As we have also seen in the press there are 8.4 million people drinking alcohol at harmful and hazardous levels, that is at levels that are creating physical and psychological harm to the person drinking. Of course, drinking does not happen in isolation and someone’s problematic relationship with alcohol will impact on family, friends and work as well. And even though the person drinking may try to deny this to themselves and others, deep down they know it is true. In fact, the very knowledge of the fact that their drinking is negatively affecting others creates a sense of pain and shame which then causes them to drink to make this go away. Therein creating a perfect self-perpetuating storm.
The situation with drugs is no different, particularly cocaine, ketamine and the misuse of prescription-based opiates and benzos, and the impact of COVID-19 for many people is to self-medicate even more.
Even people in long term recovery are struggling because of the impact of COVID-19 as no one saw this coming and maintaining copying strategies is not easy when some of your support systems are removed.
Individuals, friends, and families are therefore looking for new solutions. With limited and stretched local authority funded services many will turn to the private sector as they can’t afford to wait to make changes and stop their decline into further chaos. With finances tight then value for money is going to be even more important when looking for treatment. So why intensive Dayhab?
The Effectiveness Of Dayhab
Intensive Dayhab works; research backs this up but it is an underused resource as GP’s and advice bureaus are just not up to date with its availability so is often overlooked when people approach them looking for help.
Intensive Dayhab has been proved to be highly effective. Although new to the UK Intensive Dayhab has been running in the US for over 10 years and there are more than 11,000 Intensive Dayhab/Intensive Outpatient Programmes in operation. Data suggests that around 67% of people that complete Intensive Dayhab are still abstinent 9-12 months on completion. That being said Help Me Stop have clients that are now into their 15 month of being abstinent and more.
Treatment – What Goes On In Face-to-Face and Online Dayhab Treatment.
All the research into drug and alcohol treatment suggests that the most effective method of long-term abstinence is through psychotherapy and peer support. For those requiring medically assisted detox there is also a need for some medical support to deal with withdrawals but in the main behaviour change takes place through therapy and supported maintenance via peer support.
In Dayhab one of the key factors in creating behaviour change is via groupwork. But I hear you say, I don’t like groups or don’t want a programme that has groupwork. This is much like saying I want to travel to from Lands’ End to John O’Groats by car, but I don’t want my car to have wheels.
You may well get your recovery via just one to one support, but it is a bit like travelling from Lands’ End to John O’Groats with no wheels on your car. It’s going to be hard, bumpy and take for ever and the chances are you will give up before reaching your destination.
The natural propensity of human beings to come together makes groupwork a powerful therapeutic tool for treating drug and alcohol problems. One reason for this is that groups intrinsically have many rewarding benefits—such as reducing isolation and enabling those taking part to witness the recovery of others—and these qualities draw clients into a culture of healthy recovery. Another reason groupwork is an effective tool is that it is one of the most effective methods of dealing with issues that commonly accompany drug and alcohol problems, such as depression, self-esteem issues, isolation, stress, and shame.
Groups can support individuals in times of distress and trouble, and they can help individuals grow in ways that are healthy and creative. Because our need for human contact is biologically determined, we are, by nature, social creatures. Groupwork and drug and alcohol treatment are therefore natural bedfellows. The evidence tells us that individuals who have issues with drugs and alcohol remain abstinent and committed to recovery when treatment is provided in groups, because of the rewarding and therapeutic forces such as affiliation, confrontation, support, gratification, and identification. This capacity of groupwork to bond individuals to treatment is an important asset because the greater the intensity, quality, and duration of effective treatment, the better the client’s outcomes. It is because of the high efficacy of groupwork, and as a testament to the high level of success that follows, that Help Me Stop’s programmes have a high percentage of groupwork in both the face to face and online programmes. So, in a typical 9am to 2pm face to face day someone may well do 4 groups and have a 1:1 with their primary therapist. The same is true for the online programme in that 8 out of the 10 interactions over a week (Mon-Fri) will be groupwork and the remaining 2 slots 1:1’s
What Type Of Groups Are Delivered?
- Psychoeducational groups, which explore about how drugs and alcohol work and effect the mind and the body, what is going on when you crave, what is going on in the mind and body when you get stress, are depressed etc. and what you can do about all of this.
- Skills development groups, which hone the skills necessary to break free of drug and alcohol use.
- Cognitive–behavioural groups, which rearrange patterns of thinking and action that lead to drug and alcohol use and address other issues such as depression, self-esteem issues, stress, and trauma.
- Focus groups, which comprise a forum where clients can debunk each other’s excuses and support constructive change.
- Interpersonal process group psychotherapy which enables clients to recreate their pasts and current problems in the here‐and‐now of “group” and rethink the relational and other life problems that they have previously been managed by their use of drugs and alcohol.
Not all activity takes place in or on the programme. Help Me Stop is committed to delivering an intensive programme so there is a need for clients to do some self-reflected homework outside of the programme, which is presented back to the group or their primary therapist. Reflection is necessary to the treatment process because it enables those in recovery to really think about themselves and their past to help determine the reasons behind their behaviours and how they can deal with and address these things without the need to use drugs and alcohol.
