Michael Liimatta

Organizing the Addiction Counseling Process Part 5

By Michael Liimatta on February 25th, 2012

In our last installment in this series we discussed, briefly, the importance of meeting the needs of each individual in the recovery program. To do this most effectively, a process of documentation is essential, using paper forms or computer-based data collection.   In residential recovery programs for the homeless, it is also important to adopt a team approach to working with our clients.

A.  Developing a system of documentation.     The essential elements include:

1. Regularly updated recovery plans/contracts
2. Daily progress notes
3. Summaries of one-on-one counseling sessions

When all of these elements are in place, supervisors can get a good picture of what each counselor or chaplain is doing with each of the individuals with whom he or she is assigned work.   Besides serving as a measure of job performance, proper documentation makes it easier for another counselor to step in and keep working with the client if that is necessary.   Good documentation provides a permanent record that can be accessed if the individual leaves the program and returns at a later date.   And, it provides valuable information that may be used by other ministries or agencies that work with the client in the future.

B.         Developing a team approach – The centerpiece of the team approach is a weekly meeting that involves all staff members who work with program participants.   IN this meeting, each chaplain or counselor updates the rest of the team on the progress of his or her clients.   This includes the issues each client is working on, any special challenges her or she faces, and the specific recovery-oriented tasks that have been assigned.   Time is afforded for feedback from other team members. Combining a simple written documentation system with this sort of team approach creates an important level of accountability.   Best of all, counselors and chaplains benefit from the insight and advice of their peers.   This is sure to result in more effective approaches to meeting the needs of people they are helping.   Does a team approach violate confidentiality?   The answer is “no” if clients are informed of the team approach when they first start the program and as long as team members do not discuss what is shared

C.         Why a written recovery plan? – To truly meet needs on an individual, we must first know what his or her needs are!   We know homeless addicts need food and shelter.   They need a personal relationship with Christ and need to stop using alcohol and drugs. After this, things much more complex.   If we don’t help them to walk through their deeper problems, we are in danger of “missionizing” our clients.   By this I mean teaching them to live successfully in the mission but not preparing them to live a healthy, sober Christian life when they leave.

D.       An effective recovery plan begins with a comprehensive intake process— In the first week of an individual’s stay, it is vital that his or her primary counselor — or a staff member specializing in intakes — spend adequate time with them for program orientation and data gathering.   Instead of hand out list of rules and expectations, staff members need to discuss each one of them with the new program participant. This should be in the form of a contract that is signed by both client and counselor.   The new program member must indicate that he or she agrees to the expectations and understands that noncompliance to certain requirements can lead to dismissal. After this understanding is reached, the data gathering process begins.

The best approach is what might be called a “diagnostic interview” where the staff member uses a questionnaire to obtain information that will be used later in the counseling process.   The intake process needs to be very thorough. We certainly don’t want to learn after two weeks in the program that the person has AIDS or that they have an outstanding warrant in another state or county.   These issues, and many others, need to be discussed in a process that can that more than one session.

The intake/diagnostic interview should gather information address all of the following areas:

1. Family, cultural and ethnic background
2. Family of origin relationships
3. Use history – alcohol
4. Legal/criminal history:
5. Medical history
6. Treatment history
7. Suicide assessment
8. Current emotional status
9. Nutritional assessment
10. Education
11. Employment history
12. Financial assessment
13. Military experience
14. Social relationships
15. Significant life experiences
16. Marital/relationship history
17. Client’s impression of problem
18. Counselor’s impressions/observations

For downloadable forms and other helpful information for creating recovery plans, see theGuide to Effective Rescue Mission Recovery Programs

  For the rest of this series go to the  Organizing the Counseling Process Index