Connecting populations in need with the professional services and treatment that will help them to get back on their feet and start living a life characterized by balance is the focus of a social worker. A rewarding job on its best day, helping patients who struggle with homelessness, mental health disorders, legal problems, family issues, trauma and/or addiction is not without its challenges.
With some patients, it’s a relatively simple fix: help connecting with legal assistance to maintain parole or probation requirements, a referral to a free or sliding scale medical clinic for health care, or enrollment in a skills-building and resume workshop to connect with employment. But for other patients, especially those who struggle with mental health issues as well as substance abuse, the course to recovery is far steeper.
Jacqueline Valencia Rodriguez, LCSW-R, is a social worker who provides substance abuse treatment and assistance to people in recovery from substance abuse in New York City and southern Miami. Through personalized case management, she has helped addicts and their families to make progress in recovery, helping them to overcome obstacles along the way. She has found that the most progress is made when she works to understand her patients on a personal level.
She says: “Treating the patient as though they are sick, versus ‘bad’ or ‘immoral,’ has been instrumental to allowing them to get well and heal.”
By treating patients based on their goals for the future as opposed to defining them by the problems they are facing in achieving those goals, social workers are instrumental in helping people to change their course and begin living the lives that they envision for themselves without drugs and alcohol.
The Goal of Social Work: Personalized Case Management
Personalized case management allows the social worker to aid the patient in connecting with exactly the right resources and treatment, if necessary. No two people have the same needs, even if they both struggle with similar issues (e.g., homelessness, joblessness, addiction, etc.) and may require different resources to assist them. As a result, social workers are tasked with getting to know their patients in a short period of time and then working quickly to connect them with the programs that have the resources – and the availability – to help them as soon as possible.
This often involves:
- Helping the patient to secure immediate basic needs (e.g., safe home, acute health care, job, aid if dealing with abuse, etc.)
- Meeting regularly with the patient to assess their needs and goals, and to determine whether or not the referrals and plans made to meet their goals are useful
- Meeting with family members of the patient and assisting them as needed
- Helping the patient to choose short-term and long-term goals that are achievable and then creating plans to meet each one
- Helping the patient to meet the requirements of other legal agencies as needed (e.g., parole or probation requirements, requirements of the court, etc.)
- Helping the patient to address chronic health issues, including drug abuse or addiction
The more detailed and specific the social worker’s understanding of the patient’s individual needs, the better able she will be to address those issues and help the patient to create a plan to stabilize in recovery.
The Benefits of the 12 Steps
Though each case is different, there are some services that have proven to be helpful across the board. For example, psychotherapy can be helpful in aiding the patient in adjusting to their new life in sobriety, providing them with a forum to work through issues and co-occurring mental health disorders that may have initially informed their addiction. It also offers them the ability to seek immediate guidance in addressing emotional and psychological issues as they arise and learn how to deal with triggers to relapse in a way that is progressive and healthy. Similarly, group therapy sessions that focus on a specific challenge common to the group (e.g., dealing with a chronic illness, learning how to avoid relapse in recovery, and healing family relationships after addiction) are also an excellent option for many patients.
Rodriguez says that 12-Step groups like Alcoholics Anonymous and Narcotics Anonymous have helped to provide her patients with structure as well as support in recovery that has been instrumental to their abilities to stay connected to their sobriety and continually progress.
Says Rodriguez: “As a substance abuse provider, I have found it extremely helpful to my patients and their families, to refer them to 12-Step recovery support groups in conjunction with psychotherapy services.”
The fact that 12-Step meetings are available all throughout the week in a number of different locations at all times of day all over the country means that many patients have the option of attending meetings daily – or even more often – if it helps them to stay sober. It can also help patients as they transition from inpatient or intensive outpatient addiction treatment services into a sober living or independent living situation as they maintain continuity of care. The principles and ideas underlying 12-Step meetings in a drug rehabilitation program are the same as the principles and practices of 12-Step meetings out in the community, which can help patients as they begin to build new lives for themselves on their own.
Family Support and Therapy
The support of other members of the family can play a huge role in helping the addicted person to stay on track during treatment and beyond. However, it’s important for the family members to have the support they need so they can be of assistance while also addressing their own difficulties in living with a loved one’s addiction. Not only should they seek out treatment and healing on their own (e.g., address their own mental health issues that are perhaps related to the issue of the family member’s addiction, create and work toward their own personal goals, etc.), but it is also recommended that family members work together with the addicted person to learn how better to communicate with each other and get personal needs met going forward.
Says Rodriguez: “I have found that providing family and couples counseling to patients, while encouraging 12-Step healing work has been the best form of treatment and shown the highest rate of remission. The family work in therapy as well as Alanon 12-Step group therapy for family members has been what really helps addicts and alcoholics heal long-term.”
The more support that family members have in understanding the addiction issues facing their loved one, and what treatment and recovery can and should look like, the better able they will be to avoid enabling behaviors or inadvertently create new triggers for the person in recovery.
Additionally, meeting with other people in the 12-Step setting who are similarly living with and attempting to support recovering loved ones can give family members a wider frame of reference, reinforce the fact that they are not alone in this hugely difficult situation, and provide them with a forum to share while also learning from the experience of others.
Obstacles to Recovery: Paying for Treatment
One of the biggest challenges that Rodriguez and other social workers face in their work with addicted patients is helping them to connect with the treatment services that will enable their recovery without wiping out their bank account – especially if they don’t have a bank account to speak of. Treatment can be expensive, and state-sponsored addiction treatment programs may be minimalist at best. Also, long waitlists and short-term treatment periods can put a person who is ready to fully embrace recovery in jeopardy when they don’t get the amount of support they need when they need it. Unfortunately, health insurance policies are often of little assistance, even when a patient has insurance coverage.
Says Rodriguez: “According to the patients I have worked with, they report that their insurance carriers have been negligent in assisting them in obtaining long-term care. They end up having to pay out of pocket, which is a fortune for many, and if your income is ‘too high’ or ‘too low,’ insurance plans won’t pay for more than a two-week stint in rehab.
“Sadly, this has just not been proven to be enough time to truly make a difference in an addict’s life and long-term recovery lifestyle. Insurance plans have truly stifled the ability of a person in recovery to obtain the needed help they deserve. That has been the most frustrating piece of my work with people in recovery and betterment.”
Without more time to focus solely on recovery and healing, patients often struggle with trying to stay sober alone while also struggling to deal with the same issues that may have originally driven their use of drugs and/or alcohol – for example, securing and/or maintaining employment, finding a safe and sober place to live, or maintaining legal requirements.
Says Rodriguez: “They don’t get the long-term care they need to obtain the necessary instruments and tools to achieve long-term sobriety. That’s when we see the high recidivism rate with addiction, when the symptom has not been treated properly.”
Building a Future in Recovery
Patients often work with social workers for a short time at the beginning of their journey in recovery. The resources provided by this unique substance abuse treatment relationship can enable the patient for success in recovery and every aspect of their lives. It’s one of many options for patients and their families as they seek out the changes that will help them to improve their lives and learn how to function healthfully at home and out in the world as well.