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The Colorado Model - or Open Community Model of Care - in treatment of chronic relapsing addicts and alcoholics.

The Colorado Model - or Open Community Model of Care - in treatment of chronic relapsing addicts and alcoholics.
Presented 1-31-12 at the Colorado Springs Symposium on Addictive Disorders

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  • I want to leave you with FOUR key ideas at the end of our talk today.Start out with the iPod shuffle story. The morale: Extended Care is no more a step down from primary than the iPhone is a step down from a personal computer. We will be zooming in on the part of the continuum that lives in between primary acute care and independent living in the recovery community.Take some risks – who says they can’t?? Your patients are amazing if you just give them a challenge and if you’re willing to take a chance or two.It’s never over – alumni have been treated as an afterthought, but now we realize they are at the very center of our program. Do not simply focus on the recovery community – focus on the ENTIRE community at large. They provide your structure, your curriculum, and if you just pay attention to them, they will LOVE you!!Steve Jobs – famously said we are innovators, therefore we don’t have competitors.
  • I am going to talk about the continuum of care – specifically that part of the continuum between the end of primary care treatment and before sustainable and autonomous recovery in the community at large. How it Works … is a discussion of the definitions and distinct differences between traditional treatment and the new open community models that are emerging. I will talk about how the open community model is uniquely positioned to specifically address the needs of the chronic relapsing client in early recovery. Into Action… is an examination of the lessons we’ve learned about the Open Community model since we began operating nearly seven years ago. There have been numerous mistakes and miscalculations, misplaced assumptions, adjustments and changes along the way. Hence, we will discuss the “evolution” of treatment on this leg of the continuum.Working with others… refers to best practices by other programs and services in the industry. Specifically, I will take a few minutes to discuss how other practioners and provides in other communities are implementing their own forms of the Open Community ModelFinally, in a Vision For You… I will recklessly propose where I think all of this is headed in the future. One part predictions of the inevitable, one part wishful thinking…Afterwards, I would really like to open the floor for questions and discussion about what you all have encountered and overcome in your communities.
  • I am going to talk about the continuum of care – specifically that part of the continuum between the end of primary care treatment and before sustainable and autonomous recovery in the community at large. How it Works … is a discussion of the definitions and distinct differences between traditional treatment and the new open community models that are emerging. I will talk about how the open community model is uniquely positioned to specifically address the needs of the chronic relapsing client in early recovery. Into Action… is an examination of the lessons we’ve learned about the Open Community model since we began operating nearly seven years ago. There have been numerous mistakes and miscalculations, misplaced assumptions, adjustments and changes along the way. Hence, we will discuss the “evolution” of treatment on this leg of the continuum.Working with others… refers to best practices by other programs and services in the industry. Specifically, I will take a few minutes to discuss how other practioners and provides in other communities are implementing their own forms of the Open Community ModelFinally, in a Vision For You… I will recklessly propose where I think all of this is headed in the future. One part predictions of the inevitable, one part wishful thinking…Afterwards, I would really like to open the floor for questions and discussion about what you all have encountered and overcome in your communities.
  • I am going to talk about the continuum of care – specifically that part of the continuum between the end of primary care treatment and before sustainable and autonomous recovery in the community at large. How it Works … is a discussion of the definitions and distinct differences between traditional treatment and the new open community models that are emerging. I will talk about how the open community model is uniquely positioned to specifically address the needs of the chronic relapsing client in early recovery. Into Action… is an examination of the lessons we’ve learned about the Open Community model since we began operating nearly seven years ago. There have been numerous mistakes and miscalculations, misplaced assumptions, adjustments and changes along the way. Hence, we will discuss the “evolution” of treatment on this leg of the continuum.Working with others… refers to best practices by other programs and services in the industry. Specifically, I will take a few minutes to discuss how other practioners and provides in other communities are implementing their own forms of the Open Community ModelFinally, in a Vision For You… I will recklessly propose where I think all of this is headed in the future. One part predictions of the inevitable, one part wishful thinking…Afterwards, I would really like to open the floor for questions and discussion about what you all have encountered and overcome in your communities.
