Responses to the story of the Judge and the Grieving Team; It’s time to retire “graduation” and “treatment completion”; My four words for the year ahead.

Welcome to the January edition of Tips and Topics.

In SAVVY, It’s time to retire terms and concepts like “graduation” “treatment completion” and embrace terms like “transition” and “commencement” after having done an initial piece of work on the path to recovery.

In SKILLS, what to say to Orient Participants to entering Drug Court and about “graduating”. Rename the Graduation or Treatment Completion Ceremony.

In SOUL, my four words to encapsulate the year ahead. What words do you see?

savvy

Last month, I told the story of the judge and the grieving Treatment Court team. They were grieving the loss of a graduate from the treatment court program who had relapsed and died from an overdose. The participant had graduated several years ago, was in long-term recovery, coming back to the court often to help those in recovery. She was recognized for that service in 2019 with an award given to alumni.

Two readers wrote about their reactions to the story. 

Tip 1

“Instead of a graduation ceremony we had a transition ceremony”.

Beth Kurren Cox, MSW, CSAC was the Admission and Assessment coordinator at Salvation Army Women’s Way program in Honolulu for 20 years but retired in 2019.

Beth wrote: “I was struck by the word “graduate” in terms of finishing a treatment program. When I worked in a residential treatment program we decided to change the word “graduate” to transition. So instead of a graduation ceremony we had a transition ceremony. It changes the whole essence of what we know about addiction.”

My Response:

Beth, thanks for writing and I totally agree with your concern about the word “graduate” and I have written about that before.

In SKILLS of the March 2011 edition, I wrote about unintended consequences of focusing clients on “graduating” and “treatment completion”. Instead of seeing addiction treatment as a process, too many teach compliance with a fixed program from which a person “graduates” when they “complete treatment”.

Influenced by what he had read, Izaak Williams researched the topic of “graduation” and authored a peer reviewed paper entitled “Drug Treatment Graduation Ceremonies: It’s Time to Put This Long-Cherished Tradition to Rest” I asked him to summarize his paper in the SAVVY section of the November 2014 edition.

If you want to take a deeper dive into this subject, take a look at a paper I co-authored with Izaak Williams “Rethinking Court-Sanctioned Reintegration Processes: Redemption Rituals as an Alternative to the Drug Court Graduation” I summarized some highlights in SAVVY of the June 2017 edition.

Tip 2

“To this day none of my programs have graduations. Instead we have commencements”.

Here’s the second reader, Kurt Zunker, M.S., Director, Laramie County Treatment Court Programs and his message about what he did to deal with grief and his story about “AA Mike”:

Dear Dr. Mee-Lee,

First thing today I read your latest tips and topics and was moved by the treatment court in Pennsylvania who is grieving the loss of a program graduate to an overdose. The story reminded me of some of my program participants, some who successfully completing the program, others who did not, who ultimately lost their battles with addiction. Personally, I decided to see a therapist to assist me in dealing with the pain and grief working in treatment courts can sometimes bring. It was one of the best decisions I have ever made.

Also as I was reading the article, I was reminded of a conversation I had years ago with “AA Mike” (not his real name). AA Mike was a neighbor of mine who found sobriety through AA thirty-plus years ago. AA Mike would come to my DUI Court every week to offer support to the participants, hand out AA meeting schedules, and offer rides for those who made need one.

AA Mike told me once that he hated the word “graduation” and how we used it to celebrate a participant’s successful completion of the program. He said to me, “What are they graduating from? Alcoholism? If anything, we should be celebrating a commencement, because that’s what the ‘graduates’ are doing. They are commencing on a new path of recovery.”

I do believe lots of treatment court programs focus too much of their energy on the notion of graduation. Sobriety and recovery is a lifelong journey that constantly needs to be evaluated, tuned-up, and adjusted. I worry that treatment court participants get a sense that once they complete the requirements of their programs, that they never have to evaluate, tune-up, and adjust their recovery ever again. 

AA Mike died a few years ago from Parkinson’s disease, which he attributed to his years of drinking. I will never forget the graduation vs commencement conversation we had. To this day none of my programs have graduations. Instead we have commencements. I credit AA Mike’s keen observation for this policy change.

Happy Holidays and God Bless. 

Sincerely,

Kurt

Kurt A. Zunker, M.S.

Director, Laramie County Treatment Court Programs

Cheyenne, WY

kurt.zunker@laramiecountywy.gov

skills

Tip 1 

What to say to Orient participants entering Drug Court and about “graduating”.

“Thank-you for choosing to enter join Drug Court. The reason you have been given the opportunity to get treatment rather than be incarcerated is that you have addiction that is related to your charges. We believe that if you get addiction treatment and establish recovery, this will not only be good for your life, but society will benefit from increased public safety, decreased crime and spending resources on treatment rather than incarceration, which is much more expensive.

But you are accountable for doing treatment, not time; for working on changing your attitudes, thinking and behavior; not just complying with a program and graduating. In fact, while you may hear the word “graduation”, your time here in this program is just an initial piece of work to get you started on the path of recovery. If we can attract you to start that journey, it really won’t be a graduation but a commencement celebration.”

Tip 2

Rename the Graduation or Treatment Completion Ceremony.

Perhaps you could call it the RCA – the Reflection, Celebration and Anticipation ceremony or event.

Reflection on what the client and family have learned, seen, gotten in touch with, changed since entering treatment. It can also be a reflection not just of positive things, but in all honesty (this is an honest program), reflection about things still not resolved or still not accepted. This is to model that this is about Progress not Perfection; about beginnings in recovery, not an end or completion of treatment; about reflecting on what might not yet be working, not just putting on a brave front to say everything is rosy.

Celebration of any accomplishments in this piece of recovery work done at this time in this program. Celebrating what has worked and what the program community has given the person; a time to be thankful for the challenging work the person has done so far in their recovery that is just beginning, not ending. Celebrating the hope that can be there for the client and family when there was only despair and hopelessness.

Anticipation of what lies ahead in their recovery – plans on how to continue gains that have been made; but also how to keep working on doubts or ambivalences or challenges that still may be there or are even likely to be there. Anticipation of what needs to be done to keep progressing and if not “perfect” and there is a slip or flare-up, what is plan B to get back on track – not with shame or a sense of failure, but with determination and commitment to keep moving forward – a day at a time with serenity.

soul

I don’t know who invented this fascinating “Rorschach” of words. It just popped up in my social media one day and I couldn’t resist trying it. You can do it too, just don’t overthink it. Just pick the first four words you see.

I’ll tell you my words after you try it. I don’t want to influence what pops out for you…..

My four words: Creation, love, gratitude and connection. Those words really did resonate for me.

Creation – Even though I am heavily in retirement mode, I still enjoy and will continue creating through writing Tips and Topics, and maybe even creating other ways to harness over 20 years of Archives.

Love – Who doesn’t want love? In English, our one word “love” is so inadequate. According to Greek philosophy, here are the 7 different kinds of love:

Eros – Romantic, Passionate Love (Of the Body).

Philia – Affectionate, Friendly Love.

Storge – Unconditional, Familial Love.

Agape – Selfless, Universal Love.

Ludus – Playful, Flirtatious Love.

Pragma – Committed, Long-Lasting Love.

Philautia – Self Love.

Gratitude – Living an attitude of gratitude can only bring more and more reasons to fuel even more gratitude.

Connection – Strengthening my ability and serenity to be alone only enhances any connection with others. Connections fueled by loneliness, insecurity, inadequacies and disempowerment are recipes for disaster.

So there you have it for a glimpse on what lies ahead for me in 2023. What about you?