Q&A with Barbara Cox, MS, LSW
Since Oxford Treatment Center debuted its tailored treatment program for young adults age 18 to mid-20s, older patients are also benefiting from groups and living arrangements that are oriented around their clinical needs and make their treatment experience even more effective.
Clinical Therapist Barbara Cox, MS, LSW, often works with groups and individuals age 40 to 70s.
How do you think older adults at Oxford Treatment Center have benefited from the introduction of the Young Adult Program?
“It’s been very positive. Having their own space makes it easier for the older adults to be engaged. They approach the treatment experience differently than young adults do; they’re more serious about the work involved.
“Patients who are age 30 and older tend to be more mature and more settled in life, so sharing a living environment with younger people can be distracting for them. Now, they have a quieter space in which to reflect and prepare their assignments before their group meets. It’s made the group meetings even more powerful: Everyone comes engaged and ready to share.”
What are some of the challenges older adult patients face as they enter treatment for drug or alcohol addiction?
“Many of the patients I work with have been using for many years. They can’t imagine life any other way. So often, they come to us depleted physically, socially and emotionally — and convinced that their situation is hopeless.
“That’s why, as treatment begins, it’s important for my patients to know how much I believe in them. No matter what they’ve done or what they’ve experienced, I have confidence in each patient’s ability to participate, persevere and succeed in treatment. In the midst of all they face, truly there is hope.”
How are things different for those who became addicted more recently, after being prescribed pain medication?
“For this group, the initial challenge is simply coming to terms with the reality of their addiction. I work with many individuals who have never taken a drug or been addicted to it until they had a major surgery and were introduced to pain medication. They liked the way it made them feel, and they wanted more. In many cases, people were also struggling with depression — and suddenly they discover the feeling of a high. They say, ‘I never thought I could feel so good again.’
“So in contrast to those older adults who have been in and out of treatment all their lives, these are patients who never dreamed they would find themselves needing treatment for addiction.”
Your background is in vocational rehabilitation. What are some ways you help your patients get back on track in their careers after treatment for addiction?
“Focusing on work or on volunteering can be a healthy part of recovery, because when you are productive in your community, it makes you feel better about yourself. It helps you establish an identity and define your purpose — and keeps you from falling into depression, where relapse is more likely.
“On the other hand, I have individuals who will complain about their job while they’re here in treatment. They say, ‘I’m clean and sober now. It’s time to make a change.’ But I tell my patients: Generally, don’t make any major decisions within the first year.
“Sometimes, when you get clean and sober, you start looking at things through a different lens. It may be that there’s nothing wrong with the job. It may have been you. So I tend to advise them: ‘Let’s try to tough it out. If, within a year, things haven’t improved, then think about a change.’
“People also talk about going back to school right away, but I encourage them to wait, because of the high stress level involved. The main thing is to work on your recovery first and get well prior to making any major decisions.”
What are some ways you help prepare your patients for life after treatment?
“I work a lot on relapse prevention. It’s easy for people in recovery to think: ‘I’m fixed. I’m cured.’ I don’t want them to be surprised later to find that’s not the case.
“We talk through different high-stress situations that they might encounter when they return to their normal life, and we focus on developing new coping skills they can use to respond to those situations. It’s a huge advantage when they can anticipate these situations and have a plan for how to handle them without turning to drugs or alcohol.
“Helping people reestablish their personal values helps prevent relapse, too. You tend to throw your core values out the window when you’re using drugs or alcohol. But through identifying and reestablishing your values, you are better able to keep them at the forefront as a defense against relapse.”
How has your work at Oxford Treatment Center helped shape your perspective as a therapist?
“I know there is hope in treatment. I’ve seen people leave with a change. It involves coming to a place where you’re honest, open-minded and willing. And whether you’re a young adult or an older adult, it involves putting your laundry on the table. But it’s worth it.
“People wonder: Can I be successful in life without drugs and alcohol? Yes, you can. It’s being done every day, and the individuals we work with are living proof.”
About Barbara Cox
Clinical Therapist Barbara Cox, a licensed social worker, holds a bachelor’s degree in social work from Union University and a master’s degree in counseling from the University of Kentucky.
Prior to joining Oxford Treatment Center, she served clients through Mississippi Vocational Rehabilitation Services, working with the disabled and with those in recovery from alcohol and drug addiction. She has served on the advisory board for Ability Works in Oxford and is a member of the National Association of Social Workers.
As a resource on relapse prevention, Barbara recommends: “Relapse Prevention Workbook for Recovering Alcohol and Drug Dependent Persons” by Dennis C. Daley, PhD.