Is This Rehab a Danger to Addicts?

Jabberwocky

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Hunter R. Slaton said:
Burning Tree is known for its tough clients and tough treatment. When The Fix got an alarming complaint about its practices, we investigated to see if the rehab was guilty as charged.

In January, The Fix received a complaint about a Texas rehab called Burning Tree, which has been featured in our Rehab Review since last July. We get such complaints on a fairly routine basis; however, this one was so detailed and disturbing that we could not let it pass. So we undertook an investigation. Here’s what we learned.

According to the complaint, which was made by a relative of a client, the rehab invades its clients’ privacy by censoring mail and listening in on phone calls, engages in isolation and humiliation, and practices questionable therapies, such as confrontations and unusual “contracts”—a rehab term for an agreement between a client and a counselor for the client to modify his or her behavior in some way. In the view of the complainant, all this—and more—amounted to “cult-like activities” at Burning Tree.

Opened in 1999 by founder David Elliott, Burning Tree is a long-term rehab with two facilities, in Kaufman and Elgin, Texas. Its target client is the “chronic relapser”—a serial rehabber who can’t stay sober. One alumnus told The Fix, “Burning Tree is the perfect place for someone who has had multiple failed attempts at sobriety and is looking for a different experience.”

Other alumni called Burning Tree “high accountability” and “no-nonsense.” “The treatment and the staff are very tough love,” one ex-client said. “They were strict because I wasn't the best or easiest ‘student,’” another said. “There were a lot of tough-love approaches thrown at me.”

But at what point does a confrontational, tough-love approach stray into the territory of psychological cruelty and abuse? Did Burning Tree cross the line in its surveillance of client reading materials and mail and in practices that an addiction-treatment expert called “a form of shaming”? Or are these necessary and effective measures when dealing with a population of, in the words of the rehab’s CEO, “classic manipulators”? These questions go to the heart of addiction treatment, and raise concerns not only about what is helpful but about what is ethical.

What are the actual facts in the Burning Tree case? Our first stop was the Texas Department of State Health Services (DSHS), whose director of media relations was initially cooperative, telling The Fix that their office had received two complaints—not just the one we had received—against Burning Tree. State officials were investigating both, with the outcome due in the next couple of weeks.

But a few days later, the spokesperson reversed her position, and said that a previous determination from the Texas Attorney General made information about such complaints and their outcomes confidential. In a letter to The Fix, Texas DSHS Public Information Coordinator Sherry Mansell wrote: “All records made by the commission during its investigation of alleged abuse or neglect in an alcohol and drug abuse treatment facility licensed by the commission are excepted from disclosure.”

So that was a dead end. The Fix next spoke to a therapist who had been contracted to work at Burning Tree for “a couple of years.” She was familiar with the situation, and said, “This person making this complaint may be rude, but they are not wrong.” (The therapist asked to remain anonymous.)

Asked about specific allegations in the complaint, the therapist offered confirmation. She said that clients’ five-minute weekly phone calls are monitored by a rehab staff member sitting in the room with them. “Every piece of mail was opened prior to somebody receiving it.”

As for “questionable therapies”—which the complainant said included making clients wear clothing inside-out, not allowing them to speak for up to a week and making them lie down outside in the dirt—the therapist said she was aware only of the no-speaking contract. Although what the complainant alleged is a “slight exaggeration,” the therapist conceded, sometimes clients are contracted not to speak to certain individuals or family members for some amount of time.

“I was very worried for this man’s life,” said the therapist, referring to the client named in the complaint. “And he was not the first.” But the most galling thing about Burning Tree, she said, was its leadership’s arrogance: “They are always right, and the client is always just a liar or a shameful person.”

We took the allegations to Burning Tree’s CEO, Brian Percox. Throughout our interview, Percox was surprisingly forthcoming—in an industry where client confidentiality is an oft-cited bulwark—even offering unsolicited information about the complainant herself. “We thought of suing this woman,” he said. He noted that both complaints concerned more or less the same things.

