Professionals

Checklist of Symptoms Leading to RelapsePremium Content

While each individual must maintain the disciplines that insure sobriety, there are ways in which others can help. Nearly every person close to the addicted person is able to recognize behavior changes that indicate a return to the old ways of thinking. Often these individuals and fellow Christians in Recovery® members have tried to warn the subject, who by now may not be willing to be told. He may consider it nagging or a violation of his privacy. There are many danger signs.

Most addicted people, if approached properly, would be willing to go over an inventory of symptoms with a spouse or other confidante. If the symptoms are caught early enough and recognized, the addicted person will usually try to change the way they think, to get "back on the beam" again.

A weekly inventory of symptoms might prevent some relapses. This added discipline is one that many addicted people seem willing to try. The following list can be used by spouses, close friends, or the addicted person.

1. Exhaustion: Allowing yourself to become too tired or in poor health.

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Professional Distance in Addiction CounselingPremium Content

Sooner or later, every counselor will face the fact that he or she is not able to help everyone who becomes involved with their program. Recovery programs can have a very high turnover rate among their residents. Among rescue mission workers, some have reacted to this situation by becoming discouraged, "burned out," or even skeptical about the chances of any homeless addict "making it."

Why Professional Distance is Needed
Often, when people first hear the term "professional distance", they think it means are to be cold, unloving and uninvolved with those we counsel. Actually, it is just the opposite! Over involvement on an emotional level causes counselors to lose their objectivity. They cannot exercise proper judgment in their dealings with those with whom they are seeking to help. Instead, counselors can practice favoritism toward some residents and even end up feeling rejected by them when they don't respond favorably to their attempts to help them.Mostly, a lack of professional distance is manifested when workers have an improper sense of responsibility for the actions and decisions of their clients. And, it is important to remember that, since so many of those we work with at rescue missions have a background of addiction and codependency, they know how to make others feel guilty about not "taking care of them."Mission workers must be committed to being part of the solution and not a part of the problem. Their own unresolved issues will inevitably hinder their ability to minister effectively to others.

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Client's Boundaries and RecoveryPremium Content

In our two earlier installments, we highlighted the importance of counselors carefully guarding their own personal boundaries while working with troubled people. Respecting the boundaries of those we seek to help is equally important. Here are a few thoughts on the topic:

A. We must teach and model healthy boundaries

    People who grow up in dysfunctional families tend to believe that they are not allowed to have personal boundaries. Though abused and mistreated, they do not feel they deserve anything else. As mentioned earlier, a personal boundary is, essentially, the line that divides me from you. Without boundaries I can't tell what's my stuff and what's yours. Something as simple as saying "No" to drugs and alcohol - or to sin in any form -is a boundaries issue. To do so takes a commitment to caring about myself, while seeking to maintain a growing relationship with God. So, teaching and modeling healthy boundaries is vital if these folks are to begin the road to recovery.

B. "Fixing" vs. "Empowering"

    Healthy recovery can not happen until an individual is able to establish a program of "self-care." At the Pool of Siloam, Jesus said to a crippled man, "Rise, take up your bed and walk. " (John 5:8) In a very real way, this illustrates how we ought to minister to troubled people.

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Free Addiction Treatment is Available

Many people do not know what options are available to them when seeking addiction recovery treatment free of cost.

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Another Look at CodependencyPremium Content

Some who work in the recovery field are hindered in their efforts to minister to others because of their own codependency. Here are a few common symptoms experienced by these "wounded warriors":


Inability to detach. Staff members who lack personal acceptance and a good self concept tend to look to their clients for affirmation and a sense of worth. They take their work home with them and tend to feel terribly guilty and personally responsible when a client leaves the mission and messes up his or her life.

Caretaking & Enabling. They do not allow their clients to become responsible for their own actions and attitudes. Instead, they cover up for them, make excuses, and blameshift. By doing this, they become "enablers", allowing people then to stay in their sins, addictions, and other problems.

