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Shootout at the I’m Okay Corral
The “Open Community Model of Care” in the Treatment of Chronic Relapsing Addicts and Alcoholics
Bob Ferguson
CEO / Founder, Jaywalker Lodge
Colorado Springs Symposium on Addictive Disorders
January 31, 2012
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William White, MA
“The collaboration that once existed between treatment agencies and local recovery communities has dissipated in the professionalization of addiction counseling and the industrialization of addiction treatment.”
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An “Open Community” Model of Care
How It Works Into Action
Working with Others
A Vision
for You
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An “Open Community” Model of Care
How It Works
- What is the open community model of care? (ROSC)
- How is it different from traditional treatment (ACM)
- Which model works best for relapsers?
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An “Open Community” Model of Care
Into Action
- Expectations and outcomes in the model
- Myths vs. Reality in treating relapse clients
- The evolution of the “Colorado Model.”
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An “Open Community” Model of Care
Working with others
- Utilizing community service as a therapeutic tool
- Three innovative examples of the open community models
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An “Open Community” Model of Care
A Vision for You
- What are the inevitable changes we are facing in the future?
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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 White
“
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How it Works
PRIMARY CARE
Arresting Addiction Education Counselor directed Secluded setting Intro to 12 Steps Safe, secluded time out
from life’s distractions
Letting go of substances
EXTENDED CARE
Initiating Life in Recovery Application Peer directed Community setting 12 Step Immersion Structured, hectic re-entry
into real life recovery
Letting go of self
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How it works
Primary Care
30 – 45 days
Extended Care
90+/- days
Transitional Care
90+/- days
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A – Extended Treatment811 Main Court (90 days)
B – Transitional Treatment725 Main Street (90 days)
C – Admin & Sober Living734 Main Street (3-6 mos)
D – Outpatient Offices1152 Hwy 133 (90 days)
A B
C
D
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How it works
Self Group Community
Body MindSpirit
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How it works…
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Key Elements of the Model
• Trust • Community meeting• Alumni Involved• Service
Into Action
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Into Action
Trust:
• Phase 1: 80/20 containment to community in first 90 days…
• Phase 2: Trust ratio “evolves” to 20/80 containment to community
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Into Action
Effective (+)
• Experience = educational• Adopt-A-Highway • Extended Table Soup Kitchen
• Organized, structured
• Staff and community participate with and among clients
• Prior preparation, supervision during, process experience afterwards
Ineffective (-)
• Experience = punitive• Sustainable Settings• Set up for sweat lodge
• Random, unprepared, disorganized, not structured
• Clients are separated, isolated, working alone.
• Lack of information
Service
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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!
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Into Action
AA sponsor Home Group Volunteer FT job/school
8071
60 60
9180
7565
100 100
80
100
Alumni After Treatment
3 mos (35) 6 mos (31) 6 - 18 mos (25)
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Into Action
Alumni:
• Networking (social/recovery)• Events Calendar• Volunteer programs• Outcomes
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True or False?
Into Action
Myths vs. reality
Lessons learned along the way…
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True or False?
Into Action
Chemical relapse is the greatest single risk in managing and open community model.
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True or False?
Into Action
SECRETS (and coalitions) represent the greatest threat to an open community model
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True or False?
Into Action
A common standard for all treatment programs is to achieve the highest completion rates possible.
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True or False?
Into Action
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.
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Into Action
2009 2010 2011 Avg
153145
178
159
64 64 62 6371 65 71 69
Completion Rates – 90 day program
Census WSA % Avg LOS
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True or False?
Into Action
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.
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True or False?
Into Action
In order to achieve lasting and sustainable sobriety, clients must learn to manage an environment which offers a daily choice between relapse or recovery.
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True or False?
Into Action
The counselor’s role in any treatment setting is to build a so-called Therapeutic Alliance (a trusting relationship) between himself and the client.
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True or False?
Into Action
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.
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The model evolves…• New Found Life – Long Beach, CA• The Right Door – Aspen, CO• Phoenix Multisport – Front Range, CO
Working with Others
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New Found Life
• Ocean Blvd., Long Beach, CA
• Separate Men’s / Women’s Houses
• Primary and extended care residential
Working with Others
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Rides 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 meeting
Working with Others
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The Right Door
• Aspen, CO• Non-profit agency
established in 2003• Provides low cost
intervention, case management, treatment and scholarships
Working with Others
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Roots in Recovery
Working with Others
• 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.
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Phoenix Multisport
• Boulder, Denver, and Colorado Springs
• Sober Activities• Recovery Network• NO Charge for
services, events!
Working with Others
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Action, 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!
Working with Others
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What’s next?
A Vision
for You
• Friendship – our new “goal-ed” standard?
• Sober College Programs… Everywhere!
• Future focused care
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Shootout at the I’m Okay Corral
Bob Ferguson bferguson@jaywalkerlodge.comwww.jaywalkerlodge.comwww.slideshare.com KEYWORD: “Colorado Model”