As an initial focus, clients explore the specific effects of addiction on their lives by completing the first three of the Twelve Steps. The principles and concepts addressed include powerlessness over addiction; unhealthy, destructive, and repetitive thoughts and behaviors; and making the decision to stay abstinent and participate in a lifelong recovery process.
Goals for the initial focus include:
- Assessing the client's understanding of the disease of addiction and address areas of misunderstanding or lack of knowledge.
- Assessing the family's/friends' commitment to maintaining agreed-upon leverage.
- Assessing the client's level of motivation for making the changes necessary for recovery and addressing any barriers to making needed changes.
- Using the therapeutic relationship to assist the client in taking responsibility for their recovery.
- Assessing the client's current utilization of, and potential for, self-advocacy with family, recovery, and community resources.
- Providing information and referrals to relevant twelve-step recovery and community resources.
- Beginning to identify and address all relapse risks.
- Assessing the client's plan for post-discharge recovery and living situation (if the client will be discharged after five weeks of treatment), and assist the client in modifying and strengthening their recovery plan as appropriate.
- Having the client complete Steps One, Two, and Three and be able to verbalize a clear understanding of how these steps and the principles they embody apply to his or her use of substances, thoughts, behaviors, and other manifestations of addiction.
As a second step—ideally taking place after an initial five-week stay—clients focus on building on the recovery process established during the first phase of treatment by completing a personal life inventory (fourth of the Twelve Steps), which helps them get a clearer and more accurate picture of their lives and patterns related to thoughts, beliefs, emotions, behaviors, and relationships. This process also includes identifying clients' assets, strengths, and resources so these can be applied in support of the clients' recovery.
Goals during this period include:
- Continuing to explore and clarify their understanding of the disease of addiction (mental, emotional, physical, and spiritual dimensions) and its potential manifestations in their lives.
- Writing daily in the guided journal, My First Year in Recovery.
- Completing life inventory (Fourth Step) and process with counselor and temporary sponsor.
- Completing Step Working Guides Four and Five and be able to verbalize a clear understanding of the patterns in their lives that have contributed to their addiction.
- Reading and highlighting Chapters Five and Eight in the Narcotics Anonymous basic text.
- Attending all assigned groups and complete specified writing assignments.
- Demonstrating recovery-based attitudes and behaviors with increasing consistency.
For Family and Friends:
- Participating in twelve-step meetings, Friday-night family support groups, family sessions, and other recommended workshops, and attending the Family Renewal Program.
- Practicing the plan put in place at the beginning of Treatment as needed to utilize, maintain, and strengthen the leverage available to the family in setting and enforcing boundaries to support the recovery process for both themselves and the client.
Third and finally—and preferably during the final four weeks of a twelve week stay—the focus turns to helping clients make the transition from reliance on the structure of the treatment environment to taking initiative and personal responsibility for their recovery. This phase is designed to increase opportunities to strengthen the recovery principles and the skills clients have learned by applying them in daily experience. Through continued practice of new, recovery-oriented ways of relating to self, to others, and to the world, positive changes in thinking and behavior gain critical traction.
The Goals for this final phase include:
- Verbalizing a solid understanding of the disease of addiction (mental, emotional, physical, and spiritual dimensions) and its potential manifestations in client's life.
- Writing daily in the guided journal, My First Year in Recovery.
- Attending all assigned groups and completing specified writing assignments.
- Demonstrating recovery-based behaviors and the ability to model these for other clients.
- Reading and highlighting Chapters Nine and Ten in the Narcotics Anonymous basic text.
- Continuing to work on relationship with temporary sponsor.
- Completing Step Working Guides Six and Seven and processing with counselor and temporary sponsor.
- Attending outside twelve-step meetings with sponsor.
- Exercising at Sports at least three times weekly.
For Family and Friends:
- Continuing to participate in twelve-step meetings, Friday night family support groups, family sessions, and other recommended workshops, and attending the Family Renewal Program if not already done.
- Continuing to practice the plan developed at the beginning of treatment as needed to utilize, maintain, and strengthen the leverage available to the family in setting and enforcing boundaries to support the recovery process for both themselves and the client.
PROGRAM ASSESSMENT TOOLS
The following is a list of the Eleven Life Areas we assess to develop an individualized addiction treatment plan for clients, to monitor clients' progress throughout treatment, and to determine clients' discharge/aftercare plans. After the initial five-week phase, all eleven areas are continuously reviewed to determine the extent to which clients' functioning is helping or hindering their ability to stay abstinent and continue in the recovery process; to determine any issues that remain to be addressed, and to identify any new areas of concern that may arise as treatment progresses.
If clients are receiving enhanced services through participation in our Pain Recovery Treatment Program, the treatment plan will be developed to ensure that this complements, rather than conflicts with, the overall structure of their program.
- Family/Significant Others: Quantity and quality of relationships with family members/significant others and the degree to which these relationships help or hinder the recovery process; knowledge of addiction and family recovery; motivation and willingness to continue providing agreed-upon leverage; use of and involvement in recovery resources, including family support group, Family Renewal Program, workshops, lectures, and twelve-step programs.
- Social: Quantity and quality of social relationships and degree to which they help or hinder the recovery process; strategies for strengthening healthy relationships and reconsidering, modifying or ending clients' unhealthy relationships; strategies for establishing new supportive relationships.
- Work: Employment status, history, and skills; transitional issues regarding returning to work; if applicable, the quality of clients' relationships with clients' employer and other coworkers; interest in or necessity for vocational training.
- Health: Current state of health; health issues needing attention or treatment, e.g., medical conditions, exercise, nutrition/weight management; plan for regular check-ups with physician, dentist, and other healthcare providers.
- Emotional: Emotional state and degree of balance; style of emotional expression; areas of greatest emotional discomfort and their connections to clients' substance use; ability to identify and cope with feelings and emotions; remaining “secrets” in clients' “emotional closet” that may need to be addressed.
- Cognitive/Thinking: Mental health status and history, including treatment and medications; cognitive/thinking style and degree of balance; status of clients' recovery-oriented thoughts and patterns of thinking; capacity for using reading and writing resources, including recovery literature.
- Spiritual: Spiritual beliefs and practices; current state of acceptance regarding the disease of addiction, including powerlessness and willingness to seek support; capacity to use the spiritual aspects of recovery, e.g., meditations and prayer; reservations or obstacles related to spirituality as a recovery-supportive resource.
- Financial: Current financial issues influencing recovery process; financial status, stressors, and viability; actions needed to stabilize client's financial situation.
- Hobbies/Interests: Use of down time in treatment and plans for use of free time post-treatment; activities engaged in for fun and recreation; special interests and/or hobbies clients can develop to enrich the quality of life.
- Legal: Need for a plan to resolve any legal issues upon discharge; need for LVRC contact with probation, parole, judges, attorneys, etc.; need for documentation of client's completion of treatment/discharge plan.
- Patterns of Recovery: Degree of clients' understanding of the recovery process; previous recovery and related experience; extent to which clients' motivation for treatment and recovery is internal vs. external; degree of clients' demonstrated honesty, open-mindedness, and willingness; specifics of how clients are working a program of recovery; quality of work on Steps One through Five.