Percox denied that client phone calls are monitored or mail opened prior to distribution, noting that both acts are illegal. The five-minute, once-a-week phone call policy is accurate, however—and “the reason we do that is to protect the family,” Percox said. “These are classic manipulators we are dealing with.”

Books and music may be disallowed, but not because they are non-12-step-appropriate, Percox said. Rather, counselors make decisions as to whether or not specific materials are in line with “general spiritual principles”—or, as one former client put it, “recovery-related.” Marilyn Manson CDs, for example, and the book Fifty Shades of Grey do not make the cut, Percox said.

Percox also addressed claims of “questionable therapies.” The “inside-out-clothing” exercise, he said, is called a “disarray contract,” which, while “pretty rare,” is sometimes given to clients (with their agreement) who have “everything together on the outside”—i.e., being sharply dressed and well-groomed—"but not on the inside.” So the client agrees to dress crazily or poorly for a certain amount of time, sometimes with clothing picked out by another client.

As for the “no-speaking” contract, Percox said that it is more often for periods of 48 to 72 hours, and only during group sessions. And yet, he added, “We have done it where you can’t speak at all for 48 hours. But only if it’s necessary—and very rarely.”

For our Rehab Reviews, The Fix uses alumni of the facility as an important source of information, and we contacted them again with our questions about this case. In general, their answers split the difference between Burning Tree management’s version and that of the complainant and the therapist.

For instance, alumni denied that mail is opened by staff before it is given to a client. Rather, “Burning Tree requires that the client open the mail in front of staff,” said one former resident, adding, “Additionally, if there is something that may affect the client’s treatment—divorce papers, death, nude photography—the clinical team can help the client process and stay focused.”

Another ex-client, who said his experience at Burning Tree “was nothing but helpful,” echoed this account. “Prior to anyone receiving mail it was opened in front of a staff member. They never read your letters but simply checked to assure no contraband was in the package,” he said. Both alumni denied that staff listen in on phone calls, although they do monitor the length of the call with a timer.

Are these practices and "therapies" helpful, harmful or just irrelevant? Clearly it was time for us to call in an expert. Practical Recovery President Tom Horvath, PhD, is the founder of Reunion San Diego, an addiction-treatment center that in many ways stands opposed to Burning Tree’s confrontational approach.

Horvath was reluctant to say that certain aspects of Burning Tree’s approach couldn’t ever work. “[With the disarray contract], they want someone to open up. What they are doing is essentially a form of shaming,” he said. “I wouldn’t ever do that. But if I were to put somebody on a contract like that, they would be allowed out of it on a moment’s notice.”

Yet these contracts—more pedestrian versions, it should be said, are common at many rehabs—are not the most troubling allegations against Burning Tree. More serious is the rehab’s alleged disregard for clients who also suffer from underlying mental disorders.

The rehab’s website claims, “Dual diagnosis of addiction, and any underlying psychological conditions..., is not divided into component parts and treated separately. Rather, all possible elements and factors are addressed through an integrated approach that acknowledges that each has a simultaneous impact on the other.”

But Burning Tree does not use an “integrated approach” in treating a dual diagnosis, according to the therapist. In fact the rehab basically does not treat clients’ mental issues at all, she told us. “Really it just amounted to them sending that client to see me [once a week] for a few minutes.”

The rehab’s confrontational practices, she said, are an attempt to “break [clients] down mentally, which does not work for people with underlying mental disorders.” She said, “I’m willing to concede that this could be a difference in philosophy of treatment—but only for substance-abuse cases.” She also claimed that the rehab took some clients off all their prescribed medications, without consulting a psychiatrist. (Percox denies this, saying that only Suboxone and methadone are disallowed, Burning Tree being an abstinence-only rehab.)

Percox countered that the facility does adequately care for its dual-diagnosis clients, providing once-a-week psychotherapy with a licensed master’s-level therapist. Yet he also concedes that “primarily we are a treatment center, but we do do co-occurring disorders.”

When asked whether the rehab attempts to “break down” its clients, Percox’s denial was emphatic. “We treat the chronic relapser. Our belief is that they’ve never truly been treated for their spiritual malady,” he said. A former resident agreed. “If you are a chronic relapse addict like I was, you need to be confronted about your lies, as well as be held accountable.” Percox made no apologies: “We are confrontational, but we do it in a loving, honest way,” he said.

