Coming Home from Sober House
StrongerTogether is concerned about her Loved One’s transition out of sober home. He seems to be running out the clock at the sober house, just waiting to resume his regular life. He sees “coming home” as a pass to pretend nothing ever happened. She needs help crafting a plan for his continued recovery once back home…
Yes, I could use your insight. My son is living in a sober house, commuting to PHP. He's been there 60 days after 30 days inpatient.
He is not engaged in treatment. Seems he is just 'running out the clock' until he can come home and resume his 'regular life'.
A drug test shows he stopped Naltrexone. He also is refusing to take the prescribed anti-depressant. He 'feels fine' his 'mood is good' and he 'doesn't need it' he says. This feels to me like pre-lapse behavior, or risky behavior.
It's difficult to use CRAFT rewards when he lives 90 minutes away and doesn't ask for anything. I'm paying for treatment and sober living but he would happily leave tomorrow if he had a place to go to.
I'm inclined to meet with him and his treatment team and draw up a treatment contract which includes the medication (and a pathway to return to his home city). He has never been to a 'meeting' or had SUD treatment here in his home city–when he left college for rehab it's been treatment/sober houses to three other states in two years.
His idea of 'coming home' is thus a magical treatment-free world like nothing ever happened. I feel the need to craft a plan that calls for him to transition back here via a sober-house, a local therapist, and a local sober network, meetings. etc. I'm encouraging him to visit for a day or overnight and attend a meeting here, to start building that network.
Maybe we can line up a case manager/sober coach to help navigate the transition (and help support his recovery over time). The treatment scape is so fragmented and this illness so pernicious and uneven that we families become de facto social workers without training.
Ideas welcome.
Yes, I completely agree. The family members are, in this system, de facto, untrained caregivers of individuals with a complex condition.
The first thing is to get him started on Suboxone before he leaves the sober house. Get him a link to a local clinic in the city to which he is being discharged. This is critical when you consider the laissez-faire attitude you are describing. (Some sober houses are not big fans of Suboxone. You may need to intervene here.) Your son is in danger of relapsing and overdosing. He could easily get the dose wrong now that he is opiate-free.
Is he definitely coming home? Is there a local halfway house or transitional house that could take him? Would he go to one of these if your home was not given as an alternative?
I’ve just finished a little search for case managers in my area. They are pricey: $125 to $300 an hour. Having a case manager does put someone in place between the family and the Loved One. Someone in this role can help with the linkages to treatment, self-help, and living arrangements. This person can help with decisions on material resource support, providing informed input as to when and what is wise to provide.
A contract is a good idea. He may not fulfill his end, but the conversation and expectations have at least been made clear. Look at the list of tabs to the right. We have written about returning to college and contracting. We have also thought through some of the ways that college can help.
Finally, yes, you are far from him and only able to speak to him by phone. Yet you did shift into new communication patterns with him when you spoke after the death of his roommate and he responded well to this. Even with the distance, you can still be CRAFTy.
Update (in which CRAFT and compassion continue to work its magic)
After my son’s sober housemate died last week he withdrew from the IOP they both attended. My son says he ‘knows what he needs to do’ to stay sober and that ‘AA meetings and his sober housemate community” are enough.
I leaned on CRAFT and what I’ve seen and heard on these pages. (Thank you all for that.)
I made an appt. with his IOP therapist for the next day and invited him to join us. Once he texted to say he would come and I didn’t call the next morning to remind him. When he arrived I thanked him for coming, praised him for answering my calls quickly,and for telling his therapist directly that he was withdrawing from treatment (rather than not showing up.)
I resolved to myself that even thought I knew EXACTLY what he ‘should’ do, that I would listen to HIM, knowing he was an adult (at 23) still sober (90 days) and could and would make his own treatment decisions anyway.
Using CRAFT we remained calm, We both worked hard to use “I” statements instead of “You “statements. I kept emphasizing the good. How he’d built of 20 months of sobriety before the relapse. How he was such a hard worker. How he’d sought help in crisis. How he’d overcome adversity in the past. How the next steps were up to HIM.
I set firm boundaries (hard for me.) I told him I would pay for 2 months of sober housing back in our city while he sought work and got his own place but that he couldn’t live at home. Told him we pay his health insurance, and telephone while he is in treatment.
He doesn’t want therapy, naltrozine for alcohol cravings, or anti-depressants. I said I disagreed (that science shows treating co-morbidity is key to extended recovery) but that I knew I couldn’t force him. The power was in his hands.
CRAFT and compassion turned what could have been a stormy, stalled meeting into a productive one and together we helped him come up with two options:
1) Explore sober houses and jobs in our home city and transition back as soon as possible,maybe next week.
2) Remain at his current sober house, find a job, and continue with AA meetings.
Of these he chose #2, staying where he is for the moment.
We left on loving terms. I bought him a sandwich and gave him $5, resisting the urge to hand him more. He said he was surprised how smoothly
Was this the exact outcome I wanted? Heck no.
