Confused about halfway house/aftercare post residential treatment

[in a daze]

So my difficult child is presently at a dual diagnosis residential treatment center, and is tentatively scheduled to be discharged on Thursday, day 21, although they are going to ask for more additional days from insurance. Because his counselor has been gently trying to persuade him that he needs aftercare (he finally agreed to this last week) plans are still in flux. We liked one program, but difficult child has heard negative input about it from other residents (bad neightborhood, etc.) Checked it out with the staff who say area is safe, on fringe of well to do suburb and clientele is diverse. My cousin the licensed social worker has sent patients there and says the program has a good reputation. It has a dual diagnosis PHP program and focuses also on life skills, which he needs very much. Another program not much information about it, he has appointment 3/19 before they will even put him on the list.

So do people go to the halfway house and go to a PHP program on the outside? Do they take the bus if they don't have a car? He has bipolar disorder which fueled the substance abuse, or maybe the orther way around, who knows, resulting in 3 hospitalizations in 3 weeks. Any information you can provide would be so helpful.

 

[Nancy]

You ask very good questions. I remember when we were going through this we had no idea what to expect and had to learn along the way. I'll tell you how it is done here and I will admit we have some very good options that many cities don't have.

Most substance abuse treatment centers will release you to either a halfway house, also called a sober house, or an intensive outpatient program (IOP). Much of it depends on your insurance or your financial situation and also on your individual situation, whether you are working and your employer requires a certain program or if you have a job and need to get back to work, etc.

The sober houses around here work in several different ways. If your inpatient treatment was extensive (60-90 days) you may be able to go into a three-quarters house where you can get a job right away, attend AA?NA meetings, group meetings, counseling, etc around your work schedule. Most often you enter a sober house where you attend meetings all day and slowly phase into looking for a job or going back to work. Twenty-one days is very short for treatment so around here you would enter the most restrictive aftercare so that treatment is uppermost and you are not thrust back into the envrionment before you are ready.

My daughter was in a substance abuse treatment center for 60 days and then entered an IOP for two months where she went to group counseling four days a week fours hours a day. She relapsed almost right after being released. She ended up in a halfway sober house where she attended meetings/counseling all day every day and was not allowed to look for a job for three months. Once she got a job she attended meetings after work and continued to have group sessions with the other house residents. She could stay in this house for as long as she needed. The cost was very reasonable, $400 a month. They cooked their own food and everyone had a job. They got many food donations from the community. Family could only visit on Sundays.

Some of the men's sober houses around here are split where you stay in the more restrictive environment for about 6 months and the move to a house with several other men and work and begin getting back into the community. It usually works on a sliding fee schedule and they do not turn anyone away if they have no funds. Again I say our city is very fortunate, with the number and variety of aftercare programs.

Most of these places are located in the city, on the fringe. There are several reasons for this, they need to be on the bus line for people who do not have cars so that you can get to meetings and work. Also the suburbs do not want these centers in their area and it is too expensive to locate there. It's a shame because I have never known any problems to come from any of these places and in fact the residents are very community minded and give back in many ways both in services and support.

One of the philosophies of treatment is that you give back, so that when members are in recovery for a certain amount of time and they have their own car, they are encouraged to drive other residents to meetings and to help those just coming into recovery. I can tell you that the support they give each other is unlike anything I have ever seen.

I would not be concerned about the area the center is in, they take care of each other and I would trust your cousin.

If you have any other questions I would be happy to try and answer them.

 

[in a daze]

Thanks, Nancy, very helpful. He needs more than substance abuse counseling which is why I was looking at the dual diagnosis programs...I suppose if he went into a sober house he could commute to a IO program. Found one in the city which is in walking distance to a halfway house we were looking at.

And what about a car? Some of these are way out in the suburbs and it would seem a car would be mandatory if one was to go to work, but I wouldn't trust my son with a car because I could see him going out to visit his old friends. Would prefer in the city with bus/train service.

 

[Nancy]

Some sober houses do not allow the residents to have cars in the beginning. My difficult child was not allowed until she graduated the three month program and got a job, which could be longer than three months depending on progress. The sober houses around here include IOP's. They have very extensive counseling and substance abuse and life skills training. You don't just live there, you really WORK at staying clean and sober. In all honesty they are far more involved than the IOP my daughter was in. I am sure some sober houses have their residents transported to outside IOP, but ours are mostly all inclusive.

I would not have wanted my daughter to have access to a car when she first entered either. It is best to ask a lot of questions to any aftercare program you are considering so you know exactly what their program consists of.

