Rehab, Relapse, Repeat (Lindsay Lohan, Take Note!)
Gustafson says there also should be a seamless transition between different stages of care—from detox into a residential program, for example. And people need access to various services during and after treatment, such as protection from an abusive boyfriend or transportation to and from a group meeting.
Carise has developed a computer program that gives counselors easy access to those needed "wrap-around" services. Entering a few keywords and a ZIP code might yield info on where to take the GED in Spanish. One patient couldn't make it to a regular family support group because he had to watch his Alzheimer's-stricken mother; the software identified three local groups dedicated to caring for Alzheimer's patients while their caregivers were getting other human services. A study published in 2005 found that patients counseled with Carise's program had better matches for the services they needed, and were more likely to finish treatment, than patients counseled using standard methods.
Addiction researchers are also struggling with how to define "success" or "recovery" in the context of rehab. Historically, the benchmark has been total abstinence from drugs and alcohol, says Carise, a definition that doesn't take all factors into account. Consider a former heroin addict and alcoholic who is HIV positive and doesn't have a job. After treatment, perhaps, he has stopped using heroin, has a job, has his infection under control, and occasionally drinks a beer when watching a football game. "While I hope that he doesn't drink," says Carise, "I don't see that guy as a failure."
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