How To Make An Aftercare Program

After you get out of rehab what's next? The aftercare program kicks in. Or at least it should.

Transcript

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Time again for Doc Jacques, Your Addiction Lifeguard Podcast. I am Dr. Jacques Debruckert, a psychologist, licensed professional counselor, and addiction specialist. If you are suffering from addiction, misery, trauma, whatever it is, I'm here to help. If you're in search of help to try to get your life back together, join me here at Doc Jacques, Your Addiction Lifeguard, The Addiction Recovery Podcast. to be real clear about what this podcast is intended for it is intended for entertainment and informational purposes but not considered help if you actually need real help and you're in need of help please seek that out if you're in dire need of help you can go to your nearest emergency room or you can check into a rehab center or call a counselor like me and talk about your problems and work through them but don't rely on a podcast to be that form of help it's not it's just a podcast it's for entertainment and information only so let's keep it in that light all right have a good time learn something and then get the real help that you need from a professional Well, what better time than today to talk about the need for structure in recovery. The topic for today, structure in recovery. Why do you need structure in recovery? Let's say that you had just discharged from rehab or maybe you bypassed rehab and you did detox, but then you did something else, whatever it is, I don't know, whatever you chose to start the path of recovery. That confinement stage where you're not really completely safe and you need to be contained during the very beginnings. And you began to the journey of recovery. What's next? Well, what's next is you need to have some structure around you so that you can actually begin the path of recovery. And so we use the term in this country, we use the term aftercare. Aftercare is what you do when you get out of rehab and you begin the actual journey of recovery. So it's the plan. The aftercare is the care that you get after you get out of rehab. So when you're starting your recovery, usually there's a lot of questions, a lot of confusion, a lot of doubts, and you're just kind of stumbling along not knowing what to do. And maybe it's not your first time. getting through rehab. Maybe it's not your first time of relapsing. Maybe it's, you've been out and picked up like eight times, but it's not working. So what you're doing is not working. So you got to do something else. So in that case, aftercare is changing what you've been doing to do something else. In the case of it's a first timer, it's the thing you do when you get out of rehab. If you haven't gone through rehab, you haven't really gone through that containment phase where you just start to lose your sanity in a building that you can leave I mean rehabs are not prisons right you can leave at any time but the idea is that you're contained during the time when you're probably the most vulnerable it's the most difficult stage of recovery and that is the very very beginning so the idea that you're going to give something up because you want something different is what's fresh in your mind so in any case so you go to rehab or you don't whatever and you at that point now you need to begin the process of full engagement and recovery, which is where the aftercare comes in. So if you went to a rehab, I hope, and this is a real problem when you're going through recovery, as many places don't do this, but I hope that you chose to go to a place that really engaged with you on the process of working on your recovery in aftercare. Now, they're going to discharge you out to the street, right? So now their job is done, quote unquote. I use my finger quotes. Their job is done. However, the real work now starts with what you do next. And so the. The idea of aftercare is something that most people don't really think that they want to engage in. At least that's my experience. It's kind of like, ugh, I don't want to do aftercare. I don't want to have to go to meetings. I don't want to have to meet with a sponsor. I don't want to have to go to Smart Recovery or whatever you're doing for meetings in the community. I don't want to have to read that book. I don't want to have to go to a counselor. I don't want to see a psychiatrist. I want to know, well, you're not going to get sober and clean period. You're just not. It doesn't happen that way. You can't do it on your own. You can't do it by yourself. Can't do it in isolation. You got to be really open and honest about it. And you got to be with people who are also in recovery because that's really how you get there. So aftercare is a heavily structured time consuming process that takes a year to two years of really hard work. And during that time, as one of my clients recently quoted Gabor Mate saying that addiction is a teacher. And that's what happens is you learn from your addiction that you can't do it by yourself. It may not be something you learn immediately. It might take you a while. But let that teacher guide you. And so when other people are in recovery and they've already gone through this process, you've got to listen to them. First of all, because they actually have done it. You haven't. And they've been successful and you haven't. So you got to copy what they do. If you want to be an expert, you got to have, you know, go find the people that do what you're trying to do to the best of your abilities. And when you do that, then you replicate what they do until you've learned it. And then maybe you put your own little twist on it. But you're not an expert the first time you do it. You're an amateur. So aftercare helps guide you through that process. And that's why it is so important that you do aftercare. You have to engage in aftercare. If you don't, I can guarantee you that you are not going to be successful long-term in recovery. You might for a short term, a month, two months, three months, maybe as long as a year. But if you're not doing aftercare, you have no safety net. You have no guide. You have no direction. You're just stumbling along on your own. So aftercare is a highly structured, pre-planned guide that you have to