The Portage Therapeutic Community - Drug Addiction Rehabiliation
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Transcript of The Portage Therapeutic Community - Drug Addiction Rehabiliation
The Portage Therapeutic Community
François BourdonAllan Farkas
• 1
The Therapeutic community
Today we will present you the therapeutic community
We will show you the tools we use to help our residents acquire skills and competencies that will support them in their reinsertion in the community.
Phases &WorkshopsCompetenciesPASS EvaluationEducationOutreach Research Results
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Portage phasesPortage Program works with different phases based on acquisition of competencies
Phase 1 through 6
In each of those phases the expectations and responsibilities increase with the status of the resident in the community
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ExpectationsThe residents are expected to acquire skills and competencies. These expectations grow at each phase change.
Phase 1
Get to know your environmentGet to know the people in the communityGet use to the schedule
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Phase 2Phase 2Learn basic expectationsIntegrate in the communityUnderstand the basic tools of therapyFollow the structure of the program Participate in groups and meetingsPut the tools of therapy in practiceParticipate in all workshop
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Phase 3
Be responsible and a model in the community
Accomplish the tasks for witch you are responsible
Show leadershipFollow treatment planTransfer competenciesMaintain a balance between your
recovery and your role in the community
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Phase 4Be a leader in the community
Prepare your exit plan
Be a role model
Help new members integrate in the community
Work on positive networking during outings
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Phase 5Reintegrate in the community and your
family
Be a support to the community and your peers
Be a role model
Attend aftercare groups
Reinforce your positive network
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Phase 6Practice a positive lifestyle
Go back to school or work
Attend aftercare meetings
Have a personal inventory of your own progress
Reintegrate with family and community
• 9
Competencies
Demonstrate objectivityAbility to take initiativesDemonstrate empathyExpress self in an appropriate mannerActive participation in treatmentEncourages othersPlanned and orderlyShows consistencyDemonstrates reliability and is trustworthyEnergetic and enthusiasmDemonstrates good problem solving and
decision making abilities
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Competencies
High level of team workAbility to prepare structured activitiesAbility to conduct structured activitiesAssist well in conflict resolutionAbility to ask for helpDemonstrates accurate self-awarenessTransfer of learningAccepting of supervisionAbility to communicate effectivelyHas developed realistic goals and objectives
for post treatmentDemonstrates social adjustment
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Workshop Topics Who am I?
• Feelings: Part 1 Identify feelings Taking responsibility for and expressing
feelings• Feelings: Part 2
Controlling behavior Building relationships
• Separating feelings, thoughts, attitude and behavior
• summary of positive qualitiesCommunity as method
• Community meetings (Morning meeting, night meeting)
• Safe community• Coaching and coaching board• Importance of belonging/only as strong as the
community
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Workshop Topics Self-help/mutual help
• Helping myself by helping others/positive engagements
• Relationships • Empathic confrontation
Practical aspects• Role of cleanups in therapy/how to do a
cleanup• Relationship between school and therapy• Competencies • Belief system: Philosophy
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The PASSA tool designed by the research departmentThe purpose is:
to measure the progress made by the resident from the beginning of therapy to its conclusion, including the aftercare phase.
to help clinical staff members measure the acquisition of the 21 competencies/skills.
to assess the clients’ progress.The PASS must not be used to compare
residents. The results of the pass must be used as part
of the monthly treatment plans of the resident
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The PASS Using the following scale, which ranges from
Strongly Disagree (1) to Strongly Agree (7), please circle the number closest to the way you rate the client now for all statements. Please provide a fair and honest evaluation of the client.
1 The client is organized and orderly. 1 2 3 4 5 6 7 2The client behaves in a consistent way. 1 2 3 4 5 6 7 3The client is reliable. 1 2 3 4 5 6 7 4 The client participates actively in his/her recovery. 1 2 3 4 5 6 7 5 The client demonstrates the ability to plan structured
activities. 1 2 3 4 5 6 7 6 The client demonstrates the ability to lead structured
activities. 1 2 3 4 5 6 7 7 The client uses his/her acquired skills in different
situations (transfer of learning). 1 2 3 4 5 6 7 8 The client takes initiative. 1 2 3 4 5 6 7 9The client expresses himself/herself appropriately. 1 2 3 4 5 6 7 10 The client encourages others. 1 2 3 4 5 6 7 Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree
Please circle only one number per statement.
