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What would you do?

Discussion in 'Political Discussion' started by Patters, Apr 10, 2011.

  1. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    The following is based on a situation that I had to help someone with about three weeks ago.

    A 19 year old man who grew up in a violent and abusive home is thrown out of a rehab after 6 months of sobriety because he was caught in bed with a woman, which is strongly against the rules of the rehab program. The young man has no money (I mean no money--not even bus fare), no family, his friends are all addicts, and he is not particularly worldly wise.

    If you were in his situation, what would you do?
    (1) Steal
    (2) Prostitute yourself
    (3) Try to get into a wet shelter. (Wet shelters house active addicts and also very often house Level 3 sex offenders; dry shelters are hard to get into on short notice.)
    (4) Bum a fix from one of your drug addict friends so you could get into a detox, which would then place you into another taxpayer funded program.
    (5) Live homeless on the streets and beg and eat out of garbage cans.

    Believe it or not, this is reality for a surprisingly large number of people.
    Last edited: Apr 10, 2011
  2. DarrylS

    DarrylS PatsFans.com Supporter PatsFans.com Supporter

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    Your penchant for drama minimizes personal responsibity...

    When I was an active professional, ran across these types of things often and perhaps it has to do a lot with my reality therapy training, but everyone is responsible for their own behavior..

    Every action has a consequence, whether it be good or bad.. sooner or later you learn to make good decisions or continue to make bad.. if you do the former good things happen, if the latter bad things happen...

    Millions of people grow up in violent and abusive homes, some do ok, many less so.. but to define a person where they grew up and how they grew up, minimizes personal responsibility.. bottom line is that you always have a choice, no matter what your background is..

    This scenario is filled with enabling messages, and may be harmful to the recovering person..
  3. Real World

    Real World Rookie

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    I can't answer the question because I would never be in that situation. The question is what do you want to do for him. You can help him if you want. No one else should have to. Everyone should be free too, but not obligated to in any way.
  4. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    But, Darryl, you didn't answer the question. The question has nothing to do with personal responsibility. That comes later. The initial problem was that the young man faced a crisis, and frankly your argument, which avoids the reality, is the conservative response. Would you care to explain how personal responsibility would help the young man deal with the crisis at hand?
    Last edited: Apr 10, 2011
  5. PatsFanInVa

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    Okay, weird.

    I can see how a sex offender might have a "no sex" condition in rehab, but why would a drug offender?

    But then again, if he's not a drug offender, why is one choice "bum a fix so he can get into another rehab program"?

    I have no experience w/the line of work you guys are discussing. It just seems weird to me that because I have a heroin problem, one of the rules is "by the way, even though you're a young adult male, we expect you to turn down every opportunity to have sex." He's not a minor. Why can't he have sex?

    Unless it is a program for sex offenders.

    I'm just trying to figure out the facts & circumstances... as to the choices listed that is a pretty stark set of options.

    Darryl, in support of the premise here I would have to say, thank God that this isn't me. When I was 19, there was no such thing as delayed gratification, and the whole point of any other cleaning up of my life would have been to have more sex in the first place.

    It just so happened that my immature azz came from a home that pushed me toward College (aka, the Big Sleepover,) rather than abusing me to the point where the home was an unsafe environment. For most here, our ability to stand on our own two feet was enhanced not undercut by our homes. Even those of us kicked out of our homes early -- for the most part -- were not in the position this guy is in.

    I do say "for the most part." Perhaps some of us did face similar or identical circumstances. I only say that the circumstances as I understand them do throw in a big dose of "there but for the grace of God go I."

    I would love for one option on the list to be "Get a job." But when there are experienced workers with a place to shower ahead of this guy in line, I don't know how successful he'd be at self-support via that strategy.

    So anyway, was the kid in some sort of sex rehab, or was "don't get laid" a condition of his drug/alcohol rehab, or was he in sex rehab of some kind, possibly as an alternative to incarceration?

    I just feel like I'm short on details here.

    PFnV
  6. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    Most rehab programs do not allow relationships because even a good relationships can be very stressful and triggering. In fact, AA discourages people from having relationships for at least the first year of sobriety.

    One way to get shelter is to go to a detox, which will then house you for several days while you safely withdraw from drugs or alcohol and then move you into some sort of rehab program (if possible). Generally speaking, you need to go to a detox to get into a rehab program, and you cannot go to a detox unless you're high.