  • I am going to talk about the continuum of care – specifically that part of the continuum between the end of primary care treatment and before sustainable and autonomous recovery in the community at large. How it Works … is a discussion of the definitions and distinct differences between traditional treatment and the new open community models that are emerging. I will talk about how the open community model is uniquely positioned to specifically address the needs of the chronic relapsing client in early recovery. Into Action… is an examination of the lessons we’ve learned about the Open Community model since we began operating nearly seven years ago. There have been numerous mistakes and miscalculations, misplaced assumptions, adjustments and changes along the way. Hence, we will discuss the “evolution” of treatment on this leg of the continuum.Working with others… refers to best practices by other programs and services in the industry. Specifically, I will take a few minutes to discuss how other practioners and provides in other communities are implementing their own forms of the Open Community ModelFinally, in a Vision For You… I will recklessly propose where I think all of this is headed in the future. One part predictions of the inevitable, one part wishful thinking…Afterwards, I would really like to open the floor for questions and discussion about what you all have encountered and overcome in your communities.
  • I am going to talk about the continuum of care – specifically that part of the continuum between the end of primary care treatment and before sustainable and autonomous recovery in the community at large. How it Works … is a discussion of the definitions and distinct differences between traditional treatment and the new open community models that are emerging. I will talk about how the open community model is uniquely positioned to specifically address the needs of the chronic relapsing client in early recovery. Into Action… is an examination of the lessons we’ve learned about the Open Community model since we began operating nearly seven years ago. There have been numerous mistakes and miscalculations, misplaced assumptions, adjustments and changes along the way. Hence, we will discuss the “evolution” of treatment on this leg of the continuum.Working with others… refers to best practices by other programs and services in the industry. Specifically, I will take a few minutes to discuss how other practioners and provides in other communities are implementing their own forms of the Open Community ModelFinally, in a Vision For You… I will recklessly propose where I think all of this is headed in the future. One part predictions of the inevitable, one part wishful thinking…Afterwards, I would really like to open the floor for questions and discussion about what you all have encountered and overcome in your communities.
  • PROBLEM STATEMENTMy dad once told me that treatment is just a very time consuming and expensive way for stubborn people to discover that AA meetings are free.TELL STORY HERE: My final and most spectacular relapse was filled with shame and desperation. The PARTY was OVER… (Tour and Travel News)But why? A. Failure to grasp step one and B. I was still on my own… emotionally isolated even in a room full of people.William White puts it this way in his2008 research findings entitled Recovery Oriented Systems of CareIt is important to define and distinguish between two very different models of care: an acute care (AC) model that focuses on bio psychosocial stabilization and a recovery management model (RM) that emphasizes sustained recovery support. The historical tension between these models is reaching a tipping point, and the stakes involve in the outcome are quite high. As a professional field, we have oversold what a single episode of acute care can achieve for the more than 2 million individuals enter addiction treatment programs each year in the US.
  • This is a discussion about the very fundamental differences between programs designed to stop addiction, and those designed to start recovery.William White puts it this way:Circa 2006 “Linking addiction treatment and communities of recovery”Completion of addiction treatment AND participation with recovery mutual aid groups is more predictive of long-term recovery than either one of these alone.
  • This is only a small chunk of the larger continuum. Intervention is not represented here, for instance… nor is outpatient aftercare and mutual help groups after that. And yet – as the industry has evolved, we are slowly discovering that each level of care here is discreet and distinct unto itself, with a need for its own setting, its own dedicated staff, its own goals set, and most importantly… its own distinct and separate peer group.William White puts it this way:Circa 2006 “Linking addiction treatment and communities of recovery”With great sadness, the counselor reflects, “The patients who come here do SO WELL while they are in treatment, but so many of them relapse in the days and weeks following their discharge. We bring them back into treatment and they seem to do well again but often repeat the relapse patter when they go back home. How can they do so well in treatment and so poorly in their natural environments?”Addiction treatment was birthed in part to eliminate the revolving door through which alcoholics and addicts cycled through the criminal justice system and the hospitals. Addiction treatment programs have now BECOME that revolving door. Today, 64% of clients entering publicaly funded treatment in the US have already had one or more prior treatments. And 50% will be readmitted to treatment within 2 – 5 years.