I want him in formal treatment, or at least in private therapy with medicine to treat cravings and depression.
But the CRAFT process revealed to us a new way of communicating calmly and effectively. It helped me set boundaries. It helped us shift the decision-making (and responsibility for sobriety) on to him where it belongs. It helped me relinquish control.
The next days/weeks won’t be easy. But we didn’t make them worse. We built a foundation for conversations (and crises) to come. I’ll take it.
This was a beautiful report in this season of hope. You are doing the best things for him and for yourself. We have little control over our loved one’s addiction and it goes against everything we are as parents to let go of the reins while they make their own way, always thinking of them as the dependents they were as children.
Our daughter is sober 19 days now, using Naltrexone and seeking therapy again. I am enjoying the upswing and controlling my urge to pressure her into formal treatment.
It is heartening to hear that your son is in recovery under his own terms. I’m sure your support using the CRAFT method means the world to him. His burdens must be heavy and you have taken some pressure off him.
Thank you for the support. Great news about your daughter. Hang in there. You’ve got this!
I started to make my son’s travel arrangements to come home for an overnight at Christmas. Then I caught myself and told him: check the train schedule. I know your goal is to be more independent so why don’t you make your own arrangements (I will pay once you’ve decided on a timetable and schedule that works.)
One step at a time. Thanks again for reaching out. A season of hope indeed.
Figuring out where that line is between taking things on for our Loved Ones, and letting them be responsible for themselves, is not easy. I think you’re ready to teach the master class! You deserve a huge round of wild applause (follow this link: https://www.youtube.com/watch?v=barWV7RWkq0 )! We just don’t get enough of that in life.
It was so satisfying to read your description of the facilitated session: how you got your son to attend, how you held back, how you kept your CRAFT strategy in mind. You allowed the conversation to be about his choices and not yours, and you were able to reward him – while still maintaining your boundaries – afterwards. What an amazing conversation you had. You kept your cool, and your son stepped forward. You are keeping that bridge alive, and the partnership intact.
Your son was ready to leave his sober house, come home, re-install himself on the sofa, and wash his hands of recovery work… He seemed to be saying “I have it covered mom, I don’t need anyone’s input.” Read Dominique Simon-Levine’s full response here: https://alliesinrecovery.net/discussion_blog-son-choses-his-plan-through-facilitated-meeting
Thank you for sharing your experience. It is so helpful to know how CRAFT is used in different situations. You remind me of things I need to keep in mind, such as the power is in my son’s hands – not mine.
Update: My son has declined to take prescribed medicine for depression and alcohol cravings. Last week his housemate at the sober house ODd and died.
Today the rehab (partial hospitalization day program) called to tell me he had withdrawn from the program as he “didn’t need it.”
I scheduled a meeting with his IOP therapist tomorrow and invited my son to join us. Using CRAFT I remained calm. Promised I was not coming to “bully him back into treatment,” but to hear what HIS plan was. He hadn’t discussed the cessation decision with his therapist, his sponsor or his family, just the “guys in the (sober) house.”
He also told me he was glad he went to his friend’s wake, he was able to tell the dad what a great guy his son was. Then he told me he thought that would be a comfort to me at his funeral.
Does he think if his friend died while in treatment, what’s the use? Is he just planning his next relapse? Or worse?
My goal is to be calm, to listen, to exude compassion.
“My goal is to be calm, to listen, to exude compassion.”
We are here to help support you in this. Your son is acting and saying things that worry you. There is no doubt these things are worrisome.
CRAFT says be strategic. Staying calm and compassionate is strategic, despite being difficult….I would imagine any parent would want to scream from the highest points – No, don’t…no, don’t!
Families can expect change in their Loved One, in either direction, a lot of it, at a moment’s notice. You’re going to want to stay low and flexible. He is talking to you. Well done.
Thank you for your support.
Today is the funeral for my son’s sober-housemate, a great guy by all accounts who leaves behind a beloved toddler. As my son and his peers grapple with the death of this well-liked man, he said, “It’s not my first rodeo, mom. This is what happens.” That struck me as so sad: the notion that these young people in recovery/rehab inhabit a world where early death is frequent, occasional loss the norm. It can also lead to a numbing, fatalistic effect: this is what happens. No matter how hard you try. So why bother? What’s the use?
The challlenge is to keep on keeping on.Which is what every last one of you are doing.
Shout out to all you fams, folk in recovery, and treatment professionals doing your best. Shine on!
Thanks for responding to my post. Just wanted to clarify, it was Naltrexone my son is reluctant to take – for alcohol cravings, not Suboxone. It doesn’t make a difference re: addiction but just as far as next steps in treatment, opiates aren’t the exact issue.
Thanks again for helping us see the good and navigate the bad. You guys are lifesavers in a broken world.
