Topic: compliance and noncompliance
In their eagerness to reduce the size of government, states have stripped away staff who would otherwise make onsite visits to ensure compliance.
An important step that programs often skip: the collection of baseline data. Improvements are often incremental, and if you don’t know exactly where you started, it’s easy to miss them.
In his review of long-term outcome studies involving both alcohol and heroin users, Vaillant noted the inspirational aspects of such participation.
“You don’t see much motivation or insight. But I guess that’s why they have to be compelled in the first place, right?”
I’ve never had much success explaining to a patient in the first 30 days of recovery that when Bobby smokes dope, it’s medicine, but when Liz lights up, it’s drug abuse.
If you’re not careful, the whole thing turns into an endless game of cat-and-mouse, that leads nowhere.
Clients who struggle to stay drug-free can resent the presence in group of others who openly use substances.
Most people in stable recovery got there the hard way, through major alterations in the way they live.
We spend a great deal of time in treatment seeking to increase patient motivation, but these programs do not rely on a motivated patient.