  • Here is the great news about the evolution of treatment as I see it unfolding in real time before our eyes: As an industry we have held fast to the holistic principals of Body, Mind, Spirit which take their roots in the Minnesota Model when a handful of recovering drunks and doctors left Wilmar State Hospital and founded the Hazelden program together in 1949. Body + Mind + Spirit = is a sacred and enduring principal in our field even today. Multidisciplinary teams continue to flourish, although outside factors such as managed care and an ever shifting payer mix have produced a dynamic tension between who leads that team… ie. The primary care addiction counselor of the guy in the white jacket with his prescription pad. But THAT is a talk for another day.The question for us today is how does – or how should – the holistic approach (body, mind, spirit) be adjusted or recalibrated as we move down the continuum of care from acute primary treatment to extended relapse treatment
  • LESSONS LEARNED (continues to EVOLVE!!) Trust and Service = both issues where you need to strike a “delicate balance” – will talk about some of the LESSONS LEARNED in the next slide.COMMUNITY MEETING:Who’s your sponsor, when did you last meet, and what step are you working onWe Believe Statements: Core Values shared out loud over and over again. (Spiritual grafitti.) ALUMNI INOLVEMENT: William White’s research on the importance of Alumni programs:Peer based recovery support system (P-BRSS) is the basis for our JWL Alumni programAlumni in our community have been identified the single most important resource for recovery in our model of care.Volunteer Program (60+)Peer directed aftercare groupsWednesday night dinnerFriday Speaker meetingSandwich and Salad Bar open at all timesAlumni SWAT teams…. The alumni SWAT team consists of JWL alums with over 1 year of sober time, who are actively working the 12 steps, and are active JWL volunteers. 1. When word hits Jaywalker that an alum is having a hard time I (alumni coordinator) gets a call from the concerned party.2. Coordinator gathers info from individual and community and consults with his supervisor and IP’s counselor to determine next steps.3. If the alum is in immediate danger or risk to harming himself or others the police will be called.4. Where appropriate a team of no fewer than 3 JWL SWAT alums will then reach out and visit in person.5. The alum in trouble must agree to a few things before my guys take him, he must ask for help, he must be willing to do anything, and he must come immediately. 6. Where the alum goes after extraction is dependent upon extenuating circumstances, detox, sober house, treatment, hospital, are all options, my primary concern is the alums safety.
  • TRUST: Balance 80/20 containment to community in first 90 days.Morphs to 20/80 ratio over the next 90 days.Expeditions – Adventure, challenge but never defeatedSkiing, but no terrain parksMtn biking, but only after being certifiedSign out onto Main Street campusRec CenterAlano ClubhousePot Shops, Liquor Stores and Casual Culture off limits12 Step conferences in San Diego, San Antonio and across the state. Service and recovery expeditions across the country:New Orleans and iowa for flood reliefPine Ridge SD to do a week of service work on Native American reservationsGrand Canyon restoration projects in Colorado and UtahKICKER: Solutions clients drive a box truck, for instance – would you allow that?
  • Service and recovery expeditions across the country:New Orleans and iowa for flood reliefPine Ridge SD to do a week of service work on Native American reservationsGrand Canyon restoration projects in Colorado and UtahWeekly or twice monthly:Feed the homelessHabitat for HumanityAnimal rescueHigh School wellness class speakersAdopt a highway
  • We’ve all been there: It’s QUIET in the dining room. That means one thing only… somebody’s holding onto a secret. Secrets in treatment are like termites, they eat away at the very foundation of the house. And with so many distractions, how can their NOT be secrets – girls in the AA community, porn or gambling, online or in the community… there is so much “leakage” possible in an open community model.How to root out the secrets?We learned that the solutions to these problems does not lie in root cause or family of origin issues or regressive trauma resolution work. You don’t work on making your bed. You don’t work on going to AA. You just make your bed and you go to AA. The spiritual dashboard is a peer-directed accountability index of made beds, meditation attendance, AA meetings, house chores, on-time dinner attendance, and daily focus sheets.
