Johnny Manziel and the Recovery Process

Cleveland Browns backup QB Johnny Manziel is back in the news for all the wrong reasons: Alcohol. Reported physical altercation with a woman. Speeding. Police report. As a mental health professional, licensed with the State of Ohio, I take you inside the recovery process.

All Cleveland Browns fans, even those who don't really want Johnny Manziel as their QB of the Future, were hopeful that the young man had turned the corner. All reports and statements from the team, including players who called out Manziel last year, were effusive in praise of the 2nd year QB.

However, as we all know at this point, the negative attention has returned to the one time Heisman Trophy winner with the moniker of "Johnny Football." Adam Schefter posted a report on Facebook yesterday afternoon. Nothing in the report was positive about Manziel but one paragraph really stood out:

Minutes later, police stopped Manziel's car on Nagle Road where he said both he and Crowley had been drinking in downtown Cleveland earlier that day.

Everyone knows Manziel's history. Partied too hard in college. Continued that tendency in his rookie year with the Browns. Then entered a rehabilitation center this offseason, being released in time to participate with his teammates to start the season.

A report that Manziel told the police that he had been drinking earlier that day raises flags. Especially for me as a mental health professional, 13 years of experience including working with addiction related issues. Manziel later tweeted about the incident but, unlike some have stated, did not say he hadn't been drinking:

The word "sober" does not mean that Manziel was not drinking, as the report Schefter posted he was. Instead all we know is Manziel was sober when speaking to the police, that he wasn't charged with anything and allowed to go home seems to prove Manziel's tweet to be accurate. 

The response from the media, and social media alike, has attacked Manziel, his behavior and his future with definitive statements.

"Manziel is done." "Johnny doesn't get it." "He doesn't care." "He is an idiot." "How could he drink after going to rehab?" "Manziel didn't take rehab serious."

And on, and on it has gone over the last 24 hours. Some have even noted their own issues with substances or a relative/friend that has dealt with addiction related issues.

Definitive statements made from limited, incomplete or ignorant (meaning lack of information not an attack-ative word) positions.

For a diehard Browns fan, someone who is paid to cover sports and a counselor by trade, I find myself upset and frustrated. To try to speak into the void, I decided to write to try to help educate and inform the discussion in a way that can help move it forward.

A few key pieces of information before I go forward:

  • I have never had any part of Manziel's treatment.
  • Nothing that I write should be considered a clinical recommendation for Manziel or anyone else.
  • I don't assume to know everything about Manziel's situation.
  • While I hope Manziel can pay off for the Browns long term, I am far from a Manziel fanatic.
  • None of this is in defense or excuse for Manziel.

What is Rehab?

What I have learned throughout the Manziel rehab process is that most believe rehab is a place someone goes to get fixed. Much like taking a car to the mechanics. This is not what rehab is and is an unrealistic expectation.

There are three basic goals of rehabilitation facilities:

  1. Stability in Medical, Emotional and Behavioral aspects of life.
  2. Understanding and agreement of root causes and behaviors that led to the need for rehab.
  3. Distinct plan for aftercare to assist in return to society.

The first goal is the most important. One way to think about it is like a juice cleanse. On a cleanse, people remove everything from their life to get rid of toxins and reset the system. Rehab pulls a person out of their everyday life, including away from substances, friends and family and their day to day routine to help them reset.

Once someone is stabilized in all three aspects, work begins on understanding and agreement on both the behaviors and causes of said behaviors. This agreement is between the client and the treatment team (generally a therapist and psychiatrist at a minimum). Just knowing and understanding these two things help form a foundation for which a client can move forward.

Finally, making the treatment team, along with the client and his support system, create a very distinct aftercare plan (think discharge plan upon release from hospital). This generally includes scheduled appointment with an outpatient therapist, a Relapse Prevention Plan (a lot of details are included in this) and contact information for any and all support client might need upon release.

Many, most, who go to rehab tend to go for 21 or 30 days. This is considered the bare minimum necessary to achieve the three goals listed above. It also tends to be the longest clients are willing to leave their lives. That, from all reports, Manziel went to rehab for at least double the standard stay is a positive sign.

What is Addiction?

