Saturday December 10th 2016

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Social model residential programs for addiction: Best practices INTERVIEW with Jeremiah’s Inn

Social models of residential addiction treatment

There are different programs a person can choose from to successfully continue down the path of addiction recovery. Today, we’d like to present you with a somewhat different program of transitional living – The Social Model Residential Recovery Program.

Our correspondent is Robert Siemaszko, Director of Clinical and Program Services at Jeremiah’s Inn. He’ll offer us some more information about this community based model while answering questions like:

  • What is a social model program?
  • What is the success rate of this type of program?
  • What kind of activities are included, and what are some of the core challenge for implementing this program?

We hope that our Q&A will inspire you to consider this unique type of program and share it with others. Plus, we invite any comments or questions that you may have in the comments section below this interview. We will be happy to provide you with a personal and prompt response, or can help connect you with Mr. Siemaszko directly.

ADDICTION BLOG: What is a social model program?

JEREMIAH’S INN: The social model is a peer-oriented process of rehabilitation and healing and recovery.

Social model programs are heavily influenced by the mutual help principles of Alcoholics Anonymous (AA). The first social model programs were in the early days of AA, when AA members would bring recovering alcoholics into their homes to sober up and get back on their feet.

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From these beginnings, social model programs have evolved over the last 70 years to incorparate new information about addiction and the use of evidence based best practices regarding treatment.

ADDICTION BLOG: How does this therapeutic community model help men address substance abuse?

JEREMIAH’S INN: The basis of Jeremiah’s Inn is experiential knowledge. Program participants learn from one another as they live their way through recovery. Peer counseling, staff and volunteers collectively provide and help in the experiential learning process.

This is different than talking their way out of addictions in a more traditional, therapeutic model. Program participants are guided by staff as they provide one another with a culture of recovery, support, sharing and a positive peer role modeling experience.

Staff members are part of the community. They function as guides and mentors rather than as therapists. Staff cannot over-function by assuming the responsibility of the program participants.

The primary therapeutic relationship is between the person and the program, rather than between the person and the individual therapist. Recovery services are realized through the entire community of staff, volunteers and program participants. The foundation of social model programming lies within the culture of abstinence and group membership.

ADDICTION BLOG: Your philosophy is – “Everyone gives and receives help.” How exactly do you apply this?

JEREMIAH’S INN: Everyone gives and receives help. From the Program Director to the newest program participant,
everyone has a contribution to make toward the program operation. As new program participants progress in their recovery they take on responsibility, often through sharing their experiential knowledge.

Additionally, program participants are continuously involved in the design and operation of social model programs. The recovery activities are primarily participant driven. Program participants have “ownership” in the program. A program participant governance body is in place.

Jeremiah’s Inn also takes an active role in our neighborhood. We also run a food pantry out of Jeremiah’s Inn which the men in the house regularly donate their time to. We also participate in other community activities, such as advocacy walks, sober based events, etc. We encourage all residents in the house to help each other and to be a positive role model in the community.

ADDICTION BLOG: What kinds of success rates (an estimate) are you seeing in long term treatment (24 months or longer) upon program completion?

JEREMIAH’S INN: To be honest, it is hard to collect accurate data for long term success. Due to the nature of constant movement or changing of telephone numbers, it has been hard getting an accurate account of people with long term success. We are currently in the process of transitioning to the use of electronic medical records which we will hope will provide us with more accurate data about this.

Still, we see success! We have implemented an alumni night in which former residents are welcome to come to the program and attend an AA meeting. We also have some former residents who now work in the field.

ADDICTION BLOG: What are some of the common features/needs of homeless men that you encounter?

JEREMIAH’S INN: A positive sober environment is a crucial part of program operation. Social model programs should provide and
maintain an environment that promotes recovery. Basic elements of this environment can be found in a clean, homelike atmosphere.

