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Why Recovery Needs Healing Space

Addiction is a family disease. The Recovery Book advises family members of people in recovery that “Everyone in your family, as well as other people in your lives, has been affected by addiction in some way. Now you all need to work on getting your lives back to some kind of normal.”

Michael Arnold is a recovering alcoholic who now works as an alumni relations manager at the Harmony Foundation. In a recent Facebook Live with her twin sister, Michael and Casey talked about the impact Michael’s addiction and recovery had on their relationship. Both siblings demonstrated how important clear and honest communication is for the family dynamic.

Michael talked about the need to share with “brutal honesty what addiction can do to your family.” Casey talked about how hard it was for her to watch Michael decline in active addiction, realizing there was nothing she could do, that Michael had to save herself.

Michael recalls doing things to her family that “just weren’t nice.” Casey remembers all too well. Seven years ago Michael helped to put her twin sister briefly in jail—just to hurt her. Michael was in such a bad place that to hurt her sister made her feel better.

“I never thought I could be close with Michael again, never thought I could trust her again,” Casey said. But change can happen. Recovery can work miracles. “Michael has changed. She is not the person she was seven years ago,” Casey said. “She is not that selfish person that put me in jail. She’s working very hard at it every day.”

For desperate family members the trick is to be patient and supportive. “Don’t hammer people in recovery about all the mistakes they made in active addiction” all the time. “Show your love,” Casey said. “You need to have grace and patience with them. As family members you have to give them space to recover, the harder you are on them the worse it’s going to be.”

Appealing to people in the audience who have family members with addiction, Casey said, “You have to choose either to be there and support them or walk away. You can’t live in the middle and hold their past wrongdoings against them—that doesn’t help them recover. I have nothing but complete love for Michael now and I’m just so proud of her. It’s been a journey for both of us.”

Michael shared her side of that journey. Only “when I went through rehab did I get the tools to tell myself everyday to have that patience, to be so grateful that I’m sober. I have to know that my family will trust me; that they should realize that I’m a changed person but time is not on my side.”

It’s important to remember that recovery is a process. “I thought simply that Casey and I would be okay now that I’m sober. The relationship would be fine but it wasn’t,” Michael remembers. “Casey gave me that space for about a year to recover, but then she said ‘we need to talk about what happened’ so that we can move forward.”

Casey had to tell Michael what she had done to her and “she took it hard. I love you, I forgive you, but you have to earn the trust back.” That shook Michael, “but now our relationship is even stronger because you have to be able to open up about these things or they will simply fester.”

Making amends is an ongoing process for Michael now and Casey knows it. “Michael is ruthless and relentless about her recovery—she has even written a book about it. She is working hard every single day and that is all you can ask.”

The Insurance Dance with Recovery in Mind by Jim Geckler

Collaboration

We recently received a Facebook post regarding frustration over Harmony’s handling of payments made through insurance. I wanted to use this opportunity to discuss questions and concerns about our partnerships with insurance partners and how we believe it helps benefit access to treatment.

First and foremost, insurance companies make it easier for us to cover some of the cost of treatment, a service that many of us do not plan for when the time requires it. When we consider our personal relationships with insurance partners, how many of us would be able to have yearly physicals, emergency procedures, or access to treatment? As a provider, Harmony works with our insurance partners to provide the appropriate level of care for the appropriate period of time.

Harmony has a 49 year history of providing a residential level of care; this is the highest level of care for people suffering from substance use disorder. We have a responsibility to our clients to stabilize them medically, assess their conditions, provide them with a diagnosis, work with them to create a foundation for sustained recovery, and construct a comprehensive continuing care plan which will support their recovery. The relationships we have fostered with insurance partners has allowed us to work collaboratively to support access to care along the continuum. Under the umbrella of the American Society of Addiction Medicine (ASAM), together, insurance companies and treatment providers alike are held to the highest standards of care for addiction treatment. This common language, reviewed in tandem with insurance providers determines what level of care an individual requires.

Sometimes there is disagreement.  For example, when Harmony feels that a client would be better served by remaining at a residential level of care and an insurance provider feels they would be successful at the next level.  Other times, a client would like to remain in treatment, however our expert clinical and medical staff believe they are ready to move toward self-management of their own recovery at a level of care which empowers them to practice the early skills of recovery they learned here. In most cases, to arrive at a decision to move a client to the next level of care, involves a conversation with our Medical Director and a physician reviewing the case for the insurance company. We work to keep people at the appropriate level of care indicated by our clinical staff recommendations based on the client’s progress.

Harmony has a dedicated utilization review team, clinical professionals who work with our insurance partners, staff, and clients to keep people at the level of care which will provide them the greatest opportunities for success. When it is determined that funding for residential care has ended, we work to inform the client as quickly as we are able. Unfortunately in this situation the determination for a shift in levels of care is immediate, funding ceases that day. In order to ease the transition for clients and families, Harmony is committed to absorbing the expense of an additional night’s stay for clients. This is not common practice and comes at a fair cost. For example, in the month of July, we provided $28,000 in housing and care at no additional expense to clients. We are able to continue to do this through the generosity of our donors. We recognize the challenge and frustration of learning at 4 pm that one no longer has financing for treatment, however we are dedicated to continue to support our clients during this transition period.

There is nothing magical about 28 days of treatment. We have heard the 28 day timeframe used for many years, growing in public awareness with the Sandra Bullock film. The reality is that proven success is driven by long term engagement in treatment within a full continuum of care, at multiple levels  increasing the opportunity  for self-management.

We will always remain committed to providing access to treatment whenever possible, using all means necessary to help individuals receive treatment that can build an early foundation of recovery.  This could look like something as short as a few days or as long as 4 months.  Either way, our partnerships with insurance and our recommendations for treatment will always be the focus in providing individualized care for clients.

Jim Geckler is the Chief Executive Officer for Harmony Foundation.