support to addiction recovery a model developed by the office of behavioral health services division...
TRANSCRIPT
S T A RS T A R
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
Support To AddictionRecovery
On-Going Assessment & Evaluation
Specialized Programs Withdrawal Management
Basic Elements for Pre-Recovery InterimSuccessful Outcomes Services
Intensive Recovery Programs (IRPs)
Customer
STAR
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
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
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
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)
Main Components (Cont.)
Basic Elements to Support Recovery for Successful Outcomes
Specialized Programs Women’s Co-Occurring Chronic Other
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
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
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%)
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
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
IRPS (Cont.)
Coordination with Community Support Services On-Going Assessment and Evaluation (Both
Formal and Informal) Co-Occurring Capable Three Phase Process
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
IRP – Phase 2
The Following 6 Weeks Decreasing Intensity with Continuing
Community Support More Attention to Individual Needs
Vocational Educational Life-Skills
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
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
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
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
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
Peer Support Services
Peer Support is:Being open to new ways of thinking
about our experienceRe-defining help and helpingA 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 meansTelling someone what to doSuperficial power-down
relationshipsTelling you you’re sick and socially
unacceptableOne 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
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
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
Child Care
Required of All Programs Serving Women Must Offer Prevention Programming for the
Children Trained Community Volunteers Coordinated by the CDs
Specialized Programs
Long-Term Chronic Unit Women’s Programs Co-Occurring Enhanced Unit
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
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
Long-Term Chronic Unit (Cont.)
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
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
Co-Occurring Enhanced Program
All Referrals from MICA Units Access to Psychiatrist Medical and Medication Management,
Including Psychotropic Medications Cross-Trained Staff
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
GOOD-BYE
Thank You for Your Attention and Support