The glamorous public veneer of high profile families and high net worth individuals can give an impression of pure privilege. Yet in these people’s private lives, hidden behind cushions of wealth and success, silent struggles with depression, burn out and substance use disorders are in fact frequent features. It is now common to hear that yet another celebrity has checked themselves into clinics like the Betty Ford, the Meadows, Promises Malibu or the Priory, which all offer exclusive specialised services for these clients.
Enter the emerging world of Bespoke Treatment which allows for optimal levels in the three pillars of custom care, privacy, and holistic approaches. Bespoke Treatment is essentially tailor made for each individual case, as opposed to ‘one size fits all’ approaches.
Unique Challenges for High Profile Families Facing Substance Use Disorders
Statistics about something as stigmatised as Substance Use Disorders (SUD) are notoriously hard to gather for obvious reasons of confidentiality and privacy, however a study published in the American Journal of Psychiatry (2011) found that affluent individuals are more likely to drink alcohol and substantially more likely to engage in binge drinking than those with lower incomes. In the corporate world, research by the National Safety Council (NSC) found that executives and high-level professionals are twice as likely to use cocaine compared to the general workforce due to stress and work demands.
High profiles bring extremely high levels of responsibility in all areas of life – family, social and economic. Reputations are at stake and businesses demand high performance with staff depending on their salaries and investors watching closely.
For a high profile individual already suffering from anxiety, these relentless pressures can seem cold and uncaring. The external interest is on their profile, wealth, standing and performance with little care being shown for their personal well-being and mental health.
One clear example of this is that of Avicii (Tim Berling) whose struggles with mental health have been publicly documented in his biography “Tim” by M Mosesson (2021).
I was his lead therapist during his treatment for substance use disorders some years before his tragic death. After completing his treatment by detoxing and studying healthy, natural methods for self-regulation he wrote his “letter to the world’ stating his intention to stop touring in order to create and maintain a work-life balance. Over the next months and years I had many phone conversations with Tim in which he described how difficult it was for him to meet the ongoing expectations of the music industry and his fans. It was an unbearable and unwanted weight on his shoulders – despite his desire to step back from public life. He reported that using alcohol and other substances was his only way of dealing with that pressure. Sadly, the spiral into depression and anxiety also fuels the need for public recognition in a vain attempt to deal with the emotional bankruptcy and shame experienced within. We become addicted to the very things that are causing us so much harm.
How many public figures and high earners are struggling with these very same ‘privileged’ responsibilities right now? It really can be a matter of life or death.
What are Bespoke Retreats?
As discussed in a previous blog, bespoke treatment clearly differs from more standard treatment methods in several ways.
Essentially, “bespoke” in a therapeutic context refers to tailor-made programs as opposed to the standardised ‘one-size-fits-all’ approach used by the large majority of facilities offering residential treatment for substance use disorders and co-occurring mental health issues. The bespoke approach allows for expansive highly personalised treatment plans which address the uniqueness of the individual, instead of focusing only on the common traits shown by those suffering from substance use disorders. In bespoke there is great flexibility for the clinical team in program design so that individual’s needs, circumstances, and states of mind are all carefully considered from the moment of initial contact to aftercare support.
Of course, individualised bespoke treatment will tend to be significantly more costly to deliver. Thus, high profile / high net worth clients find their preferences for space, privacy, and luxury surroundings catered to, while leading clinical experts can be called in to form the ideal team for each particular client.
Advantages of Bespoke Retreats for High-Profile Individuals
The individual attention offered by bespoke treatment is also expressed in the amount of clinical attention offered. It is common in standard treatment facilities for each client to see their lead therapist only once a week in one-on-one sessions. The rest of their program is generally delivered as part of a group – including the major modality of group therapy.
Compare that, for example, to Thera Bespoke in Bali where each modality is presented individually and a client can choose up to 15 hours of clinical sessions per week with a choice of psychiatrists, psychologists and psychotherapists. The same applies to the supplementary sessions of yoga, acupuncture, reflexology, energy healings and martial arts etc. Essentially the client is not given a standard program with inherent limitations, but instead can choose what and how much support they find helpful as they progress through the different stages of treatment.
The same specialised advantages are found in the areas of food, nutrition, fitness and leisure. Bespoke clients have their own dedicated chef and individualised nutritional plans, depending on the needs of each individual. A dedicated luxury vehicle and driver is on hand for transport. Again, in a culturally rich location such as the rice fields of Bali, inspiring excursions abound and leisure activities support the healing that is offered clinically. A good example would be discrete visits with informed local team members to hidden temples for the world famous water healings and ceremonies, yet far removed from the tourist crowds.
Free from the necessary house rules in group therapy settings, bespoke treatment teams can design the schedule and clinical program around the life of the client – allowing space for work hours if needed and adapting the daily schedule to fit the energy levels of the client. Combine that with the luxury accommodation and dedicated hospitality team, the treatment environment provides a spa atmosphere, as opposed to a strictly clinical environment.
