Cara Gardenswartz, Ph.D: People who can afford to get the best of care are in and out of jail, rehab and hospitals again and again. Familiar tabloid names include Lindsay, Paris and Britney.
Rather than asking, "What's wrong with them?", perhaps a better question is, "What's wrong with the system?"
When celebrities are caught with illegal substances or display other addictive or illegal behaviors, they may have to go to jail and/or rehab, but typically their sentences are cut short. Lindsay Lohan's most recent rehab stint, for example, was cut in half. As it stands, rehab is often treated like a "Get Out of Jail Free" card. But the irony is, true freedom occurs as a result of rehabilitation. Until these young adults (or anyone, for that matter) have intensive treatment that includes more than a two-week trip to rehab, they will not get better.
Research has shown that abstinence-based treatment (e.g., never having a drink again) is the most effective type of treatment for people with severe substance abuse or addiction problems. Here's what "real" treatment entails: After a period of detox (typically three to five days in which the addict is monitored for seizures or other withdrawal reactions), he or she stays in a rehab facility for a minimum of thirty days. (A sixty-day stay is ideal -- it's been shown to be significantly more effective -- but many can't afford it.) While in rehab, clients learn tools for coping with their daily lives without using drugs. A typical day includes two psychotherapy groups, a psycho-educational group, an individual therapy appointment, a coping-skills lesson, meditation and a 12-step meeting. Following rehab, a program of "90 [12-step] meetings in 90 days" is the rule for continued sobriety.
Getting sober isn't easy. That's why people relapse and typically have to reenter rehab. But for those who choose it, reentry may be the beginning of a successful journey. Their willingness to reenter rehab means that they learned enough skills the first time to know that, with another turn, they could triumph.
Before my patients enter rehab, I let them know that, on average, a person requires two stints in rehab before they can get -- and stay -- sober. (I tell them this in order to limit any unrealistic expectations they may have.) And then I tell them to work their butts off to be the exception.
So: When addicts' lawyers and family members try to get them out of rehab quickly, they are doing them a disservice. Why not allow your child or client to get better, so they can live a healthier life? And I'm not just talking about Paris and Lindsay here. This advice is for every addict who is LUCKY enough to afford great care.
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