    I called a wet shelter to reserve a bed for him, though I knew he would not go, given his history, and counseled him against stealing and against prostitution (though I talked to him about safe sex). He chose to get high and go to a detox, which was probably the best option, though not a good one.
    Last edited: Apr 10, 2011
  7. Mrs.PatsFanInVa

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    If you believe in God the answer is epically and biblically simple, "I am my brother's keeper."
  8. Mrs.PatsFanInVa

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    As Patters says, it's pretty much standard policy that there be no romantic or sexual relationships of any kind while in any sort of rehab.

    There are strict rules at drug rehab centers. Individuals who enroll in drug rehab can expect a strict set of rules and regulations while engaged in the process. These rules (which are more likely to exist at a residential treatment facility) include no substance abuse on site, no physical relations with other patients, limited visitors and required attendance at all sessions. These rules are designed to help individuals get the most out of the program and insure the safety of everyone concerned.

    Drug Rehab Center Basics | Michael's House


    The following list details the drug rehab guidelines in place at Freedom Rings.

    Participation in all scheduled activities is expected (unless you have a doctor's excuse) and you must be on time for each activity.
    Smoking is permitted only in designated areas - please use the ashtrays.
    Chewing tobacco or spitting is not permitted inside the addiction treatment center.
    Strict confidentiality for any issue discussed in your primary group is enforced.
    No romantic involvement or sexual relationships will be permitted. Modest dress is required. If it is felt by staff that you are dressed inappropriately, you will be asked to change clothing.
    Physical violence and/or threats, sexual harassment, racial slurs or willful destruction of facility property may result in administrative discharge from the addiction treatment program or alcohol rehab.
    No weapons, alcohol, drugs or pornographic material are allowed on the premises.
    Headphones or CD/radios/tape players are only permitted in your room.
    No cell phones are permitted. If you choose to bring a cell phone, it will be kept in the safe for the duration of your rehab and will be returned upon discharge.
    You are responsible for being on time to group or individual sessions and participating in all activities per program guidelines.
    You are responsible for keeping your room organized, and your bed made.
    Hats or sunglasses are not permitted in alcohol rehab at any time.


    Drug Rehab Guidelines | Rules

    And an explanation:


    Treatment is about getting better; it's not a dating service. Due to the heightened state of emotion that goes along with being in rehab, it is quite common for patients to engage in sexual or romantic encounters. The reason that it is mandatory that you stay away from such occurrences is that you are in a state of transition; everything in your life is up in the air right now. Throwing romance into the mix can serve as a major distraction from recovery for both of you. While it might feel like a relief to distract yourself, even for a moment, remember that you are here to recover from a disease, and that it takes serious focus.

    Read more: Inpatient Rehab Regulations | eHow.com Inpatient Rehab Regulations | eHow.com
  9. reflexblue

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    Are you having a rough time with one of you're clients?

    To answer your question i'd rob a bank in such a way that if and when i was caught i'd get the max. Then i'd have a roof over my head, eat three times a day, and have medical care.
    Last edited: Apr 10, 2011
  10. PatsWSB47

    PatsWSB47 Rookie

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    I'm inclined to agree with you but I have to point out that being your brothers keeper doesn't necessarily mean instantly gratifying a need. In an emergency situation then yes but wholesale keeping is enabling which can reinforce destructive behavior and the good intentions backfire.

    In this particular case I think rehab is the best answer, though I don't have any idea how to get him there. You would think these situations are not all that unique. Are there effective protocols?
    Last edited: Apr 10, 2011
  11. PatriotsReign

    PatriotsReign Rookie

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    Honestly Patters, that was a very foolish thing to say! Darryl's response was HIS response...conservative or liberal has nothing to do with it. Not every thought, belief or response can/must or should be categorized at "conservative or liberal". In this case, we all know Darryl isn't conservative, so his response can't be conservative...and it wasn't.

    We are all responsible for our own behavior. Addiction is a disease, but we're still responsible for our actions.

    Your question can not possibly be answered by anyone here. It's a hypothetical situation so how would you expect anyone to answer it if we've never been in that situation? We can't.
  12. PatriotsReign

    PatriotsReign Rookie

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    From my personal experience with alcoholism and addiction recovery, a person is only able to get sober when they are willing "to do anything to stay sober". It must be the motivating factor driving their lives. If somone is NOT willing to do anything to stay sober, no power on this earth will keep them sober.

    So, to your point about "my brother's keeper"...it would be useless to try to help somone who isn't willing AND it would be the wrong thing to do from any perspective, biblical or otherwise.

    We can only help those who are willing to help themselves.

    The best thing to do when someone is not willing to do anything to stay sober is to walk away. Some die so that others may live...it's sad, but it's the truth. And there are many who need help, so better to spend our time with those who actually want help.