A social model program “safe place”, safe from violence, alcohol and other drug use. Safety is also proved through the
culture of recovery that should exist within the program. The culture is compromised of the belief that you only get drunk from drinking, the value that sobriety is better than drunkenness and the norm that whatever you do: don’t drink/ drug.

From this safe place, program participants can practice doing things sober, knowing that they can return to the safety and sanctuary of the program.

ADDICTION BLOG: Can you tell us a bit more about the types of programs and activities that residents attend during their stay?

JEREMIAH’S INN: During the resident’s time at Jeremiah’s Inn they a subjected to a large variety of groups surrounding:

  • health and wellness
  • relapse prevention
  • psychoeducation of addiction
  • life skills

Jeremiah’s Inn also works with community providers to provide free:

  • legal help
  • financial planning
  • professional counseling
  • Opiate Overdose Prevention
  • health education

In addition we are a working house, so we encourage all residents to work or volunteer or go to a day program. We also have a program that will waive program fees if a resident goes to school full time.

ADDICTION BLOG: How do you prepare residents for life after treatment?

JEREMIAH’S INN: Our goal is to provide a safe environment for residents to practice their recovery. We help clients balance their work, recovery, and personal needs.

There is a phasing process that each resident must go through to achieve completion of the program. Not only does the individual need to complete the program requirements, the other residents in the house must approve of the completion of each phase also.

The goal is to have each resident get use to working a full time job and balancing their recovery and other responsibilities. We ensure that each resident has a source of income, safe housing, providers, a sponsor, and a network to rely on once they complete the program. The house also welcomes back alumni to visit whenever they want as long as they are sober.

ADDICTION BLOG: What kinds of aftercare should be in place after any residential program for addiction? What steps do you recommend?

JEREMIAH’S INN: It is recommended that each person has an understanding of what it means to live a sober lifesyle. I try to ensure that the person has secure and sober housing, an income, a sponsor, a recovery or support network, and outside providers.

In addition, I find it useful that each client who graduates has a schedule to follow once they move out of the program. They should also be familiar with the resources in their community in case they need help once they graduate.

ADDICTION BLOG: What are some of the “best practices” that programs using this model MUST employ?

JEREMIAH’S INN: First of all, we are a “social model” house and that means all of our practices should focus on helping people achieve sobriety.

As far as clinical interventions, we put a heavy emphasis on Motivational Interviewing and Trauma Informed Care. We also bring in outside clinician(s) to run clinical groups which focus on Cognitive-Behavioral Therapy and coping skills. We also self-evaluate ourself quarterly on a number of statistics and we use this information to implement program changes.

ADDICTION BLOG: What would you say are the biggest challenges of this program? How do you overcome them?

JEREMIAH’S INN: The biggest problem in our program is to educate new residents about what it means to be in a social model program.

Many men come from inpatient treatment or incarceration, which means they are use to just focusing on themselves and doing what the staff directs them to do. In a social model program, each resident is expected to be able to give and receive constructive criticism. Most residents are used to keeping to themselves and do not usually speak their mind freely.

Here, we tell residents that this house is 30 men working their recovery together, not 30 men each working their own program. We help residents understand the rules and  philosophy of the program by having them attend 4 separate “social model” groups. It is here that they begin to understand what it means to be in a socail model program  and how to benefit from it.

ADDICTION BLOG: Is there anything else you would like to add?

JEREMIAH’S INN: I would like to say that everyone at Jeremiah’s Inn is focusing on helping our residents obtain sobriety.

I feel there are two separate ways to run a program, either you enforce compliance or facilitate recovery. At Jeremiah’s Inn, we focus on facilitating recovery and we individualize each client’s treatment to ensure that they get the support that they need. Everyone who is a part of Jeremiah’s Inn has this goal also: from the live-in house manager to the food pantry staff to the senior residents in the house.

Everyone here is making sure everyone’s “internal needle” is pointing towards recovery of mind, body, and spirit. Jeremiah’s Inn hopes to continue to help men obtain recovery  along with being an active member of the community through our food pantry and recovery program.

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