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a brief rant: incredibly bad rehab counselors

simco

Bluelight Crew
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Aug 20, 2014
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I had an experience last night that pissed me off so bad, even this morning, I still feel like I need to vent about it...

So, I'm in an "intensive outpatient" rehab program offered through a local hospital. In fact, I'm almost done with it; this is my last of 5 weeks. From the get-go, it's been absolutely awful. While the medical staff are nice, the counselors just *suck*. Everything here is abstinence-only, 12-step dogma. For instance, they continually berate me about the 1.5 mg/day of clonazepam long Rx'ed to me (and recently reintroduced to my regimen by psychiatrists in a world-class inpatient psych hospital). There are a million gotchas like that.

But last night, the counselor who was leading the group crossed a line (as it happens, he's also the counselor who is assigned my case, so I deal with him a lot).

There's a young woman in the program who is trying to get out from a dope habit. Several inpatient rehab stints. Goes to 12-step meetings like crazy even though she hates them. She's been on suboxone for several months, but keeps relapsing. (This is an experience I had, as well.) So last night, during our "check ins" it came out that she started methadone.

The counselor just lit into her, shaming her like crazy. It started with a pouting, surly "well...you know *our* position on methadone." She said she had talked with her Dr about it and simply felt it was her last best option. Which brought out this fucking tirade from the counselor... "You're not taking your recovery seriously. You're always looking for the easy way out. You're never going to get out of this if you don't take responsibility for your actions." It went on and on, long after she had understandably started sobbing.

Of course, going onto methadone is a serious decision. But I can't imagine *any* situation in which publicly shaming someone in a group therapy setting is even remotely OK. I was stunned...and PISSED.

I think I'm going to call them today and ask to be transferred to a different counselor. None of them are great, and it's late in the game. But I don't even want to be in the same room as this asshat any more.

Anyhow. Sorry for the kinda random post. I just felt like this was going to eat at me if I didn't get it off my chest.
 
Simco - I feel your frustration and can certainly relate. It's disappointing that so many institutions follow 12 Step ideology when that seems hit or miss. Your counselor was out of line, the patient should not have been berated, and certainly not publicly. If feel that is harmful, and the counselor should be reported. I agree with you, it sounds like an it would be in your best interest to change counselors.
 
Welcome to the backwards depths of abstinence only culture in the US simco. I am sorry to hear you had this experience, and feel deep compassion for the poor woman who had to undergo that ordeal. I have been on the receiving end of just such a tirade myself. It is disgusting, and sadly far from an uncommon display of the kind of "recovery" you find in most of those rooms.
 
Thanks, Moreaux and TPD. I appreciate the support. For what it's worth, I lodged a complaint about the counselor this morning and initiated the process of switching my own case to someone else.

I have to admit, though, that in some small way, this event was helpful for me (definitely not for the woman on the receiving end of the tirade). I had been feeling cowed and guilty that I wasn't going to 12-step meetings, and I was even occasionally smoking cannabis. But the truth is, I made real tries with the 12-step approach when I first started this process of quitting heroin...~4 months of daily meetings, working with a sponsor, no weed smoking. That mode of therapy just didn't (and doesn't) work for me. This event gave me a bit of confidence, reminding me that I need to find a way to get better that helps me capitalize on my own talents etc.
 
Thanks, Moreaux and TPD. I appreciate the support. For what it's worth, I lodged a complaint about the counselor this morning and initiated the process of switching my own case to someone else.

I have to admit, though, that in some small way, this event was helpful for me (definitely not for the woman on the receiving end of the tirade). I had been feeling cowed and guilty that I wasn't going to 12-step meetings, and I was even occasionally smoking cannabis. But the truth is, I made real tries with the 12-step approach when I first started this process of quitting heroin...~4 months of daily meetings, working with a sponsor, no weed smoking. That mode of therapy just didn't (and doesn't) work for me. This event gave me a bit of confidence, reminding me that I need to find a way to get better that helps me capitalize on my own talents etc.


