What to Do When a Drunk Comes to the Shelter

Some organizations use breathalyzer machines to keep all intoxicated individuals out of their shelters.   Those who “blow” over the legal limit for intoxication (in most states it is a .10 blood/alcohol content) are not allowed to stay for the night.   In my opinion, this strict policy may actually prevent us from reaching people with the Gospel and the message of recovery.   The fact that they come to the mission intoxicated certainly tells us they have real needs in their lives!   Still, there are situations where we should not offer shelter services to intoxicated individuals.

The main question is: “Are we ‘enablers’ or ‘interveners.'”   To “enable” means to provide “help” that actually allows people to continue in destructive ways. Being “interventive” means to develop strategies   that   work to disrupt destructive cycles and assist people to develop new, healthy lifestyles.   By develop a definite strategy for dealing with intoxicated individuals we can intervene in their lives.   Let’s take a look at some approaches that could be taken.

A.   The Ideal Situation –   The best way to deal with intoxicated individuals who need shelter is to have a dedicated “wet dormitory” that serves as a special detox center.   This type of program requires 24-hour   staffing by people who understand the medical issues involved in detoxification from alcohol and drugs.     It takes approximately 72 hours for the body to become free of mood altering drugs.   So, the stay in detox should be three days.   During that time, basic intake forms, addiction assessments, and other evaluation tools would be administered to the individual.   During their stay they would be introduced to the rescue mission’s long-term recovery program.     After three days, they may choose to move into the program or move to the mission’s emergency shelter for a limited stay.

B. Other Situations – I believe intoxicated people who come to the shelter for the first time   should be allowed to stay as long as they are not disruptive.   Once they are sober, we should make a special effort to reach out to them and introduce them to the mission’s recovery program.   Those facilities that do not offer such a long-term program need referral arrangements with other rescue missions in nearby cities who do.   Or, they need a relationship with local agencies that offer addiction treatment services.   With this sort of arrangement in place,the person needing shelter can be presented with the opportunity to stay for a few days, with the understanding that they will enter a program when they are able.

C.   Avoiding Enabling –   The “worst case” scenario is to simply offer shelter to anyone, any time, with no stipulations.   Offering a bed to a person so that they can get drunk as often as they like and still have a place to “crash” is not helping them.   Instead, we end up becoming a part of the problem.   I am not advocating denying shelter to people when the temperature is 40 below zero – there are extenuating circumstances. But, what I do advocate is setting limits on the services we make available to those individuals with whom we have repeated contact. Here are few “rules of thumb” to consider:

  • Never try to “minister” to an intoxicated person –   They probably will not even remember what you say to them the next day.   Instead, gently lead them to a place where they can sleep it off and then speak with them.
  • Limit the number of “free” shelter nights offered –At many rescue missions, 3-7 days of completely free nights are given.   After that period, those who stay must do some sort of work in the facility, or pay some nominal amount (even $1.00 a day) for a bed.   Others require that individuals who stay beyond the initial “free” period to actually demonstrate that they are working to improve their lives.   This could mean making a certain number of contacts each day in search of a job, participation in support group meetings and classes, or saving up money for housing if they already have a job.
  • Restrict shelter for those who do not want to change – For those individuals who constantly show up at the rescue mission intoxicated, it is important to draw the line on which services will be offered to them.   A few nights a year might be appropriate, but, in some cases, we may need to simply tell them that no overnight shelter is available – except in the long-term recovery program.

In conclusion, dealing with homeless alcoholics and drug addicts requires some thought and prayers for discernment.   It also requires good record-keeping and a strategy for dealing with specific individuals who look to us for assistance.

Respecting Client Boundaries

We previously highlighted the importance of counselors carefully guarding their own personal boundaries while working with troubled people.   Respecting the boundaries of those we seek to help is equally important.   Here are a few thoughts on the topic:

A. We must teach and model healthy boundaries – People who grow up in dysfunctional families tend to believe that they are not allowed to have personal boundaries. Though abused and mistreated, they do not feel they deserve anything else. As mentioned earlier, a personal boundary is, essentially, the line that divides me from you.   Without boundaries I can’t tell what’s my stuff and what’s yours. Something as simple as saying “No” to drugs and alcohol – or to sin in any form – is a boundaries issue.   To do so takes a commitment to caring about myself, while seeking to maintain a growing relationship with God. So, teaching and modeling healthy boundaries is vital if these folks are to begin the road to recovery.

B. “Fixing” vs. “Empowering” – Healthy recovery cannot happen until an individual is able to establish a program of “self-care.” At the Pool of Siloam, Jesus said to a crippled man, “Rise, take up your bed and walk.” (John 5:8)   In a very real way, this illustrates how we ought to minister to troubled people.   The goal is not to carry (or enable) people through the rest of their lives.   We don’t want to do their part for them.   Our part is to give them the “tools” they need in order to make good decisions.   Their part is to take those “tools” and learning to live sober and godly by applying them to “real life” situations.   Of course, imparting the tools can be a very lengthy process, which also involves removing the many “roadblocks” to recovery, such as denial. Still, we need to be mindful about keeping the focus on each individual taking responsibility for their own lives, helping them to understand fully the consequences of the decisions they make.

C. Allowing People to Feel – The return of the emotional life is a signal that people are beginning the road to recovery. Repressed emotions, some very scary and painful, often begin to surface.   These can include anger, sadness, loneliness and fear.   Christian workers sometimes do not feel comfortable with strong feelings being expressed by others. By dismissing, rejecting, or shutting down those feelings, we can end up sending the same signals they received in their dysfunctional families.   Instead, in a kind, supportive manner, we must allow them to talk their way through those feelings, even when they don’t seem very realistic or accurate reflections of their current situations.

