Magazine article Addiction Professional

Extending the Professional Recovery Model

Magazine article Addiction Professional

Extending the Professional Recovery Model

Article excerpt

Better outcomes require the kind of aftercare support physicians and pilots receive

Strict adherence to continuing-care plans is crucial if the addiction field intends to improve recovery outcomes for those treated for chemical dependency. The responsibility for ensuring this adherence, and for the lack of adherence to date, rests squarely upon those of us in the addiction profession. For too long we have done what we have perceived as "our job" while clients were within our care, and then hoped for the best as they made the very difficult transition to early recovery-often with predictably disappointing results. If we are to continue to evolve as a profession and improve our efforts' results, we have a responsibility to create new paradigms for continuing-care plan implementation and accountability.

Addiction professionals know that treatment for chemical dependency works. Yet 40 to 50% of clients experience a relapse during their first year out of residential treatment.' For many years, solutions have been in place to ensure long-term, sustained recovery from chemical dependency. Those solutions are found in the form of "assistance programs" that are generally accessible only to licensed professionals in regulated industries such as the medical profession and the airline industry.

Last year, when our addiction consulting firm Addiction Intervention Resources (A.I.R.) began to research ways to improve our clients' posttreatment outcomes, we were amazed by the rates of success for professionals participating in these assistance programs. The question we continued to raise was: If this type of program is so successful, why isn't it available to the general public? After a year of research and trials, we are convinced that structured monitoring programs that focus on adherence to the continuing-care plan hold the key to improving recovery rates for all who suffer from chemical dependency.

Chemical dependency is a chronic illness. Other chronic illnesses, such as asthma and diabetes, see relapse rates similar to those for chemical dependency/ But there is a difference between treatment and recovery for chronic illness in general and for chemical dependency. This lies in addiction professionals placing the responsibility for following the prescribed continuingcare plan solely in the client's hands.

For most chronic illnesses, regular follow-up visits to a physician are a standard, accepted practice. During a followup visit a physician can monitor a diabetic patient's health and determine if the continuing-care plan (involving medication, diet, and exercise) is being followed. With chemical dependency, follow-up is generally not part of the continuing-care plan. Why? A mother and father certainly would ensure that their diabetic child followed through with the recommended continuing-care plan from their physician. However, loved ones too often do not understand the significance of continuing care for someone with chemical dependence.

Inventory of existing programs

In an effort to identify what was available and what was working in continuingcare efforts for chemical dependency, our organization looked at some of the more commonly used modalities. One of the assistance programs that we looked at closely, designed specifically for airline pilots struggling with alcohol and drug problems, is based on the Human Intervention and Motivation System (HIMS). The purpose of HIMS is to identify the pilot's problem, intervene, refer the pilot to the appropriate treatment facility, and then ensure that the pilot maintains sobriety. The overriding goal is to allow the Federal Aviation Administration to allow the pilot to resume flying.3 The data show that airline pilots have recovery rates as high as 92 to 95%.1 This represents a 32 to 45% improvement over the recovery rate found in the general population.

HIMS has been used as the model for the majority of assistance programs that deal with licensed professionals such as doctors, nurses, and attorneys. …

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