Employers can play important role in employee’s return to health
Rob Ford’s well-publicized struggles with substance abuse and alcohol addiction reached new levels this spring when he attended a residential addiction facility. But after two months away, the Toronto mayor returned to his city declaring he had gone through “intensive rehab therapy” where he had confronted his demons.
“I learned about things like triggers and what happens when you have cravings. I learned that my addiction is really a disease, a chronic medical condition that will require treatment for the rest of my life. And I also learned that I’m not alone. That this disease touches many lives.”
And it is a long road to recovery, he said.
“Substance abuse is a very difficult thing to overcome, but I will keep battling this disease for the rest of my life. I will continue to receive ongoing professional treatment for my substance abuse problem.”
Ford’s quest for health will not be easy. On top of the usual pressures of the job, he returns in the middle of a mayoral campaign. But for any employee returning from rehab treatment, the journey is tough.
“Very often, rehab or residential programs are a very protected environment for people, so they are away from all the major challenges they have to face,” said Michael Krausz, director of the addiction psychiatry program at the University of British Columbia in Vancouver.
“They’re very often coming back to an environment which is not prepared in terms of dealing with the process a person goes through in a residential or rehabilitation process.”
Many people with substance dependence or severe problems also have mental health issues they need to cope with, so substance abuse is a strategy to cope with other symptoms, he said.
“Coming back, then, very often, the stress level is increasing very dramatically and the amount of support they have in the community or in the family or whatever is not comparable to what they had during the treatment.”
Work really is one of the top environments where people deal with difficult situations, said Oren Amitay, registered psychologist and media consultant in Toronto, and addiction can be related to work, as a stress relief. If the workplace is associated with the person’s downfall, there’s a lot anxiety in returning.
It’s hoped that in rehab, the person has learned to cope with more than just his addiction, because often there are other issues, such as maladaptive coping, he said. And the two top triggers are exposure to old cues and internal or external stresses.
“Going back to work, you’re hitting both of those triggers.”
But for some people, a job is the only thing that makes them feel good and productive, especially if the family situation is bad, said Amitay.
“For some people, going back to work, if it’s done properly, is the right thing to do — it gives them structure, it gives them value. But… if the stress is too much, then they’re setting themselves up for failure.”
Another option is a phased return to work, so people can ease back into their roles while on the path to recovery, he said.
“They can’t just jump right back in because all the same triggers are going to be there, and the same vulnerabilities.”
But a phased return to work depends on the person and the situation, said Lorne Hildebrand, executive director of the Edgewood addiction treatment centre in Nanaimo, B.C. Somebody coming out of treatment has a lot of time and anxiety on her hands, so it can make sense to get back to work right away.
“This is certainly a case where idle hands are not good — the quicker they can re-engage with their workplace, with their families, with their support networks… the quicker they can get back into the swing of life and feel like they’re doing something important and valued, the better.”
Employer support
Sometimes, employers pay for the rehabilitation and the after-care, he said.
“We will often ask the company to take on a responsibility, or at least their EAP company, of monitoring somebody for anywhere from one to five years after to make sure that the investment in treatment has been well-spent.”
That can mean regular drug screening to make sure there’s no relapse, meeting one-on-one with a counsellor on a weekly basis or joining a support group.
Prior to seeking treatment, there is likely conflict between the employee and her employer so, after treatment, it’s about creating a situation where they feel like they’re on the same team, said Hildebrand.
“The monitoring is not necessarily punitive but it’s a way to help the person to stay on their goals, stay and do what they need to do to have decent life and to be able to perform their job adequately and have continued employment.”
It’s important for employers to recognize that this person has a treatable illness, and there is a way out for her if she can follow a prescribed path of treatment, he said. Employers can also play a huge role in accountability.
“A manager should and a company should say to somebody, ‘Listen, we’re going to wipe the slate clean from the past but it doesn’t mean we’re going to let you off the hook for being healthy. So we’re going to ask for drug monitoring, we’re going to ask for drug testing, we’re going to ask that if there’s anything that puts our company or our employees or customers at risk or creates a problem, then you’d better be held accountable for it, so we’re going insist that you perform your job in way that is consistent with a healthy, sober individual.’”
Many employers are not aware of the issues involved and not really prepared to deal with them, said Krausz. Hiring an external counsellor to discuss privately the person’s problems and possible strategies can help.
“It’s much cheaper to support your employees than to fire them in a critical situation like that,” he said.
Very often, direct colleagues are an important resource, so human resources can suggest, “Your colleague has a problem, there’s no golden bullet for a solution, it will take some time — he needs your support,” said Krausz.
EAP services are also helpful but often short-term, with four or five sessions, so longer-term services would be helpful, said Amitay. And while employers are required by law to provide accommodations, this may mean “they will follow to the letter of the law but not quite the spirit, so to speak,” he said.
What’s really needed is understanding from the employer, and colleagues, so the person doesn’t feel guilty or under suspicion upon his return.
“Shame really is the number-one trigger in many cases,” said Amitay. “The employer should keep that in mind and understand that the person’s going to be hypersensitive to signs of that. Even if it’s not intended, even if it’s not real, the person may infer this type of atmosphere.”