  • ALUMNI INOLVEMENT: William White’s research on the importance of Alumni programs:Peer based recovery support system (P-BRSS) is the basis for our JWL Alumni programAlumni in our community have been identified the single most important resource for recovery in our model of care.Volunteer Program (60+)Peer directed aftercare groupsWednesday night dinnerFriday Speaker meetingSandwich and Salad Bar open at all timesAlumni SWAT teams…. The alumni SWAT team consists of JWL alums with over 1 year of sober time, who are actively working the 12 steps, and are active JWL volunteers. 1. When word hits Jaywalker that an alum is having a hard time I (alumni coordinator) gets a call from the concerned party.2. Coordinator gathers info from individual and community and consults with his supervisor and IP’s counselor to determine next steps.3. If the alum is in immediate danger or risk to harming himself or others the police will be called.4. Where appropriate a team of no fewer than 3 JWL SWAT alums will then reach out and visit in person.5. The alum in trouble must agree to a few things before my guys take him, he must ask for help, he must be willing to do anything, and he must come immediately. 6. Where the alum goes after extraction is dependent upon extenuating circumstances, detox, sober house, treatment, hospital, are all options, my primary concern is the alums safety.
  • Relapse and Atypical DischargesThe Problem: We are STILL evolving the model w respect to this area. Consistently discovered that about 1/3 of the clients who begin our program will not complete our program. Of the group that gets kicked out, 75% are for non-compliance, and 25% are for chemical relapse. The Solution:We Believe StatementsSpiritual DashboardDiscreet levels of careContinuous Process ImprovementsThe Lesson:A paradigm shift away from Atypical discharges as a measure of a failed outcome. In our attempts to solve the atypical dc issue, we have seen our conversions increase year to year, to the point that 80% of our WSA graduates will remain in the community after treatment, and 55% will re-engage in some level of supported care along our continuum. So the focus is no longer on the guys who don’t complete level one, it’s on our graduates and alumni.
  • The greatest threat is secrets and cliques, not drugs and alcohol.Atypical discharges.... Vast majority are behavioral vs chemical. Two key factors. 1 - open community model is not effective on Axes 2, borderline or anti social diagnoses. 2 - credibility with the peer group is the epoxy that holds the community together in the face of real world temptation and distractions.Think of internal container - positive peer pressure vs external container - isolated setting, secluded and apart from mainstream community (intrinsic v extrinsic?). Relapse and Atypical DischargesThe Problem: We are STILL evolving the model w respect to this area. Consistently discovered that about 1/3 of the clients who begin our program will not complete our program. Of the group that gets kicked out, 75% are for non-compliance, and 25% are for chemical relapse. The Solution:We Believe StatementsSpiritual DashboardDiscreet levels of careContinuous Process ImprovementsThe Lesson:A paradigm shift away from Atypical discharges as a measure of a failed outcome. In our attempts to solve the atypical dc issue, we have seen our conversions increase year to year, to the point that 80% of our WSA graduates will remain in the community after treatment, and 55% will re-engage in some level of supported care along our continuum. So the focus is no longer on the guys who don’t complete level one, it’s on our graduates and alumni.
  • The greatest threat is secrets and cliques, not drugs and alcohol.Atypical discharges.... Vast majority are behavioral vs chemical. Two key factors. 1 - open community model is not effective on Axes 2, borderline or anti social diagnoses. 2 - credibility with the peer group is the epoxy that holds the community together in the face of real world temptation and distractions.Think of internal container - positive peer pressure vs external container - isolated setting, secluded and apart from mainstream community (intrinsic v extrinsic?). Relapse and Atypical DischargesThe Problem: We are STILL evolving the model w respect to this area. Consistently discovered that about 1/3 of the clients who begin our program will not complete our program. Of the group that gets kicked out, 75% are for non-compliance, and 25% are for chemical relapse. The Solution:We Believe StatementsSpiritual DashboardDiscreet levels of careContinuous Process ImprovementsThe Lesson:A paradigm shift away from Atypical discharges as a measure of a failed outcome. In our attempts to solve the atypical dc issue, we have seen our conversions increase year to year, to the point that 80% of our WSA graduates will remain in the community after treatment, and 55% will re-engage in some level of supported care along our continuum. So the focus is no longer on the guys who don’t complete level one, it’s on our graduates and alumni.
