***Turning Point’s Habitude™ Addiction team will provide bio-psycho-social and spiritual assessments based on their integrative professional recommendations.
Here is a very useful guide to help understand why certain lengths of stay are recommended
The six stages of the model are:
Precontemplation-Individuals in the precontemplation stage of change are not even thinking about changing their behavior. They are still being manipulated by the addiction. Even though they accept treatment, they still may not be convinced that it is as a big of a problem as others see it and believe others are exaggerated or have a motive other than trying to help them. They believe they have the “power” to stop any time they choose too and do not see their problems as “problematic” as the others around them do. These individuals choose to spend time with others who are also pre-contemplative and see the “issues” as being the problem vs their role in their own addiction. These individuals are quiet needy and immature. They will get angry if people don’t go along with what they perceive to be the problem.
The Four Rs” —reluctance, rebellion, resignation and rationalization:
Reluctant precontemplators are those who through lack of knowledge or inertia do not want to consider change. The impact of the problem has not become fully conscious.
Rebellious precontemplators have a heavy investment in their addiction and in making their own decisions. They are resistant to being told what to do.
Resigned precontemplators have given up hope about the possibility of change and seem overwhelmed by the problem. Many have made many attempts to quit or control their addiction.
Rationalizing precontemplators have all the answers; they have plenty of reasons why drinking or abusing substances is not a problem, or why drinking or drug use is a problem for others but not for them.
Contemplation-Individuals in this stage of change are willing to consider the possibility that they have a problem, and the possibility offers hope for change. However, people who are contemplating change are often highly ambivalent. They are on the fence. Contemplation is not a commitment, not a decision to change. People at this stage are often quite interested in learning about addiction and treatment. They know that their substance abuse is causing problems, and they often have a mental list of all the reasons that drinking/using is bad for them. But even with all these negatives, they still cannot make a decision to change.In the contemplation stage, often with the help of a treatment professional, people make a risk-reward analysis. They consider the pros and cons of their behavior, and the pros and cons of change. They think about the previous attempts they have made to stop drinking or abusing, and what has caused failure in the past.
Determination-Deciding to stop drinking is the hallmark of this stage of change. All the weighing of pros and cons, all the risk-reward analysis, finally tips the balance in favor of change. Not all ambivalence has been resolved, but ambivalence no longer represents an insurmountable barrier to change. Most individuals in this stage will make a serious attempt to be abstinent in the near future. Individuals in this stage appear to be ready and committed to action.This stage represents preparation as much as determination. The next step in this stage is to make a realistic strategic plan. Commitment to change without appropriate skills and activities can create a fragile and incomplete action plan. Often with the help of a treatment professional, individuals will make a realistic assessment of the level of difficulty involved in being abstinent. They will begin to anticipate problems and pitfalls and come up with concrete solutions that will become part of their ongoing treatment plan.
Process Driven/Action/Implementing the Strategic Plan for Recovery: Individuals in this stage of change put their plan into action and understand their commitment to getting well and long term recovery. This stage typically involves making a open commitment to their family, friends and maybe even their employer to be abstinent. Individuals in this stage are open to personal and family counselling and some form of outpatient treatment, start to look at going to some type of supportive peer based meetings or tell their family members and friends about their decision—or all of the above.
Maintenance/Early Solution Based Recovery: The action stage normally takes three to six months to complete. Change requires building a new pattern of behavior over time. The real test of change is long-term sustained change over many years.
Termination– (3-5 years) The ultimate goal in the change process is termination. At this stage, the individual no longer finds that substances presents a temptation or threat; he has complete confidence that he can cope without fear of relapse. This is the stage that individuals in early recovery believe they can accomplish short term if they just “stop”
Other examples of some considerations:
1. Individuals length of time abusing substances
2. Current Health conditions
3. Is there any history of trauma such as emotional, physical, and sexual abuse, grief and loss
4. Where will individual be living when they complete program- is family ready for them to return home?
5. Does the individual require any medical follow up
6. Does the individual need to apply for sober living accommodations?
21 day Detox Program or Relapse Prevention Program
Candidates must complete a thorough pre-assessment prior to being accepted into program.
Pre-contemplative to Contemplative – Stages of Change
Candidates manage their own recovery and are planning to attend a long term treatment centre that is government or insurance based.
1. Understand that 21 day withdrawal or detox is not treatment
2. Understand that 21 day Relapse Prevention Program is only for individuals with long term abstinence who want to feel physically well or have had minimal short term lapses and need help getting back on track.
Example of Supportive withdrawal detox program only
1st 7 days- Medically supervised Withdrawal and Peer Support
Next 7 days – Stabilization
Final 7 days- Discharge planning
28 day program Recovery Program
have had extensive abstinence, but are seeking physical and therapeutic for long term solution based long term recovery
for all others this would be a Pre-contemplative to Contemplative Candidate
45 day Recovery Program
can range from Contemplative to Preparation or Action Stage
60 day Recovery Program
can range from Contemplative to Preparation or Action Stage
90 day Recovery Program
can range from Contemplative to Change or Action Stage
Some questions to ask yourself before coming or leaving Turning Point
1. How long have you been abusing substances?
2. Over your life time, what will staying an extra “__” mean to you in the big scheme of things?
3. Will staying additional time make a difference in your life, long term?
4. How much time and money have you spent abusing substances and making poor decisions ?
5. Did the lack of money ever stop you from using substances ( or supporting someone else?)
6. Do you want your physical concerns addressed properly?
7. Do you want to do the work that is required necessary emotionally to do better in your recovery?
8. Do you have a safe place to go home too, now or when you finish the program?
9. Is your family ready for you to come home if you called them now?
10. Will staying longer in a program hurt or help you and your family?
11. How solid is your relapse prevention plan?
12. Do you have legal or financial issues that you have now or will have to go home too?
13. Does your employer or lawyer have any requirements from Turning Point pre-treatment or prior to discharge?
14. Does your employer know what you need to help support your recovery?
15. Do you have a comprehensive pre-recovery or after care plan?
16. Do you have a sponsor/mentor that you can be open and honest with?
17. If you have a counsellor, that do they recommend?
18. Are you qualified to say you can do this in X amount of days? Are you open to professional feedback?
19. Do you understand that Recovery is a journey and we need to be humble when we start that journey?
20. Do you “want” to finish your program in a specific time frame or do you “need” to stay focused on long term recovery?
Interesting note:Long Term Programming with a structured aftercare is always the best recovery plan
All clients who have completed a 60 or 90 day program felt more prepared on their discharge date than they were are at 28 or 45 days in treatment.
Clients who decided on shorter programs regretted their decision and felt the transition challenging.
Stages of Change adapted from Mark S. Gold MD and Carlo C. DiClemente and J. O. Prochaska