    If this young man Patters is referring to is willing to do anything to stay sober (and breaking the "no sex" house rule may indicate he is not), then he'll be ok. People in AA will give him all the help he needs if he is solidly grounded in an AA group.
    Last edited: Apr 10, 2011
  13. Mrs.PatsFanInVa

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    As far as I can tell the "system" is horribly inefficient.

    I am acquainted with one situation in which a youg man, in his mid twenties, was going through some tough times. He'd lost his job, his girlfiend, his apartment and his car. He attempted suicide and was taken to a local ER. While there he admitted to an alcohol problem and was admitted to a local psych/rehab hospital as a 72 hour "involuntary police hold" as a danger to himself or others.

    He needed help, knew he needed help and was willing to cooperate with anyone who was willing to give him help. After 2 days he was given a court hearing which was held in the hospital to discuss what he could do to get better. The options were A) stay in the rehab program for 30 day, either voluntarily or involuntarily, depending on the judge's decision, B) seek outpatient treatment or 3) be found not in need of further assistance. He, and his parent's were opting for A, his counselors were opting for "A," his physician was opting for "A."

    All of them testified. The judge asked one question and one question only. The question was, "Do you have health insurance?" The answer was, "No."

    The "verdict?"

    "The court no longer finds you to be a danger to yourself or to others and capable of being realeased with no need for mandatory treatment."

    His counselor frantically gave him 2 names and numbers of free clinics in the area and he was discharged within 20 minutes.

    When the local clinics were called he was informed that there was a waiting list of 6 months to a year.

    When his parents took him to a private psych doctor the doctor informed them that he did not take "private pay" patients because he felt too "pressured " by money constraints to be effective. The second doctor said he did not take patients who'd been previously hospitalized because, without insurance, it would be too hard to admit the patient should he need admittance again.

    So, yeah, right, how hard can it be to get help when you need it?
  14. DarrylS

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    A professional walks away from these choices and allows the client to make his or her own decision.. that is where your role ends and he has to figure it out.. to continue involvement will only create dependency.

    It is not conservative or liberal( that is a dumb allegation), it is personal responsibility.. the way you frame your whole argument is disabling and denies personal responsibility of the person involved..

    I did a lot of victimization work in the past, and discussions of the abuse and neglect has its place, but no matter what a person is responsible for what he or she does. What is more helpful is helping a person grow and develop despite their hardships..

    Your attitude is an enabling knee jerk response that will only serve to create a dependency for the client and will not allow him to grow away from these types of systems..

    To frame is as a political statement is flat out stupid and only shows your lack of understanding of the spectrum and array of various types of therapy...

    William Glasser Institute - Reality Therapy

    Last edited: Apr 10, 2011
  15. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    Of course we're all responsible for our behaviors. In fact, when I've run groups, I talk a lot about personal responsibility, but what does personal responsibility mean in the face of disaster? How would you exercise personal responsibility if you were homeless, had no money, and no resources? Rely on taxpayer funded services? Steal? Prostitute yourself? Live in the streets and scrounge for food out of garbage cans?

    As far as the question goes, of course you can answer it. If you were in a desperate situation, what might you do? What should we expect these people to do given that our society, if anything, because of conservative tax policies, has given them fewer options. I would think someone who opposes increased funding of social services would have some better answer than the meaningful phrase "personal responsibility." I suppose you also like Nancy Reagan's "Just say no" approach to addiction, too. It's about as pointless and emptyheaded as is the phrase personal responsibility, if it's not coupled with an action plan.
  16. PatsFanInVa

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    Wow again, thanks guys. Well aside from all the facts about relationships throwing in a monkey wrench, I will say that if you buy into that and get sober for a month, you're a damn sight more likely to make a year, if that's the only way you're going to er um become intimate with someone again.
  17. PatriotsReign

    PatriotsReign Rookie

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    I actually answered your question in my post after the one you quoted, here...

    One important point here is that AA has done more to help addicts/alchoholics that all the efforts of the medical, psychiatric and gov't programs combined. No one can help an addict more than another addict who has learned to live sober.
    Last edited: Apr 10, 2011
  18. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    A professional certainly doesn't walk away from the choices, but helps the individual explore and weigh the choices and provides a certain level of practical help. For instance, you can't easily get into a shelter or other programs without a referral. Walking away is not professional at all in my opinion.

    Personal responsibility is not liberal or conservative, but it's meaningless and pointless in terms of being a solution. It's a fine phrase for preachers and politicians, but it carries no value in the face of crisis. It's a philosophical point, not a solution.