 

[Kathy813]

My experience is a lot different than what Nancy described. For one thing, the sober houses here are much more expensive. In Atlanta, good ones run $1800 a month and that does not include food. My difficult child managed to find a much cheaper flop house where unbeknownst to us, she continued to drink, use drugs, and moved on to harder drugs. This was after a 30-day inpatient rehab.

This last stay was in a 90-day dual diagnosis treatment center in south Florida. It was worlds away from the first rehab and was very costly. My difficult child was required to get a job while she was still in-patient and is about to be discharged. The Residential Treatment Center (RTC) recommends sober houses from a very short list and my difficult child will be moving into one of them on Friday. It will cost $860 a month which is one of the cheaper ones on the list. She will be allowed to have her car so she can get to her job. I haven't talked to the director yet but I know from the Residential Treatment Center (RTC) that the sober house will require meetings and drug testing while she is there. My difficult child will continue her out-patient care through the residential treatment center 6 - 9 hours a week.

There was a guest speaker when we were at the Residential Treatment Center (RTC) for the family therapy weekend. He was a 24-year-old former client who has done great since his stay at the Residential Treatment Center (RTC). He he had been using every drug known to man and has been clean and sober for 2.5 years. While he credits the Residential Treatment Center (RTC) for saving his life, he says the stay at the halfway house for 6 months made it possible for him to continue to stay clean and sober until he was ready to make it on his own. So a good halfway house is critical for success and a bad halfway house can made things worse.

So I guess the answer is that there is no one answer. I do know that you have to trust the people that recommend the sober house and that your difficult child will probably not like the ones that they recommend because he will not like the restrictive nature which is exactly what he needs.

~Kathy

 

[PatriotsGirl]

Yes, every place is different. The place in Atlanta that my difficult child found was 125 per week and that did not include anything. She was expected to find a job right away and attend meetings when she wasn't working. There was always a lot of meetings and they did drug test. The place was cheap and no Ritz Carlton, but it was a sober, supportive environment for those who wanted a sober life. I would not recommend this place to anyone that is being forced to go through treatment, however. There was nothing holding them there and I don't think there was supervision during the day. The place would have worked just fine if it was truly what my difficult child wanted. I think she wanted to strike a deal to see her boyfriend in jail, didn't expect to stay in treatment as long as she did, and left right before she reached 30 days.

My brother attended rehab and then lived in a halfway house for at least two years before moving on his own. All his own decision and he is still clean and sober today. Won't even touch a drink, pot, anything. I couldn't be more proud of him but he has really cut off contact from the rest of the family and I don't talk to him very often...

I honestly feel sober living offers the best chance of staying sober after rehab...

 

[Nancy]

Sober houses are not lockdown facilities. They are places to live usually run by former addicts/alcoholics in which the resident is slowly acclimated back into society while at the same time learning how to live a sober lifestyle. They are not for profit, they charge the minimunm to take care of rent, utilities, food and meetings/group expenses. You can walk out any time you want, and some do. You can also be kicked out for not following the rules or using. Depending on the director they can be very restrictive to quite lax. I belong to a support group that is connected to one of the best men's halfway houses in the area. They have wonderful support from the community. Some residents are court ordered. They go in kicking and screaming. Some leave and then the courts follow through with whatever sentence they would have gotten. Some get clean even though they are ordered there. There are no bars to keep them in, other then the consequences they face upon leaving. Some of the local professionals in the city have gone thorugh this place and come back to talk with and support the guys on a regular basis.

The true halfway houses, the more restrictive living environment before you step down to a regular sober house, do not want you to have a job when you first enter because many are either coming off the street and this is their only treatment or they are coming from short term treatment centers. You can't learn how to live sober until you are sober and that doesn't happen in 30 or 60 days.

In our support group we have many men recovering addicts who come to our meetings and tell us ver and over that they were in some of the most expensive treatment facilities around until they entered the halfway house with other addicts and wanted to change and had the support of each other. One person told us how he was in one of the most exclusive treatment centers in Boca Raton for 9 months and he used as soon as he got out. It wasn't until he came here to the halfway house that he got it.

The halfway house my daughter was in is an old nuns convent connected to one of our catholic churches. It housed 24 women and they truly lived sober including shopping for their groceries and cooking for all the women. They were required to volunteer in the community. They believe that you cannot hold a job and devote yourself to the program and to learning how to make a sober support group at the same time. The rent was reasonable because it is non profit. Most of these facilites are in old factories or businesses in the city that have been abandoned and donated. They receive furniture and appliances as donations. I would be very leary of a place that charged a high rent. But then the cost of living here is much more reasonable than other cities.