  • The greatest threat is secrets and cliques, not drugs and alcohol.Atypical discharges.... Vast majority are behavioral vs chemical. Two key factors. 1 - open community model is not effective on Axes 2, borderline or anti social diagnoses. 2 - credibility with the peer group is the epoxy that holds the community together in the face of real world temptation and distractions.Think of internal container - positive peer pressure vs external container - isolated setting, secluded and apart from mainstream community (intrinsic v extrinsic?). Relapse and Atypical DischargesThe Problem: We are STILL evolving the model w respect to this area. Consistently discovered that about 1/3 of the clients who begin our program will not complete our program. Of the group that gets kicked out, 75% are for non-compliance, and 25% are for chemical relapse. The Solution:We Believe StatementsSpiritual DashboardDiscreet levels of careContinuous Process ImprovementsThe Lesson:A paradigm shift away from Atypical discharges as a measure of a failed outcome. In our attempts to solve the atypical dc issue, we have seen our conversions increase year to year, to the point that 80% of our WSA graduates will remain in the community after treatment, and 55% will re-engage in some level of supported care along our continuum. So the focus is no longer on the guys who don’t complete level one, it’s on our graduates and alumni.
  • The greatest threat is secrets and cliques, not drugs and alcohol.Atypical discharges.... Vast majority are behavioral vs chemical. Two key factors. 1 - open community model is not effective on Axes 2, borderline or anti social diagnoses. 2 - credibility with the peer group is the epoxy that holds the community together in the face of real world temptation and distractions.Think of internal container - positive peer pressure vs external container - isolated setting, secluded and apart from mainstream community (intrinsic v extrinsic?). Relapse and Atypical DischargesThe Problem: We are STILL evolving the model w respect to this area. Consistently discovered that about 1/3 of the clients who begin our program will not complete our program. Of the group that gets kicked out, 75% are for non-compliance, and 25% are for chemical relapse. The Solution:We Believe StatementsSpiritual DashboardDiscreet levels of careContinuous Process ImprovementsThe Lesson:A paradigm shift away from Atypical discharges as a measure of a failed outcome. In our attempts to solve the atypical dc issue, we have seen our conversions increase year to year, to the point that 80% of our WSA graduates will remain in the community after treatment, and 55% will re-engage in some level of supported care along our continuum. So the focus is no longer on the guys who don’t complete level one, it’s on our graduates and alumni.
  • The greatest threat is secrets and cliques, not drugs and alcohol.Atypical discharges.... Vast majority are behavioral vs chemical. Two key factors. 1 - open community model is not effective on Axes 2, borderline or anti social diagnoses. 2 - credibility with the peer group is the epoxy that holds the community together in the face of real world temptation and distractions.Think of internal container - positive peer pressure vs external container - isolated setting, secluded and apart from mainstream community (intrinsic v extrinsic?). Relapse and Atypical DischargesThe Problem: We are STILL evolving the model w respect to this area. Consistently discovered that about 1/3 of the clients who begin our program will not complete our program. Of the group that gets kicked out, 75% are for non-compliance, and 25% are for chemical relapse. The Solution:We Believe StatementsSpiritual DashboardDiscreet levels of careContinuous Process ImprovementsThe Lesson:A paradigm shift away from Atypical discharges as a measure of a failed outcome. In our attempts to solve the atypical dc issue, we have seen our conversions increase year to year, to the point that 80% of our WSA graduates will remain in the community after treatment, and 55% will re-engage in some level of supported care along our continuum. So the focus is no longer on the guys who don’t complete level one, it’s on our graduates and alumni.
