John Harden – Sadly, addiction treatment clients who are involved in a traditional program may feel that it is just another form of punishment, not treatment at all. Treatment centers often reinforce that idea through “clinical over-reach,” insisting on highly restrictive care in practically all cases. However, NIDA estimates that 95% of treatment-seekers are clinically appropriate for care in an environment that does not require confinement or intense restrictions. Clinical over-reach (too much intensity for too long) also damages the therapeutic bond that addiction professionals know is the best predictor of a good treatment outcome.
Dignity can be and should be promoted, even in a court-involved case. For instance, Florida’s compassionate Marchman Act allows for “involuntary treatment” outside of locked or inpatient programs. In this way, the court becomes the “change agent,” promoting accountability and adherence to the treatment plan over a long period time (months) in a real-world setting. This approach affords the necessary time for lasting change to take root in the individual, promoting dignity and self-esteem. Compliance is usually very good and clinical outcomes are much better than those seen in short-term programs.
Unwarranted confinement is not a “best practice.” Neither are short, intensive approaches. Motivation for lasting change emerges over time through an engaging approach that promotes human dignity and self-efficacy, in a real-world setting. When looking for treatment, choose a provider who has a track record of engagement and who is not afraid to say that good outcomes take time.
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