A Case Manager's Story: Options for Recovery

June: In Her Own Words

When I met Sara,* she was 35 years old and had been abusing drugs for more than 15 years. She was pregnant and also had a 14-year-old daughter who lived with her grandmother. Sara entered the program willingly but frequently said, "Why should I stay? I've never finished or succeeded at anything in my life." In spite of her self-doubts and temptations, she stuck it out.

It wasn't easy. "I really want to use" was her nearly constant refrain. When she vacillated, I introduced different strategies to try to keep her on track. I gave her a journal and told her to write her thoughts and feelings when she was scared and wavering. She'd never had a journal, but she came to love journaling, and it helped her through several crisis times. We also used a balance sheet approach, listing what she'd gain and what she'd lose if she left the program.

It was difficult for us to find transitional housing for Sara, so she moved in with her mother and the daughter from whom she'd been estranged for virtually the child's entire life. Because Sara was clean and sober, she was able to start repairing her relationship with her mother and getting to know her daughter.

Sara has begun to take responsibility for herself. She wants to rear her baby and not be separated from him the way she was from her daughter. She now makes competent, conscientious decisions, and she's in school learning a trade that will allow her to support her family.

And I recently realized it's been months since the last time she said she wanted to use.

*Names and identifying details have been changed to protect client confidentiality.