core concepts of the model clyde harperchris budnick louisville, kyraleigh, nc working together for...
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Core Concepts of the Model
Clyde Harper Chris BudnickLouisville, KY Raleigh, NC
Working Together for What Works
3rd Annual Healing Place Summit
October 13 – 14, 2011Richmond, VA
Replicating Success
• Since 1993, consistently high
sobriety outcomes have been
achieved very cost efficiently for
persons with:
High problem severity/problem
complexity; and
Low recovery capital
Replicating Success
• Replicating success begins with
having the right elements in place:
This can be done while being flexible
with the model to account for various
differences between communities
Addiction as an acute illness
Similar to treatment for an infection or broken bone
Expect people to achieve complete & enduring sobriety following a single, brief episode of treatment
Crisis-oriented responses
Professionally dominated decision making
Punitively discharge clients for becoming symptomatic
Terminate the service relationship following treatment
Treatment in serial episodes of self-contained, unlinked interventions
Similar to treatment for hypertension or diabetes
Does not limit the number of recovery attempts
Focus on interventions to increase readiness and to support recovery initiation
Emphasis on peer and indigenous recovery supports
Do discontinue help when a person is symptomatic
Continuing care interventions to enhance the durability and quality of recovery maintenance
Emphasize a sustained continuum of pre-recovery, treatment and post-treatment recovery supports
Addiction as chronic illness
• “As many times as it takes” Clients are always given a way to get back into the recovery
program
• Outreach and engagement
• Assertive linkage to recovering communities
• Continuing-care support
• Integration of alumni in the program and milieu
What this looks like at THP
• Based upon certain beliefs:
1. Individuals present with different levels of readiness for change
2. It is unrealistic to expect someone to resolve their problems before receiving services
3. Eliminate unnecessary barriers
i.e. waiting lists, pre-admission abstinence/sobriety requirements
4. Provide help when someone presents in need of help
Low Threshold for Engagement/ Services on Demand
• Wet shelter
• Motivational component of the program
• Community Assistance Program (CAP Van)
• 24/7 admissions into SUC
• Open referral for law enforcement
What this looks like at THP
• Based upon certain beliefs:1. Sobriety is the first and foremost focus
Other services are provided as a person becomes capable of assuming these responsibilities
(i.e. employment/housing/legal assistance)
2. Attraction is essential For many people, what is missing is hope
3. Current treatment services (i.e. 7 – 14 days inpatient treatment) are inadequate for individuals with high problem severity and low recovery capital
Long-term, Peer-driven Social Model Recovery Program
• Utilizes the shared experiences of those
who have found a common solution to a
seemingly hopeless condition
• Provides mentoring
• Networking in the community
• Not clinical/professionally conducted
treatment
Long-term, Peer-driven Social Model Recovery Program
• Important concepts of social model recovery
programs:
Recovery is the responsibility of the recovering
person within the context of peer support
Primary relationship is between the participant and
their peers, not the participant and therapist/MD
Increased program responsibilities result in
increased input into program decisions
Long-term, Peer-driven Social Model Recovery Program
• Important concepts of social model recovery
programs:
Recovery is self-paced
Program participation is voluntary
Few professional clinicians within the program
Mentoring
Responsibility and ownership for the physical and
recovery environment
Long-term, Peer-driven Social Model Recovery Program
• Decision to initiate participation in the
program rests with the individual
• Peer mentors
• Working with new clients
• Community process
• Job assignments
What this looks like at THP
• Hiring alumni into key positions
• Diversity in lengths of time to complete
the program
• Responsibility of participants to maintain,
reinforce and support a culture conducive
to recovery
What this looks like at THP
• Recovery is firmly rooted in the program
and fellowship of Alcoholics Anonymous and
other mutual aid societies (CA/NA)
• Assertive linkage into the 12-step
communities
• Exposure to 12-step fellowships is not
limited to meetings held at THP
Twelve Step Based
• Participants begin attending 12-step
meetings, both at THP and in the
community, from the beginning
• Sponsorship/home group requirements as
participants advance in the program
• Sponsors are able to visit at THP
What this looks like at THP
• Integral to the success of The Healing
Place model has been intensive instruction
and study of the Twelve Steps of
Alcoholics Anonymous
Teach a 12-Step Curriculum
• The “Community Process” is a vehicle for
change in a recovery program that
significantly shifts the dynamics from staff
to peer accountability
Community Process
• All components of the program must be
present and sized proportionately in order
to:
Provide services on demand
Operate cost-efficiently
Operate effectively
Program Elements and Size
• Program components need to include:
Non-medical detoxification
Motivational Component (Off The Street)
Educational Component (Phase I)
Transitional Component (Phase II)
Continuing Care Component (Silver Chip)
Program Elements and Size
• The right leadership
One new Core Concept