But confrontation, said Horvath, is “the one thing that should not be done.” While he was only cautiously critical of certain Burning Tree practices, Horvath took a hard line against its treatment philosophy. “Confronting people is harmful, and there is very clear evidence about that now. Getting in somebody’s face and insisting that they accept the label or the notion of a disease or a particular approach to recovery—that makes people worse.”

The evidence appears to support Horvath. According to a 2007 study in Counselor: The Magazine for Addiction Professionals, William Miller, PhD, and William White, MA, concluded: “Reviewing four decades of treatment outcome research, we found no persuasive evidence for a therapeutic effect of confrontational interventions with substance use disorders. ... Several have reported harmful effects, including increased drop-out, elevated and more rapid relapse, and higher DWI recidivism.”

As for the Texas DSHS’s investigations into Burning Tree, a state official reported that no enforcement action was taken against the rehab. “The state came, did interviews and a review, and nothing came of it,” Percox said. Yet one thing did raise concern with the state in Burning Tree’s accreditation audit. “We used to not give their [driver’s] license back if they left until after 96 hours,” Percox said. “We did it as a retention tool.” But state investigators said the rehab could not continue this practice. “Now we give their license back in four hours, but we won’t give them a ride to the bus stop”—which, Percox noted, is a long way off in rural Texas—“until 96 hours.”

It became clear during the course of this investigation that Burning Tree—while it is apparently on the right side of the law—engages in practices that might give many people pause, especially if they are considering it as a treatment option. Yet despite conclusive evidence that confrontational approaches like Burning Tree’s do more harm than good, numerous alumni testified that the place is a “welcome” alternative for some addicts who have been through the rehab mill.

Burning Tree’s hard-core practices are controversial—and are likely to remain so for as long as the debate between confrontational and self-empowerment approaches continues. So buyer, beware. Information and education about what a rehab experience is really like is the best weapon in your arsenal. The Fix remains committed to uncovering these experiences in our Rehab Review, and—should they be warranted—future investigations.
It's nice to know I'm not the only one who experienced the worst that the rehab industry's obsession with their distorted perception of AA, that I'm not the only person raped by my council and later my sponsor's sponsor. I am not a violent person, but if it I could get away with it, I'd be more than happy to end the lives of these two people. But I digress..

The best thing anyone can do to truly help someone with a drug "problem" or drug (ab)use or "addiction," is to simply ASK the person in point what THEY would like to do. As opposed to others forcing them into rehab or acting, no doubt often in what they think is their best interests, in other coercive, paternalistic and fankly thoughtless and bigoted ways (i.e. treating the heroin user as a dope fiend, some horrible thieving junkbox, with no respect for the fact that they're (the person with the drug "problem) is much more of a human being than merely a heroin user - except in the most hard core cases that are in the vaassssssst minority. Rehab or any threatment form has a very, very low likelihood of success if the person going into it either doesn't honestly have a strong desire/drive to (re)build healthy life habits or those like lawyers and doctors and home owners who have a LOT to love if they don't get their shit together.

Shit like this just pisses me off. The military industrial complex, the prison industrial complex and the recovery industry complex, at least at the present, are really one in the same. So. Fuck. Sad. Not to mention stupid and unconstructive...

Although there are some differences, this place sounds a lot like another rehab in North Hollywood (CRI HELP)
 

23536

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I scanned the article and I can't see any difference between what's described here and what I've experienced at almost every rehab. My opinions may seem contradictory:

1) People have gotten too delicate. Our species can possibly tolerate an infinite amount of psychological abuse, so long as no actual pain is inflicted. It's really just a series of stupid games.

2) All compulsory rehab is a violation of fundamental human rights, and therefore abusive.