Perhaps there is a larger distinction between halfway houses and sober houses then I originally described. Sober houses are usually a normal house where only 4-6 people can live. The residents there must have a job and pay thier own expenses because they are deemed ready to live and interact in society without the same restrictions of the halfway house.

AA was formed here in our area by Dr. Bob and Bill W. I believe we have some of the best facilites for recovery anywhere around, but not the most expensive ones. My difficult child was in a treatment facility in our city that cost us $25,000 out of pocket for 60 days. She found a way to break every rule in the place, had sexual contact with other residents, male and female, never did commit to recovery and looked for any way out. Fortunately she did not use while in there but most of the other residents did. It is very well thought of in the medical community but ask those in halfway/sober houses and they will tell you it was a farce.

 

[PatriotsGirl]

Oh yeah, that is another thing that really chaps my cheeks when it comes to recovery places - there are FAR more for men than there are for women.

 

[Nancy]

I agree PG.

 

[toughlovin]

We have had a lot of experience with a variety of sober houses.. the rules differ and how much they are invovled with the residents differ, size differs. One thing to know is that other addicts live at sober houses... and so if the place is real lax it may be a place that has drugs... shouldn't be but could be. My son has been kicked out of several for using.... and some of the time he got the drugs while there. And yet good ones will be very clear and very firm about their standards.

The one my son is in now is quite a bit more expensive but it is also smaller than the others, has great counselors there. They also buy all the food because they found there was less conflict between residents when the food was all purchased by the house..... the guys do cook their own meals though. My son does have a lot of freedom but and feels that the managers are more understanding.... but I think they do a good job of making sure the guys are clean... and if they are not they are kicked out immediately. That is made very clear.

So things to look for... definitely should be single sex, should be small (there are some huge ones out there), should have options for treatment/meetings and definitely should be recommended by the treatment center. I dont think sober houses are regulated and there are definitely good ones and bad ones out there.

And yes it makes a huge difference if the person wants to stay sober.... and they need to be willing to follow rules.

TL

 

[Kathy813]

Well, here's how NOT to pick a sober house. . .

Today, during our family therapy call we were discussing our concerns about difficult child's discharge on Friday. I mentioned that she had told us when we were there for the recent family weekend that she had never intended to stay sober after her last stay in rehab. She ended up in a "halfway house" that was really a flop house.

The therapist asked difficult child how she found that halfway house and difficult child answered "Craig's List."

:wildone::wildone:

~Kathy

 

[Nancy]

Hahahaha that is so funny and so my difficult child!!!!!!!

 

[rejectedmom]

When my son was discharged from rehab he was given an IOP and a social worker. If you do not get that go to the MHMR office nearest to where your difficult child is going to be living and have them do an intake and evaluation. There are alot of support services out there if you are willing to do thefot work. Of course in the end it iis all up to your son to be sucessful. -RM

 

[in a daze]

Thanks, everyone. Called difficult child today. Said he didn't know where he was going, would call back with the information, then cut me off "I gotta go now". My therapist says he is probably angry because he can't manipulate us anymore. Put in a call for the counselor. He was supposed to be discharge tomorrow, so I was kind of very anxious because I work tomorrow, would be difficult to arrange transport, but they must have gotten more days from the insurance as his counselor said they were going to do (it is a 28 day dual diagnosis program and he also has bipolar disorder, had a manic episode which put him in the hospital in January, besides the substance abuse).

 

[in a daze]

Thanks, everyone. Called difficult child today. Said he didn't know where he was going, would call back with the information, then cut me off "I gotta go now". My therapist says he is probably angry because he can't manipulate us anymore. Put in a call for the counselor. He was supposed to be discharge tomorrow, so I was kind of very anxious because I work tomorrow, would be difficult to arrange transport, but they must have gotten more days from the insurance as his counselor said they were going to do (it is a 28 day dual diagnosis program and he also has bipolar disorder, had a manic episode which put him in the hospital in January, besides the substance abuse).

So turns out he is going to the place he didn't want to go to that we wanted him to go to in the bad neighborhood ( not really that bad according to my sources). Somehow, he agreed to sign. He is being transferred a week from today. Counselor said they put in for more days from the insurance, then he can go straight from Residential Treatment Center (RTC). I was worried about that.

We hope to keep him in some kind of transistional housing for a year. We own this condo that he was staying in before he went into the hospital (he lived there for only 2 weeks). I think he would like to go back there sooner, but i'm thinking it's not a good idea.