Privacy and Confidentiality
Perhaps the most important consideration for a high profile individual entering treatment is whether their privacy and confidentiality is protected. Of course, all serious clinical and healing facilities will have strict confidentiality protocols in place. But privacy is simply more easily delivered with more intimate settings provided by bespoke care. There is no exposure to other clients, smaller clinical and hospitality teams and heightened confidentiality protocols to satisfy the critical need that high profile clients have for complete discretion.
Innovative Approaches in Bespoke Retreats
The entry days of treatment for substance use disorders are often referred to as the ‘motivation’ or ‘persuasion’ stage. This is when a client typically recognises that change is necessary, but is still ambivalent about making that change. A very effective modality at this point is ‘Motivational Interviewing’ (Miller and Rollnick 2013). It is a collaborative approach that allows the client to be where they are at in their journey, as opposed to telling them where they should be. Instead, the clinician gently identifies why the client wants to change and helps them express their own yearning by highlighting their positive self-talk. In this sense, the clinical team positions themselves as agents of inspiration for the client, through empathy fanning the flames of the client’s personal desire to improve their lives and themselves.
This approach can be continued throughout the bespoke program as the client journeys through the other stages of treatment. The dedicated team encourages the clients to find within anything that inspires them and then offers modalities to match the inner drive for change. Sometimes meditation, sometimes a study into the conscious and subconscious mind, sometimes a desire to learn to surf or climb a volcano. This is all made possible by a skilful bespoke approach. It is a wealth of opportunity.
How Effective Are Bespoke Retreats in Transforming Lives?
As mentioned at the beginning of this piece, statistics about treatment of substance use disorders are difficult to obtain. People are loath to speak about such a personal aspect of their lives – especially in the case of high profile individuals.
It is also difficult to establish what can be determined as success in treatment for substance use disorders. Is it complete abstinence from all mind-altering substances including alcohol? If so, for how long? Is it an improvement in the quality of the client’s life after treatment? If so, how is that to be measured? Fortunately there have been studies that suggest that the bespoke approach is favourable in many ways.
A study published in the Journal for Substance Abuse Treatment found that personalised treatment plans significantly improve treatment adherence and outcomes. (McLellan et al (2000). The fully collaborative plans commonly used in bespoke retreats such as Thera are inherently highly personalised.
The patient-centred approach enhanced in bespoke retreats is also supported by a study which suggests that it has been shown to improve engagement and outcomes in substance use disorders treatment, when therapies are customised to the individual’s needs. (Mee-Lee and Shulman (Journal of Psychiatric Practice 2014).
In my own experience working with a bespoke approach, I have found that clients generally benefit from what they have learned in treatment, improving the quality of their health, businesses and relationships even in cases when complete abstinence is not consistent. One example would be Jason, a highly successful 33-year-old self-made entrepreneur who was hopelessly handicapped by addiction to alcohol and Valium. He entered treatment to satisfy his business partner, who was threatening to pull out of the business. Jason has improved all areas of his life over the last 3 years, despite periodic short slips. Hopefully, with continued aftercare and support, the seeds of primary treatment will take root and complete abstinence will become a habit.
The Importance of Continued Care
Early last century society viewed alcoholism and addiction as being symptoms of weakness and low moral fibre. People with what we know as substance use disorders were confronted, judged and hidden away. Fortunately, we have now come a long way in forming a more compassionate and medical view of this problem. DSM – the diagnostic and statistical manual of mental health, now recognises substance use disorder as a mental health issue, and updates its recent versions to reflect greater understanding in each edition.
Substance use disorders is widely recognised as being a condition which is notoriously difficult to heal, however countless individuals around the world have now shown recovery is possible and no-one should be treated as a lost cause. Recognizing the prevalence of co-occurring mental health issues on the substance use disorders population has created ever richer and more effective treatment methods – some of which have been briefly mentioned above.
One thing is clear. Ongoing care significantly improves the chances of long term positive outcomes. Once change begins to happen, it needs to be practised until it becomes a deep habit in itself.
The bespoke approach will suggest different, individualised ongoing care to suit each individual being treated. Zoom calls, top up visits, family support sessions and mutual support groups are all available to suit each client’s personalised needs. Whichever they choose, ongoing care is highly recommended. In bespoke retreats it is the clinical team’s responsibility to inspire in their clients a strong desire to keep learning, to keep healing and to create a life which expresses their full potential.
Bespoke treatment offers many positive features which benefit any high-profile individual suffering with substance use disorders and co-occurring mental health issues. Confidentiality and privacy are more securely delivered, collaborative treatment plans take into careful consideration each aspect and need of the client and offer the flexibility to include innovative modalities designed to fan the coals of inspiration and desire for transformation and change. Family and others close to the client can be included as aspects of the treatment in ways they utilise the particular characteristics of their lives. And all this can be delivered in luxurious settings that satisfy the high demands and expectations acquired in the lives of high-profile, high net worth families.
Problems with substance use disorders are becoming increasingly common in anyone in the public eye, though these difficulties are often kept as shameful secrets. In fact, there is nothing shameful about being ill, and there are ways to address this condition with compassion, comfort and complete discretion.
If you or anyone you know might benefit from a bespoke retreat, please contact Thera Bespoke to learn more about our personalised services and the steps to take to move forward. Your enquiry will remain totally confidential.
