Central Texas Treatment Center

Philosophy of Treatment:

The philosophy of treatment has purposeful involvement and environmental support at its core. In addition, our acquaintance with Wansburg and Milkman’s work in Criminal Conduct and Substance Abuse Treatment has added concepts related to the joining of therapeutic and correctional approaches to our philosophical understanding of our program.

Involvement

Our philosophy of involvement has the following ingredients:

1. Communication between interdisciplinary team members (treatment team meeting every work day at 8:00 AM, daily staff participation in Large Group, and weekly program development and program management meetings.

2. Modeling an adult-adult relationship

3. Not operating in a caste system, but one in which people are helping people to accomplish their goals and objectives, and where both staff and offenders are winners.

4. Daily Large Group Community meetings for clear communication between staff and offenders, and to model problem solving skills. We believe that it is of supreme importance that resident offenders realize that we are more `alike’ than `unalike’ and that we all can be successful.

5.Continuity of Care is essential and we treat the offender as we would want to be treated

6. The offender cannot be treated in isolation from significant others, and individualized family therapy and multi-family therapy is essential to their recovery and reintegration.

7. We believe that the resident offender must be responsible in the here and now, and we provide an environment where the offender can assume personal responsibility and accountability for their behavior. We believe this is a pathway to building healthy self-esteem.

8. We believe that treatment team members should not practice in isolation, and use a Co-Therapy model of involvement. In this way staff can model pro-social ways of problem solving and effective ways of being responsible and accountable. This integrated involvement of Corrections and Chemical Dependency treatment starts with the admission assessment. The counselors, RCSOs, residential supervision and administrative staff function as a team who support and advocate for the offender’s success.

Environmental Support

Environmental support has also been referred to as “Milieu for change”. Essentially, our philosophy is that: Everything pertaining to the program must support what is taking place within the program....CHANGE.

A great deal of effort and time is spent in developing and maintaining a milieu for change; an environment in which residents feel safe, supported, and willing to identify problem behaviors and the thoughts that enable them, and make the changes necessary to reintegrate into their communities and lead chemical and crime free lives. Material provided during Basic Case Management training is the basis for our thinking regarding a therapeutic milieu.

There are six primary areas of focus in an environment for change.

1. Offenders are often “under-socialized” that is, they lack the values, attitudes and problem solving and social skills necessary for pro-social adjustment. These skills can be learned. Therefore, education is a necessary part of treatment for offenders - directly and systematically training them in the skills needed to live more effectively.

2. Effective SAO treatment must integrate the principles of both the therapeutic and correctional treatment models. AOD treatment has been based mainly on the former, criminal offender treatment has been based mainly on the latter.

3. Self-improvement and change involves, first and foremost, developing the motivation to change.

4. Effective SAO treatment depends on not only developing standard approaches which are applied to all SAOs, but also on the development of individualized treatment strategies drawn from comprehensive and ongoing assessment practices.

5. Treatment must engage the client’s significant others. Treatment needs to enlist the support, understanding and reinforcement power of the family and significant others in the person’s effort to make change.

6. The principles of relapse prevention must be utilized in order to assure long-term maintenance of positive treatment outcomes. In the case of the SAO, relapse and recidivism must be seen within the context of both criminal conduct and AOD abuse. In many cases, the two are closely related. Relapse into AOD use and abuse can lead to recidivism into criminal conduct and vice versa.

7. Effective treatment makes the most of the strengths of diversity. Treatment is culturally responsive and sensitive and addresses the client’s cultural values, competencies and strengths. It utilizes these strengths and competencies to promote growth and change. These strengths are found in the client’s gender, age, ethnicity, culture and life-span.

8. The SAO clients have only too often not learned the important lessons in life which will allow them to handle critical life experiences. The over riding purpose of this program is to provide clients with the necessary lessons to pass the tests of living - to handle the experiences they encounter. Thus, we see each element of the program as a lesson designed to help the client pass the crucial tests of living.

9. Each stage of change is characterized by certain thoughts and beliefs. Precontemplators are individuals who presently deny having problems: “I don’t need to make changes.” Contemplators are individuals considering that they may have such problems: “I might benefit from changing.” Individuals in the preparation stage are formulating strategies for change: “It’s time for me to do something different.” Individuals in the action state have changed their behaviors for at least 24-hours: “I’m doing something good for myself.” Individuals in the maintenance stage have succeeded at maintaining change for at least six months: “I’m no longer a drinker, smoker, drug user, or criminal.”

10. Alcohol and drug abuse are highly associated with antisocial personality traits, mania, and schizophrenia.

11. Addiction results from pervasive negative beliefs about self, world and future. These negative beliefs are seen as influencing the way people attend to and process information.

12. Substance abusing individuals are most likely to engage in addictive behaviors following exposure to certain activating stimuli or triggers. These cues can be both internal and external. Common internal cues include emotions like anxiety, depression, boredom, anger, frustration, and loneliness. Common external cues include interpersonal conflicts, availability of preferred substances, and task accomplishment when drugs or alcohol are used to celebrate. The ultimate goal of drug or alcohol use is to alter internal mood states. Cognitive therapy provides alternative cognitive strategies for mood regulation.

13. Automatic thoughts spring from basic beliefs. They are brief, spontaneous cognitive processes or abbreviated versions of corresponding basic beliefs. They can be just thoughts or mental images.

14. We support total abstinence as a treatment goal for individuals dependent on psychoactive substances.