  • The greatest threat is secrets and cliques, not drugs and alcohol.Atypical discharges.... Vast majority are behavioral vs chemical. Two key factors. 1 - open community model is not effective on Axes 2, borderline or anti social diagnoses. 2 - credibility with the peer group is the epoxy that holds the community together in the face of real world temptation and distractions.Think of internal container - positive peer pressure vs external container - isolated setting, secluded and apart from mainstream community (intrinsic v extrinsic?). Relapse and Atypical DischargesThe Problem: We are STILL evolving the model w respect to this area. Consistently discovered that about 1/3 of the clients who begin our program will not complete our program. Of the group that gets kicked out, 75% are for non-compliance, and 25% are for chemical relapse. The Solution:We Believe StatementsSpiritual DashboardDiscreet levels of careContinuous Process ImprovementsThe Lesson:A paradigm shift away from Atypical discharges as a measure of a failed outcome. In our attempts to solve the atypical dc issue, we have seen our conversions increase year to year, to the point that 80% of our WSA graduates will remain in the community after treatment, and 55% will re-engage in some level of supported care along our continuum. So the focus is no longer on the guys who don’t complete level one, it’s on our graduates and alumni.
  • The greatest threat is secrets and cliques, not drugs and alcohol.Atypical discharges.... Vast majority are behavioral vs chemical. Two key factors. 1 - open community model is not effective on Axes 2, borderline or anti social diagnoses. 2 - credibility with the peer group is the epoxy that holds the community together in the face of real world temptation and distractions.Think of internal container - positive peer pressure vs external container - isolated setting, secluded and apart from mainstream community (intrinsic v extrinsic?). Relapse and Atypical DischargesThe Problem: We are STILL evolving the model w respect to this area. Consistently discovered that about 1/3 of the clients who begin our program will not complete our program. Of the group that gets kicked out, 75% are for non-compliance, and 25% are for chemical relapse. The Solution:We Believe StatementsSpiritual DashboardDiscreet levels of careContinuous Process ImprovementsThe Lesson:A paradigm shift away from Atypical discharges as a measure of a failed outcome. In our attempts to solve the atypical dc issue, we have seen our conversions increase year to year, to the point that 80% of our WSA graduates will remain in the community after treatment, and 55% will re-engage in some level of supported care along our continuum. So the focus is no longer on the guys who don’t complete level one, it’s on our graduates and alumni.
  • The greatest threat is secrets and cliques, not drugs and alcohol.Atypical discharges.... Vast majority are behavioral vs chemical. Two key factors. 1 - open community model is not effective on Axes 2, borderline or anti social diagnoses. 2 - credibility with the peer group is the epoxy that holds the community together in the face of real world temptation and distractions.Think of internal container - positive peer pressure vs external container - isolated setting, secluded and apart from mainstream community (intrinsic v extrinsic?). Relapse and Atypical DischargesThe Problem: We are STILL evolving the model w respect to this area. Consistently discovered that about 1/3 of the clients who begin our program will not complete our program. Of the group that gets kicked out, 75% are for non-compliance, and 25% are for chemical relapse. The Solution:We Believe StatementsSpiritual DashboardDiscreet levels of careContinuous Process ImprovementsThe Lesson:A paradigm shift away from Atypical discharges as a measure of a failed outcome. In our attempts to solve the atypical dc issue, we have seen our conversions increase year to year, to the point that 80% of our WSA graduates will remain in the community after treatment, and 55% will re-engage in some level of supported care along our continuum. So the focus is no longer on the guys who don’t complete level one, it’s on our graduates and alumni.
  • Quote from William White: One of the brightest stars in this rising culture of recovery is Phoenix Multisport (PM)—a community of recovering people who share strenuous physical activity as a support for and expression of their addiction recovery process.

