A sober companion is a human services-related career path with the goal of helping the client maintain total abstinence or harm reduction from any addiction, and to establish healthy routines at home or after checking out of a residential treatment facility. Although regulations do not exist for the specific sober companion position, ethical existing peoples and businesses abide by the U.S. standards of mental health treatment. A sober companion may be a part of a whole medical and/or a clinical team of professional(s), may be formally licensed as a mental health professional, or have well-respected experiential experience in the field and/or may work independently on their own.
Protocols for a sober companion when working with a client, their family, and/or friends are established immediately. These may include a psychotherapeutic approach, 12-step or non-12 step plan, other outside support groups, help establishing nutrition and fitness daily, medication therapy, or holistic practices. The primary duty of a sober coach is to ensure the recovering individual does not relapse. They may be hired to provide round the clock care, be on-call, or to accompany the recovering addict during certain activities.
A companion acts as an advocate for the newly recovering person and provides new ways for the client to act in their own living environment. A sober companion either completely removes the addict from his own environment of hidden stashes, or may search for hidden drugs in that environment, in an effort to prevent a relapse. [1] [2]
An engagement with a sober companion usually lasts 30 days or longer. The time required to effect a meaningful change varies depending upon the client, co-occurring disorders, and life at home. Ethically, a companion's presence in the client's life will titrate down as the client's ability to connect to newly defined healthy behaviors with family, work, and legal issues without relapse is proven. Some recovery coaches stay with their clients for many months, and some offer only transportation services (for instance, to and from treatment facilities or sober living homes). The sober companion's duties vary from case to case, from simply ensuring the client remains abstinent, to establishing and ushering a specific plan of recovered resources and relationships into their home and community.
Many sober companions are ex-addicts [3] themselves and are sometimes hired in cases where a celebrity, actor or musician will not attend residential treatment, but must remain abstinent to complete a film or recording project. [4] [5] [6] [7] They are also depicted by some media outlets as "adult babysitters". [8] Doctors may also refer to sober companions as "advocates" for actors, musicians, and other celebrities. [5]
There has been controversy among sober companions over the use of drug replacement therapy and prescription drugs to ease withdrawal, cravings or other side effects of long-term narcotic and alcohol use. Sober companions are sometimes used as a replacement for residential addiction treatment or other forms of drug rehabilitation. Dr. Ronald J. Hunsicker, FACATA, National Association of Addiction Treatment Providers' president and chief executive officer, introduced an alternative perspective in mental health and addiction treatment programs. It was recommend that a combined approach be taken, particularly for people at high risk of relapse. Hunsicker's speech on “The Challenges for Implementing Evidence-Based Practices in Addiction Treatment" [9] suggested that companions can help a patient successfully transition from a heavily structured, secure environment into the world where he previously failed to stay sober. [1] [7] Other experts are skeptical of the companion approach and its dependence on a single individual. [7]
The television series Elementary depicts Watson as a female sober companion to a modern-day Sherlock Holmes. [10]
Rational Recovery (RR) was a commercial vendor of material related to counseling, guidance, and direct instruction for addiction designed as a direct counterpoint to Alcoholics Anonymous (AA) and twelve-step programs.
Drug rehabilitation is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cannabis, cocaine, heroin, and amphetamines. The general intent is to enable the patient to confront substance dependence, if present, and stop substance misuse to avoid the psychological, legal, financial, social, and medical consequences that can be caused.
Alcohol dependence is a previous psychiatric diagnosis in which an individual is physically or psychologically dependent upon alcohol.
A halfway house is an institute for people with criminal backgrounds or substance use problems to learn the necessary skills to re-integrate into society and better support and care for themselves.
Intervention is an American documentary series that premiered on March 6, 2005, on A&E. It follows one or two participants, who are dependent on or addicted to drugs and/or alcohol. They are documented in anticipation of an intervention meeting by family or friends. During the intervention meeting, loved ones give the addict an ultimatum: go to an inpatient drug rehabilitation program immediately, or else risk losing contact, income, or other privileges. The show follows up on the recovery progress for future episodes or for web shorts.
In internal medicine, relapse or recidivism is a recurrence of a past condition. For example, multiple sclerosis and malaria often exhibit peaks of activity and sometimes very long periods of dormancy, followed by relapse or recrudescence.
Substance dependence, also known as drug dependence, is a biopsychological situation whereby an individual's functionality is dependent on the necessitated re-consumption of a psychoactive substance because of an adaptive state that has developed within the individual from psychoactive substance consumption that results in the experience of withdrawal and that necessitates the re-consumption of the drug. A drug addiction, a distinct concept from substance dependence, is defined as compulsive, out-of-control drug use, despite negative consequences. An addictive drug is a drug which is both rewarding and reinforcing. ΔFosB, a gene transcription factor, is now known to be a critical component and common factor in the development of virtually all forms of behavioral and drug addictions, but not dependence.
The modern disease theory of alcoholism states that problem drinking is sometimes caused by a disease of the brain, characterized by altered brain structure and function. Today, alcohol use disorder (AUD) is used as a more scientific and suitable approach to alcohol dependence and alcohol-related problems.
Transitional living refers to any type of living situation that is transitional. The primary purpose or mission of transitional living environments is temporary. Transitional living facilities often offer low-cost housing. Transitional living residents that cater to those recovering from economic hardship often graduate from a shelter to a lesser crowded living situation. Transitional living may or may not have other common threads among residents. Transitional living provides professional support, education, and a stable living environment. Common types of transitional living include transitioning from jail or prison, an addiction treatment center or a mental health facility. They may also target homelessness, especially among youth. Transitional living is provided by many well known private and non-profit organizations, by government, churches and other charitable organizations.