I also think that Rutgers coach being fired is bullshit, even though somebody should have smacked him for throwing those balls.
 

miss.tassa

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Omg I went there! I thought all those things too. I don't think they were helpful at all. Plus they are lying about a lot in their responses. my friend was put on silent for a week and that was everywhere, not just in groups. They do nothing at all for mental disorders. They made me wait three weeks before I saw a therapist which was only because my parents raised hell. Usually they make you wait longer. I suffer from ptsd and whenever I brought that up I was told to pray and ask God for help. There was a girl w.a long history of eating disorders who confessed that she was purging right up until she was discharged and they didn't seem to care at all. The worst thing in my opinion is the counselors involvement w.each clients sponsor. My counselor made my sponsor fire me after I came clean about some things I had lied about (not using. Just questioning whether that rehab was working for me). They also require the sponsors to call the counselors and discuss the clients progress. euh... Thinking about that place makes me shudder. I'm so glad that nightmare is over. I feel for all the clients that they are tormenting now tho
 

PurpleKush1

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and this,ladies and gentleman, why i rather hole up in a shithole to kick a habit than to go to rehab. Fuck these cocksuckers, oh yeah better fuck em up mentally so they dont relapse, anyways rehab is just money, rehab is useless,fuck this. Most of the people i know who kicked hardcord H or crack or both habits did it whitout rehab. Interstingly those who did go to rehab are the ones that relapsed.
 

weekend addiction

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I had to go to rehab before court once. I called dozens of rehabs. All of them insisted that I CT a high Xanax dose and a moderate Vyvanse dose even though I was prescribed these meds and didn't abuse them (not often anyway). I was there to quit alcohol and IV heroin. Anyway the one I went to gave me something called Depakote to keep me from seizing. This caused me intense vomitting and made me feel like shit. So I told them it wasn't working for me. They said tought titties. Either quit bitching and take the Depakote or your going to have a seizure.

After 3 days of intense drug withdrawal, vomiting and suicidal depression I decided that I really wanted a seizure and told them to keep their damn depakote. What a fucking nightmare that was. I don't ever want to be sober because the only time I've been sober in years where the times when I was grossly mistreated at this rehab. I wish I could have experienced sobriety for a while, only taking prescribed meds, so I could know what its like.

Also I met a guy there on the same dose as Xanax as me. He was on OC bad (300mg a day). Anyway 3 weeks after they CT'ed him he had the first seizure of his life at 38 years old and fell down a flight of stairs. He got his Xanax from a doctor and only took them at night for sleep. Poor guy.
 
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cj

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Google syanon if you want see a good example of AA treatment becoming a cult. My personal experience in rehab wasnt terrible but it wasnt very helpful either. Like someone already said its usually about money.
 

manboychef

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Syracuse behavioral healthcare was actually helpful for me. It wasn't the fourteen hours of programming everyday, but the fact I met a few counselors that were recovering addicts themselves. These people were actually helpful. One in particular, but I won't say his name got me started on the real road to recovery.
 

Diloadid

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I wish I pressed charges against the rehab I went to. I was made to stand out in the middle of 90 men and degraded because of my religious beliefs. Such nasty and ignorant things were said to me that day by people who were no better than me. I sometimes wish I would have said 'fuck this' and went back to jail. I let it be known that I was atheist and that the 12-steps were really un relatable for me. Because you know what a higher power is. 90 men for thirty minutes hurled insult after insult, calling me a 'faggot' and insisting I was going to 'burn in hell with all the other faggots'. It was mainly just variations of that, it became redundant quick and had absolutely nothing to do with recovery. I don't know why not believing in God makes you gay, but most every resident had that opinion. My phone calls home and smoking privileges were taken away and I had to write the entire AA book from front to back. It was bullshit. Fuck that place.
 

cj

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I wish I pressed charges against the rehab I went to. I was made to stand out in the middle of 90 men and degraded because of my religious beliefs. Such nasty and ignorant things were said to me that day by people who were no better than me. I sometimes wish I would have said 'fuck this' and went back to jail. I let it be known that I was atheist and that the 12-steps were really un relatable for me. Because you know what a higher power is. 90 men for thirty minutes hurled insult after insult, calling me a 'faggot' and insisting I was going to 'burn in hell with all the other faggots'. It was mainly just variations of that, it became redundant quick and had absolutely nothing to do with recovery. I don't know why not believing in God makes you gay, but most every resident had that opinion. My phone calls home and smoking privileges were taken away and I had to write the entire AA book from front to back. It was bullshit. Fuck that place.
Jesus you should call the licensing board for the state it happened in and file a formal complaint.
 

