27 ,May, 2019

Since posting the article “ Rehab Model Fundamentally Flawed” I have received a lot of feedback and in Part 2 I will address some of the comments and feedback.

The first issue that reared its head was the Article was nothing more than a promotion for 21Renew. I thought this view might be taken and that is why nowhere in the article did I mention 21renew or what 21Renew is all about. It is my view, and one of the main reasons I created 21Renew was the current Rehab Model of the Therapeutic Community (TC) overlaid by a version of the 12 Step Facilitation Program (TSF) is fundamentally flawed when it is promoted as a one size fits all program for people needing treatment for substance abuse issues. This model has its origins the 1950’s in the USA and still retains the underpinning foundation it was built on over 70 years ago. As I explained in the article the early members of Alcoholics Anonymous viewed recovery very much in black or white terms. There was no grey area or individualized approach. It was a one size fits all approach.

The model presumes you can treat everyone with substance issues in the same manner and this is just ludicrous. How can you have a functioning executive with cocaine issues undergoing the same learning program as an out of work long term heroin user? How can you have the same method of learning when there different learning styles for example,

a) visual,

b) auditory,

c) reading/writing, and

d) kinesthetic.?

Further, there are major differences in a client’s type, length and quantity of usage, background, education, family relationships, support structures, work opportunities etc. etc. etc. which makes a one size fits all approach unworkable.

Another comment was the article focusses on what is not working without providing any solutions. This is a legitimate comment abut the article and one that I will be in a position to provide evidence based research in the not too distant future.  

That said there are several key ingredients to a successful recovery from substance abuse and none more important than the client coming to an honest and sincere belief they can achieve recovery if they follow a certain path or plan. For this to occur the individual has to become engaged in the program and in the people delivering the program. Without this engagement the chances of success are limited at best. A strategy of program engagement based on discipline and penalties for non-compliance is destined to off-side a number of clients and they either leave the program or “tune out” to the learning sessions.

The TC/TSF model would have far greater success if they re-engineered the method of delivery of their daily programs and removed the penal type rules for many of the “so called transgressions” that currently invoke disciplinary action.

The other major initiative they could invoke is to better introduce clients to the 12 Step Model. Popular belief has it the 12 Step Model is a one size fits all solution. Nothing could be further from the Truth. The 12 Step Model is a “recovery supermarket” with aisles and shelves full of tools which cater for all types of learning styles and people with very different educational backgrounds. Finding the best solution for each client within the 12 Step framework will lead to a better client understanding and belief in this model being included in their recovery plan.

I would like to thank everyone who has taken the time to reach out to me over the article. The more we discuss and continue to question how we go about treating substance abuse the more informed the Recovery Community will be and this will lead to better treatment options and client outcomes.