For the families we are privileged to meet, starting residential drug rehabilitation can be a roller coaster of emotions. Starting treatment is really about widespread change since, by the time we get involved, addiction has progressed to the point where everything our clients hold dear – family, friends, health, and home – is in jeopardy. For clients and their families alike, addiction treatment can be symbolized as the light at the end of a very dark tunnel.
Starting Treatment Can Be Overwhelming
However, while clients may be hopeful, they are often also awash with conflicting emotions, particularly fear. Regardless of how dysfunctional their lifestyle has become, it was, at least, familiar. Nothing about treatment is familiar. Clients ask, “Where am I going?”, “Who will I be sharing a room with?”, “How long am I going for?”, “Can I use the telephone?” These basic questions can be found on our website, but most people are in no shape to research our program beforehand.
Most of our clients complete our program. For those who don’t, the majority of the 1 in 10 that do not complete treatment* leave in the first week. Therefore, if your loved one makes it through the first week, their actual likelihood of completing treatment is closer to 93%.
The goods news for family members is that there are steps they can take to make the odds even better.
*Note: Includes clients who left due to either leaving against staff advice, at staff request due to a dischargeable offence, leaving without notice (AWOL), or due to medical complications (MD).
Why Some Clients Want to Leave Treatment Early
First off, it’s important to understand why some clients want to leave treatment early. It is easy to dismiss a client’s decision to leave treatment early as nothing more than “not being ready” or an overwhelming desire to get drunk or high. However, as is often the case with addiction, it’s not that simple. Most clients in early recovery struggle with uncertainty. Early recovery offers the promise of better days, but also the expectations of significant others, uncertainties of a life in recovery, and the daunting task of cleaning up the huge mess that may await them back home. Usually, when confronted by this reality, the automatic response for clients would be to use drugs, alcohol, gambling, or sex. In treatment, however, we help clients learn to deal with these conflicts in more personally meaningful ways.
Clients Often Call Home Before They Leave Treatment
There is really no prevailing behaviour for clients who decide to leave treatment early. Some don’t hesitate to make their intentions clear the minute they arrive, while others keep it such a secret that staff doesn’t know until we find a note on a pillow the next morning. Somewhere in between these two extremes is the client who calls home first before leaving treatment. If you are the family member who gets that call in the middle of the night, it is important to remember that you may be the first person who is aware of your loved one’s decision. Staff may be busy performing their duties, unaware one of their clients is in the midst of “making a run for it”.
Why Clients Call Home Before Leaving Treatment
It’s actually a huge opportunity for positive change when clients call home before they leave. After all, if someone was really intent on leaving, they wouldn’t complicate matters by calling home first. These phone calls can represent one of two things:
- They don’t have the resources to leave or
- They are seeking approval before they leave treatment
Either way, you as a family member do not have to be a helpless victim to your loved one’s intentions.
4 Possible Responses to The Same Scenario
To help you deal with a loved one who calls home intent on leaving treatment early, here are 4 different ways family members usually respond.
Scenario: A client calls home late one night and says he wants to leave treatment. You, the family member, call us the next morning and say…
You: “Hi there. Keith called me last night and told me that his stay there isn’t how he thought it was going to be. He complained that he just can’t relate to the other clients there and he just can’t imagine having to stay there for 6 more weeks.”
Us (Family Program Coordinator): “Oh, that’s unfortunate. Now, remember what we talked about while Keith was on his way here? I pointed out that individuals in their first week of treatment have to contend with unfamiliar surroundings and strangers. To complicate matters, they are also going through withdrawal and don’t have their drug of choice to fall back on, so they will often try to think of a reason to leave treatment. Do you remember this conversation?”
You: “Yes, I remember that.”
Us: “Right. That is why we reviewed all of the excuses that you could expect were going to come up and one of them was that about the “wrong peer group”. So, when Keith told you he wanted to leave, how did you respond?”
You: “Well, I thought about what you said, but then I thought what’s the point of Keith staying in treatment if he’s just going to be hiding out in his room the whole time he’s there? So I booked a flight for him.”
Conclusion: The client packs his bags and leaves treatment. The family member pays for his flight. Keith flies home.
You: “Well, I thought about what you said and I told him that I wasn’t going to pay for his cab or his airfare to come home. Besides, I told him, if he does come back he won’t be staying here and I won’t be paying his car insurance either. Then I hung up.”
Conclusion: The client, realizing he has nowhere else to go, decides to stay, at least for as long as he can figure out another option. Treatment center staff remain unaware of the situation.
You: “Well, I thought about what you said, so I immediately hung up the phone, then called SCHC and talked to one of the night staff there.”
Conclusion: A counsellor is called in to talk to Keith. It turns out that Keith is homesick for his daughter. Keith feels he has not been much of a father due to his preoccupation with his addiction and is overwhelmed with guilt. His counsellor is able to talk Keith through his overwhelming emotional state. Keith decided to stay in treatment for at least a week and try to work through his feelings of guilt with his counsellor and peer group.
You: “Well I thought about what you said and reassured him that he was probably just going through an adjustment period. I also told him that there was no way he could come home until after he completes treatment. Then I hung up and called the treatment center.”
Conclusion: Client feels he has no other option, but to stay in treatment. Similar to Response #3, staff are aware of the situation. However, this time the client, realizing that he is not welcome at home until he completes treatment, commits to staying for the duration of treatment.
Obviously, these conversations are not always as cut and dry as the scenarios described here. Remember, if a loved one calls home and tells you that he wants to leave treatment, it’s because he needs your money, your approval, or assurance that life can return back to the way it used to be before treatment.
Regardless of the rationale, you are not powerless in the face of these apparently dire circumstances.
Taking a firm line with your loved one and partnering with the staff in these types of crisis situations is critical. So, the minute you hang up the phone with your loved one call the treatment centre for support. Don’t assume that staff know about your family member’s intentions and don’t worry about being a nuisance. Typically, these types of calls happen late at night when clients are not busy engaged in the program (see more about the link between boredom and addiction) or have the support of their peers. Don’t worry about it being too late at night to call. Most treatment centres are staffed 24/7 and prepared for these little emergencies.
For additional information, see our pamphlet “Contact Guidelines for Family Members”