Simulated Back-To-Work Conference:

A Smooth Return to Work After Treatment

©1995 by Lewis N. Foster

 

     Employees who complete an inpatient, intensive outpatient, outpatient or continuing care program may benefit from a back- to-work-conference setup by the treatment program and involving the employees' supervisor, personnel director, manager or company owner.  This meeting can pave the way for a smooth return to work and set the tone for any expectations all parties have for each other.

     This writer at an inpatient treatment program in South Carolina used the idea successfully.  The conference was setup by the marketing director to take place a few days prior to the patients’ discharge.  The most important people to be involved are the patients' supervisor, the company personnel director (or a representative), the patient and the therapist.

     These people arrive at the center about thirty minutes before lunch and are given a tour of the facility by the marketing department personnel.  At noon, the therapist, patient and company representatives have lunch together.  This is a casual social time and conversation is guided (to some extent) away from treatment issues or serious topics.  After the meal everyone works their way to a private room where there may be a table for everyone to sit around and the therapist takes charge of the meeting.

     When everyone is seated the therapist begins the conference.  The following is a simulated back to work conference.  Present at the meeting are the therapist, John the patient, Mary the personnel director and Jack the supervisor.

      Therapist:  John, are you willing to share with your supervisor and personnel director the difference between when you were admitted to this program and John today?

      John:  Yes.  I was angry after the intervention.  [John is sitting up straight, looking everyone in the eye and speaking confidently.]  When I was admitted to this program I came because I wanted to save my job, to make things easier on me when I go to court and to get my family back.  I didn't know how mixed-up my thinking was.  I feel better, think clearer, enjoy playing table games and since coming here, volleyball.  My wife and I can talk to each other without fighting.

     She and the kids have been coming to the family program every week.  They attended the family education program and multiple family therapy groups.  There is hope for my family and me now.  We all agree that at the moment we need to focus on our recovery.  I really do feel better and I'm happy for the first time in years.  I know now that I am addicted and that I can't put that chemical into my body.  Coming to treatment has been a good experience for my family and me.

      Therapist:  What do you think it was like for Mary and Jack to be around you on the job while you were under the influence?

      John:  It wasn't easy, I'm sure.  I was a good worker and loyal to the company.  I've been there fourteen years, but I really don't know what it was like for them.

      Therapist:  Will you ask them what it was like for them?  What they saw, what they thought about what they saw, what they felt and what they did?

      John:  Sure, what was it like for you Mary?

      Mary:  John you are right.  You're one of our best and most productive employees.  Everyone likes you, respects you and sees you as a leader.  You work hard and play hard.  Without you, our Christmas parties would not be as special.  Over the past year, however, you began to change.  You were moody, irritable, hard to get along with and rude to our customers and us.  We had to move you so that you didn't have contact with customers.

     I think that was painful for you and for me.  You promised me several times that you could and would check you’re drinking. There came a time when I wouldn't let you work and sent you home.  To be honest with you, I've experienced all the drinking side of John that I want to experience.  I'm glad you're getting help.

      John:  Thanks Mary.  What was it like for you Jack?

      Jack:  As your supervisor, I couldn't ask for a better worker.  You are my best employee.  I wish I had a dozen just like you.  There were times when I thought that I smelled alcohol, but I thought that it was from the evening before.  You know, we were occasional visitor to Mack’s Place after work.  I'm your supervisor, but until recently there was mutual respect for our responsibilities on and off the job.  I called you my friend and it never got in the way.

     Over the last six months, or a year, communication broke down; you were hard to be around.  I began dreading coming to work because I knew you would be swinging from one mood to another and I didn't want to be around you.  I had been talking about finding a new job or at least transferring.  Thanks to Mary, she knew what to do.  We planned and did an intervention.  I must say, that was the right decision.  You look like the old John.  That is who I want to come back to work.

      John:  [Fighting the tears and taking a deep breath.] I'm sorry about that.  I think I've gotten a handle on my drinking now.  I'm ready to get back to work.  Those days are over, I hope.  This program has taught me a lot and I think I've got the tools I need to stay sober.

      Therapist:  You are going to be discharged in several days John.  Are you willing to find out from Jack and Mary what they expect of you when you return to work?

      John:  Okay

      Therapist:  I'll write on this pad what is said so that a back-to-work agreement is created and we'll all sign it and I'll make copies for everyone.  (I found that a lined pad of paper with a number two pencil works well.  Corrections can be made easily and it copies well.)

      John:  What do you want and need from me when I return to work?

      Mary:  Well, as you know, the number one thing is that you not drink.  We expect you to attend AA twice a week for a while, find a temporary sponsor within a week of your discharge, meet with your continuing care counselor regularly, and go with your family to the multiple family therapy groups weekly.  They have been coming and I understand that your wife wants to attend the family groups.  We've made a big investment in you and it makes sense that we follow through with the continuing care treatment.