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Organizing the Addiction Counseling Process - Part 5Premium Content

Part 1 | Part 2 | Part 3 | Part 4

In our last installment in this series we discussed, briefly, the importance of meeting the needs of each individual in the recovery program. To do this most effectively, a process of documentation is essential, using paper forms or computer-based data collection. In residential recovery programs for the homeless, it is also important to adopt a team approach to working with our clients.


    A. Developing a system of documentation.
    The essential elements include:
      Regularly updated recovery plans/contracts
      Daily progress notes
      Summaries of one-on-one counseling sessions

    When all of these elements are in place, supervisors can get a good picture of what each counselor or chaplain is doing with each of the individuals with whom he or she is assigned work. Besides serving as a measure of job performance, proper documentation makes it easier for another counselor to step in and keep working with the client if that is necessary. Good documentation provides a permanent record that can be accessed if the individual leaves the program and returns at a later date. And, it provides valuable information that may be used by other ministries or agencies that work with the client in the future.

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Organizing the Addiction Counseling Process - Part 4Premium Content

Part 1 | Part 2 | Part 3 | Part 5

Most rescue recovery programs for homeless addicts have no trouble filling up their beds. Yet, it is better to have a smaller program with committed participants than to have a large one filled with people who are not serious about changing their lives. A well-organized long-term recovery program is -- "A planned, organized, and systematic delivery of services -- using both internal and external resources– with the goal of meeting the unique needs of each individual."

A 30-day "pre-program" can be instituted to serve as a trail period where prospective program members can demonstrate their commitment to recovery. Inevitably, this approach will promote stability in the long-term program by avoiding the turmoil that occurs when men and women come and stay for just a few days or weeks. A more consistent, serious group of people who can support one another on the road to recovery will surely develop.

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Organizing the Addiction Counseling Process - Part 3Premium Content

Part 1 | Part 2 | Part 4 | Part 5

Because they do not receive government and insurance monies, rescue missions that serve the homeless are not bound to strict time limits on the days of service they can render. There is no magic to 30-day, 90-day 120-day programs. These have always been set by the people who provided the dollars.

That’s why I recommend a program for homeless addicts that is based totally on accomplishing a set of treatment goals -- instead of one based on the calendar. Still, there are some special considerations for the first 30 days of sobriety to which we need to pay special attention. If we make a special effort to help a newly recovering people through them, more of them will stay around longer and go forward in recovery. A "pre-program" program has definite advantages.

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Organizing the Addiction Counseling Process - Part 2Premium Content

Part 1 | Part 3 | Part 4 | Part 5

In this installment, I would explore a very basic question; "Just what can we expect to accomplish in the life of a homeless addict during their stay at a rescue mission program?" The answer comes from recognizing some basic needs that need to be addressed so those we work can develop productive, satisfying sober lives.

The answer comes from recognizing some basic needs that need to be addressed so those we work can develop productive, satisfying sober lives. The goal of a written recovery plan is to set down these goals, in order of priority, and then develop a strategy for working through them while in the program. This plan, then, becomes the basic road map for the counseling process with the individual. Weekly one-on-one sessions should always begin with revisiting the written plan and discovering what progress has been made toward accomplishing its jointly agreed upon goals

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Organizing the Addiction Counseling Process - Part 1Premium Content

Part 2 | Part 3 | Part 4 | Part 5

In the past thirty years of my work, I have had the opportunity to visit many facilities that help the homeless. When I see a man in a recovery program I like to ask, "How is he doing?" I usually just get a pat answer like, "Well, he’s been with us for six months." The problem with this answer, of course is that a sober, healthy lifestyle is not automatically picked up just by hanging around the mission for a certain length of time.

The only way to really know is by keeping accurate written records that show how we are meeting the individual needs of the people in our programs. A formal needs assessment process is needed. The information that is gathered provides the foundation for a written recovery plan (or discipleship plan). The purpose of such a plan is to help program people think through their options, to identify their own needs, and to determine which specific actions they must take to get their needs met. To ensure maximum "buy in," the plan should be developed with lots of input from counselees themselves.

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