Sober living houses (SLHs), also called sober homes and sober living environments, are facilities that provide safe housing and supportive, structured living conditions for people exiting drug rehabilitation programs. SLHs serve as a transitional environment between such programs and mainstream society. Many SLHs also accept people who are in recovery from substance use disorders but have not recently completed a rehabilitation program.
A peer support specialist is a person with "lived experience" who has been trained to support those who struggle with mental health, psychological trauma, or substance use. Their personal experience of these challenges provide peer support specialists with expertise that professional training cannot replicate.
Drug addiction recovery groups are voluntary associations of people who share a common desire to overcome their drug addiction. Different groups use different methods, ranging from completely secular to explicitly spiritual. Some programs may advocate a reduction in the use of drugs rather than outright abstention. One survey of members found active involvement in any addiction recovery group correlates with higher chances of maintaining sobriety. Although there is not a difference in whether group or individual therapy is better for the patient, studies show that any therapy increases positive outcomes for patients with substance use disorders. The survey found group participation increased when the individual members' beliefs matched those of their primary support group. Analysis of the survey results found a significant positive correlation between the religiosity of members and their participation in twelve-step programs and to a lesser level in non-religious SMART Recovery groups, the correlation factor being three times smaller for SMART Recovery than for twelve-step addiction recovery groups. Religiosity was inversely related to participation in Secular Organizations for Sobriety.
Secular Organizations for Sobriety (SOS), also known as Save Our Selves, is a non-profit network of autonomous addiction recovery groups. The program stresses the need to place the highest priority on sobriety and uses mutual support to assist members in achieving this goal. The Suggested Guidelines for Sobriety emphasize rational decision-making and are not religious or spiritual in nature. SOS represents an alternative to the spiritually based addiction recovery programs such as Alcoholics Anonymous (AA). SOS members may also attend AA meetings, but SOS does not view spirituality or surrendering to a Higher Power as being necessary to maintain abstinence.
Willingway, located in Statesboro, Georgia, is a privately owned Substance Use Disorder facility which specializes in treating alcoholism and drug addiction. The treatment modality at Willingway is based on the principles of the twelve-step program, Alcoholics Anonymous. It is referred to by many as "The Betty Ford Center of the South."
The Alberta Adolescent Recovery Centre, or AARC, is a drug rehabilitation centre for adolescents and family members located in Calgary, Alberta. AARC specializes in treating young people suffering from drug addiction and alcoholism, and takes in clients who have been thought of as being too far-gone for recovery. The AARC program is a multifaceted drug treatment program that uses twelve-step recovery processes, peer counselling, family and group therapy. A survey conducted by AARC found they had an 80% success rate, and that former addicts can permanently abstain from using drugs or alcohol following treatment at the centre. Another study found that the "AARC program is a unique model for comprehensive, long-term adolescent substance use treatment with a high rate of treatment completion (80.5%)."
Recovery coaching is a form of strengths-based support for people with addictions or in recovery from alcohol, other drugs, codependency, or other addictive behaviors. There are multiple models, with some programs using self-identified peers who draw from their own lived experience with substance use and recovery and some utilizing people who have no lived experience but some training in support, depending on local standards and availability. They help clients find ways to stop addiction (abstinence) or reduce harm associated with addictive behaviors. These coaches can help a client find resources for harm reduction, detox, treatment, family support and education, local or online support groups; or help a client create a change plan to recover on their own.
About 1 in 7 Americans suffer from active addiction to a particular substance. Addiction can cause physical, psychological, and emotional harm to those who are affected by it. The American Society of Addiction Medicine defines addiction as "a treatable, chronic medical disease involving complex interactions among brain circuits, genetics, the environment, and an individual's life experiences. People with addiction use substances or engage in behaviors that become compulsive and often continue despite harmful consequences." In the world of psychology and medicine, there are two models that are commonly used in understanding the psychology behind addiction itself. One model is referred to as the disease model of addiction. The disease model suggests that addiction is a diagnosable disease similar to cancer or diabetes. This model attributes addiction to a chemical imbalance in an individual's brain that could be caused by genetics or environmental factors. The second model is the choice model of addiction, which holds that addiction is a result of voluntary actions rather than some dysfunction of the brain. Through this model, addiction is viewed as a choice and is studied through components of the brain such as reward, stress, and memory. Substance addictions relate to drugs, alcohol, and smoking. Process addictions relate to non-substance-related behaviors such as gambling, spending money, sexual activity, gaming, spending time on the internet, and eating.
Douglas Caine is an American and an addiction treatment professional, he is the founder of the rehabilitation facility Sober Champion. Many of his clients are Hollywood celebrities and the wealthy.
Community reinforcement approach and family training is a behavior therapy approach in psychotherapy for treating addiction developed by Robert J. Myers in the late 1970s. Meyers worked with Nathan Azrin in the early 1970s whilst he was developing his own community reinforcement approach (CRA) which uses operant conditioning techniques to assist those with addictions live healthily. Meyers adapted CRA to create CRAFT, which he described as CRA that "works through family members." CRAFT combines CRA with family training to equip concerned significant others (CSOs) of addicts with supportive techniques to encourage their loved ones to commence and continue treatment and provides them with defences against addiction's damaging effects on themselves.