We Need to Find the Middle Ground

Coydog3948 seeks guidance for handling her Loved One's upcoming release from detox. She'd like to help his parents implement CRAFT, but they aren't in agreement about the approach. Can they come up with a neutral plan that everyone agrees on?

Hi,  I appreciate this website and have listened to the modules several times and just listened to podcast “heads up tips for families with a loved one on the recovery path”. My addicted loved one is my nephew. I shared this website with my sister and her husband but we are “newbies” to Allies in Recovery. I am one of my sister's supports and she is at a crossroads. Her 30 year old son is in a detox facility as of three days ago. (I think the modules helped, dip/wish to make happen.) He has been been in/out of treatment since he was 17. We hope he will choose inpatient rehab but found out today he wants to come home, go on MAT, and go back to work. Work seems to be his one thing he uses as a reason to not do inpatient rehab. He has good insurance thru his estranged wife. Of course we are scared his plan isn’t going to work. My sister has “hijack brain” and wants to make this time work. She isn’t taking time to care for herself. We need help with a plan for him to stay at her house that is safe, fair for her, her husband and her son. Her husband and her differ in opinion of boundaries. I think a plan that is unbiased …a happy medium maybe. Help!

Welcome to the community. We're so glad you've found us and that you're working with the modules, listening to the podcast, and finding these resources helpful.

The short answer, and the shortest way through, is for your sister and her husband to watch our site’s Learning Modules and answer the questions together. Once they are more clear and more unified in their approach towards him, then they could invite him home. Some boundaries would certainly need to be established between the three of them. This would be accomplished by using the essential skills laid out in Learning Module 4. Embracing the communication techniques and the strategies for making a request will help the family approach this conversation in a new, productive way.  Here are many of the components that could be discussed.

For the son:
 

• Medication Assisted Treatment (MAT) – accountability through regular attendance. Your nephew is at high risk of overdose – see my article on the importance of MAT here
   
• Other treatment: early recovery group? psychiatry? a therapist?
   
• Regular work (is work a healthy enough environment? is it complicated by a strong drug/alcohol culture?)
   
• No drug use, including cannabis or cigarettes, in the house (amend as needed)
   
• Recovery activities (aim for 3 a week. Be creative – go online, look for recovery centers. See our resource for online support groups for a broad variety of options) 
   
• All kinds of self-help meetings, daily
   
• Chore list (the reality is that we are now in a group living situation where each adult must contribute)

For the family:
 

• Continue to rely on support groups and the Allies in Recovery program for issues that come up. This list of online resources also contains support options for family members
   
• Training in Narcan and supply in the house
   
• Family therapy – even just a few times can help establish the boundaries and bring awareness to old patterns that are no longer useful. This helps give a broader context and more support for any changes they’re trying to implement
   
• Chore list (see above)

Also, we are fond of the daybed and foot locker transitional home plan. We’ve written about this set-up in a number of different posts that may be helpful to read through.

The goal is to cultivate and establish a respectful, compassionate communication style. This can lay the groundwork for sufficient flexibility in this plan and an openness in your exchanges. This way, a problem can pop up and be resolved with little anger or conflict escalation. Working in collaboration is always the goal. The family members position themselves as allies in their Loved One’s recovery. This recent post by Resident Expert Patrick Doyle, LICSW, sheds light on how that collaboration might take place.

What all of this means is that your nephew could really use a place for a couple weeks to bridge the discharge from the detoxification unit to your sister’s house. Look for 2-week treatment programs. In Massachusetts, Clinical Stabilization Services (CSS) serve this purpose.

Your sister and her husband need to be united, informed, and skilled in communicating and reacting and responding to your nephew. This takes practice, time and patience. It takes patience not only with the Loved One, but with one’s self. Shifting old communication patterns is hard work. They definitely need time to deep-dive into the program on this site. Their son’s disorder is serious and long-standing. So now it’s time for CRAFT boot camp. There are going to be challenging moments. Even if their son does everything perfectly, they are not going to trust him very much. Not for a long time. This is part of their own work to undertake, hopefully with plenty of support.

With our approach, the focus is always on what the Loved One is presenting in the moment, so holding on to past grievances ends up clouding one’s ability to truly practice CRAFT. This post by Annie Highwater on trust and boundaries may be useful for them to explore as well.  

If this reaches you after his discharge, and your nephew has already moved back in with mom and dad, the plan remains largely the same. In this case, his parents just won’t have the time to work through their differences and discuss new strategies much beforehand. The timing will be such that they’ll have to learn and emerge with strategies as they go. If they can agree to work with CRAFT, they’ll have a chance of shifting the environment for your nephew at home. They’ll be able to find a path to that middle ground you suggest: one which feels manageable for all involved and which allows your sister to take some time to restore her energies and focus on her own well-being. But this doesn’t happen overnight. Hopefully with some patience and a willingness to look at the situation with new eyes, they’ll be able to embrace the basic rhythms of the CRAFT approach and help steadily shepherd your nephew towards recovery. 

Thank you for being there for your nephew, and for your sister. It sounds like the whole family is lucky to have you on the sidelines, suggesting a new approach and shining that light on the path to safer, more solid ground. You’ve already seen some recent success in seizing on a “dip” and getting him back into treatment. Good for you for taking the lead, and for being willing to educate your family about CRAFT. All our best for helping your sister & her husband implement these changes in the coming weeks. We are here for you all and we’re rooting for you – please let us know how it goes.