Prescottdave

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Burning Tree featured in thefix investigation was closely affiliated with Gatehouse Academy until the closing of Gatehouse in 2012 following the sentencing of the CEO. This individual was part of the inception of Burning Tree Recovery Ranch and was heavily involved with wire fraud, money laundering and drug trafficking. The following links document the affiliations as well as tell part of the story. The CEO of BT up until 2011 previously worked at Gatehouse and went through the program. This should give you a good idea what type of abusive so called therapeutic methods are used at both RTC's.


Both programs used their morning meeting to conduct their daily public "therapy" sessions. This included standing in front of a large group of over 90 people while being yelled at and humiliated till the point of an emotional break. These sessions involved the use of untrained staff fresh out of high school and sometimes lasted several hours. It was not uncommon for staff to use race, religion, sexual orientation and spiritual beliefs as something to be ashamed of. Hardcore conservative republicans screaming and cussing at you as a therapeutic tool for individuals with serious mental illnesses, eating disorders and developmental disabilities. One commenter above mentions the fact that this rehab sounded like all the other rehabs he had been to. Let me make it clear in the state of TX and AZ it is illegal to listen in on phone calls or to censor/deny phone calls or mail in all state licensed treatment centers. The tactics used at Gatehouse and Burning Tree went much farther then what most rehabs would do when using tough love techniques. There are thousands of state licensed and regulated treatment centers across America in which you have basic rights just like being in jail. You can make calls and send mail. These rehabs would not let you make phone calls for the first 6-8 weeks and they would take your ID. This is illegal. It would also take you 6-8 weeks to go up on the level system and be allowed your first appointment with your prescriber or doctor. Basic mood stabilizers could be given to SMI clients or denied based on willingness to follow the rules. At Gatehouse staff used crack cocaine with residents and statutorily raped minors. I witnessed two instances of assault by staff. All this while they laundered money through the company. No instead Burning Tree and Gatehouse stepped over the line. As far as we know Burning Tree was not involved with the fraud but they certainly mistreated their clients.


These under regulated behavior modification "schools" and unlicensed rehabs require more oversight from the DOH. Thankfully Gatehouse was forced to close by the state but Burning Tree continues to stay open. Not surprisingly the TX regulators have not been to keen on helping.




http://www.heal-online.org/gatehouse.htm
http://www.heal-online.org/burntree.htm
http://www.thefix.com/content/adolescence-interrupted
 
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Jabberwocky

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Awesome post Prescott! same with the regs in CA (and I imagine most states). Policy Makers don't give a shit about "addicts", and those that "do" would be just as happy to see then dead as they would see them "recovery" from their "addition".
 
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Tickturd908

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Oh my god, I knew something wasn't right with gatehouse academy. I was just barely 18 when I went. I tried running away a times and when they wouldn't let me call my family I put a hole through a door and ran away. Cops came to me in the road o was walking on and when I wouldn't talk to them they handcuffed me, only after I was handcuffed the cop through me on the ground face first and sat on me with his fat ass. Officer Gary Newton. I'll never forget his name. I got locked up for a week in maricopa county for a minor misdemeanor which got dismissed. When I got out the gatehouse fuckers picked me up and took me back. Luckily my old man got me out of there, that place was a nightmare. Threatening if you leave they would have you arrested for endangerment of self. Even when my dad showed up to take me out they sat me in the middle of a big group of my "peers" and said I swear to God, " if we told you your dad was here to take you out of the program to leave, would you go?" There was so much pressure I honestly said I wouldn't go. I snapped out of it and joined my dad but it shows you the power of mental manipulation these people had and it is very scary. It fucked my head up. I'm convinced they were putting shit in the food or something. There bogus college somehow passed and I'm sure made alot of money, I hope the people involved coordinating this hell whole rot in hell and get AIDS.
 

