• H&R Moderators: VerbalTruist | cdin | Lil'LinaptkSix

A rant about current treatment models

FWIW, my own IOP seemed terrible at first. And in many ways, it actually was terrible; I nearly bailed several times. But in the end I found quite a few fellow patients whom I really liked, and the lot of us would have some great conversations on break and after the meetings. Also, many of the counselors were dreck, but I did find two whose numbers I kept and who I do talk to still. Obviously your mileage may vary. But I was surprised how long it took for the non-shitty aspects of the IOP to come to the fore.

Good luck, man!
 
I actually like the therapist on some levels, mostly because she is understanding about my ambivalence toward 12 step recovery and they don't have an issue with me taking benzos since I have a legit prescription for them. And for the most part, I like the people in the group, but here's where I'm at with this. The copay for each session is 25 shekels. So if I go three times a week, that's 75 shekels. I don't want to pay 75 bucks a week to be shooting the shit when I could see my own therapist for a $65 copay and actually get stuff accomplished.

cj said:
Perhaps a different IOP could be found?
It has been extremely difficult finding a night IOP program. Which baffles me. Isn't one of the purposes of IOP to allow people to get treatment while they hold down a job??? There's the one I went to in 2014, but they force feed you 12 step and they told me if a random urine test turned up positive for benzos, I'd be out of the program. The other is a dual diagnosis IOP, which in theory I have no objection to, but my psych disorders (depression, general anxiety, panic, ADD and PTSD) are medicated and are being managed. I picked up a drink because it was the holidays, all my friends that I do shit with were out of town, and I was bored; I wasn't self-medicating.

I'll
probably stick with it for the time being, though, because it's just another thing that adds more structure in my life for the moment, and that can't necessarily be a bad thing.
 
Last edited:
The one time I had some experience with IOP it was pretty good actually, it was the only marginally good thing about being on probation. The counselor was good, he was a former crack dealer from Detroit and he had a lot of good "hood tales"...some of them were really funny.

He was a compassionate man and I've always wanted to write him & thank him for some of his insights, I still remember his name...
 
"If you go to a barber shop, sooner or later you're going to get your hair cut."

haha - I attended an NA meeting for the very first time last sunday and remember hearing this line almost immediately.

My experience was about what I expected, it seems to be a great social outlet (kind of like a church) for people that don't have much else going on in there life. I can see it does some good for a lot of people but I share most of the criticisms mentioned in this thread already.

A lot of the people who shared stories in the meeting were 10-20+ years sober. I just felt what a fucking waste of time, surely there's better ways to get the same benefits like connection, community, socialising, friendship from life than this.
 
It's time for me to say adios to this IOP. I found myself thinking some really hostile thoughts during this evening's session and I don't need to be putting myself through that. We wasted a considerable amount of time listening to a bored housewife type talking about an excursion yesterday with fellow bored housewives to St. Augustine, then I don't know how the subject turned to the subject of Egypt, but one of the others had lived here as a high school student and so we had to then talk at length about the Pyramids and the Sphinx. The patients are running the asylum. I understand that most people are being made to go because of DUIs or having been caught under the influence on the job, but I can't believe that not a single damn one of them seems to care anything about learning any sobriety maintenance skills. It's fucking babysitting.

And if it doesn't sound like it could get less unproductive, the therapist volunteered that she enjoys watching fucking Intervention. Yes, she enjoys the show that puts on display everything that's wrong with the treatment industry. I told the therapist I probably wasn't going to come back and she says since I am there voluntarily, there's nothing they can do if I just don't show up again, but she "hopes that I'll reconsider." I didn't say it, but I can shoot the shit with people I like a whole lot better and not have to pay a fucking $25 copay to do it. What a waste of time and money.
 
Last edited:
Yup, run like hell. That is the norm with treatment in America, so it doesn't really surprise me though. Generally when I find that there are a significant client population (like 10-20% or more) who are being forced into treatment either by their families or the courts, the quality of treatment (generally not to high to begin with) suffers tremendously.

Finding a program where clients are their through their own volition and not primarily their to appease powers that be is generally going to lead to a much richer recovery oriented culture. Even when it comes to hardcore bible thumping abstinence only programs, those that are at least made up of people genuine about moving forward in their lives for themselves are going to be infinitely better than those filled with coerced placements.

Have you thought about finding an mindfulness based stress reduction course in your area? It won't be covered by insurance (at least this would be unlikely; good ones should run between $500-1000 for everything) and they only last for like six weeks, but they can provide some really life changing resources. As well as the folks you meet there, particularly the people organizing it, can help provide good referals to quality treatment.

I found in my own case that the only positive experience I had inpatient or outpatient was when I got a worthwhile referral. From the outside it is really hard to judge the quality of care provided at a program. Then again, if you don't have a doctor you've been working with for a while and trust, this isn't exactly a sure fire solution either.