    Obviously, that's why the options I presented were options that the person in crisis could choose.

    I really don't see your point Darryl. Nothing in my attitude is about enabling the person, since the person obviously has to help himself. I realize you would go up to the homeless person and toss out phrases like personal responsibility, but frankly I think that tone of yours is condescending and naive. Frankly, I think the down and out have far more personal responsibility than many of the middle class who are vastly more dependent on government services (roads, fire, police, water, construction codes, etc.) than are the very poor.

    Do you know what therapy is? It does not feed, house, or clothe someone. It is not a quick fix. The problem I cited required a quick fix, and frankly Glasser favored government programs to help people in crisis, so it sounds to me like you looked up "personal responsibility" and "therapy" and came up with his name. His views have nothing to do with the problem my client faced, and the problem my client faced was certainly political in nature because his solution lay in either violating norms (crime or homelessness) or turning to taxpayer funded solutions.
  19. DarrylS

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    Do not know what I am talking about?? was involved with youth services for more 40 years.. Master of Social Work from Boston University.. at one time was licensed as a private therapist, for while was certified as a sex therapist, have supervised staff of 35 people including a staff of 7 professionals, have written for professional journals, staged conferences, consulted in various settings, and have been called on to testify as a witness in state and federal court.. on and on..

    No I do not know what therapy is??? Guess you know better.. when you start a scenario with a description of horrific and violent abuse that is enabling..

    If you do not see yourself as enabling, need to spend some time with a professional supervisor.. this has nothing to do with politics, it has to do with a set of standards and beliefs that are time tested and work..
    Last edited: Apr 10, 2011
  20. IcyPatriot

    IcyPatriot ---- JAG ----- PatsFans.com Supporter

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    #87 Jersey

    I'd give him a ride to the middle of the Tobin bridge.
  21. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    In this age of brief therapy, the luxuries of the past are simply not available. As you certainly know, therapy was largely a luxury for those who could afford to go to therapy frequently for many years if necessary. While I'm impressed truly by your credentials and you work as an administrator, they have nothing to do with my point that my question is essentially a political one about dealing with crisis, not about therapeutic interventions.

    The long-term work I do with this client is around ego strength and abandonment, and my theoretical orientation is drawn from the Stone Center and relational theory, which is certainly more in vogue for the last 25 years than Glasser, who I have not read and is not mentiioned in two standard texts I have before me. (And I'm sort of suprised you did not know that part of being in this field is to have a professional supervisor, and mine is probably as old as you, but like me she does not see compassion as enabling.)

    My question had nothing to do with therapy, and if you see the normal human decency of providing some practical help (including CBT) who is scared and in crisis as enabling, then I wonder what your motives of going into social work were.
    Last edited: Apr 10, 2011
  22. PatsWSB47

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    oh oh,............:popcorn:
  23. Mrs.PatsFanInVa

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    I wonder if you have any idea of what hearing that does to anyone who's life has been forever altered by the suicide of a loved one?

    Any idea at all?
  24. patsfan13

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    If I were advising the person in question, it would depend on whether their person wanted to be helped ie change their pattern of self destructive behavior. If they hadn't 'hit bottom' I would send them on their way, because there is nothing you can do for them, say a prayer that they decide not to destroy themselves before they die or hurt an innocent person.

    If they had 'hit bottom' and wanted to change? I would find out what sort of philosophy and or religion could help 'change their mind' in the literal sense to change/ reprogram their imprinted behavior their metaprogramming.
  25. Harry Boy

    Harry Boy Look Up, It's Amazing PatsFans.com Supporter

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    How does China handle these situations-----------:confused:

    Has anybody thought of giving the guy a newspaper and told him to read the Help Wanted section, (wal mart, mc-donalds, gas stations, bowling alley's, toilet cleaners, sh!t scrapers, dog walkers, car washes, fruit pickers, lawn mowers etc etc, he'd go to work tomorrow, if he can't read english get some moonbat to read it for him.

    :bricks:
  26. Mrs.PatsFanInVa

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    You do realize that it's virtually impossible to just "get a job" when you do not have a place to live, don't you?

    Most places don't hire the homeless.....

    I don't think Patters was talking about how to fix this guy's life forever (unless I seriously misunderstood the topic.)

    He's talking about the right now, the immediate. Where do you tell this kid to sleep tonight?