As the coverage of Manziel's issues has been talked through, one thing has become clear: Most believe addiction is a behavior, will power issue. While using does require a behavior, it is a mental health issue. 

First, substance addiction is best described as an allergy. Much as my eyes, nose and throat reacts to the presence of cats even though most people don't have that experience, use of substances are similar. Most people can use substances within control because the feeling of being drunk or high doesn't feel good and actually makes them feel ill.

Those with a substance related allergy are the opposite. Without choice, they react positively to the feeling of getting buzzed. For them, it actually feels uncomfortable, unnatural to stop using before getting drunk or high.

Addiction is a mental health disorder that plays out behaviorally. Much like someone with Obsessive-Compulsive Disorder (OCD), where someone either obsesses or feels a compulsion then tends to act out, the behavior is not the issue. Someone with OCD may compulsively wash their hands but it is the compulsion that is the problem, not the washing hands. Just addressing the hand washing or substance use, or blaming the behavior, is accurate or appropriate.

What is the Plan?

There are two types of plans that are agreed upon in substance related treatment: Abstinence or Risk Management based treatment. These are behavioral plans as a piece of the holistic treatment for the client. 

Abstinence Based - Exactly what it seems, in abstinence based treatment the client makes a plan to avoid any and all use of substances. Based on the need to get drunk/high, and not just use or get buzzed, abstinence based treatment keeps clients from even starting down a dangerous road. For some clients this plan seems too difficult even though long term it is actually the easier plan.

Risk Management Based - The plan many clients start with, risk management is about limiting use to only when there is little to no risk. For example, a client who was drinking two bottles of wine a day, throughout the day makes a plan to only drink two glasses of wine a day and only between 6PM and 10PM.

Have no idea what therapeutic plan Manziel was working. If it was the first, he certainly relapsed if Schefter's report is accurate. If it was the latter, nothing is certain but it seems he wasn't intoxicated as the police allowed him to drive home with no charges.

Most who leave rehab continue in holistic treatment for a minimum of 3 to 6 months. Group therapy is generally considered best practice for substance related disorders. Intensive Outpatient Program is for those actively using with a dependence related diagnosis. That treatment is a minimum of 9 hours per week, generally three group sessions for three hours at a time.

Clients in aftercare from rehab still need to be dealing with the root issues and compulsions that led them to need to go into rehab in the first place. This treatment happens in connection to group treatment and is at least once a month for about an hour. Just working on the behavior related issues is not enough, the mental health issues have to be priority to achieve goals.

Expectations?

While most believe that someone coming out of rehab, if "they cared, tried, put in the work", should not use again. Those thoughts are based on false assumptions. Going to rehab is a great decision for someone having a big struggle. It is great for resetting the system, understanding the struggle and making plans for a healthy future.

On average, an addict relapses eight (8!) times before their recovery really takes. That starts when a client makes the decision to really work a recovery program. For some it can take right away, for most it is a much longer process.

In treatment, therapists are looking for progress, not perfection. While we hope that clients can quickly move forward in health, we look to help them progress towards that goal instead of focusing on failures. In weight loss treatment, which is also progress oriented, it isn't about your current weight but how far you have come. Drinking, speeding and having the police involved isn't a great sign for Manziel's progress but all the reports coming out of the Browns locker room seems to indicate progress is noticeable day to day.

Do Consequences Matter?

Manziel could have lost his job in the NFL after last year's behavior, much of which connected to the issues that led to rehab. If the Schefter report is accurate, Manziel is lucky his driving didn't cause an accident as he reportedly was speeding, driving on the shoulder and seemingly reckless. Employment at risk, possibility of jail and the need for rehab seem like they should be enough consequences for Manziel to change his ways.

Except consequences are rarely proven to create change.

Three months later, about 75% of people who have a heart attack are back to eating and exercising the way they were the day they had their heart attack. If having a life threatening event (I'm considering all heart attacks serious) is not a big enough consequence to change behavior, not much is.

Instead, having positive goals, not avoidant related goals, and support people affirming the positive changes are the most important aspects of success.

Am I Concerned about Johnny Manziel?