Colorado Model Colorado Model Presentation Transcript

  • Shootout at the I’m Okay Corral The “Open Community Model of Care” in theTreatment of Chronic Relapsing Addicts and Alcoholics Bob Ferguson CEO / Founder, Jaywalker Lodge Colorado Springs Symposium on Addictive Disorders January 31, 2012
  • William White, MA“The collaboration that once existedbetween treatment agencies and localrecovery communities has dissipated in theprofessionalization of addiction counselingand the industrialization of addictiontreatment.”1/31/2012 Colorado Model of Care 2
  • An “Open Community” Model of Care How It Into Action Works Working A Vision with Others for You1/31/2012 Colorado Model of Care 3
  • An “Open Community” Model of Care - What is the open How It community model of care? (ROSC) Works - How is it different from traditional treatment (ACM) - Which model works best for relapsers?1/31/2012 Colorado Model of Care 4
  • An “Open Community” Model of Care - Expectations and Into outcomes in the model Action - Myths vs. Reality in treating relapse clients - The evolution of the “Colorado Model.”1/31/2012 Colorado Model of Care 5
  • An “Open Community” Model of Care - Utilizing community Working service as a therapeutic tool with others - Three innovative examples of the open community models1/31/2012 Colorado Model of Care 6
  • An “Open Community” Model of Care - What are the A Vision inevitable changes we are facing in the for You future?1/31/2012 Colorado Model of Care 7
  • How it works “ It is important to define and distinguish between two very different models of care: an acute care (AC) model that focuses on bio psychosocial stabilization and a recovery management model (RM) that emphasizes sustained recovery support. As a professional field, we have oversold what a single episode of acute care can achieve… - William White1/31/2012 Colorado Model of Care 8
  • How it Works PRIMARY CARE  Arresting Addiction  Education  Counselor directed  Secluded setting  Intro to 12 Steps  Safe, secluded time out from EXTENDED CARE life’s distractions  Initiating Life in Recovery  Application Letting go of substances  Peer directed  Community setting  12 Step Immersion  Structured, hectic re-entry into real life recovery Letting go of self1/31/2012 Colorado Model of Care 9
  • How it works Primary Care Extended Transitional Care 30 – 45 days Care 90+/- days 90+/- days1/31/2012 Colorado Model of Care 10
  • A – Extended Treatment811 Main Court (90 days) A BB – Transitional Treatment725 Main Street (90 days)C – Admin & Sober Living734 Main Street (3-6 mos) CD – Outpatient Offices1152 Hwy 133 (90 days) D1/31/2012 Colorado Model of Care 11
  • How it works Body Mind Self Group Community Spirit1/31/2012 Colorado Model of Care 12
  • How it works…1/31/2012 Colorado Model of Care 13
  • Into Action Key Elements of the Model • Trust • Community meeting • Alumni Involved • Service1/31/2012 Colorado Model of Care 14
  • Into Action Trust: • Phase 1: 80/20 containment to community in first 90 days… • Phase 2: Trust ratio “evolves” to 20/80 containment to community1/31/2012 Colorado Model of Care 15
  • 1/31/2012 Colorado Model of Care 16
  • IntoService Action Effective (+) Ineffective (-) • Experience = educational • Experience = punitive • Adopt-A-Highway • Sustainable Settings • Extended Table Soup Kitchen • Set up for sweat lodge • Organized, structured • Random, unprepared, disorg anized, not structured • Staff and community participate with and among • Clients are clients separated, isolated, working alone. • Prior preparation, supervision during, process experience afterwards • Lack of information1/31/2012 Colorado Model of Care 17
  • 1/31/2012 Colorado Model of Care 18
  • 1/31/2012 Colorado Model of Care 19
  • 1/31/2012 Colorado Model of Care 20
  • Into Action Broken Windows Theory (1982) New York City saw a 50% reduction in violent crimes (such as murder, rape and robbery) as the result of a “community policing” campaign which focused repairing broken windows, cleaning up graffiti, and a crack down on minor offenses such as subway fare- scoffers and squeegee-wielding panhandlers. * But the Jets STILL didn’t make the playoffs!1/31/2012 Colorado Model of Care 21