      John:  I may need to take an hour off occasionally during the day to meet with my aftercare counselor.

      Mary:  I'm sure that Jack will work with you and we want you to go to the counseling sessions.

      Jack:  Just let me know.  I'll make sure you get to the meeting; even if I have to drive you (everyone laughs).

      Mary:  I want you to treat Jack, all the other employees and our customers with respect and me.

      John:  The alcohol played a big role there.

      Mary:  That does right and as a representative of the company I am tasked with making sure our employees help keep our customers.  One of our long-standing customers began using another supplier last year because of the way you treated his buyer.  They placed their first order with us in a year, last week.  We want you to treat our customers with respect.

      John:  I'm really sorry for the way I treated Sam.  Looking back, I can see how the alcohol changed me.  If I ever do anything like that again, for the good of the company, you should fire me on the spot.

      Mary:  I will John.

      John:  I won't put you in that position Mary.

      Therapist:  John are you willing to ask Jack what his expectations of you are when you return to work?

      John:  Sure, what do you want and need from me when I return to work Jack?

      Jack:  First, I want you to come to work on time every day and call if you are not going to come to work.  Second, treat me with respect and if you have a problem, come and talk with me.  Everyone in the shop has been asking about you and they're looking forward to your returning to work.  They only know that you are in the hospital.

     Like Mary, I want you to attend the meetings you need to and I'll work with you so you can make those meetings.  We want you as a sober employee for many years to come.  I will not be drinking around you or with you again.  In fact, since all this happened I've started looking at my drinking behavior.  I haven't been to Mack's since you entered this program.

      Therapist:  John, what do you think Mary and Jack should do if you begin using alcohol again?

      John:  They need to fire me if I start using again.

      Therapist:  Will you ask them what they are gong to do?

      John:  What are you going to do if I start drinking again? 

      Mary:  If you make a decision to start using alcohol again John, or any drug, then you will be making a decision to give up your job.  In fact, if you start drinking again just bring us a letter of resignation.  I'll respect you much more if I don't have to come to you, to let you know, you've made a decision to leave the company.

      Therapist:  Mary are you and Jack willing to ask John what he wants and needs from you when he returns to work?

      Mary:  Yes!  John what do you want and need from me?

      John:  Your support, encouragement, and an ear if I need to talk.  I think it would help me if I could move to working all days.  That way I can setup a schedule and be consistent.  It will also make it easier for me to attend AA meetings and multiple family therapy group sessions in the evenings with my family.  I need to spend more time with my wife and kids too.

      Jack:  What do you want from me John?

      John:  I want to be your friend again and I appreciate your deciding not to drink with or around me.  Your support and encouragement is what I need.  I'm going to be honest with the guys at work about my addiction to alcohol and where I've been.  Helping me move to straight days for a while will make a big difference.  I know I can come to you if I need something.

      Therapist:  We have come to know that people recovering form an addiction will slip and use as they learn to live a sober life.  We call that a lapse.  When a lapse is not checked it usually turns into a relapse that takes the addicted person out of control again.  Will your company take lapses into consideration with John?

      Mary:  First, we will move John to straight days so that he can maintain a recovery schedule.  Second, recently we began looking at the idea of lapse and relapse.  The policy is not complete.  (She turns and looks at John.)  We are willing to work with you John if you slip and use alcohol.  Should you slip tonight, for example, and you come to Jack or me and report it, we will work with you.  The key here is that you honestly keep us informed about your recovery or any slips.  If you slip we need to know within twenty-four hours.  We will then support your meeting with the continuing care counselor and attending at least one AA meeting the same day, and reporting the lapse to your sponsor.  If you go into a full relapse then we will be forced to honor your decision to give up your job.  What do you think about this John?

      John:  I don't think I'll ever use alcohol again and if I do I think you need to fire me.

      Therapist:  That's always an option for your company John.  Sometimes, patients just leaving an inpatient program will have very high expectations of themselves and not leave room for being a growing human.  Not everybody lapses or relapses.  You may be one who never does.  Just in case though, let's make some backup plans so that the company doesn't lose a good employee and you have all the support you need to stay sober.

     Are you willing to be honest with Mary and Jack about any slips and let them know within twenty-four hours of any alcohol use, and to follow-through with a plan to deal with any lapses?

      John:  Sure, I'm willing to work with Jack and Mary and to follow the plan.  If I do slip, and I don't think I will, it is good to know that I can be honest with them about it.

      Therapist:  I'll read the back-to-work-agreement to see if anything else needs to be added?

          (1)  Avoid the use of alcohol and any other drug.

          (2)  Attend AA twice a week.

          (3)  Find a temporary sponsor within a week of discharge.

          (4)  Meet with the aftercare/continuing care counselor as scheduled.

          (5)  Attend multiple family therapy groups with your family weekly.

          (6)  Treat coworkers and customers with respect.

          (7)  Be at work as scheduled and on time.