I can't knock 12 step programs as they do help many people. They actually kick started my recovery as the people there put me in touch with the resources I desperately needed and wouldn't have found on my own or with just listening to my GP, but they are not an end all means to getting healthy. The actual method didn't work for me, though I went off and on for over ten years, and still gonsometimes because I enjoy the people and the support. Addicts should. Or feel bad if the meetings don't work for them and I hate that we are bullied into having to go to them either by rehab, friends and family, or court. I think everyone should try them out just to see what they offer but they should not be forced upon us.

Please don't feel bad that they are not your thing. You are doing very well and working very hard towards getting healthy and that speaks volumes more then sitting in a chair in a letting you are getting nothing out of. One of the hardest aspects of recovery is that we have to find what works for us. Keep up the great work!
 
Thanks, Moreaux. And fwiw, I think there are some great aspects of 12-step fellowships. As you said, the camaraderie is such a helpful tonic against the awful loneliness of being addicted. And I'm sure there are people for whom 12-step participation is profoundly therapeutic. My gripe is mainly with the overreach with respect to 12-step effectiveness that is pervasive in US addiction treatment.

Also, I think you hit the nail on the head: finding what works for me truly has been the hardest part of getting better. Slowly coming to realize that nobody has a silver bullet that would fix me, and that I need to find ways to fix myself (and let others help), has been very hard.
 
Exactly, the twelve step approach is way over applied in the US. For a long time it was all there was, but thankfully that is changing. It is going to be interesting to see how the abstinence-only community changes with the times, because I agree that they have a lot of resources to offer folks in recovery.
 
Also, I think you hit the nail on the head: finding what works for me truly has been the hardest part of getting better. Slowly coming to realize that nobody has a silver bullet that would fix me, and that I need to find ways to fix myself (and let others help), has been very hard.

That is a pretty profound place to be in your thinking. I think that is applicable for so much of our strife in this life--not just addiction: accepting that we can heal ourselves and must even while the temptation still exists to believe in that silver bullet coming in from somewhere outside.

That counselor needs drug education!8(
 
Also, I think you hit the nail on the head: finding what works for me truly has been the hardest part of getting better. Slowly coming to realize that nobody has a silver bullet that would fix me, and that I need to find ways to fix myself (and let others help), has been very hard[/b[.



I wasted years waiting for this to happen for me. I would talk to so many different people and never understood what they meant by "you have to keep working" for it - I really thought being sober was enough :/. I think if treatment facilities and doctors really emphasized and defined what what meant by work, many addicts would get sober sooner.
 
That is exactly why there needs to be higher professional standards amount those providing addiction treatment services. I mean basic standards requiring people who are providing treatment services, which are meant to help people get sober, know what strategies work for which populations. In other words, that they are able to actually lay out how each of their real life, multidimentional, individual clients can get from point A and do the work required to get to a healthier place, point B.

We need to demand nothing but the best of treatment providers. Regardless of what they have to work with, all the knowledge and tools are available to effectively treat clients in this day and age. It is just a matter of getting the right services to the right clients. Not everyone should be working in the treatment field. First hand experience of addiction is invaluable, but it is hardly enough on its own considering the current dearth standards and minimal licensing requirements in the field.

It is so much better than it used to be, but it has such a long way to go before things become something approaching acceptable compared to modern medical care (which is what addiction treatment, in the end, boils down to).

/end rant :\ =D
 
That "counselor" should lose there job. Berating a patient is so unbelievabley unprofessional that it's not even funny. You should certainly speak to his boss then the actual licensing agency if he even has a real degree.
 
Unfortunately that counselor's boss probably has more sympathy for the counselor's point of view than the fact they were acting totally inappropriately and unprofessionally. Still, worth a shot. Behavior like that should never be tolerated, it is just that as clients hoping to get treatment, we have very few choices.

In this circumstance, if I were that client, I'd complain to the relevant authorities, see what happened, and either stay on and (more likely) leave the program for something more professional/useful.
 