  • Into Action Alumni After Treatment 3 mos (35) 6 mos (31) 6 - 18 mos (25) 100 100 100 91 80 80 80 71 75 65 60 60 AA sponsor Home Group Volunteer FT job/school1/31/2012 Colorado Model of Care 22
  • Into Action Alumni: • Networking (social/recovery) • Events Calendar • Volunteer programs • Outcomes1/31/2012 Colorado Model of Care 23
  • 1/31/2012 Colorado Model of Care 24
  • Into Action True or False? Myths vs. reality Lessons learned along the way…1/31/2012 Colorado Model of Care 25
  • Into Action True or False? Chemical relapse is the greatest single risk in managing and open community model.1/31/2012 Colorado Model of Care 26
  • Into Action True or False? SECRETS (and coalitions) represent the greatest threat to an open community model1/31/2012 Colorado Model of Care 27
  • Into Action True or False? A common standard for all treatment programs is to achieve the highest completion rates possible.1/31/2012 Colorado Model of Care 28
  • Into Action True or False? In an open community model, atypical discharges are the antibodies which scrub your community clean, building the level of safety and trust among the peer group.1/31/2012 Colorado Model of Care 29
  • Into Action Completion Rates – 90 day program Census WSA % Avg LOS 178 153 159 145 71 71 64 64 65 62 63 69 2009 2010 2011 Avg1/31/2012 Colorado Model of Care 30
  • Into Action True or False? The best possible environment for a relapsing client in early recovery is a safe, secluded “time- out” from the distractions and temptations of real life.1/31/2012 Colorado Model of Care 31
  • Into Action True or False? In order to achieve lasting and sustainable sobriety, clients must learn to manage an environment which offers a daily choice between relapse or recovery.1/31/2012 Colorado Model of Care 32
  • Into Action True or False? The counselor’s role in any treatment setting is to build a so-called Therapeutic Alliance (a trusting relationship) between himself and the client.1/31/2012 Colorado Model of Care 33
  • Into Action True or False? In working with treatment savvy, recovery resistant clients, the role of the counselor is to foster open and intimate relationships AMONG his clients… We value the peer to peer relationship above all else.1/31/2012 Colorado Model of Care 34
  • Working with Others The model evolves… • New Found Life – Long Beach, CA • The Right Door – Aspen, CO • Phoenix Multisport – Front Range, CO1/31/2012 Colorado Model of Care 35
  • Working with OthersNew Found Life• Ocean Blvd., Long Beach, CA• Separate Men’s / Women’s Houses• Primary and extended care residential1/31/2012 Colorado Model of Care 36
  • Working with OthersRides to AA Meetings • You cannot: • walk / ride a bike • take public transportation • take a taxi •You can: • call known alcoholics and addicts with time • When you ride with an alcoholic • meeting before meeting • meeting at a meeting • meeting after a meeting1/31/2012 Colorado Model of Care 37
  • Working with OthersThe Right Door• Aspen, CO• Non-profit agency established in 2003• Provides low cost intervention, case management, treatme nt and scholarships1/31/2012 Colorado Model of Care 38
  • Working with OthersRoots in Recovery • Started by AA members driving defendants from jail to detox to meetings. • Battles addiction at the intersection of public safety and public health • Sliding scale, no client turned away. • Random UA’s and daily phone check ins.1/31/2012 Colorado Model of Care 39
  • Working with OthersPhoenix Multisport• Boulder, Denver, and Colorado Springs• Sober Activities• Recovery Network• NO Charge for services, events!1/31/2012 Colorado Model of Care 40
  • Working with OthersAction, Action, Action! • Since 2007, Phoenix had provided programs to 3,620 people… • Hosts 40 – 50 events a week, all at NO charge to the participants! • Average age: 34 years • Gender split: 40% women, 60% men • No treatment… Just recovery!1/31/2012 Colorado Model of Care 41
  • A Vision for You What’s next?1/31/2012 Colorado Model of Care 42
  • Shootout at the I’m Okay Corral Bob Ferguson bferguson@jaywalkerlodge.com www.jaywalkerlodge.com www.slideshare.com KEYWORD: “Colorado Model”1/31/2012 Colorado Model of Care 43