ADDICTION SCIENCE
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Treatment providers will often ask people about prior treatment experiences. This article is most useful for those who have gone through some form of addiction treatment in the past. If you have no prior experience with treatment, these concepts and ideas can still be valuable to you. Learning from the past is our goal.
Intake Questions
For an intake assessment at either inpatient or outpatient programs, it is common to understand past treatment experiences. You may be asked why you chose previous programs, and what difference they made in your addiction. Here are some questions you may be asked:
- Have you ever sat down with a professional to talk about your drinking patterns before? This could include a doctor, therapist, psychologist, psychiatrist, life coach, spiritual or faith leader, or another such clinician.
- How did this experience feel to you?
- Did you feel uncomfortable, judged, dismissed, or confused by the process?
- Did you feel validated, understood, or positively challenged by the professional?
- How many times did you have an appointment in this fashion? Was it just one time or did you work with someone on multiple occasions?
- How honest were you about your problem? Could you rate your honesty on a 1 to 10 scale?
- Is this dialogue still continuing with the professional or did it end?
- How did it end? Was the termination process abrupt, thoughtful, disorganized, or for unknown reasons?
Past Treatment Questions
Based on whether you have you ever participated in formal treatment like Alcohol / Drug Rehab, Day Treatment, Intensive Outpatient (IOP) or some other form of care you may also be asked:
- How motivated did you feel to change when you were in this program?
- Did you trust the program you were using? Did it seem credible and as though it could offer you something for your health goals?
- Were you in the program more at the request of someone else rather than yourself?
- How long did the program last?
- When you ended the program, was it prematurely or after full completion?
- Did you work with a clinician while there to plan for future care (this is called Aftercare Planning)? Were you on board with your aftercare plan?
- Did you follow through with the aftercare plan after the treatment program had ended?
- Were you able to maintain sobriety following the treatment? For how long?
- Did you feel that the program addressed the things you wanted to work through while in treatment? Was there conflict about this (i.e. you and your clinician didn’t see things the same way)?
People can have a wide range of past treatment experiences ranging from highly positive to outright destructive and harmful. These past experiences really shape how you move forward (or don’t) in using treatment for your benefit. When looking at all of the questions discussed above, there is strong scientific evidence in the field of psychiatric and behavioral health that the presence (or absence) of a Treatment Alliance is the most important factor in reaching a good health outcome in your care. There are two core ingredients necessary for such an alliance.
Treatment Alliance
- A sense of trust and/or collaboration with your clinician
- A set of specified goals you share with that clinician
In most situations where a person had a poor experience in treatment, it can be likely traced back to the absence of a treatment alliance. The interesting part of this is that an alliance really is a two-way street. Both you and your clinician need to be on the same page. For instance, a well-meaning life coach may garner your trust and collaboration but not be helpful if you are seeking guidance about specific medications you should take…that’s not within the expertise of the clinician.
Reasons for Failure
If you have felt that you never really developed a good treatment alliance, we need to think about reasons why. What are some of the common reasons an alliance fails to form?
- Motivation isn’t really there. You entered treatment because of a family intervention and you were eager to leave whenever you could.
- You have trouble trusting people. This is very common amongst those struggling with alcoholism or other addictions. There are sometimes trauma issues or family problems at fault.
- The clinician wasn’t that great. That person seemed overworked, overbearing, or disinterested.
- There was something very specific about that clinician making it not a good fit. This explanation is useful if you have felt an alliance with some providers in the past but not others. Keep searching for a good fit!
- It seemed the clinician didn’t really care nor understand addiction much. This is most common in situations where you have a primary care doctor who emphasizes other health goals and is less comfortable helping you process alcoholism.
There are numerous reasons why an alliance may fail to form. Spend some time pondering this concept in terms of how it applies to you. Once again, the presence or absence of a treatment alliance makes all the difference in terms of addiction recovery success or failure.