You only get out of treatment what you put in and tackling problematic alcohol and drug use is not something that can be fixed with a magic wand or doing as little as you can. All the clients that make a success in their treatment and recovery do so because they put the work in.
Peer support makes difference, that is why Help Me Stop asks all its clients to engage in this outside of the programme. Finding the right peer support group may take a little time, a bit like finding a decent restaurant. All restaurants provide food but finding the one with the right atmosphere, crowd and delivery of the menu can take a while. Finding the right support group is similar. Nevertheless, engaging in peer support along with therapy greatly improves a client’s outcomes and there are a number of ways peer support, in addition to regular treatment and therapy, can uniquely support people in recovery:
- Peer support provides a personal level of knowledge by sharing similar life experiences. These common personal experiences can foster meaningful connections and a deeper sense of understanding and empathy between peers who may otherwise feel misunderstood. Many clients also feel a level of shame about their relationship to drugs and alcohol so being with people who are all in the same boat is a great opportunity to level this out.
- Reducing isolation. Living with problematic drug and alcohol use and the associated feelings can be very isolating. Many people may not be able to speak with friends or family – and some people may be afraid of the subject altogether. Also, for many the recovery process can mean parting company with people that are just too risky to associate with in an abstinence life so these holes need to be filled. Outside of formal peer support like AA, NA, CA, MA and SMART there are many more social support groups that offer fun and exciting alcohol and drug free events, many of which are online at the moment.
- Peers who have lived experience of drug and alcohol problems can provide useful insight on how to deal with cravings, triggers and what to expect through the recovery process. In many ways these supporters can promote hope in peers that getting through struggles with drug and alcohol use is possible and that life gets better as well.
- Improve overall mental and physical health. Those who participate in peer support often influence other positive, self-care and lifestyle behaviours like regular exercise, healthy eating, and stress management.
Drug and Alcohol Testing
Drug and alcohol testing is helpful additional tool of motivating drug and alcohol using clients to remain abstinent. Often clients in the early stages of recovery are in denial about the nature and extent of their problems. They often lie about their substance use, either denying that they have used at all, or minimizing the amount of drugs or alcohol that they have used. It is therefore necessary to obtain objective and indisputable evidence of whether someone is still using drugs or alcohol during treatment. Many clients see the test as something positive and something to be proud off and show the people they care about that they are making progress and staying off.
Some clients involved in child custody and access situations also find the tests handy for proving their abstinence in order to see their children. Testing can therefore be a usual resource and some clients take out stand alone testing package even after they have completed the core programme and the aftercare.
Far too many people think they are fixed after completing a programme, be that an intensive Dayhab or residential rehab. Behaviour change is not a quick process and those that do not take their continuing care seriously when they complete their core programme will relapse. In fact, it is not uncommon for some people to relapse on the day they leave residential rehab. Therefore we recommend all our clients to take up the offer of our aftercare group and also continue in building on their recovery capital.
Recovery capital is the total resources that a person has available to find and maintain their recovery.
Stopping and Staying Stopped
What are your options if you’re drinking or drug use is causing problems?
Well, the first thing is to get help. Stopping and staying stopped is not as easy as it sounds.
Stopping and staying stopped is a about a psychological shift and lifestyle change which best comes about through psychological therapies and peer support. Peer support like SMART or AA, NA, CA and MA is great and is highly recommended, but they are not a replacement for psychotherapy or are psychotherapy. They are not run by trained addiction psychotherapists and neither will get to the fundamental bottom of your use from a psychological perspective. Getting to the psychological reasons why you drink or use drugs and doing something about this is fundamental to long term behaviour change and staying stopped.
There is no magic pill or magic wand to stopping and staying stopped. There is no quick fix, it takes the right levels and types of support, time, motivation, and hard work.
Giving up alcohol and drugs after prolonged use can be extremely difficult because the body and mind is so used to functioning with the substance. Dealing with the come down is one thing but learning to stop and stay stopped is another.
If you are concerned about your relationship with alcohol or drugs, or someone else’s, and want an effective option to stop and stay stopped then call us now on 0208 191 9191 or jump onto Live Chat/email us directly at https://www.helpmestop.org.uk/contact-us/
Help Me Stop’s intensive non-residential outpatient Dayhab alcohol treatment programme is an effective psychological solution that also offers 3 months of free accessible aftercare and family support options. Treatment is delivered face to face either in the mornings or afternoons over 6 weeks.
For those adults who are working and can’t access our services in London we offer a 6-week online outpatient alcohol treatment programme, run by the same therapists that provide the face-to-face programme.
Chris Cordell is Help Me Stop’s Director of Operations and is a senior associate member of the Royal Society of Medicine, Certified International Recovery Specialist, member of the International Society of Addiction Medicine and a member of the Federation of Drug and Alcohol Professionals.