Chapter 10 - Advanced Recovery

Advanced recovery is considered to continue throughout one's life. Recovery from addiction is a change in lifestyle that includes maintaining abstinence as well as involving oneself in healthy relationships; getting good nutrition, rest, and exercise; and working to resolve one's personal problems with the goal of attaining a satisfying, fulfilling life. Having established this kind of lifestyle, the patient must now continue to lead it. In this model, recovery is a lifelong process.

Ideally, in this time-limited model, counseling is concluding at the point when the patient is entering advanced recovery. Theoretically, individual drug counseling is being terminated when the patient has established and maintained abstinence and been taught all the essential strategies for recovery and for living sober. At this point the patient is ready to have greater independence and self-accountability in recovery. Also, he or she should be ready to embark upon the higher level task of integrating recovery-oriented values into all aspects of life. Of course, in reality, patients will be terminating at different points in their recovery process, particularly when the counselor is working with a time-limited approach. In this model, tailoring the length of treatment to the individual's needs is not possible.

The counselor should plan to discuss the patient's thoughts and feelings about ending treatment in the final active treatment session. The impending termination should be mentioned several sessions prior to the last one in order to give the patient the opportunity to think about the treatment experience. In the final treatment session, the counselor should ask the patient to summarize his or her overall experience of the treatment process. If possible, the counselor should recognize and compliment the patient's achievements in recovery. A major goal is to identify the gains made through treatment. Another central goal is to recognize the areas still needing work and to plan how the patient will continue to work on them independently. The counselor should encourage the patient to establish a personal commitment to continue in his or her own recovery process. To this end, the counselor should urge the patient to specify the steps to be taken to establish his or her own recovery process. The importance of continued participation in self-help groups should be emphasized. Finally, the counselor should create the opportunity for the patient to discuss feelings about ending the counseling relationship.

Following completion of the active treatment phase, patients can benefit from continuing to be seen by their counselors. They can use what they have learned in the active phase of treatment and bolster that learning with less frequent booster sessions and continued participation in self-help groups.

In the original research program, patients were seen once a month for 3 months for booster sessions. There was no empirical reason for choosing this particular length of time, so practical considerations should govern the choice of how long to continue the booster sessions. In the final booster session, the counselor should revisit the termination issues that were discussed at the end of the active phase of treatment.

The purpose of booster sessions is to provide continuing support for the recovering individual, to encourage participation in a personal recovery program, and to ensure that the person has assistance available if any problems with maintaining abstinence should arise. The subject matter discussed in the followup sessions should continue to be addiction-related and often will involve the repetition of earlier topics with a new and higher level of understanding and integration.

1. Provide a reminder to the patient of his or her commitment to recovery.
2. Offer support and feedback to the recovering person.
3. Help the individual develop a personal program of recovery.
4. Be available if a relapse or similar crisis should arise.
   
   

Next Chapter