Last Door’s Program allows clients to complete a full set of written exercises that encourages the changes necessary to integrate the principles of recovery into their lives. A minimum of 90 days affords the time needed to repair damaged family relationships, assess medication needs, assess psychological issues, improve upon limited coping skills and break deeply ingrained habits.
Here is a breakdown of what a client’s treatment plan consists of:
|Written Exercise||Action||Clinical Activity||Achievement|
|1||Stabilization||Detox, medical assessment, adapts to peer group norms, clinical assessment. Case worker speaks with family to assess family dynamics, orient to terms of treatment||Calming, beginning restoration of eating and sleeping cycles.|
Life and substance use history
|Setting first stage treatment goals, increased identification with peers, increased level of personal honesty, ability to interact with family with less conflict, increased emotional stability and willingness to tackle personal change. Begin value added groups – Media, Lifestyle and Co-Parenting Group. Ongoing contact between Case Worker and family, overview of Family Program Services||Identification of personal issues, recognition and acceptance of need for change, Improved peer interaction, improved sleep cycles, Awareness of too much or lack of personal hygiene and appearance.|
|3||Exercise 2 and 3
Become willing to accept help and work with others
|Deepening clinical rapport, cognitive restructuring, introduction to spiritual concepts as life choice, education about inter-dependence and use of support group as resource, active involvement in community based 12 step programs. Clinical contact with client’s partner to set up participation in Last Door’s Family Program, arrange visits||Shows evolving sense of direction and commitment to change, improved interactions with peers, improved self care, increased eye contact. Physical improvements – obvious weight gain, improved skin tone, increased energy levels.|
|4 & 5||Exercise 4 and 5
Historical self evaluation
|Guided historical self evaluation with clinical supports keeping focus on today, Rational Emotive Therapy, CBT and introduction to weekly alternate therapies ie yoga and acupuncture. Goal of learning stress management techniques. Full detoxification allows for accurate value exploration, Secondary Assessments of concurrent medical issues such as Anxiety disorders and PTSD||Demonstrates humility, seeks sense of belonging, less isolation, improved communication skills eg open posture, less isolation, displays increased trust with peers and more positive world view.|
|6||Exercise 6 and 7
Set personal goals and practice change.
|Personal needs assessment, establishment of mid-term goals, establish plan for self directed daily improvement. Active involvement with family designed to improve relationships – home and family visitation, recreational activities. Identify emotional or mental stumbling blocks for client and develop coping strategies. Begin couples counselling with Family counsellors (continues to tx completion)||Obvious reduction of shame based actions – less reactive, shows empathy for and interest in others, more patient. Marked increase in physical energy and willingness to interact socially. Improved level of personal responsibilities|
Assessing personal, work and community relationships; making a plan for change.
|CBT and Cognitive Restructuring with goal of helping set tone (behaviors, attitudes) for personal change to cement desired change. Establish opportunities to participate actively in community eg volunteerism, assisting peers. Practical daily assignments to improve self esteem and sense of belonging. Eg help others, work projects. Reassess financial and legal responsibilities.||Marked improvement in peer and community interaction increased self awareness. Shows and is able to clearly articulate life direction. Eagerness to face the life on life terms.|
Take concrete steps to reclaiming personal, professional and community relationships
|Review goals and set long-term goals. Clinical support to make personal statement of commitment to change, and personal responsibility in professional, family and community relationships – employer, family, children, finances. Clinical support involves planning of family meetings, financial planning.||Client displays elevated mood and demeanor, is able to gain self esteem and freedom from the past. Focus is on the future and achieving long term goals. Clients realize the gifts of being given the option to go to treatment and the importance of these exercises|
|9 & 10||Exercise 10
Make concrete plans for daily stability by attending to personal responsibilities. Goal of relapse prevention.
|Client set up ongoing self evaluation processes. Rational Emotive Therapy as a means of continuing motivation and dealing with fear based relapse to old behaviors and attitudes that can lead to substance relapse. Increased involvement with family including longer visits – home visit or extended family visits. Clinically supported to reactivate social life – dating, participation in social activities, explore hobbies. Attends weekly Alumni Group.||Continues to use group and peer support, remains open to change and accepts correction, displays patience, kindness and respect to others in daily interactions and attitudes. Less family conflict, more empathy for partner and increased patience with children and others.|
Establishes plans to keep meaning and value in daily life.
|Re-exploration of values and goals. CBT to help client link values, behaviors, attitudes to outcomes personally, professionally and socially. Development of plan for daily recovery and mental health maintenance. Continued attendance at weekly alumni group||Client displays zest for life, eagerness to face life and engage in relationships, tasks and daily learning. High levels of stability. Actively helping others.|
|12||Exercise 12 – long terms goal setting designed to entrench positive change.||Review of changes and progress to date; re-evaluation of long term goals; plans for return to home community and involvement with local 12 step community. Aftercare plans established – counselling referrals, monitoring, aftercare groups.||Displays sense of personal authority and self determination, displays strong sense of community commitment and willingness to help others.|
|Average Stay 3 to 4 months to complete a full set of written exercises|
LAST DOOR WEEKLY SCHEDULE AT A GLANCE
*Main Group consists of three groups: Group One: Males 14 to 18 years of age, Group Two: Males 19 – 30 years of age, Group Three: 30 years of age and older
|7AM||Therapeutic Duties||Therapeutic Duties||Therapeutic Duties||Therapeutic Duties||Therapeutic Duties|
|8AM||Morning Meeting||Morning Meeting||Morning Meeting||Morning Meeting||Morning Meeting|
|8AM||Lifestyle Group||Acupuncture||Lifestyle Group||Media Group|
|9:30 – Noon||Recreation||Main Group||Main Group||Main Group||Main Group||Main Group||Recreation|
|1PM TP 5PM||Recreation||Recreation, Appointments, Written Work||
Recreation, Appointments, Written Work
Mixed Martial Arts Class
|Recreation, Appointments, Written Work||Recreation, Appointments, Written Work||
Recreation, Appointments, Written Work
|6PM TO 9PM||Outside Meeting||Outside Meeting||Outside Meeting||Outside Meeting||Outside Meeting||Outside Meeting||Outside Meeting|
|6PM TO 9PM||Yoga 7PM||Co-Parenting Group 6PM||Gamblers Group 7:30PM
Alumni Group 6:30PM
|Alumni Group 6:30|
|Naranon 7:30 PM
Friends and Family Support Group
|Partner/Spouse Group||Parents Group 7PM|
Client’s Weekly Schedule *Main Group consists of three group: Group One: Males 14 to 18 years of age, Group Two: Males 19 – 30 years of age, Group Three: 30 years of age and older
Studies clearly indicate that 3 to 6 month treatment reduces recidivism by more than 50% when compared to 28 to 45 day short term treatment models. Individuals who were in long-term residential treatment were more likely to have maintained abstinence. Per event, short term treatment (28 to 45 days) costs between $16,000 to $27,000 with documented relapse rates that are twice those of long-term treatment. With this in mind considering Last Door for 90 days at a cost of $22,500 is both economic and effective.