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When difficulties with mental health, substance use disorders or other forms of addiction lead a person to a crisis in their work or family life, hitting rock bottom, may actually become a starting point for healing and recovery. John Ralphs is a clinical occupational therapist. In this opinion editorial he explains how to move positively towards a happier healthier life.

Mental health issues, depression and addiction often go hand in hand 

For a person who is struggling with deep seated trauma and emotional issues, it can seem that drinking, getting high or any other form of ‘escape’ offers a short term solution or coping strategy,

All too often, when someone does not receive the professional help they need after hitting ‘rock bottom’, the dangerous combination of a psychiatric condition and substance use disorder can cause their lives to spiral even further out of control. 

At first one area of the person’s life may begin to suffer, such as the loss of a job or a significant relationship. Tragically, there is always a new, worse ‘rock bottom’ situation that a person can find themselves in, when mental health disorders and addiction remain unaddressed.

The first step  to recovery is to admit you have a problem

Unfortunately, the stigma attached to addiction leads many people to conceal their habits even from those closest to them for as long as possible, and many are unwilling to admit they have a problem. 

Denial is the hallmark of addiction. With some types of substance use, such as crystal meth or heroin, the signs of addiction are often clear. It is not so easy to identify when a person has a gambling or sex addiction or is abusing medication, however these too can be very damaging to a person’s life. 

A person who has anxiety or depression, for example, might find alcohol dependence goes unnoticed for some time, particularly if the nature of their work involves drinking alcohol and entertaining, it may be seen as socially acceptable.  

A dual diagnosis approach

In many cases, people are reluctant to disclose they have a problem with some form of addiction. This may only come out at a later stage when their mental health is significantly deteriorating. The dual diagnosis approach acknowledges that mental health and addiction disorders are most often interlinked, and when treatment is integrated the prospects of lasting recovery and progress are more likely.

Begin treatment with voluntary admission

A person who might have been very reluctant to accept help may pause to reflect when they reach a new low – such as being evicted from their home or receiving a warning for poor work performance. For concerned loved ones, the person may be more open to accepting help when they get to a low point where they realise their quality of life is seriously impacted.”

People who begin treatment with voluntary admission to an inpatient facility tend to progress quicker.

Treatment outcomes don’t differ so significantly for involuntary admissions, when a family obtains a court order with the support of a social worker to secure treatment for a loved one whose decisions are endangering themselves or others. 

Your journey to a successful recovery

While the likelihood of successful recovery is similar to voluntary clients, the length of stay required to achieve this may be longer. For families with limited resources, the timing of an intervention is therefore crucial to make the most of the 21 days’ admission covered by medical schemes. Those who are unwillingly participating in treatment may take longer to reach the point where they are ready to change.

Some people have preconceived ideas about recovery groups and rehabilitation.  For example, we introduce clients to some of the tools available. These include the 12 Step Programme, but there are also more modern approaches that are less doctrinal. Dialectical Behaviour Therapy [DBT], which is evidence based psychotherapy that is often used in building distress tolerance and the treatment of personality disorders and interpersonal conflicts, is one of many approaches that we use.

Recovery assistants

Our dual diagnosis team also includes recovery assistants, people who are themselves in recovery from addiction and who speak from their own experiences.  These recovery assistants are crucial in connecting with clients from a place of empathy and demonstrating that progress is possible, although recovery truly is an ongoing process.

References

12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview

About the author

John RalphsJohn Ralphs is a clinical occupational therapist with a BSc in Occupational Therapy and a PGDip Law, both from UCT. He is currently studying towards his MSc Occupational Therapy. 
John has a special interest in substance abuse and addiction treatment, in which he has over three years focused experience, including the design and facilitation of occupational therapy group sessions and individual therapy for substance and process addictions within public and private treatment facilities in South Africa.
He also has experience in forensic psychiatry, learning disability, disability claim assessments and supported employment, and takes a particular professional interest in working with adolescents and adults with mental illness, school to work or university transition, conducting functional assessments, conducting music and creative-based interventions, and life and social skill group facilitation. 

About Netcare Akeso

Netcare Akeso operates a network of private inpatient mental health facilities and is part of the Netcare Group. The COPE Therapy website www.copetherapy.co.za also contains many useful blog posts on various issues and tips relating to mental health.

 

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John Ralphs

John Ralphs is a clinical occupational therapist with a BSc in Occupational Therapy and a PGDip Law, both from UCT. He is currently studying towards his MSc Occupational Therapy.  John has a special interest in substance abuse and addiction treatment, in which he has over three years focused experience, including the design and facilitation of occupational therapy group sessions and individual therapy for substance and process addictions within public and private treatment facilities in South Africa. He also has experience in forensic psychiatry, learning disability, disability claim assessments and supported employment, and takes a particular professional interest in working with adolescents and adults with mental illness, school to work or university transition, conducting functional assessments, conducting music and creative-based interventions, and life and social skill group facilitation. 

The content in this editorial is for general information only and is not intended to provide medical or other professional advice. For more information on your medical condition and treatment options, speak to your healthcare professional.

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