follow to get clean and sober. And what does it include? Well, typically for my clients, if they were unfortunate enough to go to a treatment center that didn't really give them an aftercare plan, I will sit down with them. and go over exactly what I want them to do. And I'm very, very specific about it. You have to get into the recovery community. And I don't care how you do it. I don't care if you go to one of the A meetings. I don't care if you go to one of the non-A meetings, A being anonymous, so whatever, anonymous. I don't care how you do it, but you've got to get into the recovery community. First and foremost, because that is the group of people that are going to help you get there. They're going to call you out when you're not getting there and they're going to help give you the input direction feedback and the safety. They're kind of like the guardrails when you're doing your recovery and they will be there. When you slip and fall, and they'll help you get back up, and they'll help you get right back on course, as long as you engage with them, they'll do it. Because they've already done that themselves, and they know what it's like. So they're not going to turn their backs on you. They're not going to judge you. They're going to just be there to support you. That's what you need in your recovery, is you need that support. That's the first part. The second part, the second step, if you will, but I'm going to say part because I want to get it confused with the 12 steps. The second part is you need a specific person to help guide you. That can be a sponsor. That can be somebody who is a mentor, somebody who is a guide that has gone through recovery and they need to be the same gender. I don't know how many times I've had people come to me and say, yeah, there's this woman down the street who she's been in recovery and she wants to help. And this is a guy who's saying this. And no, that does not work. There's a reason that that's not allowed in the AANA world because gender gets very confusing sometimes. because of the activity of the reward center in the brain getting activated. So you don't know what their motives are, but you also are going to get confused about what activity is going on, and it can become very inappropriate quickly. And sometimes people who are predators will go out to meetings and try to get somebody of the opposite sex so they can hook up with that person, but they'll do it under the guise of trying to help them by being a sponsor or acting like one. Stay away from that. That's bad news. So you need somebody who can be a specific person, can be the guide. In the AA, NA world, it is a sponsor. That is somebody who will sit down and talk to them, start working through the steps with that person. They will be a phone number they can call when they're struggling. They can be the person who will call them out on their stuff. And that'll be the person who also kind of keeps track of you. So if you start disappearing, they're going to help you and they're going to maybe call you out on that too. They might call you and try to get you to go back in the meetings, but they're smart enough to know that they can only do a small amount of that work because the person who's trying to get into recovery is the actual person that needs to do all the work. And they know that because they've gone through this themselves. So you need a specific person to guide you, to mentor you, to be the person that's a non-clinician peer who is in recovery. Can't be a counselor, can't be a doctor, can't be a priest, can't be a friend. It's a different role. That is not their role. Their role is to be your guide. The third part is you need a good, skilled, experienced clinician. Now that can be counselor it can be a psychiatrist sometimes they do counseling it can be a substance abuse counselor a mental health counselor it really doesn't matter but you need a experienced skilled and understanding clinician who can help you work through all the stuff that is causing you to have to rely on a drug of choice to use as a coping mechanism for what's what is really bothering you remember the drug is not the problem the problem is the problem so you need somebody who's a clinician who is skilled trained and knows how to treat addiction and by that i mean At least this is my prejudicial thinking. They need to be skilled in trauma work, but people who are skilled in trauma work who do not have any experience with addiction are not going to be helpful to you at all. You need somebody who is actually experienced in trauma. recovery and in addiction. I can't tell you what the percentage is. There's probably not even research to show this, but a lot of people who go into mental health and specialize in addiction treatment are in recovery themselves. So again, you're getting like a double bonus there of the person who actually understands addiction because they've been through that whole process themselves, but they're also a clinician. But you need somebody who's not handicapped by their own demons and they're still struggling with their mental health recovery. You need a clinician who's good, steady, rock-solid, and capable. But they do need to be trained and experienced in recovery work and dealing with addicts because it's a specialized field. So the next part... And I believe I'm on number five. The next part is going to be the work that you have to do has to be actually outlined, written down. It's got to be a plan. You have to have a written plan. And that's where the skilled clinician comes in. Because they can help you. When you discharge from... they can help you through that process because they know what that is. They know what it's about. They know why it's important. But actually have it written down. And so like when my clients discharge from treatment centers, I ask the treatment center to send me a copy of whatever the discharge planning is for aftercare. And ironically, there are some treatment centers I have seen experience with who do not have a written aftercare plan. So they can't actually provide me anything, which means that the client doesn't have anything either. And so if the client doesn't have anything, how are they supposed to know what they're supposed to do? I think it's malpractice at worst. At best, it's just laziness