I hope this article has been helpful in at least informing you about the recovery process. Trying to shrink 13 years of experience and a Master's level of education into a 2,000+ word article that is concise and accurate was a challenge. One last question is left: Is Jared, a counselor, concerned about Johnny Manziel?

Yes!

Yet, my biggest concern is not related to his substance use, though that is a concern. Manziel's girlfriend should be one of his biggest and most important support people. Her lifestyle, at least what we've seen on social media, and this incident presents that she may not be able to provide that support. She could either be his biggest support or his biggest anchor. In no way am I blaming her, Manziel is responsible for his own behaviors. If she isn't helpful, he needs to move on.

Driving fast (this is not the only report of reckless behavior since rehab) and putting himself in dangerous positions are also big concerns. These were issues in Manziel's history as well and could be a sign that some of the root issues are still not only present but strong. Change is hard.

Finally, even if he is on a Risk Management Plan, using at all after rehab, especially this soon, is concerning. Most, if not all, of us that cover the Browns have heard stories of Manziel drinking all the way back to this summer. Does he feel like he needs alcohol? Does he feel entitled to alcohol? Does he believe he deserves to be able to drink? If he is in a Risk Management Plan, is he following the plan?

What Now?

Some, including major media members, have called for Manziel to return to rehab, to get cut or to be demoted to inactive this week. Professionally speaking, those are not good suggestions and are generally based on a misunderstanding of the recovery process.

Manziel needs to follow his recovery plan that he made coming out of rehab, needs support and needs to take responsibility for his life. He needs to continue to focus on both the behavior and mental health aspects of the issues that led him into rehab in the first place. Those supporting him, and maybe even fans and media, need to focus on progress, look for the positives and encourage him towards his future goals.

---

Some will read this article and think I'm making excuses for Manziel. Some will read this article and quickly forget the information within as it doesn't fit their narratives. Others will blow off the information because of their personal experiences. Hopefully many of you will take this article as a learning tool. I look forward to the conversation that follows in our forum and on social media.


The OBR Top Stories

The word \"sober\" does not mean that Manziel was not drinking, as the report Schefter posted he was. Instead all we know is Manziel was sober when speaking to the police, that he wasn't charged with anything and allowed to go home seems to prove Manziel's tweet to be accurate. 

\n

The response from the media, and social media alike, has attacked Manziel, his behavior and his future with definitive statements.

\n

\"Manziel is done.\" \"Johnny doesn't get it.\" \"He doesn't care.\" \"He is an idiot.\" \"How could he drink after going to rehab?\" \"Manziel didn't take rehab serious.\"

\n

And on, and on it has gone over the last 24 hours. Some have even noted their own issues with substances or a relative/friend that has dealt with addiction related issues.

\n

Definitive statements made from limited, incomplete or ignorant (meaning lack of information not an attack-ative word) positions.

\n

For a diehard Browns fan, someone who is paid to cover sports and a counselor by trade, I find myself upset and frustrated. To try to speak into the void, I decided to write to try to help educate and inform the discussion in a way that can help move it forward.

\n

A few key pieces of information before I go forward:

\n

What is Rehab?

\n

What I have learned throughout the Manziel rehab process is that most believe rehab is a place someone goes to get fixed. Much like taking a car to the mechanics. This is not what rehab is and is an unrealistic expectation.

\n

There are three basic goals of rehabilitation facilities:

\n
  1. Stability in Medical, Emotional and Behavioral aspects of life.
  2. \n
  3. Understanding and agreement of root causes and behaviors that led to the need for rehab.
  4. \n
  5. Distinct plan for aftercare to assist in return to society.
  6. \n

The first goal is the most important. One way to think about it is like a juice cleanse. On a cleanse, people remove everything from their life to get rid of toxins and reset the system. Rehab pulls a person out of their everyday life, including away from substances, friends and family and their day to day routine to help them reset.

\n

Once someone is stabilized in all three aspects, work begins on understanding and agreement on both the behaviors and causes of said behaviors. This agreement is between the client and the treatment team (generally a therapist and psychiatrist at a minimum). Just knowing and understanding these two things help form a foundation for which a client can move forward.

