Is change possible? Of course!
Is sustained change possible? That’s a different story.
With relapse rates hovering around 60-70%, the outlook for sustained change is bleak (McClellan et. al., 2000). A more astute question might be: are we as treatment providers facilitating sustained change or focusing on clients’ compliance with set rules? It’s relatively easy to change while in treatment. A little motivation coupled with consequences for negative behavior often yields considerable change in the first 30-90 days of recovery. This type of change is called First-Order Change.
First-Order Change is defined as “incremental change that is largely dependent on context” (Bouton, 2014). In other words, complying with the guidelines of treatment and experiencing a moderate change in behavior and motivation. While this change often appears authentic and significant, the individual often reverts back to old behaviors within weeks or months of leaving treatment. Evidence shows that counter-conditioning, negative or positive reinforcement, and merit-based interventions are successful in the short-term but yield poor results in the long-term (Bouton, 2014). Most treatment modalities use a combination of these strategies.
At Alpha 180, our primary focus is to facilitate a transition from First-Order to Second-Order Change for all of our clients. Second-Order Change involves a complete and radical transformation in beliefs, worldview, and behaviors (Bouton, 2014). This rarely can be done utilizing conventional treatment modalities. We aim to inspire our clients by offering them opportunities that reveal the upside of recovery. Whether it be service projects, concerts, camping trips to Big Bend, 12-step workshops, or Rite of Passage experiences, our clients are exposed to sober life at its fullest. When they make mistakes or break rules, we don’t condemn or punish. We intervene with love and compassion and walk alongside them as they learn why living with integrity and values is vital for sustained recovery. They gradually begin to be intrinsically motivated rather than complying with rules or submitting to authority. We also encourage leadership and taking ownership of the culture at Alpha 180. Oftentimes our clients organize Alpha 180 functions entirely on their own.
Connection, brotherhood, and the spirit of inspiration are the primary vehicles that promote profound and lasting change within our clients. They aren’t simply complying with rules and expectations from staff. They have transformed.
Sources: Bouton M. E. (2014). Why behavior change is difficult to sustain. Preventive medicine, 68, 29-36.
McLellan AT, Lewis DC, O’Brien CP, Kleber HD. Drug dependence, a chronic medical illness: Implications for treatment, insurance, and outcomes evaluation. Journal of the American Medical Association. 2000;284(13):1689–1695.