Jamie F., the mother of current Phase III client, Matt F., nearly lost him to an overdose,

but since enrolling at Turnbridge she has watched him embrace recovery and build a beautiful life for himself. Jamie recalled that Matt was a very personable and outgoing child, who embodies many qualities of a leader. His father was in the Air Force, which required the family to relocate multiple times during Matt’s childhood.

At one point, Matt father was deployed and shortly afterward Jamie was diagnosed with cancer. “Matt and his little brother both really had to step up at such a young age because I was weak,” said Jamie. Matt was about 9 years old and was looking after his mother and little brother. “It was a lot of stress and I don’t think he really articulated the stress, but he internalized it,” said Jamie. “I believe Matt was also very worried about losing his dad because we had some friends who lost their father in the Air Force.”

According to Jamie, It was not until high school that Matt was introduced to the party scene. “I believe he began to drink maybe a few times but nothing consequential,” she said. Matt continued to drink into his college years, but was not yet experiencing consequences from his use.

“During Matt’s junior year in college, his little brother was diagnosed with cancer and his grandmother had just passed away and I think he turned to substances to help deal with the stress,” Jamie said. During a trip home for Christmas, Matt’s family noticed some things were off. “He seemed a little spaced out and wasn’t his normal self.”

“We couldn’t figure out what was going on,” said Jamie. Matt continued to do well at school, and was accepted into graduate school. Not too long after, Matt’s brother passed away. “I don’t think he processed it and he had a really tough time,” Jamie said.

Following a routine surgery, Matt was prescribed pain medications. “I think they prescribed him way too many pain killers,” said Jamie. “I think he continued taking them to ease his stress and developed a dependency on them.”

One day, Matt’s mother decided to drive down to his college to check on him. He appeared to be sleeping when she arrived. “He continued sleeping for a very long time,” said Jamie. “I then found some paraphernalia and immediately called 911.” Matt had overdosed.

“He almost didn’t make it,” said Jamie. Matt spent 7 days in the ICU and came very close to death. “We were terrified. We had just lost our other son.”

One of Jamie’s life-long friends had recommended Turnbridge to her. “They told me that long term treatment was the only thing that worked and we didn’t look back,” said Jamie. Matt enrolled at Turnbridge.

“The second he arrived, we felt very comfortable and confident in the people of Turnbridge,” Jamie said.

Matt was motivated and dove right into the work required of him at Turnbridge. “I think he was tired of doing what he was doing and was truly happy to be at Turnbridge,” said Jamie. Matt established himself as a leader in the community and started building many meaningful relationships with his peers.

“The family workshops at Turnbridge were amazing,” said Jamie. “I got involved in Al-Anon and was reading a ton of material to learn that this was not my fault. I would not have got through this without the assistance and guidance of Turnbridge.”

“We have 100% confidence in Turnbridge and Matt has appreciated and trusted the process,” said Jamie. “I think it instilled some manhood in him that we couldn’t teach him.”

Matt continued to progress through the program and was eventually offered a House Manager position in Phase III. Matt was also recently accepted into graduate school at a local university and will be attending classes next semester.

“We both agreed that coming home wasn’t the best option and he wants to stay in Connecticut,” Jamie said. “We are so grateful for Turnbridge and for Matt. We never once doubted the program.”

The Therapeutic Alliance

In many adult clinical settings, adults are choosing to seek out a private practice clinician, which means inherently that they are willing and motivated for treatment and making changes in their personal lives. The majority of our young men and women do not fall into this category when they first enter treatment. They express reluctance, sometimes to the point of resistance for treatment. Working with a therapist counters young adults inherent demand for independence and their developmental strive to differentiate themselves from authority. These factors can lead to treatment interfering behaviors (late for session, skipping session, omitting important information on purpose) if the therapeutic alliance is not cultivated from the very beginning. Research has identified that a healthy therapeutic alliance means there is mutual respect, a sharing of the time together (“were in this together”), openness (no judgment), role differentiation (clear boundaries), guidance (suggestions rather than advice), trust (consistency and clear expectations), and mutual taking of responsibility. The more resistant the client, the more essential the respect and trust in the alliance becomes.

While all of this is easy to agree with and understand in the abstract, the reality of therapeutic alliances is that they take time. Those qualities listed above take weeks of consistency on behalf of the therapist. One of a therapist’s most essential skills is the ability to “meet the client where they are at”. That means for the more resistant clients, significant clinical change does not begin until some time into treatment. This can be frustrating both to the client and to their families as our clients come to us in crisis and all parties hope to “feel better as soon as possible”. Clinically significant change can’t always be seen week to week and is instead noticed over time; similar to the phrase “Rome wasn't built in a day”.

The length and structure of the Turnbridge Program is one of the best breeding grounds for a healthy therapeutic alliance out there. All research on this topic has identified that the alliance (as in all relationships) ebbs and flows through the treatment process. For example, a healthy therapeutic alliance allows a space for more significant clinical work and healing. Though, once that more intense work begins, the alliance can become strained and seen as a place of stress rather than healing and the client can begin to avoid. Re-engaging the client again then relies on the therapist refocusing back on the safety, trust, and collaborative nature of the alliance. The evolution of the therapeutic alliance through treatment is as essential to a client as any specific breakthroughs they make in session; it is the most effective tool in demonstrating to them they can work through a setback as a learning opportunity rather than a failure with the support of a consistent adult.

The therapeutic alliance, when done correctly, becomes an example for healthy interactions with adults, healthy expression of emotion, a connection with another person with healthy boundaries, and a secure attachment based on trust that allows for empowering the client to make their own solutions. And, as is no news to any of us, our clients demonstrate increased motivation and drive when they choose to.