\n

Finally, making the treatment team, along with the client and his support system, create a very distinct aftercare plan (think discharge plan upon release from hospital). This generally includes scheduled appointment with an outpatient therapist, a Relapse Prevention Plan (a lot of details are included in this) and contact information for any and all support client might need upon release.

\n

Many, most, who go to rehab tend to go for 21 or 30 days. This is considered the bare minimum necessary to achieve the three goals listed above. It also tends to be the longest clients are willing to leave their lives. That, from all reports, Manziel went to rehab for at least double the standard stay is a positive sign.

\n

What is Addiction?

\n

As the coverage of Manziel's issues has been talked through, one thing has become clear: Most believe addiction is a behavior, will power issue. While using does require a behavior, it is a mental health issue. 

\n

First, substance addiction is best described as an allergy. Much as my eyes, nose and throat reacts to the presence of cats even though most people don't have that experience, use of substances are similar. Most people can use substances within control because the feeling of being drunk or high doesn't feel good and actually makes them feel ill.

\n

Those with a substance related allergy are the opposite. Without choice, they react positively to the feeling of getting buzzed. For them, it actually feels uncomfortable, unnatural to stop using before getting drunk or high.

\n

Addiction is a mental health disorder that plays out behaviorally. Much like someone with Obsessive-Compulsive Disorder (OCD), where someone either obsesses or feels a compulsion then tends to act out, the behavior is not the issue. Someone with OCD may compulsively wash their hands but it is the compulsion that is the problem, not the washing hands. Just addressing the hand washing or substance use, or blaming the behavior, is accurate or appropriate.

\n

What is the Plan?

\n

There are two types of plans that are agreed upon in substance related treatment: Abstinence or Risk Management based treatment. These are behavioral plans as a piece of the holistic treatment for the client. 

\n

Abstinence Based - Exactly what it seems, in abstinence based treatment the client makes a plan to avoid any and all use of substances. Based on the need to get drunk/high, and not just use or get buzzed, abstinence based treatment keeps clients from even starting down a dangerous road. For some clients this plan seems too difficult even though long term it is actually the easier plan.

\n

Risk Management Based - The plan many clients start with, risk management is about limiting use to only when there is little to no risk. For example, a client who was drinking two bottles of wine a day, throughout the day makes a plan to only drink two glasses of wine a day and only between 6PM and 10PM.

\n

Have no idea what therapeutic plan Manziel was working. If it was the first, he certainly relapsed if Schefter's report is accurate. If it was the latter, nothing is certain but it seems he wasn't intoxicated as the police allowed him to drive home with no charges.

\n

Most who leave rehab continue in holistic treatment for a minimum of 3 to 6 months. Group therapy is generally considered best practice for substance related disorders. Intensive Outpatient Program is for those actively using with a dependence related diagnosis. That treatment is a minimum of 9 hours per week, generally three group sessions for three hours at a time.

\n

Clients in aftercare from rehab still need to be dealing with the root issues and compulsions that led them to need to go into rehab in the first place. This treatment happens in connection to group treatment and is at least once a month for about an hour. Just working on the behavior related issues is not enough, the mental health issues have to be priority to achieve goals.

\n

Expectations?

\n

While most believe that someone coming out of rehab, if \"they cared, tried, put in the work\", should not use again. Those thoughts are based on false assumptions. Going to rehab is a great decision for someone having a big struggle. It is great for resetting the system, understanding the struggle and making plans for a healthy future.

\n

On average, an addict relapses eight (8!) times before their recovery really takes. That starts when a client makes the decision to really work a recovery program. For some it can take right away, for most it is a much longer process.

\n

In treatment, therapists are looking for progress, not perfection. While we hope that clients can quickly move forward in health, we look to help them progress towards that goal instead of focusing on failures. In weight loss treatment, which is also progress oriented, it isn't about your current weight but how far you have come. Drinking, speeding and having the police involved isn't a great sign for Manziel's progress but all the reports coming out of the Browns locker room seems to indicate progress is noticeable day to day.

\n

Do Consequences Matter?

\n

Manziel could have lost his job in the NFL after last year's behavior, much of which connected to the issues that led to rehab. If the Schefter report is accurate, Manziel is lucky his driving didn't cause an accident as he reportedly was speeding, driving on the shoulder and seemingly reckless. Employment at risk, possibility of jail and the need for rehab seem like they should be enough consequences for Manziel to change his ways.