Okay, good to know. You don’t see a lot of naltrexone being prescribed for alcohol, though it has been shown to be useful. Are you familiar with the Sinclair method? The person takes a naltrexone pill and then drinks as usual. The naltrexone cuts the euphoria which naturally causes the person to decrease their use. It may be worth looking up. I only found practitioners in our area in Boston.
I don’t have firsthand experience with it but I do have a family looking into it for their son.
Keep the faith
Thank you for letting us now about it. I expect the Sinclair method works well with hard drinkers who are desperate to quit. In this case my son is not motivated to stop drinking, both stints in rehab were externally motivated (family-driven). I’ll put this in my back pocket for the future as needed, thanks again.
Our 22 year old relapsed after 20 months of rehab/IP/IOP/PHP/OP/ sober living, etc.
He’s now back in treatment (PHP and a new sober house) and just got his 90 day chip.
Yesterday his sober-housemate ODd and died. My son hasn’t ansered my texts but told the treatment team he himself is ‘fine’. Of course a chill is running down my back even as my heart is shattered for that family.
UPDATE: I reached my son. At first the conversation was strained with a dash of defensive and contentious. (We were disagreeing about treatmnt issues and he hadn’t been truthful.) Then I made myself switch to CRAFT communication, for example deliberate listening. “I” sentences (instead of ‘you” sentences, “Tell me more”, “That must be difficult”, “I hear you saying that _____” Within a few minutes of this he started opening up about his housemate’s death. CRAFT helped me give him a safe space to talk about the peer he’d lost. Thank you, CRAFT.
Yes, I could use your insight. My son is living in a sober house, commuting to PHP. He’s been there 60 days after 30 days inpatient.
He is not engaged in treatment. Seems he is just ‘running out the clock’ until he can come home and resume his ‘regular life’.
A drug test shows he stopped Naltrexone. He also is refusing to take the prescribed anti-depressant. He ‘feels fine’ his ‘mood is good’ and he ‘doesn’t need it’ he says.This feels to me like pre-lapse behavior, or risky behavior.
It’s difficult to use CRAFT rewards when he lives 90 minutes away and doesn’t ask for anything. I’m paying for treatmnt and sober living but he would happily leave tomorrow if he had a place to go to.
I’m inclined to meet with him and his treatment team and draw up a treatment contract which includes the medication (and a pathway to return to his home city). He has never been to a ‘meeting’ or had SUD treatment here in his home city–when he left college for rehab it’s been treatment/sober houses to three other states in two years.
His idea of ‘coming home’ is thus a magical treatment-free world like nothing ever happened.I feel the need to craft a plan that calls for him to transition back here via a sober-house, a local therapist, and a local sober network, meetings. etc. I’m encouraging him to visit for a day or overnight and attend a meeting here, to start building that network.
Maybe we can line up a case manager/sober coach to help navigate the transition (and help support his rtecovery over time). The treatment scape is so fragmented and this illness so perniscious and uneven that we families become de facto social workers without training.
Ideas welcome.
Yes, I completely agree. The family members are, in this system, de facto, untrained caregivers of individuals with a complex condition.
The first thing is to get him started on Suboxone before he leaves the sober house. Get him a link to a local clinic in the city to which he is being discharged. This is critical when you consider the laissez-faire attitude you are describing. (Some sober houses are not big fans of Suboxone. You may need to intervene here.) Your son is in danger of relapsing and overdosing. He could easily get the dose wrong now that he is opiate-free.
Is he definitely coming home? Is there a local halfway house or transitional house that could take him? Would he go to one of these if your home was not given as an alternative? Read Dominique Simon-Levine’s full response to StrongerTogether here: https://alliesinrecovery.net/discussion_blog-coming-home-from-sober-house
I imagine learning about the death of your son’s roommate in a sober house felt like a huge blow. How terrible for the house, the family of the boy, for you and for your son. It must have raised all kinds of frightening questions for you. That you were able to get him to open up to you is so encouraging. I use these communication skills whenever I can. It is hardest of course when I’m upset. Practicing I statements and understanding statements on whoever is in front of me has taught me to think to use this way of communicating. Thank you for letting us know it worked for you. For us, this is an important CRAFT “outcome.” For you, I hope it brought you a little peace.
I wonder why the young man wasn’t on medication assisted treatment. It is protective in this early recovery period. What does your son say about MAT for him?
Thank you Dominique. Yes, see below, my son was prescribed Naltrexone but either stopped taking it or never started. Medication is a key tool in treatment – buthe’s a grown man at 23 making his own treatment decisions.I’d even prefer vivitrol: the monthly shot means he only needs to be compliant once a month instead of daily. Can’t thank you at AIN enough for your compassion and expertise.
I am also looking at the other piece you just sent in and will reply. I just want you to know that there is a monthly suboxone shot that is out, but not yet widely available. It is called Sublocade.
This is going to force people to decide if they are serious about trying abstinence or if they are more interested in having better control over active addiction by using daily dose suboxone to manage periods of lower use.
Both are important decisions.