| Abstract: Patients undergoing recovery from addiction, especially following an acute inpatient rehabilitation experience, often experience a period of time during which they are "spared" from typical daily activities, responsibilities, and reinforcers. During this time, particularly if living "back at home," demands on them are initially reduced, or non existent, but ideally should gradually increase, commensurate with ongoing successful habit development, but too often, they don't do so. Unfortunately, for some patients, their families, their rehabilitation clinicians, their healthcare payers/insurers, the legal system, their friends, and other key stakeholders in their recovery, either in being well intentioned..or simply by not paying attention.., set up an environment sheltering them not only from responsibilities "too much for them to handle" at this time, but unfortunately also from the many natural consequences that would bring life back to them, shaping their behaviors, overt and private, to assist to return them to (ideally, improved versions of) their "normal" lives. While they might participate in some sort of outpatient "program," sadly the absence of a systematically implemented, reevaluated, revised, and increased set of responsibilities and actions expected of them within their family or other living situation, outside of their formal outpatient drug rehab program activities, can allow them, or arguably, cause them, to become "permanent teenagers," returning from their outpatient program activities to their home, where they can isolate themselves into their rooms, pajamas, snack foods, phone, computer, and up all night schedules of internet or video or game controller or tv reruns, often absent even much interaction with other family members in the house. Instead of focusing on "esteem building," behavioral activation robustly employed, with a goal of developing patterns of behavior useful to returning to a (more desirable) day to day life going forward, can get them showered dressed, out of their rooms, out of their houses, and into volunteer or part time job activities which will, if guided well, expose them to natural reinforces that will train them, rehabilitate them, reanimate them, redefine them, and reintegrate them into the (hopefully well chosen) worlds around them, and increase the likelihood they will be fortified against the stimuli, internal and external, that might lead them to emit behaviors of relapse. |