11 The client accepts to be supervised. 1 2 3 4 5 6 7 12 The client demonstrates the ability to work within a
team. 1 2 3 4 5 6 7 13 The client communicates effectively. 1 2 3 4 5 6 7 14 The client demonstrates the ability to integrate
socially. 1 2 3 4 5 6 7 15 The client demonstrates the ability to be objective. 1 2 3 4 5 6 7 16 The client demonstrates the ability to be empathetic. 1 2 3 4 5 6 7 17 The client demonstrates the ability to make
decisions. 1 2 3 4 5 6 7 18 The client demonstrates the ability to solve
problems. 1 2 3 4 5 6 7 19 The client demonstrates the ability to ask for help. 1 2 3 4 5 6 7 20 The client demonstrates the ability to resolve
conflicts. 1 2 3 4 5 6 7 21 The client knows who he/she is and where he/she is
at. 1 2 3 4 5 6 7
• 15
• 16
TREATMENT PLAN
Behaviours and issues to be explored
Goals Objectives Means/method Measured outcome
1- Drug addiction & other dependencies
2- Health
3- Personal development
4- Social skills
5- Family
6- Legal issues
7- Education
8- Outings & requests
9- Specific behaviours
Resident’s name___________________Date of birth: ____________________Admission Date: _________________
Counsellor who completed the plan: _______________Case conference chair person: ____________________
Plan completed: __________Revision on: _____________
Educational model The Portage Educational Model exists
because we worked to become affiliated with the local school authority. Portage is able to act as a consultant to the school board in pilot projects; and some of the Portage methods are applied in their Alternative programs.
In effect our residents become mentors with peer students working hand and hand to mentor high school students at risk
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CLASSROOM OUTREACH
• The process gives our adolescents a sense of pride and the ability to reach a goal that is good and positive. That they have the passion for this is the why of the Portage experience.
• The concept of our outreach program also includes our adolescents giving personal, testimonial presentations to school assemblies which promotes many competencies that are acquired in the program.
PORTAGE EDUCATIONAL MODEL IN THE TC AND OUTSIDE
Integrating outside the therapeutic community(TC)
Portage partners with the local school authorities on several levels
Acts as a consultant with the coordinator of substance abuse inside the school and parts of our program is applied in alternative program settings
Portage’s educational work and goals is to engage and develop diverse young people so they can impact their lives, their families and communities positively.
PORTAGE EDUCATIONAL MODEL IN THE TC AND OUTSIDE
A very important way this is accomplished is by putting these adolescents in contexts with their peers outside of the facility, while they remain part of the program and continue their therapy. This process enhances the acquisition of competencies
Putting the problem out on the table relieves some of the shame and stigma attached to admitting to a sense of loss, (a break up with a girl friend or boy friend, a sense of sadness (not meeting their parent’s academic expectations or - an addiction).
EducationAt Portage peer-on-peer accountability is
paramount, and each resident is held responsible for their personal contribution within the community.
The Portage adolescent programs believe that academic education is an integral part of the recovery process for teenagers with drug and alcohol addictions and behavioral disorders.
StatisticsAll youth admitted at Lac Écho between January 2003 and March 2008 and having received at least 15 days of treatment have been invited to participate in a research project (77.9% have been contacted). Questionnaires were filled up to October 2008. Boys represent 60.2% (n=127) while girls represent 39.8% (n=84). The average age at admission of those who answered was 16.0 years old.
Description of youth: _______________________________________________________________________________________________________________
Polydrug users: 75.6% Committed a delinquent act criminally punishable: 91.6%Cannabis use: 89.5% Arrested or charged with an offence: 58.1%Amphetamines, speed or Ritalin use: 55.8% Suspended or expulsed from school: 87.4%Hallucinogenic use: 53.6% Five or more psychological problems: 86.5%Cocaine use: 43.2% Reported to LPJ: 62.6%Previous treatments for alcohol or drug use: 53.9%
________________________________________________________________________________________________• 22
Study results:
Number of days of use of illegal drugs in a month
________________________________________________________________________________________________________________________
Number of days in treatment Before treatment 7.5 months after treatment 14.5 months after treatment
________________________________________________________________________________________________________________________
15 to 60 days 20,1 days 10,5 days 13,2 days
(n=61)
61 to 180 days 21,8 days 7,8 days 8,7 days
(n=69)
181 days and more 22,2 days 3,1 days 5,0 days
(n=79)
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Study results:
Before treatment 7.5 months after treatment
14.5 months after treatment
0
4
8
12
16
20
24Number of days of use of illegal drugs in a month
15 to 60 days 61 to 180 days 181 days and more
Num
ber
of
days
of
use
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Study results:Percentage of youth abstinent of illegal drugs in last 30
days____________________________________________________Number of days 7.5 months after 14.5 months
after In treatment treatment treatment___________________________________________________________________________________________________________________________________________________________________
15 to 60 days 37.7% 32.8% (n=61)
61 to 180 days 58.0% 44.9% (n=69)
181 days and more 79.7% 65.8% (n=79)__________________________________________________________________________________ • 25
Study results:
15 to 60 days (n=61) 61 to 180 days (n=69) 181 days and more (n=79)20%
30%
40%
50%
60%
70%
80%
90%
Percentage of youth abstinent of illegal drugs in last 30 days
7.5 months after treatment 14.5 months after treatment
Per
cen
tag
e
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Study results:If youth use drugs for between 20.1 and 22.2 days in a month before entering treatment, they use drugs for between 3.1 to 13.2 days a month after treatment depending on time spend in treatment. Those who use the least are those who stay longer in treatment. Abstinent rates of all illegal drugs after treatment range from 37.7% to 79.7% depending on time spend in treatment. Those who are the most abstinent are those who stay longer in treatment.
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