When looking for treatment, and it breaks my heart how rare this actually happens, the patient/client should be taking an approach of like how someone would hire a contractor or business underling. The client really needs to interview, in some cases interrogate, program staff (clinical direct, doctor, psychologist(s), counselors, etc) and current patients in order to get any sense of what the thing will be like or if it is right for them.

This in itself is a skill. It is good to remember to not take the word of the folks who works there at face value simply because they are authority/work there, because they have a vested interested in getting more clients in treatment for, if no other reason, maintaining financial solvency (clients=money for employees). And to take things said by former clients with a grain of salt as the current model of treatment is all about behavioral conditioning and many patients who successful complete a program will be biased toward that program.

I find that looking at the current client population and seeing if one identifies with them and also checking out the style of the counselors (are they professional? do they use therapeutic tools that frighten you or interest you? etc) is the most practical way of judging whether a program is a good fit for someone.
 
Last edited by a moderator:
I forgot to mention what should have been a great big fucking RED FLAG when the intake therapist that oversees the IOP started getting pushy about me asking my pdoc to prescribe fucking ANTABUSE. I told him that with my background in educational psychology and firsthand experience as an alcoholic and addict I consider Antabuse positively Medieval and that I'm happy seeing it relegated into the treatment dustbin along with lobotomies, electroshock and the like. I think I am just going to see my own therapist for one-on-ones in the future.
 
After a long conversation last night a friend who is also in recovery convinced me to continue to give IOP a go. I wish I hadn't. The therapist is an idiot. She knows nothing about anything. She went on at length about kratom being an opiate and in going on further to explain her point that most medications are plant-derived, went on to say that Valium is derived from Valerian, hence the name. I wasn't about to be the kid who points out the teacher's mistake, but I just decided at that moment that this IOP is a complete fucking waste of time and money.

I'm also sick of the delusions of most everyone in the group; the guy who's pissed he has to be there "because he doesn't even really drink," he just happened to get caught the one time he did, and got behind the wheel of a car; the guy who's still convinced someone roofied him. There is nothing remotely educational taking place. It's just babysitting a bunch of people who are pissed that they have to be there, and since they're court ordered to go, it's a MAJOR cash cow for the treatment center.

I don't know where I'm going to go from here. I'm just going to cool off for a week or two before thinking about what I do next. I'm back to my regularly scheduled life, so I'm having no problems occupying my time with healthy activities.
 
Last edited:
Do you have a local university with an extension program or community college you could take classes at? That can be a better waste of time ;)

Is there anything in terms of hobbies or personal projects that would take a while you could start investing your time and energy into. Whether of the creative or academic or professional kind, anything works.

One thing I don't like about current treatment models is that they fill up your time with shit, but don't really work on teaching the patients how to fill up their time with healthy activities (outside of going to meetings, thanks a lot... 8)) IRL. Like you said, the current behavioral models that are the normal often come down to little more than druggy daycare.
 
I'm managing to keep myself busy at the moment by throwing myself into back into the activities I enjoy and trying to develop new friendships so finding things to do, overall, is not a problem. But where I really could have used the help is how to deal with the times where nothing is going on, friends are busy or out of town etc. How can I motivate myself to do something on my own so that I don't get bored and think about drinking or abusing pills? What can I do to structure this time that would otherwise be unstructured?

Thank you for that last post TPD. Thinking about how to respond to your post helped me form the questions I asked above and will give me fodder for my next one-on-one therapy appointment.
 
Ultimately I think the question is less one of avoidance but integration. Instead of focusing on totally breaking off your relationship to unhealthy substance use for once and all, you start changing how you relate to substance use. I'm not suggest you start using again. This strategy references how the current tools you use to self regulate your mood have become conditioned by the unhealthily patterns of drug use you engaged in up until recently.

Those unhealthy behavioral patterns conditioned you mind to relate to substance use in unsustainable ways, ways that essentially taught your brain to believe substance use is the most effective way to regulate your mood (and in terms of how it has an immediately powerful effect it is, it's just not a very sustainable, reliable effect given how our culture demonizes most drug use). Remove the ability to regulate you mood with substances and you're no longer just dealing with the fact life is inevitably stressful, but you are also now stressed ecause your primary tool you've developed to regulate your mood is no longer available.

As you rightly pointed out, what you need from an IOP is to learn skills that allow you to develop new tools that allow you to use effectively regulate your mood without causing you too much harm or ill health as you substance use came to. You won't be able to escape thoughts or desires to use in early recovery when you are activated and your mood becomes disregulated. Some activities you can avoid, such as hanging out with people using or putting yourself particularly stressful enviroments, but sooner than later you'll be confronted by difficult experiences that lead your coping mechanisms previously conditioned in unhealthy drug use to the fore and you'll have to deal with them.

Establishing kinder, gentler ways of dealing with difficult emotions and activating throught patterns makes it possible to give yourself the space you need to work with them more effectively than just butting up against them in a confrontational way prioritizing avoid based strategies can only take you so far.

Good luck aihfl! I love your thread :)
 
Top