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Expanding Americans’ access to substance abuse treatment is only one piece of addressing addiction as a public health issue. Another very important piece is persuading those who have been able to access medical care and enter a drug or alcohol program to complete their treatment. For those who leave treatment early and “Against Medical Advice” (AMA), and for their families, the fall-out can be heartbreaking.
That’s why it’s so essential for families to know how to encourage a loved one to stay in treatment. Here are some tips that can help family members respond in situations where a loved one may be leaning towards discontinuing medically advised treatment and has called home with intent to leave treatment AMA:
Be prepared that the first 72 hours of treatment are often when your loved one is most susceptible to leaving treatment and when you are more likely to get a call.
Their mind and body are still adjusting to a life without drugs and alcohol, and their new structured, substance-free environment may give rise to impulsive and irrational decisions. When a client in these circumstances requests discharge, a team of clinicians and support staff will meet with the client to discuss their issues and concerns. If a client is still intent about signing out of treatment, that’s when their family may receive a consult call before the client signs out.
Don’t enable a loved one’s intention to leave treatment with any money, assistance or incentives.
Don’t offer to buy a flight home for a loved one who at one week into treatment is telling you they’re homesick: that’s only more of an incentive to leave. Don’t send them money either. Money can be a huge relapse trigger and can give an individual the means to leave when they are feeling impulsive. If a client truly needs money, consult with the individual‘s therapist to determine the best way to provide financial support.
Encourage your loved one to wait just a few more days before deciding to leave treatment.
A lot can happen in just a few days. Someone who today is struggling to adjust to a new rehab setting and to coping without drugs and alcohol may be in a totally different emotional state three days from now. Try to buy your loved one more time. More time may be the very thing that keeps them from making a rash decision they’ll soon regret.
Own your responsibility to exercise clear, healthy boundaries with your loved one.
Sometimes family members in these situations will want to deflect their own responsibility to exercise clear, healthy boundaries. They’ll do this by making definitive statements about a loved one. Statements like “She is so stubborn and will do whatever she wants no matter what I say” or “He is incapable of changing, no matter how hard I try” can only reinforce a loved one’s sense of futility about treatment and why leaving AMA is better than staying.
Here are some other shorter but equally helpful pointers to keep in mind when a loved one volunteers they’d like to leave treatment:
- Consult the clinical and medical staff, especially your loved one’s therapist and the clinical director. They also have your loved one’s best in mind.
- Use positive language: “You can do this,” as opposed to “Don’t fail.”
- Separate your decision to encourage a loved one to stay in treatment from the emotions you may be experiencing when you say, “I love you but I will not assist you in leaving.”
- Encourage your loved one to be solution-oriented rather than problem-focused.
- Try to give your loved one the bigger perspective about what leaving treatment AMA will mean for them in the way of consequences.