Addiction & Recovery Expectations
Q&A with Amy Winn, CADC
Finding long-term recovery takes more than desire.
It takes will and willingness. That’s what Clinical Therapist Amy Winn has witnessed over nearly a decade working in the field of addiction treatment.
A Certified Alcohol and Drug Counselor through the Mississippi Association of Addiction Professionals, Winn joined Oxford Treatment Center in 2015. Her previous experience includes crisis intervention, suicide prevention and mental health first aid for adults and adolescents. She has also conducted outreach and aftercare focus groups for people who recently completed residential treatment.
Today, her work as a therapist focuses on adults age 26 and older in Oxford Treatment Center’s residential program on the Etta campus.
What is your role like in the treatment process here?
The focus of therapists is to work with patients one-on-one as much as possible, as well as doing group counseling. I’m in recovery myself. I’ve spent a good deal of my own personal time helping people with addiction. It’s my passion in life, and I feel like it’s what I’m meant to do.
A lot of my job also focuses on early intervention. When people are still in the earlier stages of dysfunction, you have an opportunity to get them on the path to recovery sooner rather than later — before addiction costs them the means and support that can help them get better. That approach has proven to be successful.
Among people who are in treatment for the first time, what are common expectations?
A lot of times, people in the earlier stages of their addiction don’t have family members who understand the progression of the illness and what it means to be in treatment.
The majority of the family members we work with have a sincere hope and even an expectation that their loved on will come to treatment for 30 days, get better, and return home having “put this addiction problem behind them.” Even family members who have spent a lot of time watching the downward spiral happen, have longed for some indication that things are getting better. They’ve been waiting to hear from their loved one that tone of voice that makes them hopeful. They’ve been waiting for a sign that things are improving.
When someone is here for 30 days, their family members do start to get some of those phone calls. They’ll hear their loved one say, “I feel better. I do understand that I have a problem.” Those are things that family members have been longing to hear for a long time. Those statements can also feed the misconception of the family that addiction is not an ongoing problem.
How does Oxford Treatment Center help family members adjust those expectations?
The most important way we do that is through our two-day Family Program, which is as part of the residential treatment program. When family members come here, they get the message very clearly: This is not a quick fix. Addiction is an ongoing disease that requires long-term management. Even 30 days of treatment is not going to ensure that your loved one achieves or returns to normal functioning.
We also have weekly contacts with family members. In those times, we’re really trying to impress upon them the importance of following recommendations of the professionals. We try to determine which family members are going to provide appropriate support after treatment. We also engage those family members in helping us keep people in treatment and participate in the continuum-of-care. A lot of times, family support can go a long way when someone doesn’t want to follow what we recommend.
What about the expectations of people in treatment themselves?
Usually, people who are coming into treatment often expect that they’ll come in, have a short and uncomfortable experience with detox, begin to feel better immediately, and everything will be fine. That’s not the reality.
The reality is, especially depending on the substances being used, people can feel worse before they feel better. The clinical team talks about this issue a lot, so that we are aware of patients’ physical symptoms and of the risk that poses for the patient trying to leave treatment early.
What is an appropriate expectation for the progress you hope someone will make in 30 days here?
By the time someone completes 30 days of treatment, I personally like to see them come to some understanding that they not only have a problem with substances, but have a serious need for treatment.
Ultimately, though, what we look for is willingness: we look for willingness to stay the course with their aftercare plan, to get involved in a recovery program and willingness to replace unhealthy relationships with healthy relationships. These can be the first steps to creating the life of change that will help a person stay clean and sober. Surprisingly, there isn’t much difference in results of those who say, “I’ll do it, but I’ll hate every minute of it,” and those who say, “I’ll do it, and I’ll love it.”
How you feel about making changes isn’t really that important in the beginning of the recovery process. Doing it is the most important thing.
How does treatment help people reach that point?
All of our therapies here are geared toward helping people find their own motivation for recovery: The reasons why recovery is best for your life. We offer a great deal of education on addiction as a brain disease, on family dynamics in addiction, and on building new coping skills. People learn about triggers for relapse and the types of barriers they can commonly expect in early recovery. It’s really a well-rounded education program, with the goal of helping every person find his or her own motivation for recovery.
For the person who comes in with that motivation, the key is to hang onto it. It’s easy to think, “I feel better, so I’m doing better.” It’s still important to follow the recommendations, because even those people with the motivation won’t get that “quick fix” in 30 days.
One thing I like to impress upon patients and family members is that desire is not enough to be able to maintain recovery. It’s a really good place to start. But just having the desire to be in recovery doesn’t give you the ability. What does give you the ability is consistent, hard work over a long period of time, and just taking it one day at a time.
So people can say, “I’ve made up my mind. I want to stay clean and sober.” But unfortunately, that’s not enough. At the same time, I know a lot of people who have stayed clean and sober even though they didn’t want to in the beginning. They followed instructions and did what people told them would work.
What’s the best approach for navigating the initial challenges someone might face after treatment?
It starts with a good aftercare plan. At Oxford Treatment Center, aftercare plans are finalized at least a week before discharge so the patient has a clear understanding of what needs to happen next. Then it’s a matter of following through.
For a lot of people, the best plan looks like at least 90 days of care in a structured environment. That could be either 90 days in an inpatient environment, or 30 days of inpatient plus 60 in sober living housing and an Intensive Outpatient Program (IOP). We usually recommend as much structure as their life will allow for at least 90 days, if not longer, and then participating in recovery programs like AA or NA.
This allows people to develop social supports. They’re struggling with the idea of letting go of the people in their life that are unhealthy. But what we’ve found to be more beneficial is adding in those positive supports. If you add people to your life who are helpful for you, it becomes less of a problem for those old friends to fall away.
For a lot of people, another thing that is really helpful is just staying focused on the next decision in front of them — especially in early recovery. To ask people to think about planning a year out can be really overwhelming. So we work with people to focus on making the decision that’s right in front of them, and on being open to the fact that your plans may not always unfold like you thought they would.
We encourage people to remain open-minded and willing. It leaves them flexible to accept what’s next and become more capable of coping.
How can families be in the best position to support people through early recovery?
We recommend that families get involved in Al-Anon or Nar-Anon. It’s really necessary for the whole family to recover. When family members are taking care of their own mental health, they’re in a much better position to provide appropriate support for their loved one.
When you are part of Al-Anon or Nar-Anon, you have a community to help you figure out things like when you’re enabling your loved one. Just being able to talk about these things is a tremendous support for families, because they’ve never felt comfortable expressing what they’ve experienced living with an addict. Now you’re surrounded by people who’ve been there, too.
If recovery is such a long-term prospect, how do you know when you come to a point of stability in recovery?
The first milestone that happens for people is when, at some point, they realize the obsession and constant urge to use is no longer a part of their daily life. Once you start to experience that freedom of not having to think about “Am I going to use nor not? How am I going to make it if I don’t use?” — that’s when you start to have more hope in recovery.
It can take a while to get there. For some people, that can take six months to a year. That’s why it’s so important to be part of a recovery community after treatment, and to have an AA or NA sponsor who’s guiding you through.
I think the idea of change and progression in recovery is fluid. Anyone can experience setbacks even with a significant amount of time clean. People experience divorces and deaths and other hurtful experiences. You could feel like you’re in a really good, stable place for a couple of years — then have a setback and feel like your recovery is not so stable anymore.
So you achieve recovery, and yet you keep working at recovery. One day at a time, through the twists and turns of life.
If you can understand your disease, learn new ways to cope, and surround yourself with a recovery community, you will be more capable of staying the course. And that’s what we’re equipping people to do here. It’s why we do what we do.