TREATMENT PROGRAM (CONTINUED)
Specific Elements of Treatment that Lead to Successful Completion:
Each resident must complete the following elements of treatment before leaving the Center.
The intake process starts with a court referral to the admissions office. The intake coordinator requests all information on the offender from the Courts and in concert with the treatment team reviews the information for suitability for treatment. If the offender has psychiatric/medical problems that cannot be handled at our facility, information and referral is made to a more appropriate facility. A SASSI (Substance Abuse Socialization Severity Index) is utilized. Intake is the first experience the offender has with the facility and is an important time in the offender’s introduction to the facility and treatment program. The interview process is carefully done. Release forms are explained and signed, living agreements of the facility reviewed, and goals for treatment explored. Two short questionnaires (the CAGE Questionnaire and Short Michigan Alcohol Screening Test) are self-administered at this time to note alcohol/drug problems. The offender is provided with a Big Book (Bible of AA) and asked to read the first 90 pages. Additional information packets (Step 1 packets, Feelings List, Group Rules, etc.) are given to clients, which aid in informing him/her of what to expect in their stay here. A primary chemical dependency counselor and community supervision officer are assigned along with an offender mentor. The intake coordinator gives the Offender an overview of the treatment program and carefully educates the offender to the Family Program. The offender is assigned to a Small Group that the offender will be working with during his/her stay. The offender is shown around the facility by the assigned mentor, and if family members are present, key staff and a review of the treatment program are provided to them. An admission Drug Urine Screen is performed. (4 Hours)
Orientation to the Center
Within 2 days of arriving at the Center, residents receive a thorough orientation to the Center, its rules and its guidelines for Center life. An RS I or II facilitates the group, explaining the whys and wherefores in layman’s terms so each resident can ask questions and clarify issues like length of stay, consequences for rule violations, the purpose of CSR, treatment expectations, etc.
Our program utilizes the three phases of change described above to understand the resident’s progress through treatment. Usually, the first phase (Challenge to Change) lasts 4 to 6 weeks, the middle phase (Commitment to Change) lasts 8 to 10 weeks, and the third phase (Ownership of Change) lasts 4-6 weeks. Our advertised length of stay is from 90 days to two years, but our actual length of stay varies between 120 and 360 days, and is a major part of the individualization of treatment that we offer our residents. Resident’s progress through treatment is reassessed regularly as they move from one phase to another and as important treatment and life situations arise. Resident feedback is a major part of progress review, and feedback sessions are scheduled weekly.
Phase I (Challenge to Change)
During the first phase, the following occurs:
The Primary Counselor and the RCSO complete an in depth assessment within three working days, using the Personal Experience Inventory (Adult), Level of Supervision Inventory Revised, the Wisconsin Risk and Needs Assessment, and a Biopsychosocial assessment instrument;
The GED instructor completes an Educational Assessment;
The treatment team makes appropriate referrals for additional assessment;
The resident, along with the primary counselor and the RCSO develop an Individualized Master Treatment Plan within five working days;
The resident develops rapport with staff and other residents. Without this attachment, successful treatment cannot occur;
The resident’s criminal thinking and behaviors are elucidated; and
A belief in Step One (the resident admits that he/she is powerless over alcohol and drugs and that his/her life has become unmanageable);
Phase II (Commitment to Change)
At this time in treatment, the resident moves into Phase II. The resident now has a beginning understanding of his/her Chemical Disease process. The resident now starts the difficult journey of developing new coping skills, learning how to ask for support, and learning how to accept support. During phase II, residents will accomplish the following:
- Explore the addiction process and their denial system, and start dealing with the impact of their chemical use and criminal activity on their family, job, and their relationship to community;
- Begin clarifying their relationship with a Higher Power;
- Begin to develop a capacity to be open and honest with themselves, the staff, the community and their family;
- Develop an ownership of their Cognitive Distortions (ie. feeling a victim, blaming others and not assuming personal responsibility for their behavior);
- Identify significant family conflicts and develop a plan of action for resolution;
- Identify Relapse Triggers;
- Develop an awareness of the 12-step program and its importance in their continued recovery, and acknowledge that their chances of success go down if they do not have an ownership of this process;
- Complete AA Step 2 (Came to believe that a Power greater than ourselves could restore our sanity); and
- Complete AA Step 3 (Made a decision to turn our will and our life over to the care of God as we understood him, or our higher power) will be completed.
Phase III (Ownership of Change)
At this juncture, the resident moves into Phase III and begins to have more responsibility for the integrity of the Community. During Phase III, there is an expectation that the Resident will model pro-social behaviors, not keep secrets that are unhealthy, and practice being an honest community member with integrity. The resident will need little prompting from staff and other residents to do the `next right thing’. The following will be accomplished during Phase III:
Complete AA Step 4 (Made a searching and fearless moral inventory of ourselves);
Complete AA Step 5 (Admitted to God, or our higher power, to ourselves, and to another human being the exact nature of our wrongs);
Successfully complete a minimum of three 24-hour furloughs;
Secure a temporary Sponsor;
Identify an AA/NA home group;
Function successfully as an Expediter;
Complete a Discharge Plan, including living arrangements and aftercare plans;
Complete a separation process from the facility both in small group, large group, and individual therapy;
Successfully complete treatment programming (Thinking for a Change, MRT, CD Education, Relapse Prevention, etc.;
Complete a Relapse Prevention Plan;
The Phases are both fluid and dynamic. A resident could regress from Phase II to Phase I or progress from III to II. The fears and anxieties that interrupt their progression are explored, along with the thinking that allows or promotes rule breaking, disrespect for others, and other problems. All treatment is individualized. We use the phases as our framework to know where the resident is in treatment. We do not use the phases to tell the resident where he/she is in treatment.
Residents must complete a discharge plan, which includes living arrangements and aftercare before they leave the Center. Since most residents’ conditions of probation include placement in a 3/4 way house, visits and interviews are often part of this discharge process. The counselors and RCSOs work closely together to ensure the best possible discharge situation is arranged, to enhance the resident’s prospect for continued recovery.