Starting a Mandated Client on the Road to Recovery

By Carolyn Bloom Hakes BS 01/05/17

Was Sam addicted to K2 or suffering from “cell phone preoccupation” disorder?

A pile of old mobile phones
Some are tired of a life full of arrests and incarceration, but others... Sam believed that cell phones were his problem, not K2.

Although often maligned as a sub-optimal environment in which to establish a healthy recovery, many clients in mandated treatment do find the traction they need. Mandated treatment for airline pilots and physicians, for example, is often very successful. Obviously, such clients can be assumed to have a higher level of motivation to return to their previous high levels of functioning than clients who enter mandated treatment as an alternative to incarceration, but the good outcomes with these populations support the fact that mandated treatment in and of itself is not necessarily a barrier to beginning an intrinsically-motivated recovery…Richard Juman, PsyD

“Sam” entered our treatment center like so many others—mandated by his county’s probation department. He had been in jail for several months, so had agreed to 90 days of chemical dependency treatment in order to get out early. Upon his admittance to our facility, Sam stated that his drug of choice was K2 spice—synthetic marijuana. Many users view “spice” as more natural than marijuana and therefore less harmful. In reality, some users report psychotic effects like anxiety, paranoia and hallucinations. K2 spice, often with unknown ingredients, has also been known to cause brain damage.

I’m a counselor at an inpatient men’s unit. Although I am only able to work with our clients for 90 days, the maximum length of treatment in our program, I feel privileged at the deep level that I am allowed into my clients’ lives on a daily basis. We have 39 beds, with most of them being occupied by men who have been mandated to treatment by parole, probation or drug court. Every now and then we get someone who is self-referred, but that’s a rarity. As you can imagine, the motivation for treatment for most of our clientele is mixed. Some of them truly want to be clean—tired of a life full of arrests and incarceration. But most...most aren’t sure what they want. They are so entrenched in a life of crime and drug use that abstinence and recovery behavior is a foreign concept.

I greeted Sam when he arrived on the men’s unit after going through the intake process. I stood in the office, screening his belongings. He didn’t have much. Like others, his time in jail had made him quite resourceful. Sam had playing cards in plastic soap containers. He had made bracelets by stripping cloth from bedsheets and pillow cases. He had gauge earrings made of caps from water bottles. The tops of his ears were pierced with the teeth from a hair comb. He wore a long beard, telling me that he was a Mennonite and wore a beard to signify that he was married...I thought he looked like a white supremacist.

Here’s the other thing that Sam had amongst his belongings: picture after cut-out picture of cell phones. It was mind boggling. He also had a cell phone amongst his belongings, which I had to promptly confiscate. It was actually just a display model, not able to work, but important to Sam nonetheless. With his ear gauges and piercings removed, Sam and I sat down to review his intake assessment.

When we got to Sam’s drug using history, Sam had a confession. He really didn’t think K2 was a problem for him. In fact, he told me, he believed his addiction was to cell phones and not to drugs. Sam proceeded to tell me how much he loves cell phones. “It’s all I think about,” he said. He knows every brand, every model and, until the time he got locked up, simultaneously owned several different models. He told me of his dream to build a coffee table made of cell phones. His obsession with cell phones was so profound that one day when I had my personal cell phone on the desk and walked to my doorway to take care of something, Sam told me that he had to bow his head to avoid looking at my phone. The arrest that brought Sam to jail, and subsequently to my facility was, you guessed it, retail theft of a cell phone.

I had never really heard anything quite like Sam’s story. I understand people are attached to their cell phones, myself included, but this was like nothing I had ever heard of. I had to tell him, “Sam, we’re not a cell phone addiction treatment center. You need to think about why you’re here and what you’re here for. This is not a shelter or a ‘get out of jail free’ card. This is chemical dependency treatment center.”

My first order of business was to come up with Sam’s first treatment plan. Before I went any further with treatment, I needed to establish whether Sam understood his dependence on K2 as a problem, or if Sam was really appropriate to be at our facility. Certainly I didn’t want to waste my time with someone who was just occupying a bed. The vast majority of our clients are heroin dependent. The next most common drugs of choice are alcohol and cocaine. Occasionally we get someone who is strictly dependent on marijuana, but for many of our clients marijuana is a here or there thing, and mostly something that they’ve let go of in lieu of their current drug of choice.

I could tell from the beginning that Sam was having a difficult time adjusting to the program. After all, living day in and day out with 30-plus strangers with a strict group schedule and facility rules can be hard to adjust to for some. My office sits right across from one of the large treatment rooms. One day, while sitting at my desk, I see Sam reading a magazine with ear plugs in his ears. Not exactly the most inviting way to make new friends! I had to pull him aside to tell him that, “Nothing says ‘don’t talk to me’ like ear plugs in your ears. What are you doing?” Sam’s reply: “There’s too much talking.” Hmmm. Was this a person who had difficulty with sober socializing, or was this someone just trying to bide their time and avoid as much interaction as possible?

With treatment plan in hand, Sam spent his first week in treatment attending groups and listening to didactic lectures. In the course of this first week or two of treatment, I heard from several of my fellow counselors wanting to talk about Sam and his preoccupation with cell phones. He had been asking everyone in treatment what type of cell phone they own, and trying to guess before they tell him. According to Sam, there’s a personality type that tends to go for a particular cell phone model. He had pegged me as an Apple iPhone carrier long before he laid his wanting eyes on it. Not a tough guess, I suppose, but oy vey this guy is killing me!

Sam and I sit down to review his treatment work. “You know,” he says, “listening to all these other guys makes me think I might have a problem with K2. I figured because they’re all shooting up heroin, my problem wasn’t anything compared to theirs. What I realize is I’ve had a lot of things—bad things—happen to me, and every time something bad happens, I’m high on K2.” And there we had it: Sam is beginning to make some movement from pre-contemplation to contemplation. This pleases me very much. I don’t expect to “cure” anyone while they’re in a 90-day treatment, but if I can plant a seed that may resonate at some point, I feel I’ve done my job. Sam was beginning to realize that his K2 use, and perhaps his preoccupation with cell phones, were ways of distancing himself from his inner, genuine experience of the world and of other people.

Fast forward about 10 weeks and Sam has made several friends, serves as the lead on the kitchen crew and has moved his preoccupation with cell phones down to what seems like a much healthier “hobby level” interest. It’s also noteworthy that he shaved his beard. He’s now decided he wants to be Methodist.

Sam is someone I’ll never forget. He left our facility with what seemed like a new zest for life. He didn’t have many belongings, no family support, but what he did have was enthusiasm for moving into the action stage of change and turning his life toward a healthier direction. He also decided getting a job in a cell phone store was probably not a good idea!

Update: Shortly after his discharge I hear through the grapevine that Sam is back in jail, serving time for some outstanding charges. Hopefully when he gets out, he’ll keep heading down the positive path he seemed to be heading down at discharge.

Carolyn Bloom Hakes, BS, CADC recently moved from the suburbs to the city and left this position soon after being promoted to Senior Counselor in order to be closer to her new home. She now works in DUI counseling and greatly misses the challenges and rewards of traditional treatment.

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Carolyn Bloom Hakes, BS, CADC worked in the treatment field and is now in DUI counseling.