Treatment Duration

treatment duration

Several months ago, while walking across the men’s campus, I was stopped by one of our clients who asked if he could speak privately with me. There is nothing out of the ordinary about this. I meet with and speak to clients every day. However, when he motioned me toward a place for us to sit, I recall noticing he had an unusual and uncharacteristic look of seriousness on his face. This client had been in treatment for about four weeks, and his somber demeanor had me concerned as I quickly tried to guess what I was about to hear. Had he decided to quit and leave the program? Was he planning to admit to some dishonest behavior or reveal some deep, dark secret? We took our seats facing each other, and I gave him my undivided attention. It was clear to me that he was earnest, and I waited for him to begin. He took a deep breath, paused, and then the words fell out of him, “I can’t do this in only 90 days, man! I need to stay longer.” I smiled.

I can’t say this was unprecedented, but I don’t hear this sentiment from clients often. Individuals who come to BRC are typically treatment resistant and hyper-focused on ensuring their stay is as short as possible. They view treatment as just another consequence they have to endure every few months or few years rather than as an opportunity to truly change their lives for the better. Most don’t believe their lives will change. The overwhelming majority of our clients have been to multiple inpatient or outpatient programs, and they have failed to remain sober. Their life experience tells them spending time in treatment does not work. In part, they are on to something; time, itself, is no solution at all.  

Time may be thought to ‘heal all wounds’ but it will not solve the problem of addiction. There is no magic number of days sober that will render someone cured of this illness. Addiction is a chronic disease is fundamentally about behavior. Addiction can’t be outgrown, and it never goes away. But our clients can safely recover and remain permanently sober when they learn how to effectively live with their disease by radically changing their behavior and approach to life. The basic text of Alcoholics Anonymous describes the Twelve Steps as a “design for living,” and this new set of disciplines and principles comprises what our clients must adopt and practice every day if they are to succeed.

Radical change is hard under the best of circumstances. Add the impairments to brain function which research has shown result from long-term exposure to drugs and alcohol, and change is even more difficult. Pile on the low self-esteem, shame, guilt, absent motivation, depression, and anxiety which routinely accompany addiction and you’re really struggling. The men’s and women’s programs at BRC Recovery are 90-day minimum programs. Although it may sound like a long time, three months is a widely researched and accepted length for addiction treatment. The National Institute on Drug Abuse considers 90 days to be the point when the “threshold of significant improvement is reached” and that anything short of three months is “of limited or no effectiveness.”  This is not just referring to time away from alcohol or drugs, but time spent actively engaged and participating in a course of treatment, or more simply practicing a new way to live life. A 90-day minimum means, of course, that for some clients 90 days will not be enough.

The great advantage of Twelve Step recovery is the simplicity with which we can measure participation and engagement. AA’s daily disciplines are actions. When those actions are consistently implemented in the daily lives of our clients, dramatic change occurs. For various reasons, this takes some clients longer to achieve than others. When our team concludes there is a lack of consistency, we will always recommend additional time or resources to assist our clients.

Behavior is at the heart of addiction, and at the heart of recovery. Abandoning old habits and forming new and sustainable disciplines is laborious and uncomfortable. We offer our clients the guidance, support, accountability, and discipline to empower them to face life differently. It is only through consistent and prolonged practice that our clients can experience the effectiveness of the Twelve Steps for themselves and ultimately depart treatment, having elected on their own to pursue this as a way of life.

Written by: Tim May, Executive Director