Can Addicts Change Through Self-Direction?

New programs continue the sea change in recovery.

Posted Sep 04, 2018

Do you want to recover from mental illness or addiction, but feel trapped by ‘systems’ and traditional treatment methods? Have you always felt there must be better forms of treatment that fit your personal circumstances? Well, you’re not alone.

Julia had the same experience, struggling with heavy drinking for years and looking for answers only to be told that quitting forever was her only true option and everything else was a “lie” or a “cop out.” But she tried everything else (of course) and had moderate success for short periods of time - abstinence sampling, naltrexone, therapy - they all helped for a bit and solved a little of the problem. But she was still struggling… No matter what though, she was NOT going to go into those meetings and call herself an alcoholic. That’s when she found me...

The current addiction treatment system is failing us

You may already know that the vast majority of people who struggle with addiction and mental health don’t seek, or receive, treatment (in the alcohol disorder area, as many as 90% of people don’t get professional help). You may have also heard the disheartening recent statistics that overdose rates are still increasing as they have been for the last 30 years. But you may not know that more and more options to the traditional model are emerging.

You may be interested to know about a new approach to recovery called self-direction.

A lot of talk, money, and resources have gone into this new approach to helping people make positive changes in their lives. Self-direction is built on the idea that every person is an individual and so treatment must be individualized, focusing on personal strengths, weakness, goals and flexibility- because life doesn’t always go as planned.

It sounds radical to some - the concept that there is no one way to recover and that those who are struggling with mental health can actually help determine their own way. But many of us are fighting this fight and some have been doing so for decades. From IGNTD Recovery, to Integrative Harm Reduction, to The Sinclair Method and many options of Medication Assisted Treatment, there are more and more options to choose your own way.

So what is self-direction? How does it work for people with addiction, and how can you access modern treatment plans like this in your community? Read on to find out more.  

What is self-direction?

Self-direction is a person-centered approach to working with people to achieve their goals. This method has been applied to various populations, initially used for older people, brain injury patients, and the disability segments. Most recently it has seen success in the treatment of mental health disorders and substance/behavioral addictions.

In the United States, more than 300 programs and over one million participants have been involved in self-direction programs.

What does self-direction involve, exactly? The participant is assigned a support worker to develop goals and a plan of action. There are one-on-one meetings at least monthly, with regular reviews over the course of the program. Not only can the participant set their own recovery goals, but they are also supported with a brokerage and taught how to manage their own budget.

Financial support is a unique element of the program. Many people with mental health and substance use disorders are faced with financial pressures that keep them stuck in the cycle of illness and addiction. The research emerging shows that participants are often using their allocated budget on transport, dental and medical bills, and psychiatric medications. This approach helps to break down the barriers faced by people with mental illness such as difficulties attending and accessing healthcare services.

The core principles of the self-direction method are to promote:

  • Recovery
  • Independence
  • Self-sufficiency
  • Choice
  • Individual strengths

It is based on the idea that you know what is best for you and with enough support you are capable of achieving it. Imagine that!

What sets self-direction apart from other mental health treatments?

More often than not, mental health and addiction rehab facilities focus on minimizing symptoms. And ultimately, this is the goal, but for many people, other things need to be addressed before they can begin working on recovery. Examples may include ongoing financial difficulties, past trauma, and low self-esteem.

But the goals set for clients of mental health and rehab facilities tend to be predetermined - abstinence being a primary example. Anyone who is at all resistant to this as the primary goal is seen as being in "denial" or in "pre-contemplation" and not aware of their problem. While there has been a cultural shift toward person-centered care, they still have a long way to go before they reach a self-directive approach to treatment.

Self-direction is less likely to set the person up for failure as it starts with where the person is really at, rather than where the facility wants them to be. It means you become an active participant in your treatment in every way. You get a say. So, even if alcohol abuse is the biggest problem affecting your functioning right now (as seen by others), perhaps your biggest worry is paying for your car registration and losing your only method of transportation.

Imagine what it would be like to have support like this and what a big difference that will make to your outlook. It will inevitably have a downstream effect on your mental health.

Does self-direction really work?

Research is limited, but early data suggests that self-direction does indeed work. New York State has funded a five-year pilot of self-direction programs to step away from traditional images of mental health programs and offer a modern approach to recovery.

So far, the study has found that in comparison to traditional treatments, participants in self-direction are:

  1. More likely to have positive employment and housing outcomes
  2. Have lower outpatient and inpatient mental health costs

This means that people who are involved in self-direction programs are shown to be a lesser economic burden in the longer-term by requiring less specialized mental health services, and they can contribute to the community by gaining employment and secure housing. Not only that but when you offer support, build up a person's strengths (rather than bringing them down with shame), the outcomes are more positive all around. The individual benefits are priceless.

Is Self-Direction the future of mental health treatment?

Traditional mental health treatment can learn a lot from the self-direction method. A person-centered and collaborative treatment approach benefits not only the individual, but also the facility (happier clients and better outcomes), and the greater community.

The one size fits all approach to mental health, and addiction treatment is outdated. This frustrated me to no end when I was on my own recovery journey. That’s why I studied psychology, to arm myself with as much information as possible to create a recovery program that recognizes the uniqueness in every person and the strengths they already have within them to make positive changes in their life. In the IGNTD Hero program we build people up and empower them to make their own best choices rather than believing they are powerless pawns in the throes of an impossible situation. It builds self-efficacy and self-esteem and helps people think of novel solutions and goals they hadn’t ever considered.

Own YOUR goals

Take the time to honestly think about YOUR goals and YOUR hopes and then find providers who can support you in those.

Is there one thing you’d like to change in your life right now? What is it?

You may be surprised to find it's not necessarily a symptom of your mental illness or addiction. Rather, it's possibly one of the causes (or consequences) of your addiction. But, when that one element of your life is addressed, it will improve your emotional well-being, and place you one step closer to recovery. And that would be a big win!