on the part of a treatment center. So if you're about to go into a treatment center, please ask them, hey, do you give me a written... aftercare plan when I discharge? And if they say no, or they kind of dodge the question, don't go to that treatment center. I don't care how good their reputation is. They're not doing their job because that leaves you with absolutely no idea what to do. And you're probably going to forget because you're still dysregulated when you discharge from treatment centers because you've just been through this shock of 30, 60, 90, 120 days of isolation. So In any case, you have to have a written plan of what you're going to do. And that plan has got to include like every day. Sometimes, initially, with some of my clients, it's like literally every hour, this is what you need to be doing. Because your instinctive thinking is going to be, oh, I'm out, okay, everything's fine. And then you start to get a bad case of the lazies. And the next thing you know, two, three, four weeks has gone by. You don't have a sober job. You're not going to meetings. You don't have a therapist. You don't have a sponsor. You haven't seen a psychiatrist. Your meds are running out. And you are all of a sudden back using again because you're all just right back where you were, just completely dysregulated because you didn't have any instructions. So having it written down, you know, one, two, three, four, get a psychiatrist, find a counselor, go to meetings, find a good meetings, get a sponsor and a timeline for that. I don't like to see no mention of dates. Day one, discharging from... a rehab, you must, if you haven't already got appointments with people, you must immediately get on the phone and make appointments with people. That's day one. And most people get out and they just go home and they don't really think about it. This is what I run into with regularity. I run into the person discharges. They may or they may not have written instructions on what to do. And they think, well, I'm going to take a few days off because I just went through hell. So I'm going to take a few days off. And the few days turns into a week and then two weeks, sometimes three or four weeks. And they literally have done absolutely nothing. You can't be successful at recovery by taking days off. Listen, As many of the people that are in recovery are going to know, there's a saying that we have is that, yeah, my addiction, while I was sitting in here doing nothing, my addiction was out in the parking lot doing push-ups and sit-ups, getting stronger, waiting. And that's exactly what happens. So you taking a day off from your recovery is about the same as you taking a day of not breathing because you're so exhausted from breathing. Well, guess what? You're going to be dead in a matter of three minutes by not breathing. There is no day off. You don't get a day off from recovery. It's a full-time, 24-hour, 168-hour-a-week job, 52 weeks a year. There is no time off. Time off is the leverage point that addiction gets to slide in there and start working on you again. Just like any other disease, you don't get a day off from cancer. You don't get a day off from cardiac arrest. You don't get a day off from temporary paralysis. There's no day off. So actively engage in your recovery from day one. And it must be written down. Because if you're not following instructions, you're probably not doing it right. And you probably are going to just stop doing it totally. So now we're on to number six. Number six is... Get engaged with understanding recovery, understanding addiction, read books, watch YouTube videos, listen to podcasts. You know, you got to study your enemy. The enemy is addiction. That is what's taking, it's ripping you apart. It's ripping your life apart. You must study the disease. Okay. I used to work in a cancer treatment center, and I was always impressed with what I would see cancer patients show up. And the cancer patients that we treated were the ones who had been diagnosed for some time. They perhaps have been battling it for years, and this is their second time of dealing with cancer or whatever it is. And I used to be impressed by the information that those patients would come in to the treatment center with, they come in with binders of, not their charts necessarily, but methods of treatment. They would be on the internet. I'd sit there and watch them get their IV infusions of chemo drugs. And while they're there, they're on the internet, they're surfing and reading about cancer treatment and alternatives to cancer treatment and diagnosis of cancer treatment and doctors who had cutting edge treatments that they had tried on cancer treatment and NIH research studies on cancer. and cancer treatment. They were so knowledgeable about their disease because they realized that cancer was going to kill them. And they took that seriously. There wasn't a single one that came in and said, I don't know anything about cancer. I don't know. I'm not, you know, they knew. Oh, they knew. And they knew because they knew they were going to die if they didn't understand it and didn't take charge of it. Interestingly, with addiction everybody just kind of assumes it's just a bad behavior they don't think about it actually as something that's going to kill them yes there are fentanyl overdoses and there are you know lots of drugs that will kill you and there are people that know that but they don't take their addiction seriously because everybody around them is telling them it's a character flaw, it's a behavior problem, it's some kind of defect in thinking, it's willpower they're not using, it's some kind of weakness. They're not taking it seriously. So what I'm suggesting is that you read about it. You read as much as you can. You listen to as many podcasts as possible. You become the expert in Not just usage because you're already there because that's why you're in recovery, but you're an expert in the recovery process. You need to be an expert in recovery. So there are so many good things. things that you can read that will inform you about what is recovery. You know, I've got my favorites, Gabor Maté, and I like Russell Brand. There's just, I mean, there's so many things. So you must become engaged in the educational process of your recovery. You must be an