Does “Forcing” a Loved One Into Treatment Work?
By Rodney Robertson, D. Min., M.A., M.Div., Director of Family Services at The Ranch
Few people in active addiction wake up and say, “Today is a good day to start treatment.” Often people are pressured into addiction treatment by a loved one. But does this set them up to leave treatment early, or to relapse after treatment?
The short answer: not necessarily. Loved ones can set boundaries and ultimatums that compel a family member to get treatment but ultimately the client must develop some intrinsic motivation to get better in order for it to be effective and long-lasting. The good news is treatment is set up to help clients find their own motivation for getting better.
Here are three situations we typically see in “forced” treatment situations and some of the benefits and drawbacks of them:
#1 Family Pressure to Enter Treatment
Not all families can afford to wait until their loved one realizes on their own that their life is unmanageable due to an addiction. In cases where the disease is progressing and getting more dangerous, it is appropriate for the family to use more convincing methods.
One way to compel a loved one into treatment is to define clear boundaries and then leverage them. This may include taking away their car, cell phone and/or financial support and not allowing them to live at home until they get help. These measures make it difficult for the addict to continue their destructive behavior.
While this approach can be effective in coercing a loved one into rehab, it does have its disadvantages. In my experience, applying this type of leverage could, at least in the short term, damage the relationship. The addict may become resentful because they feel a loved one forced them into treatment by trying to control them. They might even leave treatment still harboring these resentments.
Families must be careful not to get into a bargaining war with the addict. What we don’t want is for people to go through the motions of treatment just to get their cell phone, car or living situation back intact. Families shouldn’t make future promises, but rather make statements like, “Once you complete treatment, we’ll reconsider our position on your phone, car, etc.”
#2 Professional Intervention
This is my preferred approach for compelling treatment because when a third party is making the appeal for treatment, they become “the enemy” instead of the family. An interventionist is not there to make friends. Their job is to facilitate communication, show the addict that their life is unmanageable, and explain why rehab is a good idea. There is still some connection with the family because they hired them, but the interventionist is in the position of the “bad guy.”
The amazing thing I see happen after an intervention is that the client isn’t mad at their mom, dad, sister, brother or partner; they channel their anger toward the interventionist. When they’re not resenting the family for pressuring them into treatment, there is more room to accept support from loved ones and for working on any issues within those relationships in family therapy.
#3 Court-Ordered Drug Rehab
People ordered into drug rehab by the courts often do well because the hammer is ready to come down on them if they don’t successfully complete treatment. The client knows they must appear before the judge again and speak to their progress, so they use this as motivation and are more likely to apply themselves.
We often see the same situation play out here as with an intervention. The client resents the judge, not the family. Therefore, this is my recommendation for family members whose loved ones get into legal trouble: Don’t bail them out. Don’t buy them a lawyer. Let them spend a few nights in jail. Let them stand in front of the judge. Chances are the judge is going to give them the option of going to treatment or going to jail. They will always choose treatment. Once they get there they might decide to do the work of recovery and you’ve salvaged your relationship by not being seen as the one who forced them into treatment.
What Happens When a Client Is “Forced” Into Treatment
Addicts pressured into treatment usually don’t hit the ground running toward recovery. However, many of these clients do experience a shift after the first couple of weeks from feeling forced to be there to wanting to be there. They move from denial to the realization that they do have a problem and need to start addressing it before it gets worse. Of course, this won’t happen for every client, and sometimes it takes longer than a few weeks. However, I’ve found that once clients experience that shift, they tend to make progress pretty rapidly.
I’ve worked with clients who aren’t doing anything but counting the days until they leave. Then when it comes time for discharge, families must re-apply the boundaries they originally set. When the client realizes they have nowhere to go, no car and no money, they almost immediately change their thinking and begin putting in the necessary work needed to change. Unfortunately, up to that point, they haven’t used treatment to its maximum effectiveness, but in some cases, that’s what it takes for clients to self-motivate. However, that does not mean that time was a complete waste; they’ve been hearing about recovery tools since day one. Now they start reaching into their back pockets where they stuffed that information, pull it out, and actually start applying it.
Considering “Forcing” a Loved One Into Treatment?
None of these methods are right or wrong. My advice to loved ones who’ve reached the point where they need to push a family member toward treatment is to try to preserve the relationship as much as possible to minimize resentments. Sometimes you must perform the ultimate act of love, which is withdrawing enabling support. Let the addict know that you’re doing this in hopes that they’ll realize the seriousness of their behaviors. Tell them you love them and that you hope you’re the first person they call when they’re ready to get help.
Choose a better life. Choose recovery.