Fireweed3 reaches out with concerns about her Loved One’s return home. She’s coming home from residential treatment, 90+ days sober. But she’s on shaky ground right now, not taking proactive steps in her recovery. For this family member, practicing CRAFT when her Loved One was actively using was in some ways more clear-cut. How can we work CRAFT during this fragile time of transition?
My 19 year old daughter is coming home on March 7. She has been in residential treatment since November 21 (the day before Thanksgiving). She is 90-plus days clean of heroin and other substances.
While she has come an incredibly long way, she is currently experiencing a worrisome setback — just as she prepares to come home. She recently lost "mentor status" in treatment due to her not following through with "proactive steps in recovery" (job search, re=enrollment in classes, 12 step meetings, etc.). As her addictions therapist states in email: "She is settling back into old behaviors of being in contact with men who are active in their addiction and not expanding her social circle. She has not maintained contact with her sponsor and there is little evidence that she has one. She is floundering. She is also discussing having high cravings and refers to using as something she misses." Indeed, she has visited her "boyfriend" at least 2x — the 28 yo man who introduced her to IV drugs last fall. Read this member’s full comment here.
It is good to hear your daughter is completing her 90-day program, though it sounds like she is shaky in her recovery. She is headed home.
The program should be setting up a solid aftercare program for your daughter to follow. Something to help her adjust back into the community. I would also strongly suggest you both consider getting your daughter on medication assisted treatment, Sublocade is the new monthly shot of suboxone, or Vivitrol, the monthly shot of naltrexone. You can read more about both in our Resource Supplement.
Your daughter was living in the streets before entering treatment, hanging with an older boyfriend who introduced her to heroin. She has been in contact with him.
Your daughter is used to living in the detached garage and your plan is for her to return living there. You are setting up lots of guidelines for her to follow. It sounds like your daughter gets easily overwhelmed when the talk turns to earning a living.
Even if your daughter was doing a better job of talking-the-talk – “I’m well, not going to use, not contacting old using mates, going to jump right into a recovery community, therapy etc.” – I would still set up as though she was shaky, during a transition time like this. Since she is shaky, it makes sense to be cautious in the living situation that you set up for her return home.
How about leaving the detached garage as something she can graduate to, after a period of successful “transitional living” in your home. For now, it’s time to look at the daybed and locker set-up that we have talked about.
The list of activities, etc. that you are working on sounds good. Keep polishing up that list. Make sure to check about a list of treatments her current treatment provider should be linking her to. You’ll give her both of these. Really, for her to be home with you, YOU need to know she is as safe as she can be from a possible overdose. This means medication assisted treatment for the time being.
You provide her with this material. Then, how about taking it one week at a time? “We’re going to put you through your paces and see how you’re doing at the end of each week. If this home cannot provide you with enough support to work your recovery, we’ll know it very quickly. If we feel it’s not working out, we will move you to a sober living situation.”
A person can spend all day in community recovery activities: self-help meetings, therapist, MAT, a little volunteer work…? Perhaps those first few months are spent focusing on these things. This is part of recovery. The job and school get added in gradually. This is already a transition. Try to think in terms of baby steps for now, not aiming for those big goals of employment and school quite yet.
CRAFT is completely useful during this period. The hope is that your daughter does well and you get to step in and give rewards for her daily effort. The biggest reward here is going to be your home and her loving family. Certainly, if she digs in her heels and doesn’t participate in the structure you are outlining with her, you will step back with the big chill. In this sense, you’ll act as though she has just used: remove rewards, remove yourself, and allow natural consequences.
Your daughter may not like every recovery activity she tries in the community. You’ll have to give her the space to withdraw from some things, but continue to insist that she adheres to a basic structure of recovery activities of her choice. This helps foster a sense of her own independence – important for any young adult living at home – within the confines of a basic supportive structure.
You are going to have a lot of trouble trusting her. Given this, it will be a great help if you don’t give her a space to hide in right away. That will also signal to her that this is a very transitional time: nothing is as it was before. This is new territory, for both of you.
Full trust is going to take a lot of time. This next transitional period will not be easy on you. Providing her a daybed and not the garage, using MAT and recovery activities will help mark this as a transition for all of you. If you set up without the expectation of fully trusting her right away, it will go a long way in helping you manage your own emotions.
It is wise of you to recognize the need for your own “program” in order to remain calm, clear, and centered. Good for you. It is so heartening that you identify and are working on this proactively. It can’t be emphasized enough. Reach out to those you can trust. Find new ways to feel supported, to attend to your own needs. Those needs are very real. The more support systems you have, including us, the better.
One last thing. She will almost certainly reach out to the boyfriend. Ultimately it is her choice to do so. As before, it’s important to remember that the boyfriend is not the problem. He is a symptom of her addiction. She is going to have to wrestle with this. She is going to have to choose a warm home and family and recovery OR an easy return to her drug use with him. She is going to have to fight for herself.
If you choose to bring this up, add this last line to your conversation… ”I cannot stand in your way if you choose to talk to, see, or use with XXX. I am here to help you fight for yourself and for a better life. If you aren’t willing to fight for this, we need to quickly move you to a more structured program than our home.”
Thank you for sharing these updates with us. Let us know what else we can do as you prepare yourself for this transition. We are here to help.