    IS there a place for this kid to sleep tonight?
  27. PatsFanInVa

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    Okay I'll stop being clueless long enough to (maybe) throw in a middle ground for you guys. Seems Darryl is responding to phrasing the question in terms of the client's background, together with the immediate crisis, which together (I think I'm being fair here,) combined to leave an impression of a penchant for drama. Patters replies that he actually is concerned with the immediate crisis.

    Part of this is way past me because you two are pros in the same field, so you're going into the "right approach" from a professional point of view, which seems to mean having a certain orientation toward the clients. Again, I am sure I'm grossly missing the fine points, but the difference seems to be Darryl is pointing out the many decision points prior to the point the individual is at right now, and Patters is sticking to the point of "yeah. Gotcha. But what advise do you give him tonight?"

    Maybe underlying some of this stuff is a thought on Darryl's part -- and I'm not a mindreader, but it seems that way -- that you (Patters) need to be able to do just what he was saying, metaphorically, when he said "walk away." (I think.) IOW getting torn up about the drama of the immediate crisis might make you -- ultimately -- less effective than if you "turned off" some of the immediate human response to the moment when the client's in crisis.

    But I'd also back up your (Patters') assertion that you just kept the question to what would you advise the client in a crisis -- and that doesn't necessarily mean that you foster dependency in this or other clients, by paternalistically viewing them only as guys who "never had a chance." It's possible that you're putting that in to flesh out why he's in the program. It's striking Darryl as exculpatory -- if I read this correctly.

    And I'm done, I just put myself in the middle between two pros who obviously care deeply for the people the rest of us are all to happy to just jettison (and yes that has to ultimately mean getting them to the point of self-sufficiency, when you succeed.) Maybe this also begs the question, what if you/we/they fail?

    Anyway sorry to air my ignorance on the particulars of this field. It is interesting watching you guys take these shots because it seems like we're getting a window into what's probably an oft-repeated disagreement in social services settings. But everything I've seen of both you guys tells me you're on the same "side" of all this, especially compared with jackasses like myself throwing in our flip 2 cents' worth.

    And Darryl, it still stands that even if it doesn't help the client to note the hand he was dealt... it's very worthwhile, "politically," for the rest of us to ponder just how many "invisible" advantages we have in so many cases. If we're going to be arguing policy, to me we need to recognize that when our efforts as a society are supposed to address the less fortunate, the term "less fortunate" truly does have a meaning.

    Even if ultimately it's mooted that you're less fortunate, if in fact you are. You have to find your way - I'm just saying there's a reason to preserve a country where there is help (rather than a ticket to the middle of a bridge).

    Darryl, question: granted, the 19-year-old kid effed up by the rules of the program. Is your immediate response, at this moment, "I can't talk to you. I hope I'll see you when you get it together," basically? Or do you see yourself in a similar situation as having the same list of options in hand as Patters outlined?

    Pardon my voyeurism and sorry if I just piss both of you off more.

    PFnV
  28. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    I very often embrace religion for my client, urging them to go to church even if they only use it as a safe haven for meditation and reflection. I also discourage them from government services (unless they have significant mental illness, such as schizophrenia or PTSD), and help them embrace their emotions before turning to prescription meds. I'm as a rule not an advocate of methadone or Suboxone, though some clearly need it to get their recovery on track.

    Most of those in rehab truly do want to change, but not only are they addicts, they face enormous stressors not only from the past (memories of rape, murder, stabbling, etc.), but also the present, in terms of poverty, legal issues, family problems, living in dangerous areas, remorse for things they've done, and lack of healthy role models. There's a limit to what a human being can handle before they engage in bad behavior or at least make bad decisions.

    But, again, the problem is that many of these people in the course of recovery run into various crises, and that's when philosophical ideas are of little value. The nature of therapy is to promote personal responsibility but many of these people are so terribly beaten down that they have a hard time believing they're capable of anything. That, in my opinion, is where society at large plays an important role -- validating their lives, giving them a roadmap to a better life, and providing them with the basic services to help them get their lives underway. It's a shame my client felt he had no choice but to relapse, so that he could get into a detox, and frankly I think his choice was a reasonable one under the circumstances.
    Last edited: Apr 10, 2011
  29. Patters

    Patters Moderator Staff Member PatsFans.com Supporter

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    AA has done wonders, but in this case, I think the main role AA played was helping my client in his resolve to get back into rehab (even if it meant relapsing and going to detox) rather than to continue using. I think AA play a great role for addressing addiction, but the emotional pain that often underlies addiction tends to be dealt with in the privacy of therapy.
  30. Real World

    Real World Rookie

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    zzzzzzzzzzzzz..............

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