cj

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The rehab I went to in Florida called Treasure Coast Academy read our mail and listened to our phone calls. They would make you hang up if they didn't like what you said. They also didn't allow any calls for the first week. The place would have been abusive had it been better organized but luckily it was just laughably unhelpful instead. I'm convinced rehabs are the wrong phychological approach to addiction. Addicts need love and compassion not torture and humiliation.
 

g0to

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I know this will be an unpopular opinion on here, but i think alot of the users on this site are biased into thinking that the average addict (and for that matter, the average human being) are honest enough with themselves to even admit they have a problem when they first start treatment. Even if they know they need help, a person in active addiction many times, hell most times will leave as soon as they can. Especially if there's no obvious incentive to get clean (except some light jail time/community service), especially when a person is actively addicted to something like speed or coke as well as dependent on opiates, and especially (which turns out, is most of the time if not all the time) when the comedown or withdrawal exacerbates stuff like mental illness and anxiety.

I dont think that these places are to blame for anything other than the obvious (the road to Hell is paved with good intentions). I think that whats happening in these places is moreso indicative of the system failing as a whole and we want to blame the addict for being unable to control themselves, we want to blame the court system for being too draconian (its actually quite fine even in the u.s.a imo, however im of the belief that even if someone is mentally ill and drug dependent when they commit crimes like dealing and burglaries, they should be punished to the full extent of the law and undergo some type of rehabilitation in tandem), we want to blame the rehabs for mistreating their clients, the addicts want to blame their parents or society etc, or the saddest is those with more insight and that actually care about having some semblance of a normal sober life yet cannot manage it - blame themselves... the reality is i think that this is an underlying issue with more fundamental paradigms of society that cant be easily fixed or negated, this is why its called treatment.

For certain types of people, this is the only type of setting which will have any positive impact whatsoever. For others it will feel like yet another unwarranted punishment and hell on earth. People should be free to leave any time. The issue is, the court system actually pushes people through programs like this because its a net monetary gain for them.

The problem i have with it is these should be social, compassionate programs. Religion shouldn't be some kind of warped justification for them to further their views or (god forbid) turn a profit.

Yet thats just how it is here in the US, then again its much better here for addicts than many other countries. Yet we are one of the wealthiest countries and by proxy filled with the most self righteous and dogmatic individuals imaginable. Treatment programs like this are predictable based on how our society functions its still not considered societys burden and a moral issue in any way shape or form other than the addict being a burden and the addict having a moral problem so the gvmt and private industry will minimize and cut costs at every turn, and hide away the issue at hand.

Turns out that its only a problem in this society if we are addicted to drugs. Ever heard of a treatment for money addicts? No that is called being "successful" and 99.9% of people have been brainwashed to the point where they will look at you sideways and not take you seriously and become extremely uncomfortable if its even brought up. There are people out there that live to work and work to live, and they *love* their work wholeheartedly, yet they get paid pennies on the dollar compared to those manipulating and taking advantage of them through the system. It really is quite sad that good, kind people are sometimes left destitute and bankrupt and even homeless if they dont have a support structure in place, simply by trying their hardest to support their families and contribute. This still happens all the time even here more often than anyone in our society would like to admit. Its been happening since the beginning of civilization.
 

Jabberwocky

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I have a lot experience working with the sort of confrontational approach to treatment that is so popular and mainstream when it comes to how so called professionals treat substance use disorder (a problem that's highlighted in the rehab industry, but pervasive among all kinds of treatment providers).

As a way of helping individual users come to terms with issues surrounding their drug use (and especially when it comes to their mental health concerns), it very rarely works out well. An individual has to be in a rather advances stage of recovery when they're able to actually get something useful out of even gentle confrontation, a place where they are able to find a way through their own aversion and doubts related to treatment or sobriety.

What is more important IME is creating a climate where the individual feels connected, heard, accepted and safe. Recovery tends to follow very naturally from that kind of experience - the experience of everything that is lacking for those struggling with serious issues related to their drug use. The tough love approach is beyond bullshit, yet it's still the most common way treatment providers tend to mediate their work with patients.