\n

Except consequences are rarely proven to create change.

\n

Three months later, about 75% of people who have a heart attack are back to eating and exercising the way they were the day they had their heart attack. If having a life threatening event (I'm considering all heart attacks serious) is not a big enough consequence to change behavior, not much is.

\n

Instead, having positive goals, not avoidant related goals, and support people affirming the positive changes are the most important aspects of success.

\n

Am I Concerned about Johnny Manziel?

\n

I hope this article has been helpful in at least informing you about the recovery process. Trying to shrink 13 years of experience and a Master's level of education into a 2,000+ word article that is concise and accurate was a challenge. One last question is left: Is Jared, a counselor, concerned about Johnny Manziel?

\n

Yes!

\n

Yet, my biggest concern is not related to his substance use, though that is a concern. Manziel's girlfriend should be one of his biggest and most important support people. Her lifestyle, at least what we've seen on social media, and this incident presents that she may not be able to provide that support. She could either be his biggest support or his biggest anchor. In no way am I blaming her, Manziel is responsible for his own behaviors. If she isn't helpful, he needs to move on.

\n

Driving fast (this is not the only report of reckless behavior since rehab) and putting himself in dangerous positions are also big concerns. These were issues in Manziel's history as well and could be a sign that some of the root issues are still not only present but strong. Change is hard.

\n

Finally, even if he is on a Risk Management Plan, using at all after rehab, especially this soon, is concerning. Most, if not all, of us that cover the Browns have heard stories of Manziel drinking all the way back to this summer. Does he feel like he needs alcohol? Does he feel entitled to alcohol? Does he believe he deserves to be able to drink? If he is in a Risk Management Plan, is he following the plan?

\n

What Now?

\n

Some, including major media members, have called for Manziel to return to rehab, to get cut or to be demoted to inactive this week. Professionally speaking, those are not good suggestions and are generally based on a misunderstanding of the recovery process.

\n

Manziel needs to follow his recovery plan that he made coming out of rehab, needs support and needs to take responsibility for his life. He needs to continue to focus on both the behavior and mental health aspects of the issues that led him into rehab in the first place. Those supporting him, and maybe even fans and media, need to focus on progress, look for the positives and encourage him towards his future goals.

\n

---

\n

Some will read this article and think I'm making excuses for Manziel. Some will read this article and quickly forget the information within as it doesn't fit their narratives. Others will blow off the information because of their personal experiences. Hopefully many of you will take this article as a learning tool. I look forward to the conversation that follows in our forum and on social media.

","mobileBody":"

All Cleveland Browns fans, even those who don't really want Johnny Manziel as their QB of the Future, were hopeful that the young man had turned the corner. All reports and statements from the team, including players who called out Manziel last year, were effusive in praise of the 2nd year QB.

However, as we all know at this point, the negative attention has returned to the one time Heisman Trophy winner with the moniker of \"Johnny Football.\" Adam Schefter posted a report on Facebook yesterday afternoon. Nothing in the report was positive about Manziel but one paragraph really stood out:

Minutes later, police stopped Manziel's car on Nagle Road where he said both he and Crowley had been drinking in downtown Cleveland earlier that day.

Everyone knows Manziel's history. Partied too hard in college. Continued that tendency in his rookie year with the Browns. Then entered a rehabilitation center this offseason, being released in time to participate with his teammates to start the season.

A report that Manziel told the police that he had been drinking earlier that day raises flags. Especially for me as a mental health professional, 13 years of experience including working with addiction related issues. Manziel later tweeted about the incident but, unlike some have stated, did not say he hadn't been drinking:

and when we talked to the police and they realized everything was alright and I was sober, we went home together and everything is fine.

— Johnny Manziel (@JManziel2) October 16, 2015

The word \"sober\" does not mean that Manziel was not drinking, as the report Schefter posted he was. Instead all we know is Manziel was sober when speaking to the police, that he wasn't charged with anything and allowed to go home seems to prove Manziel's tweet to be accurate.

The response from the media, and social media alike, has attacked Manziel, his behavior and his future with definitive statements.

