Britney Spears has been released from the luxurious confines of the Promises treatment center; now her next step is to find a way to cope with life in the real world.
The former pop princess checked into the Malibu, Calif., rehab center last month after increasingly bizarre behavior that culminated in her shaving her head and railing against photographers.
Experts predict Spears will now have a tough road ahead of her. She will need her sober friends to rally around her, which should lessen the chance of a relapse, while her handlers must do their best to ensure that this episode ultimately provides a positive message to her army of young fans.
"A support network of the right people will be vital to Britney," Dr. Edward Dreyfus, a clinical psychiatrist, told ABC News.
Continued Therapy, Maintained Focus
And if her hair has grown back, there's a chance Spears could be tearing it out again because of the paparazzi frenzy that awaits her every move.
"Stars are treated like royalty by those who surround them, but often it's people who don't care about the person inside and are just trying to get their 10 or 15 percent," said Dreyfus.
With her release, Spears has been given details on nearby AA-style programs, which she attended while in rehab, and will be encouraged to stay in contact with a counselor at the clinic.
"The chance of relapse varies with each individual, but there's a fairly high risk of it," said Dr. Bruce Spring, an assistant professor in clinical psychiatry at the University of Southern California. "Factors such as personality, life situation and genetics all play their part, but if a patient's friends are addicts, then they're in trouble. Follow-up treatment is extremely important."
Maintaining focus is vital for those fresh out of rehab. Russ McDowell is program director at People in Progress, a clinic in North Hollywood, Calif. Though it is a very different environment from the plush surroundings of Promises, McDowell says that while media attention can exemplify stress, post-treatment recovery is no different for those in the limelight.
"Strong as we think we are, the fact is that in less time than it takes to click your fingers we can be doing what we used to do," said McDowell, who went through the 12-step program himself and has been sober for 12 years.
So what should Spears, whose exact medical condition is unknown, do if she's offered a drink at a party?
"My advice would be that she shouldn't put herself in that situation," said McDowell. "She should stay home with friends and family and speak with her counselor if she's confused as to whether to start socializing again."
Salvaging Her Public Image
The latest speculation about Spears' meltdown is that it was precipitated by the birth of her second child in September, which triggered the onset of postpartum depression. However, those in the medical field point out that this alone is not reason enough to go into rehab.
"Britney is known to like a drink, and this pre-existed her pregnancy," said Dreyfus. "The fact is, you do not go into rehab just for postpartum depression, as counseling suffices. However, the drugs used to treat it may have caused her to need the rehab."
"Postpartum blues are reasonably common, but sometimes this becomes a major depressive disorder," said Spring. "It can cause a failure to sleep, concentrate, eat, take pleasure in things and even suicide. Many who suffer from this depression use alcohol or drugs as a coping mechanism, though sometimes it is these substances which actually cause its onset."
With her impending divorce, her many nights on the town (with and without panties) and her shorn locks, Spears' image is certainly in need of some rehabilitation of its own.
"Over the long run, the best course is always honesty," said Loch Jones, a 35-year veteran of the public relations world. "I would always advise being as open as you can, as the truth will always come out eventually."
Handled correctly, Jones believes Spears can sell her time in rehab as being a troubled girl who did the responsible thing. Tara Conner, Miss USA, who will relinquish her crown when the new title-holder is chosen Friday, has done a series of press interviews in recent weeks that underscore her new sobriety and the many lessons she learned after crashing and burning (and going into rehab) late last year.
"Public opinion has changed in that people are now forgiving stars and not putting them on such a high pedestal," said Jones, who's based in Beverly Hills, Calif. "That more people know that illness can be treated by seeking help can only be a benefit to society."
Britney Spears as a positive role model may sound rather 1998, but it's certainly a more appealing prospect than the thought of her next night out with Paris.