expert. So you must study every single day and take it seriously, just like you did if you went to high school or college or you had cancer and you're studying the recovery or any other disease. This is a disease that's going to take you out. Guaranteed, it'll take you out. But it starts taking everything away from you first. So study it and understand it. Understand why people went into recovery and what they did and how they did it and who's giving what information about whatever. So start to work on being an expert in recovery by studying it to death, if possible. And number seven... is probably the final part of this multi-parts process I'm describing. And that is, you gotta surrender. Stop being so arrogant in your recovery. You can be arrogant in your addiction, yes, and that's part of the deal, but don't be arrogant in your recovery. You have to surrender And by that, I mean that you're going to spend the next two years. From the time you discharge from residential treatment, if you went there, you're going to spend the next two years surrendering to recovery. So if you can't handle what's going on in the outside world, going back home with whatever your living situation was, then you need to go into a sober living house and live with other people who have a highly structured, almost custodial care level of structure that allows you some freedom, but guided freedom with boundaries. If you need that, so that's you surrendering, right? You're surrendering the idea that somehow your pride is going to be wounded or damaged because you couldn't do it on your own. So surrender to going to meetings, surrender to the idea of talking to somebody who's a sponsor or a mentor, guide, whatever you want to call them. Surrender your time. You spent how much time getting high or getting drunk or whatever your drug of choice was, gambling or whatever, how much time and money did you spend on that activity, that drug of choice? And how much time are you spending on recovery? I am continually amazed at the number of people who, when they come in to see me, and I'm not cheap, when they come in to see me, they say, I can't afford it. It's like, you were using like$200 to$500 a day in... your drug of choice. How do you not have time for money for recovery? I don't understand this. Suddenly, all of a sudden, you're a miser who's penny pitching when before your penny pinching that you were engaged in was non-existent when you were engaged in your drug of choice. This is lunacy. I can't go see a psychiatrist. I can't afford it. Where did you get the money for all the drugs you were using when you can't spend a dime on recovery? Second, a lot of this stuff is free. You know, I have a phone. I can get on Spotify or iHeartRadio or Apple Tunes or any of the others. I can listen to podcasts. I'm doing one right now. You're listening to it. Those are free. They're free. YouTube videos, they're free. Meetings, AANA, any of the A meetings, they're free. They'll even give you books in a lot of these meetings. They have a fund where they'll give you the big book for free a lot of times. This stuff is free. There's so much of this is free. Calling a sponsor is free. There's no cost. Some of this stuff costs, yeah. But if you think about the cost you're saving from hospitalization, from... the drugs that you were using, from the alcohol you were buying, and the time that you spent either drunk, high, or hungover, incapacitated, hospital visits because you overdosed, and so on and so on and so on. I could go on forever. The cost for that versus the cost of recovery is pretty minimal. So I don't find that as a viable reason for not engaging in recovery. So you have to surrender your time, your money, and your efforts to save your life in order to get clear of your addiction and get into recovery, get to that peaceful state. It's going to take time. Yoga classes, exercise, gyms, nutrition, counseling, psychiatry, buying books, anything that involves another person that's a clinician, it's probably going to cost you. Yes, sometimes there are free services. In many of the counties around me, there are free drug and alcohol treatment programs for county residents. And I'm sure across the country, you'll find that to be the case. So a lot of the treatment you can go to is free. And then the support for that many times is free. Sometimes people who are clinicians will give scholarships for treatment. They'll give you a sliding scale. Look for those people. But you need to surrender over to the idea that you're going to lose some of your time, some of your money, But you're gaining peacefulness. You're gaining calm. You're gaining your life. And you're not destroying everything around you. That's the reward for the surrender. So that seventh part is the idea that you're going to have to surrender your time, effort, money to recovery. So those are the things that should be included in your aftercare, those seven things. And I may have forgotten some, and if some of you have some other suggestions, please let me know. But that should be what's in your basic aftercare program, your pathway to recovery. So let's start out that new year with the– I hate New Year's resolutions. Let's start out the new year with a drive towards recovery, and let's engage– and actively, spiritually, emotionally, in what we need to do to get right and to be sane, stable, and sober. Because that's what you're listening to this podcast for. So why don't you just go ahead and do those things. So that's it for this episode of the Doc Shock, Your Addiction Lifeguard podcast. Starting out the new year with some new hope. Just remember, it's not worth ending your life to save your addiction. So stop with all the nonsense and look for upcoming episodes. In the few weeks, I'm going to be bringing some guests on, talk about their recovery, their experiences, and what recovery means to them. And in the meantime, if you need help, please, you can reach out to me through my website Wellspringmindbody.com. I can get you contacted there. And email me or call me and let me know what you think and what you need. And in the meantime, get yourself into recovery because it's not worth ending everything because you're an addict. So here's hoping for a good new year and some good recovery. So until next time, see ya.