. Another word for backslide is relapse.
Far too often families will contact me for a second, third, or seventh attempt at treatment. After gathering all the information from their previous treatment attempts, I learn about the short residential stays and immediate recommendations (or lack thereof) to step-down to sober living. In looking more closely, a lot of the treatment programs they participated in were focused on the addition and treated the mental health like it was an afterthought. Unfortunately, this is all-to-common even for programs that identify themselves as “dual-diagnosis.” Families need a Therapeutic Placement Consultant more than they ever realized!
To ensure that, this time in hiring a Consultant that it really “sticks,” we make sure that we don’t skip steps through the continuum. Residential to extended care, and extended care to sober living. No matter how stellar your young adult is coming across as changed in treatment, they need to go through each of these steps. Period. With extended care being the often skipped step, it is also the most critical in ensure lasting change!
If your adult child is currently in a residential treatment program and they are pushing for sober living, you can blow the whistle. Going straight to sober living is a set-up for failure. This is not an exercise in sobriety, but it is a lifestyle change that we often refer to as “recovery.” If finances are a concern, it is more important than even to make sure you are not skipping steps during the first stint in treatment.
For questions or comments contact Joanna.
When to Return to College after Treatment
Often parents are quick to talk timeline - getting their adult child back into college. If they took a break from college to seek treatment, the pressure of returning to school to ensure they do not fall behind their peers can feel crushing. College is not going anywhere, and it will certainly be there when the young adult is healthy enough to return. But how do you know when it is time? That is a great question we want to explore.
To make sure it is clearly stated, treatment is not a quick fix. Whether we are talking about mental health, substance abuse, or both, it is important to mention that it takes awhile to for the mind and body to heal. Although the young adult or parents may be beyond eager to get them back onto campus, doing it prematurely invites failure. If the young adult is driving the return to college, the parent needs to listen to the mental health professionals in the recommended timeline. By holding the boundary of telling them they cannot go back to college, it forces the young adult to slow down. This allows them to build the strength and resilience needed to be successful when returning to campus.
Stability in recovery takes time. The stabilization period can be between three to six months. From the addiction treatment lens, that will encompass three months in a residential level of care, and three subsequent months starting off in extended care. From a mental health recovery lens, that encompasses three months in a residential level of care, and then three subsequent months starting off in a step-down or transitional level of mental health care. Notice that neither of these options mention a drop-off in care or returning immediately to campus with outpatient services. Why? Because they do not work. It is like going straight from learning to swim with floaties in the shallow end to immediately diving off the deep-end unsupervised. It is too much, too soon.
Another way to identify if your loved one is ready to return to college is if they are too ill to volunteer or have a job. During their extended care or transitional care placement, if they are still struggling to participate in that capacity there is no way they would be able to successfully complete college coursework. With the start of each passing semester and the ability to watch their peers having the time of their life on social media, it will pull hard on the heartstrings to get the young person back on campus. Post addiction treatment, returning to the same campus with the same friends still around opens the door to relapse. Looking at transferring and finding a collegiate recovery program could be the difference between sobriety and recovery.
Lastly, for chronic mental health, it can’t be said enough that taking time away from college takes precedence over achieving the college diploma before the age of 21. If your loved one is diagnosed Bipolar and just experienced their first manic episode, the next twelve months will be filled with a ton of ups and downs. Between stabilization, medication, therapy, and learning to live with a lifelong diagnosis, this is not an ideal time to be in college. Show support for your adult child by letting them know that college will be there when they are healthy enough to show up.
No timeline will be the same for a young adult. Regardless, it’s safe to say that a minimum of six months is necessary between leaving college and getting treatment and then returning to campus. The ideal separation includes a full twelve months through a continuum of care. If you push the college timeline, you jeopardize the health of your adult child. Adding to their mental health by factoring in acute stress related to school failure will only stretch out the recovery process. Think about the mental health over timeline for college diploma.
To navigate this process of knowing where to look for stabilization, or where to enroll for extended care, hire a professional. This is not a journey you want to navigate alone, and you will want someone in your corner to ensure you understand the “why” behind the clinical recommendations and timeline.
For questions or comments contact Joanna.
Treatment in Metaphors
When talking about the pace of treatment in real-time versus the pace of treatment that a young adult and their parents want, there is a gap between reality and expectations. When those expectations are driven by finances, ulterior agendas, or the need to be “back on track,” we lose sight of the importance of going to treatment in the first place: lasting change. To help families align their expectations with the pace of that lasting change, it helps to describe this process in metaphors.
One example is learning to swim. When reflecting on how a person truly learns to swim, it was not by pushing them off a diving board into the deep end to see if they sink or swim. What is most common is a young person dipping their toes into the shallow end with their floaties on, under the supervision of a lifeguard. Once they get comfortable in the shallow end, then they can start to test themselves, going into deeper water. Additionally, they are now taking swimming lessons, so they know the strokes to swim without the safety net of the floaties. This part takes time. Everyone is different in how quickly they learn and how quickly they feel comfortable trusting themselves. At the end of this continuum will be the art of diving off the diving board into the deep end without supervision knowing they will survive.
To compare this to treatment, the floaties and shallow end is when they are in a residential level of care. Once they are starting to get comfortable and learning to take swim lessons, this is when they are in extended care. By the time they are diving off the diving board into the deep-end unsupervised, this is when they have been in sober living or independent living for long enough to be graduating to complete independence from the treatment umbrella. How does this usually look in terms of the treatment world? Realistically from Residential to Extended Care to Sober Living, we are looking at least 12 months.
For those reading that love to bake, another metaphor for treatment will be in baking bread. If you are familiar with making break from scratch, it is not a completely easy process. Additionally, if you don’t let the bread rise before putting it in the oven, or if you take it out of the oven before it is completely baked, you have a loaf of bread that is practically inedible. To get the bread one wants, someone would have to start from scratch all over again. From the treatment lens, there are two negative aspects to this. First, you lose a lot of money when you pull a loved one out prematurely. Additionally, they will most-likely not have enough time to rewire their brain and heal, to which it will sadly be only a matter of time before they relapse.
The last metaphor comes in with a medical lens. Residential treatment is seen as entering an Emergency Room. It is meant to be a short-term, highly supervised and monitored stay. From there, someone is quickly patched up and given recommendations for how to heal. Following through with those recommendations is equivalent to doing physical therapy for months. You don’t go straight from surgery to running. The patient needs to relearn to use their body; they must retrain and strengthen their body. If you have had surgery before, you totally get this. Physical therapy is extended care. After months of physical therapy, then the patient can start to live their life practically pain-free. They will still have occasional follow-up appointments, but for the most part they are paying attention to their body as they independently continue to get healthier.
If you or your adult child ended treatment prematurely and you are looking for assistance in finding those swim lessons, or physical therapy (aka the extended care level of support), hire a professional to help you navigate where to go! If you are exploring the first steps in getting your adult child into treatment, be ready to tackle this year-long (or more) journey through healing. The more you anticipate this being a long-game, the more likely you are to support your loved one living a life of recovery.
For questions or comments contact Joanna.