D. Clear Expectations – Every well-run program needs written policies, rules, and procedures.       Setting appropriate boundaries begins the moment the client walks into our facility.   Each of them comes to us with a different set of needs and different expectations about what we can do for them; what participating our program really will be like.   So, a formal orientation procedure is essential.   This is most easily accomplished by creating an actual checklist of the rules that apply to all program participants, along with the program’s expectations of those who are involved.   And, we must be sure that once we have informed them of our policies and expectations of them, we must be sure to enforce the rules in a fair manner.

E. Individual Attention Given – Clients need to know that we have their individual best in mind.   The mission is there for them, and they not are just there to give their labor to keep the mission going.   Along with providing one-on-one counseling sessions, establishing personalized, written goals and objectives provides clients with a sense of purpose and direction in the recovery process.   They need a set of objective measures for their own progress (or lack of progress).   Efforts expended toward adequate needs assessment and development of individualized written plans tells clients that they are truly important to the program staff.   This is so important because if people in your program are feeling used or ignored, they will certainly shut themselves down to the recovery process.

An important element of the mission’s “therapeutic environment” comes when we give residents all the dignity and respect that they are entitled to as children of God.   And even though their defenses are up and they are angry, still they are God’s children and deserving of every bit of dignity that we can give them.   Respecting their boundaries is respecting them.   Doing for them what they should do themselves is not affording this dignity.   Instead, the message we just may convey the message that we don’t believe that they can actually change.

Why Become a Certified Addiction Counselor?

So, what is the Certified Addiction Counselor credential?   And would Christian recovery program staff members benefit from attaining it?   I think there are some compelling reasons to pursue credentialing for anyone considering a career in the field of addiction.

A.               Introducing the CAC – The CAC is the professional credential that is the standard for individuals working with addicts and alcoholics in hospitals, treatment centers and other agencies.   It is awarded through a peer review process and is administered by independent agencies in all fifty states of the US.   The CAC is based on experience and the ability to demonstrate the most important skills of addiction counseling.   No specific college degree is required.

B.               Benefits for the Worker — Pursuing of the CAC can be a rewarding   professional development experience.   Besides displaying competence in the Twelve Core Functions of the Substance Abuse Counselor (which we will discuss in more detail), credentialing bodies also require a certain number of hours in formal education in the substance abuse and counseling fields.   Participation in AGRM-sponsored training events and certain Rescue College courses can be used toward picking up these required educational hours.     Additionally, the process requires a specified number of supervised hours, where the individual works with an experienced addictions professional.

C                 Benefits for the Program  —The key to an effective program is staffing it with qualified people.   Rescue missions tend to hire people with biblical and theological training.   A growing number have also recognized the importance of having staff members who are competent in the area of substance abuse counseling.   Hiring individuals who posses the CAC means bringing in people with a combination of experience and demonstrated competence in the additions field.   It can also help when seeking financial support from private foundations and governmental funding sources.   Other agencies and ministries that recognize the value of the CAC are also more likely to refer client to the program.   Having current staff members become involved in the pursuit of the CAC is a great way to equip them by obtaining useful skills and a professional approach to their work.

C                 The Twelve Core Functions — Though administered by different bodies in the various states, there is   movement in the area of reciprocity; allowing the credential granted by one state to be transferred to another if the counselor moves.   This has been accomplished through because of the near universal acceptance of the “Twelve Core Functions” in which the counselor seeking the CACA must be able to demonstrate competence. These are:   *

I.             Screening:   Determining whether the client appropriate and eligible for admission to the program.

II.         Intake:   Completing admission, assessment and other program forms,   releases of information, and assigning a primary counselor to the client.

III.       Orientation:   Describing to the client the goals of the program; rules of conduct and infractions that can lead to disciplinary action or discharge from the program.

IV.       Assessment:     Identifying and evaluating an individual’s strengths, weaknesses, problems and needs in order to develop a treatment plan.   This usually results from a combination of focused interviews, testing   and/or record reviews.

V.         Treatment Planning: Identifying and ranking problems needing resolution; establishing agreed upon immediate and long-term goals; and deciding upon a treatment process and the resources to be utilized.     A written treatment contract (or recovery plan) is based on the assessment and is a product of a negotiation between the client and the counselor to assure that the plan is tailored to the individual’s needs.

VI.       Counseling: Basically, the relationship in which the counselor helps the client mobilize resources to resolve his or her problem and/or modify attitudes and values.

VII.   Case Management:   Knowing how to bring outside services, agencies, and resources to assist the client to recovery and attain other goals of the treatment plan.

VIII. Crisis Intervention: Knowing how to   respond to an alcohol and/or other drug abuser’s needs during acute emotional and/or physical distress that threatens to compromise or destroy the rehabilitation effort.

IX.       Client Education:   Education that supports recovery from alcohol and drug addiction can be provided in a variety of ways;   a sequence of formal classes may be conducted or outside educational resources may be used.

X.        Referral:   Identifying the needs of a client that cannot be met by the counselor or agency (mission) along with assisting the client to access   the support systems and community resources available.

XI.       Report and Record Keeping:   Charting the results of treatment;, writing reports, progress notes, discharge summaries and other client-related data.

XII.   Consultation — Relating with in-house staff or outside professionals to assure comprehensive, quality care for the client; involves meetings for discussion, decision-making and planning.

 

Learn about the requirements for addiction counselor certification in your state. If you have any questions about these matters or need help in contacting the agency in your state that administers the credentialing process, please feel free to contact me.