          (8)  A decision by John to use alcohol (or other drugs) is a decision by John to give up his job at the

               company.

          (9)  Jack agrees not to drink around or with John.

          (10) Mary & Jack agree to move John to straight days so that he can continue with a consistent recovery

               schedule.

          (11) Mary & Jack agree to work with John if he lapses.

          (12) John agrees to let Mary or Jack know within twenty-four hours of any lapse, to attend AA the

               same day, make immediate contact with the aftercare counselor, and report the lapse to his

               sponsor.

          (13) Should John allow any lapse to become a full relapse then #8 above goes into effect.

          (14) All parties concerned agree that honesty and keeping each other informed is the key to a

               successful recovery for John.

 

     Mary:  We need some way for John to let us know he is attending AA, found a sponsor, meeting with the continuing care counselor and going to the multiple family therapy groups.

      Therapist:  Any ideas?

      John:  You can call and talk to the counselors and sponsor if you want too.

      Therapist:  If we can keep John in charge then I think things will work out better.  Some employers ask their employee to bring a simple note from the counselor's stating that the employee met with them.  Other's ask that their employee verbally report weekly on the number of AA meetings attended or bring a note with the first name of someone at the AA meeting.

      Mary:  I would like for John to report to Jack each Monday morning the number of AA meetings attended the week before and Jack can let me know.  John can let Jack know when he has a temporary sponsor and permanent sponsor as well.

      John:  I can do that.

      Mary:  I would like permission from John to touch base with his continuing care counselor once a month.  I will want to know if John attended the sessions and if he is progressing.  There will be no need for specifics.

      John:  Sure, you have my permission to call the counselor as often as you wish.

 

     Therapist:  Is there anything else we need to add to this Back-to-work-agreement?

      John:  I can't think of anything.

      Mary:  Looks like all the bases have been covered. 

      Jack:  No, I'm just ready to have John back to work.

      Therapist:  That is a good point.  John will be discharged Thursday morning.  When do you want him back at work?

      Mary:  Some large companies have learned that if an employee returns to work the day after discharged from an inpatient program, then the success rate seems to improve.  So, I want John to report to the personnel department at 1:00 pm Thursday afternoon and back to work at 8:00 am Friday morning.

      John:  I'll be there.

      Therapist:  Let's review the back-to-work-agreement one more time to make sure we've included everything.   (The therapist reads the agreement to the group, adding the new points.) 

      Therapist:  Can anyone think of something that needs to be added?

      John:  No.

      Jack:  No.

      Mary:  No.

      Therapist:  Are you willing to agree to sit down in six months with each other to review this agreement, must to make sure it is still valid? 

      Mary:  That is a good idea.  There may be a need for changes.  I'll take responsibility to call everyone together six months from now.

      Therapist:  Then will each of you sign the agreement at the bottom and I'll make each of us a copy.

 (Everyone signs the agreement, including the therapist, and the therapist leaves the room to make copies for everyone, including a copy for the clients' chart.) 

     Therapist:  Here is a copy for all.  I'll put one in Johns' record here at the hospital and I'll keep a copy for my records.  Mary, Jack, thanks for your help.

      Mary:  Thank you.  Can I call if a need arises?

      Therapist:  Please do and here is my card.

   

Back-To-Work-Agreement

For John Smith

March 16, 2005

 

     (1)  Avoid the use of alcohol and any other drug.

     (2)  Attend AA twice a week.

     (3)  Find a temporary sponsor within a week of discharge.

     (4)  Meet with the aftercare/continuing care counselor as scheduled.

     (5)  Attend multiple family therapy groups with your family weekly.

     (6)  Treat coworkers and customers with respect.

     (7)  Be at work as scheduled and on time.

     (8)  A decision by John to use alcohol (or other drugs) is a decision by John to give up his job at the company.

     (9)  Jack agrees not to drink around or with John.

    (10)  Mary & Jack agree to move John to straight days so that he can continue with a consistent recovery schedule.

    (11)  Mary & Jack agree to work with John if he lapses.

    (12)  John agrees to let Mary or Jack know within twenty-four hours of any lapse, to attend AA the same day, make immediate contact with   the aftercare counselor, and report the lapse to his sponsor.

    (13)  Should John allow any lapse to become a full relapse then #8 above goes into effect.

    (14)        All parties concerned agree that honesty and keeping each other informed is the key to a successful recovery for John.

    (15)  John agrees to let Jack know each Monday morning the number of AA meetings he attended the week before. Jack agrees to keep Mary  advised about the AA meetings.

    (16)  John gives Mary permission to call and talk with his continuing care counselor to monitor his progress.

    (17)  John agrees to report to the personnel department at 1:00 pm Thursday after discharge from the hospital and to return to work at 8:00 am Friday morning.

 

     Employee          _________________              ___ Date _______

     Personnel Director__________________          ___ Date _______

     Supervisor                  _  ____________________ Date _______

    Therapist            ________          _____________ Date _______

 

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