This is the final installment in a three-column series dealing with the integration of wellness and recovery within the context of the emerging extended recovery treatment paradigm.

Extended recovery goes far beyond the prevailing treatment model, which focuses predominantly on acute stabilization, through embodying an ongoing continuum of monitoring and appropriate treatment interventions throughout the recovery process. These extended services are provided in recognition of the chronic and potentially deadly nature of substance abuse disorders – posing profound ramifications in terms of both funding and delivery of services. Significantly, in the extended recovery model, recovery is viewed as existing along a continuum of improved health, wellness and overall quality of life (Center for Substance Abuse Treatment, 2005). Wellness can be defined as the dynamic process of taking charge of our health and programming ourselves to attain optimal health and quality of life. The wellness model offers powerful applications in addictions treatment as it complements the recovery model by actively supporting the recovering alcoholic/addict in attaining a firm grounding in recovery; repairing cumulative damage to one’s mind and body; and enriching one’s overall quality of life in recovery (Newport, 2009).

The extended recovery continuum can be viewed as encompassing the following components: intervention; primary treatment; continuing care or extended care; early recovery; relapse prevention and intervention; and middle and latter stages of recovery.

Wellness can be defined as the dynamic process of taking charge of our health and programming ourselves to attain optimal health and quality of life.

It should be noted that these various phases of ongoing recovery are by no means mutually discreet. Indeed, people often move back and forth between these phases reflecting their ongoing struggle with issues impacting on their progress in recovery (Carruth, 2010).

Nutritional Foundations in Extended Recovery

Most alcoholics and addicts suffer chronic malnutrition as a consequence of dietary neglect during the active phase of addiction. Actively assisting the client in bringing his or her diet into proper balance is an important component of the treatment continuum both in terms of repairing damage to the brain and body and in safeguarding against relapse (Newport, 2009; Gorski, 1989).

Intervention: Confronting the client with his or her deteriorating physical health status during the intervention process, together with presenting a treatment option that empowers the client to play an active role in restoring health and vitality through participating in nutritional education, exercise and other wellness interventions, may help tip the balance in favor of active engagement in treatment.

Primary Treatment: During primary treatment the client should be educated concerning the impact of malnutrition on his or her overall health status and prospects for remaining clean and sober. Clients also need to exposed to meal preparation and healthy food choices and receive education regarding basic steps in transitioning to a health-conducive diet. These may include: eating three wholesome meals a day and cutting back on or eliminating “nutritional stressors” such as sugar and caffeine, etc. Residential treatment programs offer a distinct advantage in incorporating this component. Due to resource constraints, outpatient programs often provide very limited coverage in this important area.

Extended Care: Extended care embraces and goes beyond the conventional concept of continuing care, as it provides clients with continued support and treatment interventions, as needed, throughout the ongoing recovery process. Following primary treatment, clients should ideally receive a nutritional evaluation by a nutritionist with expertise in recovery, together with ongoing monitoring and counseling to actively assist them in transitioning to a diet that is fully supportive of long-term sobriety.

Measures that can be undertaken to make this component affordable include: referrals to cooking classes; periodic workshops on nutrition and recovery provided by either a treatment center or extended care provider as part of an ongoing educational series on wellness and recovery; and workbooks on nutrition and recovery containing homework assignments to be completed by clients and processed in a group setting. One example of a workbook designed for this purpose is the author’s Nutritional Foundations for Recovery workbook and instructor’s manual, published by Herald House/ Independence Press (for further information visit www.relapse.org).

Relapse Prevention and Intervention:Transitioning to a health-conducive diet provides an important safeguard against relapse throughout the recovery process. Successfully accomplishing this transition rewards the newly recovering person with improved health, vitality and alertness, while concurrently providing a tangible sense of accomplishment that serves to strengthen one’s commitment to recovery. Relapse intervention programs should include a basic focus on: improved health and hygiene; promoting grounding in such areas as nutritional foundations, exercise, stress management/time management; and sleep hygiene. Grounding in these areas helps reduce future likelihood of relapse through promoting increased hardiness and resiliency, together with a tangible investment in long term recovery.

Middle and Latter Stages of Recovery:Having attained a basic grounding in sobriety, the middle and latter stages of recovery provide an opportunity for one to focus on the qualitative aspects of recovery. These may include involvement in therapy to work on unresolved family of origin issues, committing oneself to actively pursue one’s true calling in life, and focusing attention on improving one’s overall state of health and well-being. Having secured a foot-hold in developing a positive self image and sense of self efficacy, the person may now be in a position to strive to reach new heights in the realm of health and wellness. These may include: fine-tuning one’s nutritional status and adopting sensible weight control measures; quitting smoking; and becoming more actively involved in exercise both for the pleasure and a desire to increase one’s overall level of fitness and cardiovascular health. Be on the lookout for CSAT’s forthcoming Treatment Improvement Protocol (TIP) report which will provide a detailed treatment of the exciting area of health, wellness and extended recovery. Until next time – to your health!

Dr. John Newport is an addiction specialist, author and speaker living in Tucson, Arizona. He is author of The Wellness-Recovery Connection: Charting You Pathway to Optimal Health While Recovering from Alcoholism and Drug Addiction. He is currently working 24/7 on a book titled The Tucson Tragedy: Lessons from the Senseless Shooting of Gabrielle Giffords. Comments

References

Carruth, Bruce (2010). The CDM Group, Inc., personal communication with author dated November 24, 2010.

Newport, John (2004). The Wellness-Recovery Connection: Charting Your Pathway to Optimal Health While Recovering from Alcoholism and Drug Addiction. Deerfield Beach, FL: Health Communications, Inc.

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