Words of Encouragement

By Jerry Scott | Reliance Treatment Center of Statesboro

He sat across the desk from me with the same grin that he always had on
his face as he came to see me for his weekly counseling sessions. Several
of my patients seemed to dread the day that they were flagged to see me,
but he seemed to look forward to our weekly counseling sessions. His long
hair was rarely what could be regarded as clean and he had patches of
wispy facial hair that he called a beard. He had experienced some traumatic
events as a child that I had never heard of in my years of experience as a
Child Protective Service Worker early in my Human Services career. These
events left him as a genuine loner. His support network was almost nonexistent.
Like so many of my patients in Medication Assisted Treatment, he
had exhausted his family with his drug use and they rarely spoke to him. He
called himself the black sheep of the family.

This session was unlike any I had ever had with him; today I had good
news. After we greeted each other I told him, “My friend I have good news
for you.” “What’s that”, he replied in a tone that suggested he thought I was
being less that genuine. I handed him the sheet of paper I had in my hand
and said “Here are the results of your last urine drug screen. It’s your first
negative screen.” He broke into a broad smile and jokingly said, “Now how
the hell did that happen?” We had talked about his positive drug screens for
over a year and each time I encouraged him to work toward stopping his
use so he could begin to enjoy some take home doses. He knew how hard
he had worked to have the privilege of finally holding that piece of paper.
Without thinking about what I was saying, and how moving a few words
could be to him, I said, “I’m proud of you.” The smile disappeared and he
stared at me for a few seconds that felt like minutes. He then dropped his
head and began to sniffle, then wiped his eyes with his hands. His sniffling
soon tuned to weeping, but after a few minutes he was able to compose
himself. As I passed him the box of tissues from my desk I said, “I’m sorry
pal, I didn’t mean to upset you. What just happened there?” He managed a
forced smile and replied, “You didn’t do anything. Do you know how long
it’s been since somebody told me they were proud of me?” I assured him
I didn’t l know how long it had been and that all I knew was that I was
genuinely proud of him. Something changed for him that day because in
future sessions I had the privilege of handing him many of those sheets of
paper that documented one negative drug screen after another.

One of my standard statements that I make to new employees is “We all
need on-going training and we all need to read about current events in
Medication Assisted Treatment, but if you’ll just listen to the patients you’ll get the best substance abuse treatment education available.” The young
man that I mentioned in the previous paragraph taught me a great deal that
day. Patients in Medication Assisted Treatment respond better to positive
feedback than when we point out their failures and shortcomings. People
have pointed out their failures for years before they come to us for
treatment, and look where that has taken them. Like you, I have more work
to do than I can accomplish most days but one thing I take time to do is
remind our patients when they have done well. I don’t wait for them to reach
major milestones in treatment, because many of them may never reach
those milestones. I watch for little things like first negative drug screens
and the first time I sign off on a phase up. For some patients, I leave a brief
handwritten note at the front desk when they have a full two weeks
without an absence. We talk about looking for the positives in staff meetings
and I ask the staff what they have done to point out the positives in our
patient’s lives.

Recently I signed off on a patient’s first phase advancement. He had been in
treatment for more than a year and had recently just started having negative
drug screens. Honestly, in the previous year I don’t think I had ever seen him
smile. When I signed off on his phase advancement I did what I do for most
other patients, I wrote a brief note and left it at the front desk for him.
Though I expected him to crumple it up and think it foolish of me to do such
a thing, I still made the effort to encourage him. Soon after he received my note I passed him in the hall. He stopped me to thank me for my note and told me how much it meant to him. The most important thing he
shared with me that day was something I had never seen him do, smile.

I have worked in Medication Assisted Treatment for 10 years now and
one thing I have found is that there is never a shortage of times when
our patients fail to meet what is expected of them. They have a
tremendous amount of drama in their personal lives; issues with
probation, difficulty holding on to a job, and many of them struggle with
authority figures at work and in most other aspects of their lives. It is
often difficult to find the “wins” but they are there if we look for them.
They are not always major victories, but I have found that if we take
time to point out the little ones, the big ones are much more likely
to happen.

Patient retention is an issue that we all face. I find that little things like
notes of encouragement and recognizing what many would see as small
accomplishments helps patients to see our staff as people who care. It
is much easier for our patients to come to a place where they feel they
are cared about. Once again, I find myself realizing that our patients
aren’t so different from us. If we go to a business where we are treated
with indifference, it is unlikely we will return. Can we really expect more
from our patients?