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SUPPORT TO ADDICTION RECOVERY

SUPPORT TO ADDICTION RECOVERY. A Model Developed By the Office of Behavioral Health Services Division on Alcoholism and Drug Abuse October, 2001 Revised, 10/04 Program Development Supported In Part With Substance Abuse Treatment and Prevention Block Grant Funds.

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SUPPORT TO ADDICTION RECOVERY

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  1. SUPPORT TO ADDICTION RECOVERY A Model Developed By the Office of Behavioral Health Services Division on Alcoholism and Drug Abuse October, 2001 Revised, 10/04 Program Development Supported In Part With Substance Abuse Treatment and Prevention Block Grant Funds

  2. Support To AddictionRecovery STAR On-Going Assessment & Evaluation Specialized Programs Withdrawal Management Basic Elements for Pre-Recovery Interim Successful Outcomes Services Intensive Recovery Programs (IRPs) Customer

  3. STAR • An Abstinence-Based Model • Requires Intensive Engagement of the Customer • Requires Ninety-Day Minimum Engagement in Treatment • Based on Best Practices for Addiction Services • Recognizes That No Single Recovery Plan Is Appropriate for All Individuals • Recovery Services Need to Be Readily Available • Recognizes That Relapse May Be A Part of Recovery • Individual Customers With Co-Existing Psychiatric Disorders Should Have Both Disorders Treated in An integral Way

  4. Addiction Recovery Principles • Recovery Is A Long-Term Process and Frequently Requires Multiple Episodes of Care • The Process of Recovery Has a Spiritual Component and Is Enhanced by Peer Support, Mentoring, and a Therapeutic Community Approach Among Other Methods • Recovery Leads to An Established Life-Change Conducive to a Healthy, Productive Life-Style, and Is Not Merely the Discontinuance of Use of An Addictive Substance

  5. Addiction Recovery Principles (Cont.) • Detoxification Is Only The initial Stage of Addiction Recovery And By Itself Does Little to Change Long-Term Use • Addiction Recovery Does Not Need to Be Voluntary to Be Effective

  6. Main Components • On-Going Assessment and Evaluation • Multiple Withdrawal Management Programs • PI Shelters • Detainee Shelters • Withdrawal Management Within Programs • Medical Detoxification Services • Pre-Recovery Interim Service Providers • Intensive Recovery Programs (IRPs)

  7. Main Components (Cont.) • Basic Elements to Support Recovery for Successful Outcomes • Specialized Programs • Women’s • Co-Occurring • Chronic • Other

  8. On-Going Assessment &Evaluation • Assessment and Evaluation Are Continual Processes Throughout the Customer’s Involvement with STAR • Utilizes ASAM Criteria for Proper Placement • May Include Informal as well as Formal Assessment Methods • Effective Assessment and Subsequent Care Attends to Multiple Needs of the Individual, Not Just His or Her Use of Substances

  9. On-Going Assessment &Evaluation (Cont.) • Includes an Initial Screening for Risk of HIV, STDs, TB, and Hepatitis with Appropriate Referrals for Service • Continuous Monitoring of Alcohol and Other Drug Use During Treatment Can Help the Individual Withstand Urges to Use Alcohol and Other Drugs

  10. Withdrawal Management • Utilize Withdrawal Protocols • Primarily a Non-Medical Model • Withdrawal Symptom Management • Utilization of Medical Management as an Adjunct to Other Recovery Services • Methadone, Naltraxone, Buprenorphrine, other appropriate medications • Availability of Medical Detoxification Services (<5%)

  11. Pre-Recovery Interim Services • If a Customer Is Assessed and Found Not Yet Ready for Treatment, the Following Pre-Recovery Interim Services Must Be Available • Motivational Counseling • Pre-Treatment Groups • Referral for Public Health Services • HIV, TB, etc. • Pre-Natal Care • Other

  12. Intensive Recovery Programs(IRPS) • 90 Day Minimum Engagement • Easily Accessible to the Customer • Residential, Outpatient, or a Combination • Tied-In to Basic Elements for Successful Outcomes • Peer Support/Mentors • Housing • Transportation • Child Care • Education • JobTraining • The Criminal Justice System

  13. IRPS (Cont.) • Coordination with Community Support Services • On-Going Assessment and Evaluation (Both Formal and Informal) • Co-Occurring Capable • Three Phase Process

  14. IRP – Phase 1 • 5 to 6 Weeks in Duration • 12 to 18 Hours a Week • Day and Evening Programming As Needed • Didactic – Educational Component • Weekend Activities/Involvement

  15. IRP – Phase 2 • The Following 6 Weeks • Decreasing Intensity with Continuing Community Support • More Attention to Individual Needs • Vocational • Educational • Life-Skills

