Overcoming 'Failure to Launch' with Bob Forrest

By Dawn Roberts 11/11/14

Recovery is a dirty business. Bob Forrest has the track record—and the forward thinking—to clean it up.

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Freethinkers are seldom understood or accurately framed in their time. Years from now, Bob Forrest may be seen as a fearless innovator or a misguided idealist. He sees his role as “the conscience of the recovery industry,” asking questions that elude simple, one-dimensional answers. Legacy preservation is not his concern; he's too busy engaged in the messy business of helping young suffering addicts recover.

Forrest has received more media attention than most. Between his presence on Celebrity Rehab, and the recent documentary about his life as a musician-addict-recovery advocate (Bob and the Monster), thousands of words have been written about him. Defining a man’s essence is no simple task. In Bob’s case it’s harder still, separating media mythology from fact. If he were to be characterized by one word, it would be survivor. Unlike some of his peers in recovery who have walked away from the business after devastating losses, he recalibrated and continues to move forward. That’s part of what makes his work and thoughts about the future of the recovery industry relevant. This survivor is willing to look at every crack in the facade of the addiction treatment system, with the intent to build a more effective model.

Forrest is a study in contradictions. This quality enables him to be a fiercely independent reformer with heart. Working with clients on the path to recovery is not a linear pursuit. If a practitioner cannot abide in a system rife with unresolved conflicts and navigate his way through a clutter of conflicting ideologies, he will have limited success.

A complex figure, he is inspired by a desire to change the paradigm of the recovery community while working in its nucleus. He characterizes rehabs as businesses “who have lost their souls.” That said, he is a partner in Acadia Malibu/Bob’s Place which includes an inpatient center, outpatient facility and a sober living house. More than anything he wants to improve the outcomes for treatment centers. This change won’t happen without modifications to the way addiction is treated today.

The Problems

Corporate-owned rehab facilities charge significant fees to direct clients to 12-step meetings. With a success rate hovering at about 5% it seems logical and worthwhile to give more to a client than a week in detox and 21 days to get acquainted with the “Big Book”. Many in chemical dependency study the “Minnesota Model” of recovery firmly rooted in the practices of 12-step programs. Recovery is contingent upon group membership and practicing the 12 steps of AA. Clients are told they are in the grip of a fatal disease, and that there is only one path to its cure. 

AA and its associated fellowships are not the only types of treatment programs available for individuals with substance abuse issues. The principles of AA, however, are utilized in the majority of treatment programs. Bob thinks integrated therapies are more effective techniques. They require synthesizing a variety of modalities. Since addiction affects every aspect of personhood, all components of the psyche need to be addressed. Reliance on one method for recovery creates an obvious disconnect. Informing clients that they’ll die if they don’t join a program that depends upon religious conversion guarantees that many will develop resentments that can only distract from recovery.

Forrest is critical of this approach while admitting that he is an active participant in 12-step meetings. He has learned from working with young addicts that proficiency with a number of tools is required. He has many clients for whom AA doesn’t resonate. For those in which the temperance, tone, and focus on religious conversion is a problem— there are options. 

The pillar of Bob’s philosophy is to meet clients at the psychic place they inhabit. He applies the concept of rigorous honesty to himself, as well as the patient. If asked if he is sober, he answers the question as well as admitting to his (former) drug of choice. Immediately this differs from the protocol of many clinicians. Often a therapist will not indicate whether they have ever had a substance abuse problem. Bob thinks this creates an atmosphere of distrust with clients, and creates an inability to form attachments with the treatment team. He believes trust, empathy, and accountability are the foundation for creating change in those seeking recovery.

Forrest focuses mainly on addiction in young adults. He practices a form of attachment therapy, which in this case means bonding with the client and talking honestly about every aspect of recovery. While he may be a role model for staying clean, he never infers he has perfected the art of living. This kind of sharing engenders confidence in his clients, some of whom continue to work with him for years while they reshape their own lives. Some clients who were initially resistant to 12-step programs change their minds after a time. As Bob often says, “It’s where all my friends are.” There’s also SMART Recovery, Rational Recovery and S.O.S. (Secular Organizations for Sobriety). He’s willing to direct clients to solutions that work for them.

Battle Scars

After working in the recovery business for over 20 years, on the front lines in intervention, recovery education and relapse prevention, he has strong opinions on what approaches achieve the best results. He believes in a team model where doctors, psychologists, CADAC counselors and technicians work together to create a treatment plan that is tailored for each client. Like Dr. Gabor Mate, who implores us to ask, “Not why the addiction, but why the pain?" Bob and his team search along the same lines, sourcing the roots of an individual’s addictive behavior.

Because of the economic climate rehab centers operate in, many jobs have been cut at treatment facilities. This means that marriage and family therapists are relied upon to counsel clients who might have also have worked with certified addiction specialists in the past. Every state has different laws, but the combination of weak oversight and communication lapses between officials, makes adult rehab centers easy marks for fraud and insufficient treatment. The lack of regulation for adult treatment centers is a source of ire for Bob.

Recovery is a dirty business. No one knows this better from all sides of the equation. As a patient at 24 different rehabs, and now as the owner of a facility, he has a perspective that few can claim. His view is that in recovery meccas like Malibu, treatment centers have gotten lazy. This is a bone of contention Forrest is eager to chew. His disdain for inefficient practices boils over into every discussion we have. It seems that knowing most of the clients will fail at staying clean has freed some institutions of their ethics altogether. While many who run such facilities are in recovery themselves, he has no doubt the motivation is collecting fees and keeping the patient count high. Forrest would like to take a suitcase full of dynamite and blow up that paradigm. However, he is not a terrorist. After resigning from one facility in protest and watching his first recovery center fail, he learned how to wade through ambiguity and contradiction into a focus on results.

Through his work at treatment facilities and his own enterprises, Bob has learned some hard lessons. When he took a stand against the use of detox drugs like Suboxone as maintenance for opiate addicts, the facility he worked at took a hit. A sucker punch strong enough to reduce the patient population by more than 50%. Recovery centers cannot be sustained on those figures, and ultimately the battle against Suboxone maintenance was lost, for that moment at least.

Bob has a torrent of ideas, expressed with the explosive cadence of an open fire hydrant. Sorting through, picking out the pieces and reassembling them is a worthwhile effort, because above everything else Forrest is onto something that works.

The recovery business has morphed into a mashup of a hospital and a high-end spa. To compete, offerings like personal chefs and the latest treatments (equine therapy, neurofeedback techniques) are requisite.  When you strip away the accoutrements, there are a few things that really count. Did the client gain skills that will help them navigate the world without addiction in the driver’s seat? Is there an extended aftercare program where the client is accountable to check in, and participate in processes that begin after a 30-day inpatient stay has ended? Is there someone in which that client has developed a level of trust and honesty with who can help get through the first tenuous phase of living clean?

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Dawn Roberts is a writer and media consultant in New York. Follow her on Twitter.