I do agree that inpatient programs have a role in the treatment of SUD, but very few (very very few) provide the kind of support that most people need (I have yet to hear of a program that actually provides comprehensive, patient centered aftercare, which is probably the most crucial aspect of rehab). And rehabs and treatment providers have become very much a dime a dozen. It's a hugely profitable industry. Profit maximization and ideology tends to be the name of the game, not treatment outcomes.

As long as the confrontational approach to substance use treatment remains the norm and these business are so quite to offer their services to ANYONE who comes knocking, and the whole "we know best what's going to work for you because we've been through it before or else you'll end up in jails institutions or death" kind of cultish attitude on the part of senior treatment providers remains mainstream (see Synanon - the influence this organization still wields over the treatment industry even after being outed for what it was is incredibly), going inpatient may just as well will exacerbate problems as help solve them.
 
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g0to

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^Thanks for this. I didnt know about Synanon , i had heard the name but just read up on it. Seems there are still programs based heavily on their ideology however theyve toned it down a notch..

I think the biggest thing about recovery is that 99% of the legwork must be put in by the individual. Until the addict themselves doesnt truly wish to make the difficult steps toward recovery(12step or otherwise, i think that aa has the right idea and gives a streamlined framework and functions well as a support group but its not for everyone) only then will there be progress. So as you said, alot of these forced rehabilitation programs are literally nothing but cash mills. Thats not to say that a properly self-aware individual doesnt have anything to gain from such a program though, once they themselves are truely ready to move forward and face their demons.

The conundrum lies in the fact that the very first thing alot of these inpatient/outpatient programs do is take away the individuals agency which is in my opinion a huge factor in moving along with recovery.
 

Jabberwocky

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I couldn't agree more.

Personally one of the biggest problems with treatment in the US is triage. Most rehabs will accept anyone and steer everyone away from stuff like ORT (which for many people is really and truly harmful advice). If treatment providers were more selective about only accepting people who stand a reasonably likely change of benefiting from their particular modality (as is the case with most ORT clinics), things would be a little better.

Fostering individual agency, not based upon identification with a particular recovery group, is such a crucial part of the recovery process. Based upon some of the research I've seen from other parts of the world, I've become basically convinced that for the majority of people (particular opioid users) outpatient programs that involved pharmacotherapy is more beneficial for most people than removing them from their environment and isolating them in a rehab (again, given absolutely horrendous issues with re-entry upon completion and lack of any meaningful aftercare strategy).

Although it more specifically focused on the teen treatment industry, a must read for anyone interested in the whole rehab topic is Maia Szalavitz's book Help at Any Cost. There is so much to learn about the industry that so few understand from this one work. It's super depressing to read some of the cases she covers, but it's also incredibly fascinating the insane shit that has (and largely continues) to pass as mainstream in the recovery industry.
 

cj

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Treatment in the US is driven solely by money. The 12 steps are the cheapest way to run a rehab so it is what they do. They hide behind its principals so they don't have to offer real therapists or doctors who can prescribe ORT type drugs. They then blame the client for the lack of effectiveness of the treatment they offer. I can't tell you how many times I have heard rehab workers say well they just didn't want it bad enough or some other nonsense. It wasn't till I got on methadone that I saw any way recovery would ever be possible.
 

Jabberwocky

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Something else worth pointing out it that many, many people who enter treatment do it to appease others (whether courts or loved ones). No one forces anyone to come to BL for support, so in my experience here I do believe most people I've encountered are very well capable of being honest with themselves. As they work on their recovery I have enjoyed seeing people (and myself) gain clarity into their situation - to in a way become "more honest" with themselves as they learn to understand their situation more accurately.
 

cj

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Something else worth pointing out it that many, many people who enter treatment do it to appease others (whether courts or loved ones). No one forces anyone to come to BL for support, so in my experience here I do believe most people I've encountered are very well capable of being honest with themselves. As they work on their recovery I have enjoyed seeing people (and myself) gain clarity into their situation - to in a way become "more honest" with themselves as they learn to understand their situation more accurately.
No doubt. But that still doesn't account for the awful success numbers these rehabs post. I believe coerced treatment makes up 25 percent of treatment at most.
 
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