  16. IRP – Phase 3Transition to the Community • Assessment of an Individual’s Progress, Strengths, and Support System Determines Discharge from the IRP • Continuing Community Support Service • Housing Assistance • On-Going Education and Job Training • Employment Opportunities • Peer Support/Mentoring • Identification of Therapeutic Intervention Needs • Relapse Prevention/”Aftercare” Groups

  17. Basic Elements for Successful Outcomes • Staff (IRP and Community Care Coordinators) • Shelter • Transportation • Child Care • Therapeutic Community Model • Training (CAC/CIS) and Cross-Training (SA/MH) • Access to Vocational and Educational Training • Employment Opportunities

  18. IRP Staff • Mix of Clinical/Non-Clinical, Recovering/Non-Recovering, Degreed/Non-Degreed • Educational Background and Experience Consistent with Job Function • Nuturing, Empathetic, and Supportive, but Not Enabling • Well-Trained in Job Role • Cross-Trained Regarding Co-Occurring Disorders • Philosophy of Care Congruent with Best Practices

  19. Clinical Input IntoRecovery Process • Clinicians Will Be Used to Provide Quality Control • Clinicians Will Utilize Assessment Criteria (ASAM Placement, ASI, SASSI, Etc.) • Clinicians Will Provide Therapeutic Interventions When Needed as an Adjunct to Recovery

  20. Community Care Coordinators(CCC’S) • Outreach • After-Care • Case Coordination • Community Treatment Resources Development • Utilization of Local Recovering Individuals as CCC’s Enhances Outcomes for the Custome • Utilization of Peer Recovery Network

  21. Peer Support is: Being open to new ways of thinking about our experience Re-defining help and helping A way of thinking about relationships and power that is mutual Considering the effects of trauma and abuse on people’s self-concept and relationships Mutually supportive and mutually responsible Teaching and learning from each other An opportunity to challenge the status quo About recovery and transformation Peer Support is not: An expert telling you what your experience means Telling someone what to do Superficial power-down relationships Telling you you’re sick and socially unacceptable One way relationships where one person takes responseibility for the other Being told or learning about diagnoses and treatment Protecting people from taking risks that are “too stressful” About stability and maintenance Peer Support Services

  22. Shelter (Transitional Living) • Comfortable, Home-Like, Family Atmosphere • Safe, Secure, Nurturing • Therapeutic Community • Life-Skills Training • Provides for Personal Safety and Safety of Belongings • Provides for Secure Medication Management

  23. Transportation • Must Be Provided Within the Program • Transportation To and From the Program • Transportation for Attending Program Elements • Must Be Provided as a Part of Community Support • Transportation to Vocational and Educational Training • Transportation to Peer Support Meetings and Other Support Elements • Transportation to Relapse Prevention/”Aftercare” Groups • May Be Provided in Collaboration with Other Agencies and Programs

  24. Child Care • Required of All Programs Serving Women • Must Offer Prevention Programming for the Children • Trained Community Volunteers • Coordinated by the CDs

  25. Specialized Programs • Long-Term Chronic Unit • Women’s Programs • Co-Occurring Enhanced Unit

  26. Long-Term Chronic Unit • Chronic Addicts Only • 9 Months to 2 Years in Duration • Homeless • Unemployed • No Support System • Multiple Treatment Failures • Medically Compromised • 9 Months to 2 Years in Duration • Court-Ordered or Committed

  27. Long-Term Chronic Unit (Cont.) • Provides Physical/Health Care • Provides Opportunities for Therapeutic Use of Time • Therapeutic Community Approach • Educational Groups • Peer Support/Fellowships • Step-Down Program • Strong Discharge Plan

  28. Women’s Programs • Emphasis on Pregnant Women and Women with Dependent Children • Residential with 6 Month Minimum Stay • Must Meet Federal Guidelines for Women’s Programs • Groups Specific to Women’s Needs • Abuse • Anger Management • Parenting • Others • Medical Care Including Pre-Natal Care If Needed • Child Care • Other

  29. Women’s Programs (Cont.) • Must Provide Extensive Wrap-Around Services • Must Provide the Basic Elements for Successful Outcomes of STAR • Must Provide the Basic Elements for Successful Outcomes of STAR

  30. Co-Occurring Enhanced Program • All Referrals from MICA Units • Access to Psychiatrist • Medical and Medication Management, Including Psychotropic Medications • Cross-Trained Staff

  31. Outcomes • Outcome evaluations must be collected at 3 months, 6 months, and 1 year after discharge • Continuing community support services must be provided during this time with a frequency and intensity congruent with the individuals needs

  32. GOOD-BYE Thank You for Your Attention and Support

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