Counseling
 

Hi - my AH, who just finished detox for the second time, is now on Antabuse and has a Naltrexone implant. Today is 8 days sober. He knows he needs to get set up with a counselor, and has the name of a Psychiatrist who specializes in Alcoholism and substance abuse.

Problem is, he went through counseling, group therapy, and intensive outpatient and it was all the same message. Everyone is pushing him into a religious-based program; even the counselor at the detox facility has told him he can't succeed unless he addresses his spiritual side. Now, he's convinced that seeing the Psychiatrist will be a waste of time because it will be the same old message. But, he knows he needs to see someone to address the depression that comes over him sometimes randomly. He has very intense feelings about religion and some of his beliefs may be viewed by some as being kind of out there, although he probably knows more about religion generally than most people. He's also worried that he may even be refused treatment if he doesn't participate in some sort of AA or IOP program. I don't believe that's the case, but the IOP program required him to go to so many AA meetings and if he decided not to go to write an essay as to why.

I told him he should go to the psychiatrist and be upfront from the get go about his opposition to any kind of faith-based recovery program. Has anyone else figured out a way to address this? If this happens again, he won't go back.

The psychiatrist will likely ignore the person's 'spiritual' aspects and focus on their physical and psychological well-being, via medication.

If he is court-ordered, there should be secular alternatives offered in addition to the AA option, as many state courts have ruled that AA constitutes a 'religious organization'.

See Maryland v. Norfolk (Md DistCt, No D713675 (1989), Granberg v. Ashland County (590 F. Supp. 1005 [1989]), and Griffin v. Coughlin (88 N.Y. 2d 674 [1996])

If he is voluntary, then he'll simply have to locate a secular program.

Echoing Oberman, the psychiatrist would likely be more sympathetic to an "alternate" belief system than "certified addiction counselors" who tend to be indoctrinated solely in the dominant recovery program. A shrink (an MD) will likely look at a much bigger picture.

All that aside, there is a lot to be said for social support. If he can find a way to navigate around other people's beliefs, he might find such support valuable, even though it's rooted in a recovery program that is not a good match for him personally.

It is ok to "interview" councilors and psychitirsts before comitting to a "relationship" with them. I went to two different psychirists and 3 different psychologists before I found ones that worked within my belief system. They are out there. It's ok to ask what kind of recovery models they work with, even before you make an appointment. The important thing is that your husband not let this be an "excuse" to avoid getting help. He may have to work a little harder to find the help he needs, but it is out there. Good luck. Take care.

Tyler is absolutely right. Just be up front and tell them about your husband's concerns. They should accomodate him, and not force an agenda.

Sorry, jumping in late on the thread.. but in my exerience, I was very up front about my spiritual beliefs and feelings about more traditional spiritual based approaches, with my counselor. I let him know the foundation that he was working with, and as he was trying to help me, he respected everything I told him I believed or didn't and tailored our work around it. HOWEVER.. I hope your husband isn't using this little wedge as the reason he's not getting into counseling, cuz I did that one too..but that's on him, not you.

I would be surprised if a psychiatrist specializing in addictions mandated AA as part of "his program". I would look over this guide provided by the National Institute on Drug Abuse entitled "Principles of Drug Addiction Treatment: A Research Based Guide ":

Principles of Drug Addiction Treatment


The guide is written off of solid research and is pretty clear on a few points:

"No single treatment is appropriate for everyone. Matching treatment settings, interventions, and services to an individual's particular problems and needs is critical to his or her ultimate success in returning to productive functioning in the family, workplace, and society." and "Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. To be effective, treatment must address the individual's drug abuse and any associated medical, psychological, social, vocational, and legal problems. It is also important that treatment be appropriate to the individual's age, gender, ethnicity, and culture."


The guide can be downloaded and printed in PDF format. If he would feel more comfortable, your AH could bring it in with him to the appointment with the psychiatrist to "show" him that he doesn't have to do AA in case for some reason the psychiatrist is unwilling to listen to him. However, a better course of action would be to change psychiatrists if that happens. I think a reason that people push AA is that it is long-term and free. Studies show that long-term treatment is almost a necessity for success, so if your husband is unwilling to do AA, he must be willing to do some other form of long term therapy or recovery which can take many forms and does not necessarily have to be a group.

Spritual doesn't have to mean religious.

Btw, I'm not saying that if he doesn't address his "spritual side" he'll fail. Sometimes change is good though.

Never could understand the religious/spiritual stuff. Too lofty for my chicken brain.

For me, I see human thought about human beings as divided into two categories: 1) Magic; 2) not Magic. I don't think that human beings are the product of magic. So "spirituality" flies right into the domain of fiction, where I enjoy it immensely and even learn some things. :)

Religion and spirituality are different. Religion being connected with only one form of spirituality among many.

Synonyms for spirituality = evolution, choice.

Hence spirituality has got so much to do with what we chose at any time as well as that we chose, choose and shall choose.

Incidentally the AA preamble used in the UK, states explicitly that AA is not religion based at all. We read it out every time we meet. (It is published in the U.S.)

Every single member has to translate everything everyone else says anyway, to work out whether or how much of it might be relevant to himself.

The power in all good recovery journeys is that they leave the member that independence.

Hoping your H finds one that is OK for him, and/or that he finds plenty of essay material.

How my wording arose is, that the topics in question had already appeared in the thread (the thread should have been posted in another section of the forum) and I accessed it through 'new posts' not the main listing so didn't catch the preamble.