\"Manziel is done.\" \"Johnny doesn't get it.\" \"He doesn't care.\" \"He is an idiot.\" \"How could he drink after going to rehab?\" \"Manziel didn't take rehab serious.\"

And on, and on it has gone over the last 24 hours. Some have even noted their own issues with substances or a relative/friend that has dealt with addiction related issues.

Definitive statements made from limited, incomplete or ignorant (meaning lack of information not an attack-ative word) positions.

For a diehard Browns fan, someone who is paid to cover sports and a counselor by trade, I find myself upset and frustrated. To try to speak into the void, I decided to write to try to help educate and inform the discussion in a way that can help move it forward.

A few key pieces of information before I go forward:

What is Rehab?

What I have learned throughout the Manziel rehab process is that most believe rehab is a place someone goes to get fixed. Much like taking a car to the mechanics. This is not what rehab is and is an unrealistic expectation.

There are three basic goals of rehabilitation facilities:

  1. Stability in Medical, Emotional and Behavioral aspects of life.
  2. Understanding and agreement of root causes and behaviors that led to the need for rehab.
  3. Distinct plan for aftercare to assist in return to society.

The first goal is the most important. One way to think about it is like a juice cleanse. On a cleanse, people remove everything from their life to get rid of toxins and reset the system. Rehab pulls a person out of their everyday life, including away from substances, friends and family and their day to day routine to help them reset.

Once someone is stabilized in all three aspects, work begins on understanding and agreement on both the behaviors and causes of said behaviors. This agreement is between the client and the treatment team (generally a therapist and psychiatrist at a minimum). Just knowing and understanding these two things help form a foundation for which a client can move forward.

Finally, making the treatment team, along with the client and his support system, create a very distinct aftercare plan (think discharge plan upon release from hospital). This generally includes scheduled appointment with an outpatient therapist, a Relapse Prevention Plan (a lot of details are included in this) and contact information for any and all support client might need upon release.

Many, most, who go to rehab tend to go for 21 or 30 days. This is considered the bare minimum necessary to achieve the three goals listed above. It also tends to be the longest clients are willing to leave their lives. That, from all reports, Manziel went to rehab for at least double the standard stay is a positive sign.

What is Addiction?

As the coverage of Manziel's issues has been talked through, one thing has become clear: Most believe addiction is a behavior, will power issue. While using does require a behavior, it is a mental health issue.

First, substance addiction is best described as an allergy. Much as my eyes, nose and throat reacts to the presence of cats even though most people don't have that experience, use of substances are similar. Most people can use substances within control because the feeling of being drunk or high doesn't feel good and actually makes them feel ill.

Those with a substance related allergy are the opposite. Without choice, they react positively to the feeling of getting buzzed. For them, it actually feels uncomfortable, unnatural to stop using before getting drunk or high.

Addiction is a mental health disorder that plays out behaviorally. Much like someone with Obsessive-Compulsive Disorder (OCD), where someone either obsesses or feels a compulsion then tends to act out, the behavior is not the issue. Someone with OCD may compulsively wash their hands but it is the compulsion that is the problem, not the washing hands. Just addressing the hand washing or substance use, or blaming the behavior, is accurate or appropriate.

What is the Plan?

There are two types of plans that are agreed upon in substance related treatment: Abstinence or Risk Management based treatment. These are behavioral plans as a piece of the holistic treatment for the client.

Abstinence Based - Exactly what it seems, in abstinence based treatment the client makes a plan to avoid any and all use of substances. Based on the need to get drunk/high, and not just use or get buzzed, abstinence based treatment keeps clients from even starting down a dangerous road. For some clients this plan seems too difficult even though long term it is actually the easier plan.

Risk Management Based - The plan many clients start with, risk management is about limiting use to only when there is little to no risk. For example, a client who was drinking two bottles of wine a day, throughout the day makes a plan to only drink two glasses of wine a day and only between 6PM and 10PM.

Have no idea what therapeutic plan Manziel was working. If it was the first, he certainly relapsed if Schefter's report is accurate. If it was the latter, nothing is certain but it seems he wasn't intoxicated as the police allowed him to drive home with no charges.