You got to understand they are following protocol and most of it involves treating you like shit.

That being said I would rather not go to treatment ever or go to inpatient at a hospital.
 
I've only got four more sessions before I "graduate" from this program, so I think I'll stay in it (I did insist on changing counselors, though). The trouble with bailing is that this clinic is my source for my naltrexone Rx, which I really want to keep. I don't know if they'd cut me off if I bail on the program, but I don't want to chance it, since they are kinda the only game in town for such stuff. Easier just to stay for four more nights. Some of the other patients/clients are nice, too, so I'm OK with sticking around.

The tricky part will be... when I graduate, they will pressure me to enroll in their "continuing care" program. Basically a less frequent version of the classes I'm attending now. I'm trying to think of a diplomatic way to decline. I really do find the program to be slightly worse than useless.

It's weird, I never have trouble being assertive, except when it comes to recovery stuff. Somehow, when folks in charge of any aspect of recovery tell me to jump, I just ask, how high? I think it's just because I feel so out of my depth with this stuff. Anyone have thoughts on how I can say to my new counselor, "no, I don't want to continue in this lousy program" in a polite way? Maybe I'm overthinking it.
 
Be completely direct with them is my advice. Your not on probation you don't need a glowing recommendation from them. Many outpatient places are so used to having court ordered patients by the balls that they forget that you are the customer not a prisoner.
 
Be completely direct with them is my advice. Your not on probation you don't need a glowing recommendation from them. Many outpatient places are so used to having court ordered patients by the balls that they forget that you are the customer not a prisoner.

This advice is on the money! If you don't take care of yourself, they are going to manipulate the shit out of you. At least that has been my experience in treatment. Gotta sick up for one's self.

Simao, you are doing fucking awesome man. Keep up the great work. You are an inspiration my friend.
 
I've only got four more sessions before I "graduate" from this program, so I think I'll stay in it (I did insist on changing counselors, though). The trouble with bailing is that this clinic is my source for my naltrexone Rx, which I really want to keep. I don't know if they'd cut me off if I bail on the program, but I don't want to chance it, since they are kinda the only game in town for such stuff. Easier just to stay for four more nights. Some of the other patients/clients are nice, too, so I'm OK with sticking around.

The tricky part will be... when I graduate, they will pressure me to enroll in their "continuing care" program. Basically a less frequent version of the classes I'm attending now. I'm trying to think of a diplomatic way to decline. I really do find the program to be slightly worse than useless.

It's weird, I never have trouble being assertive, except when it comes to recovery stuff. Somehow, when folks in charge of any aspect of recovery tell me to jump, I just ask, how high? I think it's just because I feel so out of my depth with this stuff. Anyone have thoughts on how I can say to my new counselor, "no, I don't want to continue in this lousy program" in a polite way? Maybe I'm overthinking it.

Just make absolutely sure that having genuine concerns and criticisms of what they are offering (proffering is probably a better word!;)) makes it "slightly worse than useless". Sometimes you can take one kernal of truth here and one there, one source of support here and one someplace else. You do not have to eat everything on your plate! Eat what you want, but make sure you try a bite of everything so that you actually know what that is. My point is that you want to make sure you have all the support you can get. My brother is in a program right now where he thinks the counselor stinks but gets so much from the group itself that he looks forward to going.
 
Herbie,

Thanks for your thoughtful suggestion. I see just what you mean. And it's true, as much as I've knocked heads with the counselors in this program, it hasn't been without value. The question I need to answer is whether the bile and bad feelings that dominate the experience totally outweigh the few--but nonetheless real--good outcomes.

I'll definitely think about it before saying anything definitive!
 
I can relate to having 12 steps forced upon me. Sucks big time. I just tell people 12 steps makes me jones and they leave me alone. hehe. Its not even really a lie. I'm trying to get out of that lifestyle not be reminded of it every single day. That shit would make me go off the deep end eventually.
 
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