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Probe the patient's relational barriers to recovery

June 8, 2016
by Gary A. Enos, Editor
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A number of factors, of both the clinical and systemic variety, can contribute to an initial treatment visit eventually becoming several. A plenary luncheon presenter at this year's Aug. 18-21 National Conference on Addiction Disorders (NCAD) in Denver will convey to substance use treatment providers that understanding patients' relational struggles can lead to breakthroughs that empower patients and prevent repeat treatment admissions. She will emphasize that patients can learn to overcome problematic patterns in their relationships.

If a treatment stay fails to address these concerns, “We're throwing them back into their primary wound” post-treatment, says Lori Jean Glass, executive director of clinical operations at Five Sisters Ranch in Petaluma, Calif. Five Sisters Ranch offers 12-day intensive programs that work with no more than six women at a time, focusing on core issues such as love addiction, love avoidance and codependency.

In an Aug. 18 talk titled “Relational Freedom—From Attachment to Addiction to Recovery … No More Crazy Train!”, Glass will discuss ways to help patients explore their problematic relational patterns and develop a healthier voice in their relationships.

She says it is common for individuals who present for treatment to be dealing with multiple problems such as love addiction, sex addiction and codependency (“a lot of clients have three or four at the same time,” she says). The focus in Five Sisters Ranch's treatment does not center on labels but on being freer in a relational sense in general—giving patients the tools to become comfortable with what might ensue in their relationships and to know that they will be all right in facing these situations.

Patients at Five Sisters Ranch work on creating a relational timeline that can help reveal recurring patterns in their close relationships. “The pattern that gets in the way, they need to come to know that better than they know their Social Security number,” says Glass.

Think more broadly

Patients' attachment styles and their impact on wellness often do not get addressed in substance use treatment programs that are structured around talking mainly about the drug, says Glass. In trainings that she has conducted at addiction treatment facilities, she says she often has asked clinicians, “If you told yourself it was not about the drug, what would you be talking about?”

It often will be found that the drug of choice represents the coping mechanism for something deeper. Glass encourages substance use professionals to position themselves to be more curious about what that underlying issue might be.

This of course can be difficult to achieve in challenging work environments where getting paid trumps all, and sometimes the additional sessions that a professional knows the patient needs cannot be delivered. Five Sisters Ranch's ability to work with no more than 6 women at a time allows the clinical staff there to “see things in slow motion” with its patients, Glass says.

She encourages professionals who work with patients who have experienced relational trauma to increase the number of clinical encounters in a typical week, even if they have to be for relatively short bursts of time. This way, “They don't feel abandoned,” Glass says of patients.

A facility website description of Five Sisters Ranch's approach states in part, “We focus on increasing self-esteem, identifying and upholding healthy boundaries, and recovering from shame. The educational part of our programs demystifies the labels and helps restore each woman back to her authentic self.” Elements of the Five Sisters Ranch program employ yoga, equine-guided recovery, healthy eating, and use of music and sound to facilitate change.

Glass brings a positive perspective to her talks, encouraging a new approach to language in treatment but never telling the audience what terms not to use with the patient. She might instead urge professionals to consider using “and” statements in place of “but” language in their dialogue with patients.

She adds, “I often tell young clinicians, 'If you want to be a great clinician, get a coaching credential. What you're doing is you're coaching people into health.'”

Main takeaway

Summarizing a main theme for attendees of her conference session, Glass says, “My hope and experience is that they walk away with a stronger sense of self. Many of them get so busy with work themselves, that that's their own coping skill. I want to give them a nudge to continue to take care of themselves.”

On the week Glass was contacted by Addiction Professional for this article, Five Sisters Ranch was preparing for the rollout of intensive workshops for men, a component that is scheduled to be launched by the facility in late June.


Join Us

Lori Jean Glass will deliver a plenary luncheon address on “Relational Freedom—From Attachment to Addiction to Recovery” Aug. 18 at the National Conference on Addiction Disorders in Denver. For more information, click here.