Why Preparing a Treatment Plan Works!

I came across a synopsis of a study of Yale students done back in the 1960s that underscores one of CRAFT’s important strategies: providing your Loved One with detailed specific treatment referrals, and removing barriers to engaging into treatment.

Before I explain the study, let me address those of you who remain unconvinced that treatment is the answer. Your Loved One has been to treatment, you’ll say, and it didn’t work. It is true that several treatment episodes on average can be necessary before getting traction with recovery. It is also true that a minority of people will be "struck sober"—a spontaneous recovery as it is sometimes called—without any treatment at all.

But for the majority of people struggling with substance issues, treatment is the answer. It raises the bottom, gives your Loved One the message of recovery, provides a pause in the drug use. It protects them from the ever-increasing and severe consequences of their use.

For the family, it is the quickest, most successful way to address a Loved One's drug and alcohol problems.

As is common with CRAFT, this means you, the family, must learn to address the addiction in new ways (read: more work for you, sorry). To be successful, when it comes to getting your Loved One to agree to treatment, you’ll want to follow Learning Module 8, which includes a detailed list of treatment options and helps you to think through and resolve the barriers keeping your Loved One from going into treatment.

So, here’s the study that affirms these two points. From the Washington Post (May 2, 2018):

When a group of Yale college seniors was given information about the dangers of tetanus, nearly all of them indicated that they wanted to get a tetanus shot, yet only 3 percent actually did so. But when a second group of Yale seniors was given the same lecture, but also given a campus map with the infirmary circled, a list of times when appointments were available and a prompt to think about a convenient appointment time, the rate at which students went to get a shot was more than nine times higher. Simply making their desired choice a little bit easier to carry out was enough to move them from intention to action…

Again and again, research has shown that people are more likely to follow through on something they themselves want and intend to do — if it is made easier to do. We are more likely to eat healthy if fresh salads are placed at eye-level in the cafeteria. We’re more likely to donate blood when the bloodmobile shows up in our company parking lot.

Years ago, I remember speaking to a young wife with two children whose husband was drinking very problematically. She had come down the stairs one morning with the children to find her husband passed out on the kitchen floor. Having seen this scene repeatedly before, she took out the family’s HMO insurance card, placed it in his hand and left for her mother’s with the children.

The wife’s solution for encouraging treatment was right on, yet it was pretty unlikely her husband would manage the tricky process and the research necessary to figure out treatment with just the HMO card. It turns out he didn’t, which was why she was talking to me.

I suggested she put together that detailed list of treatment options, wait for a moment when he was neither drinking nor hung over (and in a calm enough state to listen), then sit down with him to present the list, having rehearsed a short message of engagement:

“I know you love your children and me, and we adore you. Our family is breaking apart because of your drinking. I cannot stand by and just let this happen. We have so much going for us. I am petrified, distracted, upset beyond measure about what the drinking is doing. I’ve made up this list of options. Would you look at it with me? When you are ready, I will do everything I can to help you with your drinking.”

The husband now had the tool needed to make that first step into treatment and had his wife’s commitment to help­—both creating a huge opening. Her husband's tendency was to swing back and forth between wanting to drink and wanting to stop, but the next time he swung towards wanting to stop, he would have the plan in front of him and the support for taking that first critical step.

Several weeks ago I met with a retired woman whose 40+ year old son was now living with her, having been thrown out of his marriage. We talked about the need for inpatient treatment, along with community outpatient options. We then spent some time coming up with all the barriers in the way of her son getting into treatment, especially the inpatient program. Together we worked through each one, coming up with solutions wherever possible. Some of these included: taking time off from work (what would the work say and do about a request for the time off); the loss of income while away from work (what needed to be financially maintained for the son, rent, child support); what his young daughter would think about his absence; who would take care of his dog…..and so on.

The idea was to think like her son, and come up with solutions to the objections he would raise about going to treatment. Again, thinking about these in detail and resolving them where possible is work and effort on the part of the family. The path to treatment needs to be made as barrier-free as possible.

Detailing a treatment plan and removing obstacles on that path to treatment is a huge part of getting your Loved One to engage into treatment.

For inspiration, I'm including three messages we've received from Allies members:
 

"Going through the modules in here calmed me down … though it seemed really hard at first, eventually it worked to help me learn to say the right things at the right time…" —AiR member
 

"He seems genuinely happy and he is sober. He calls it 'starting his new life.' We are happy for him. Thank you so much for helping us get to this point." —AiR Member
 

“Thank you very much. I also used the craft method to have the talk with him on Wednesday, and that was what allowed him to open up and talk a bit and then agree to get more help.”  —AiR Member