For many of the individuals in long-term recovery with whom Terra Holbrook, MSW, LCSW, CADC, works, a recurrence of substance use no longer seems to represent the greatest threat to their personal well-being. Instead, many of Holbrook's clients go to her believing that while they have mastered the basic skills they practiced in early recovery, they are still left wondering about their lives, “Is this all there is?”
In a plenary presentation Aug. 17 on the first full day of the National Conference on Addiction Disorders (NCAD) in Baltimore, Holbrook will discuss clinical strategies for moving from stabilization to self-actualization, in a session titled “Stage 2 Recovery and Beyond: Setting the Foundation.”
“There is so much more to life outside of the rigidity of a program,” says Holbrook, a former director of clinical services at The Bridge to Recovery who operates a newly established private practice in Astoria, Ore. “The 12 Steps are beautiful and wonderful. They are great for stabilization.” However, “The second stage of recovery is a recovery of self, a connection to self.”
Holbrook, whose practice is called SeaGlass Intensives and Consulting, recalls a recent conversation with a patient whose sponsor had told her to address a stressful time in her life by doing a Fourth Step, a searching and fearless moral inventory of self. Her only thought at the time she heard the advice was that going through this process once again would make her scream.
Describing the stages
Holbrook describes her vision of Stage 1 recovery as the learning of the basic skills necessary for everyday living. These can be as seemingly simple, though not always easy to master, as consistently being on time for appointments and maintaining good hygiene and other personal habits. “This is about settling the brain down, getting the brain back on line,” she says.
Stage 2, on the other hand, involves stepping beyond the lines of early recovery and recapturing the self and spirit, Holbrook says. Her talk at the NCAD meeting, produced by the Institute for the Advancement of Behavioral Healthcare (publisher of Addiction Professional), will assist clinicians in understanding these phases and the importance of looking beyond simply calming the brain.
“Sometimes we don't understand the depth of healing that needs to happen with the addict,” says Holbrook.
Patients and clinicians both can be guided for so long by a constant fear of relapse that they lose sight of issues of identity, deeper healing, and life fulfillment beyond that, Holbrook suggests. She does see some signs of progress in the treatment field on this subject.
“Trauma-informed care is attempting to look at treatment beyond the settling of the brain,” Holbrook says. Insurance restrictions continue to pose a barrier to more comprehensive care, however, she adds.
Also among the goals of Holbrook's NCAD presentation will be to help attendees formulate a plan that addresses the objectives and challenges of lifelong recovery. These messages will apply equally for non-recovering professionals working with patients and for those struggling with aspects of their own recovery, she says.
The process of moving from first- to second-stage recovery does not always occur in a linear fashion. “It unfolds over a lifetime,” says Holbrook, as it becomes intertwined with commonly experienced life changes that alter one's relationship with self and others.
She adds that clinicians need to be reminded that even when a patient proceeds to Stage 2 recovery, the threat of a return to old behavior patterns remains.
“The [addicted] brain is different, and the professional must take that into account,” says Holbrook, who also will present a breakout session on Stage 2 recovery in women following the plenary talk on Aug. 17. “They have to remain aware of the addiction and how it still plays out over a lifetime.”
Terra Holbrook will deliver a plenary presentation, “Stage 2 Recovery and Beyond: Setting the Foundation,” at 12 noon Aug. 17 at the National Conference on Addiction Disorders (NCAD) in Baltimore. For more information on the Aug. 16-20 conference, click here.