Michael Liimatta

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.

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 City Vision University 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 possess 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 government funding sources.   Other agencies and ministries that recognize the value of the CAC are also more likely to refer clients 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 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 is 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; establish 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.

1. Take the time to determine the real needs of the people who look to you for help.
2. Help people who look to you for help to identify these needs for themselves.
3. Help people who look to you for help overcome denial if they have and alcohol or drug problem.
4. Identify resources in the community that meet needs for people who look to you for help that may not be addressed at the program (e. g. legal aid, medical services, vocational training, and self help groups)
5. Help people who look to you for help to accurately evaluate their options and to see progress – establish “benchmarks” for measuring growth
6. Help people who look to you for help to develop new personal and social resources that will contribute to a positive life style.
7. Help people who look to you for help access needed resources that have been identified for themselves.
8. Help people who look to you for help develop strategies for handling problems which must be addressed by the individual rather than agencies.   We succeed when we are no longer needed.   We ought never to institutionalize (“missionize”) people.
9. Model a healthy godly lifestyle.   Be an example in word and deed of the principles you hope the people who look to you for help to adopt.
10. Help the people who look to you for help to learn to walk with the Lord on his own; listening to his conscience, personal prayer and Bible study, etc.