Most who leave rehab continue in holistic treatment for a minimum of 3 to 6 months. Group therapy is generally considered best practice for substance related disorders. Intensive Outpatient Program is for those actively using with a dependence related diagnosis. That treatment is a minimum of 9 hours per week, generally three group sessions for three hours at a time.

Clients in aftercare from rehab still need to be dealing with the root issues and compulsions that led them to need to go into rehab in the first place. This treatment happens in connection to group treatment and is at least once a month for about an hour. Just working on the behavior related issues is not enough, the mental health issues have to be priority to achieve goals.

Expectations?

While most believe that someone coming out of rehab, if \"they cared, tried, put in the work\", should not use again. Those thoughts are based on false assumptions. Going to rehab is a great decision for someone having a big struggle. It is great for resetting the system, understanding the struggle and making plans for a healthy future.

On average, an addict relapses eight (8!) times before their recovery really takes. That starts when a client makes the decision to really work a recovery program. For some it can take right away, for most it is a much longer process.

In treatment, therapists are looking for progress, not perfection. While we hope that clients can quickly move forward in health, we look to help them progress towards that goal instead of focusing on failures. In weight loss treatment, which is also progress oriented, it isn't about your current weight but how far you have come. Drinking, speeding and having the police involved isn't a great sign for Manziel's progress but all the reports coming out of the Browns locker room seems to indicate progress is noticeable day to day.

Do Consequences Matter?

Manziel could have lost his job in the NFL after last year's behavior, much of which connected to the issues that led to rehab. If the Schefter report is accurate, Manziel is lucky his driving didn't cause an accident as he reportedly was speeding, driving on the shoulder and seemingly reckless. Employment at risk, possibility of jail and the need for rehab seem like they should be enough consequences for Manziel to change his ways.

Except consequences are rarely proven to create change.

Three months later, about 75% of people who have a heart attack are back to eating and exercising the way they were the day they had their heart attack. If having a life threatening event (I'm considering all heart attacks serious) is not a big enough consequence to change behavior, not much is.

Instead, having positive goals, not avoidant related goals, and support people affirming the positive changes are the most important aspects of success.

Am I Concerned about Johnny Manziel?

I hope this article has been helpful in at least informing you about the recovery process. Trying to shrink 13 years of experience and a Master's level of education into a 2,000+ word article that is concise and accurate was a challenge. One last question is left: Is Jared, a counselor, concerned about Johnny Manziel?

Yes!

Yet, my biggest concern is not related to his substance use, though that is a concern. Manziel's girlfriend should be one of his biggest and most important support people. Her lifestyle, at least what we've seen on social media, and this incident presents that she may not be able to provide that support. She could either be his biggest support or his biggest anchor. In no way am I blaming her, Manziel is responsible for his own behaviors. If she isn't helpful, he needs to move on.

Driving fast (this is not the only report of reckless behavior since rehab) and putting himself in dangerous positions are also big concerns. These were issues in Manziel's history as well and could be a sign that some of the root issues are still not only present but strong. Change is hard.

Finally, even if he is on a Risk Management Plan, using at all after rehab, especially this soon, is concerning. Most, if not all, of us that cover the Browns have heard stories of Manziel drinking all the way back to this summer. Does he feel like he needs alcohol? Does he feel entitled to alcohol? Does he believe he deserves to be able to drink? If he is in a Risk Management Plan, is he following the plan?

What Now?

Some, including major media members, have called for Manziel to return to rehab, to get cut or to be demoted to inactive this week. Professionally speaking, those are not good suggestions and are generally based on a misunderstanding of the recovery process.

Manziel needs to follow his recovery plan that he made coming out of rehab, needs support and needs to take responsibility for his life. He needs to continue to focus on both the behavior and mental health aspects of the issues that led him into rehab in the first place. Those supporting him, and maybe even fans and media, need to focus on progress, look for the positives and encourage him towards his future goals.

---

Some will read this article and think I'm making excuses for Manziel. Some will read this article and quickly forget the information within as it doesn't fit their narratives. Others will blow off the information because of their personal experiences. Hopefully many of you will take this article as a learning tool. I look forward to the conversation that follows in our forum and on social media.

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