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Jessica Flannery is a Maine mother who returned to school to study addiction studies and human services. She has professional experience working with individuals affected by substance use and behavioral health challenges and also brings personal experience with recovery.
Addiction does not mean or look the same for everyone. Therefore, treatment should not use a cookie-cutter approach that is the same for every person. We all have different experiences, needs, struggles, and reasons for using substances in the first place. It only makes sense that recovery is going to look different for each person too.
I have seen this in both my own life and through working with people who struggle with substance use and behavioral health issues. Two people can have similar problems and still respond differently to the same type of treatment. One person may do very well in a structured group setting, while another may barely participate. Some people benefit from counseling, while others may need medication, peer support, mental health treatment, housing assistance, transportation, or a combination of all these things.
That does not mean that treatment should not have rules or expectations. I believe accountability is still important. Recovery takes work, and people have to be willing to participate in that process. But individualized treatment is not the same thing as making excuses. It means looking at the whole person instead of expecting everyone to fit into the same program.
One problem with a one-size-fits-all approach is what happens when someone starts missing appointments or stops participating in treatment. It can be easy to say that a person is not motivated or must not really want help. Sometimes that may be true, but I do not think that should be the first assumption.
There may be other reasons. Maybe they do not have reliable transportation. Maybe they are dealing with unstable housing, depression, family problems, withdrawal, or a work schedule they cannot control. Maybe they have had bad experiences with treatment before and do not trust providers. Or maybe the treatment plan they were given does not work for them.
Instead of only asking, “Why is this person not following the plan?” we should also ask, “What is stopping this plan from working?”
This is where case managers can make a huge difference. Case management should be more than giving someone a referral and expecting them to figure out the rest. A good case manager can help identify barriers, connect people with services, follow up, and notice when something needs to change. Sometimes keeping someone involved in treatment means changing the approach rather than immediately assuming the person has failed.
I also think the relationship between the client and the people helping them matters more than we sometimes realize. People know when they are being treated like a diagnosis, a case number, or just another person on a caseload. They also know when someone is actually listening to them.
When people feel respected, I believe they are more likely to be honest about what they are struggling with and more willing to stay involved in treatment. That does not guarantee recovery, but it gives treatment a much better chance of working.
Of course, treatment programs cannot completely redesign themselves for every client. They have rules, staffing issues, funding limits, and evidence-based practices they have to follow. I understand that. Individualized treatment does not mean throwing structure away. It means giving people choices when possible and being willing to adjust when something is clearly not working.
The goal should not simply be getting someone into treatment. The goal should be keeping them engaged long enough for treatment to actually help.
If someone is willing to ask for help, we should do everything we reasonably can to meet them where they are. If we keep asking people to fit the treatment instead of asking whether the treatment fits the person, we should not be surprised when people walk away. Addiction is different for every person. Recovery is too. Our treatment system should reflect that.