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The Portage Therapeutic Community

VIEWS: 15 PAGES: 27

  • pg 1
									François Bourdon
     Allan 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 &Workshops
 Competencies
 PASS Evaluation
 Education
 Outreach
 Research Results

                                                            •2
                 Portage phases
  Portage 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




                                                                  •3
               Expectations
 The residents are expected to acquire skills and
 competencies. These expectations grow at each phase
 change.

Phase 1

 Get to know your environment
 Get to know the people in the community
 Get use to the schedule


                                                       •4
                     Phase 2
Phase 2
 Learn basic expectations
 Integrate in the community
 Understand the basic tools of therapy
 Follow the structure of the program
 Participate in groups and meetings
 Put the tools of therapy in practice
 Participate in all workshop


                                          •5
                      Phase 3

 Be responsible and a model in the community
 Accomplish the tasks for witch you are responsible
 Show leadership
 Follow treatment plan
 Transfer competencies
 Maintain a balance between your recovery and your
 role in the community



                                                       •6
                     Phase 4
 Be 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




                                                •7
                     Phase 5
 Reintegrate 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




                                                 •8
                       Phase 6
 Practice 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 objectivity
   Ability to take initiatives
   Demonstrate empathy
   Express self in an appropriate manner
   Active participation in treatment
   Encourages others
   Planned and orderly
   Shows consistency
   Demonstrates reliability and is trustworthy
   Energetic and enthusiasm
   Demonstrates good problem solving and decision making
    abilities


                                                            •10
                  Competencies
 High level of team work
 Ability to prepare structured activities
 Ability to conduct structured activities
 Assist well in conflict resolution
 Ability to ask for help
 Demonstrates accurate self-awareness
 Transfer of learning
 Accepting of supervision
 Ability to communicate effectively
 Has developed realistic goals and objectives for post
  treatment
 Demonstrates social adjustment


                                                          •11
                  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 qualities
 Community as method
   • Community meetings (Morning meeting, night meeting)
   • Safe community
   • Coaching and coaching board
   • Importance of belonging/only as strong as the community

                                                               •12
              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


                                                        •13
                      The PASS
 A tool designed by the research department
 The 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


                                                             •14
                                                    The PASS
   Using the following scale, which ranges from Strongly
    Disagree (1) to Strongly Agree (7), please circle the number              11 The client accepts to be supervised.
    closest to the way you rate the client now for all statements.            1 2 3 4 5 6 7
    Please provide a fair and honest evaluation of the client.                12 The client demonstrates the ability to work within a team.
                                                                              1 2 3 4 5 6 7
   1 The client is organized and orderly.
                                                                              13 The client communicates effectively.
   1 2 3 4 5 6 7
                                                                              1 2 3 4 5 6 7
   2The client behaves in a consistent way.
                                                                              14 The client demonstrates the ability to integrate socially.
   1 2 3 4 5 6 7
                                                                              1 2 3 4 5 6 7
   3The client is reliable.
                                                                              15 The client demonstrates the ability to be objective.
   1 2 3 4 5 6 7
                                                                              1 2 3 4 5 6 7
   4 The client participates actively in his/her recovery.
                                                                              16 The client demonstrates the ability to be empathetic.
   1 2 3 4 5 6 7
                                                                              1 2 3 4 5 6 7
   5 The client demonstrates the ability to plan structured activities.
                                                                              17 The client demonstrates the ability to make decisions.
   1 2 3 4 5 6 7
                                                                              1 2 3 4 5 6 7
   6 The client demonstrates the ability to lead structured activities.
                                                                              18 The client demonstrates the ability to solve problems.
   1 2 3 4 5 6 7
                                                                              1 2 3 4 5 6 7
   7 The client uses his/her acquired skills in different situations
    (transfer of learning).                                                   19 The client demonstrates the ability to ask for help.
   1 2 3 4 5 6 7                                                             1 2 3 4 5 6 7
   8 The client takes initiative.                                            20 The client demonstrates the ability to resolve conflicts.
   1 2 3 4 5 6 7                                                             1 2 3 4 5 6 7
   9The client expresses himself/herself appropriately.                      21 The client knows who he/she is and where he/she is at.
   1 2 3 4 5 6 7                                                             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.


                                                                                                                                               •15
                         TREATMENT PLAN
Resident’s name___________________     Counsellor who completed the plan: _______________   Plan completed: __________
Date of birth: ____________________    Case conference chair person: ____________________   Revision on: _____________
Admission Date: _________________



Behaviours and issues to be    Goals           Objectives        Means/method                   Measured outcome
explored
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




                                                                                                                    •16
                 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




                                                                •17
    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).
                   Education
 At 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.
                                     Statistics
 All 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)


                                                                                                                       •23
                                    Study results:
Number of days of use of illegal drugs in a month
                        24


                        20
Number of days of use




                        16


                        12


                        8


                        4


                        0
                             Before treatment      7.5 months after treatment   14.5 months after treatment

                                   15 to 60 days            61 to 180 days              181 days and more




                                                                                                              •24
                                             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:
                               Percentage of youth abstinent of illegal drugs in last 30 days

             90%


             80%


             70%


             60%
Percentage




             50%


             40%


             30%


             20%
                   15 to 60 days (n=61)                    61 to 180 days (n=69)                        181 days and more (n=79)
                                            7.5 months after treatment    14.5 months after treatment


                                                                                                                                   •26
             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.
                                                      •27

								
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