UB program helps restore the lives of those facing double the hardship
When Bill Burgin, Clinical Director of Cazenovia Recovery Systems, told Nancy Smyth, Dean of the School of Social Work, about his concerns with a underperforming residential treatment program, Smyth knew she could help.
Hoping to impact the number of patients staying in treatment and responding to treatment, Smyth recommended integrating a trauma perspective.
Cazenovia Recovery Systems provides four levels of community residential care: intensive residential rehabilitation, community residential services, co-occurring mental health and substance abuse residential treatment, and supportive living for clients with substance abuse problems.
Burgin was enthusiastic about implementing Smyth’s suggestions based on clinical results. “If research says that [programs] work, then we believe that they can work here,” he says.
Burgin notes that much of the success has to do with training the staff to be more sensitive to trauma issues, with the understanding that substance abuse is the aftermath of trauma.
And so under the direction of Smyth, Cazenovia built a system that implemented trauma-based services, including training counselors in motivational interviewing, and bringing in cognitive therapies such as REBT (Rational Emotive and Behavioral Therapies). In addition, Cazenovia began sending its counselors, as well as social workers, to UB for a Trauma Certificate Program in the School of Social Work that supports the revised treatment initiatives.
The integration of a trauma perspective for residential treatment has been notable. At Turning Point House, one of Cazenovia’s treatment programs, there was nearly a 20% increase in the planned discharge rate (number of patients who successfully complete a treatment program) from 2004 to 2006.
“They integrated some really excellent evidence-based interventions for their programs in addiction,” adds Smyth.
Burgin notes that much of the success has to do with training the staff to be more sensitive to trauma issues, with the understanding that substance abuse is the aftermath of trauma.
Angel Pletcher, who received her Masters in social work from UB, is a senior counselor at Visions Place, a Cazenovia residential treatment center. With Cazenovia’s encouragement, Pletcher also completed a Trauma Counseling Certificate, which she claims has been a tremendous success and given her new tools to help her patients. “Had I not gone through the certificate program, I wouldn’t have known what we could bring to Visions Place.”
“The thing I think is really wonderful about that system,” Smyth says, “is that they value quality and they encourage creativity and innovation among their staff. Alumni I’ve spoken with who work there are really happy because they feel they’re making a difference.”
“A soft rock and a soft hard place”
“I met Angel on the telephone through a counselor of mine who said I needed this place. I did an interview over the telephone. They put me on the waiting list but I didn’t go. In January this year I checked myself into the hospital and they put me on the waiting list here for the fourth time. In order to get a bed, I had to call every day. I called from the hospital on the pay phone or a staff phone every day for one month. Angel picked me up at the hospital and brought me here.”
Jim lives at Visions Place. He has been sober for more than eight months. “My outlook has changed,” he says.
“I felt at home here right away. The staff will take time to talk to you. I’ve never really cared to be around people. But the way the staff approaches me—they’re very compassionate. I’ve been here almost nine months and I’d like to be out by Christmas. I could always get another payee and leave and go to the City Mission. But I’m taking my counselor Joy’s advice to stay. I fought to get in here. I’m sort of between a soft rock and a soft hard place.”
Burgin, says that long-stay residential treatment allows him to see his work make a difference.
“I’ve never been able to track the progress of somebody as well as I have in residential,” he says. “You get them for a period of time and you can watch the wellness occur. When you’re in an outpatient situation, you see them once, maybe twice a week. In inpatient, you have a 28-day turnaround, and in detox it’s only a seven-day turnaround—you just can’t see any progress in that short amount of time.”
For Jim, simply having a residence is healing.
“My room here is all customized now,” he says. “When I moved in all I had was one bag of clothes. Now I have a stereo and a TV and toys I bought at Family Dollar. The peers here are pretty good. I’d say we all have a quiet understanding that I’ll leave you alone and you leave me alone. I came here to learn things and I am learning. I just have to keep my mind open. I like it better here because I feel like I’m getting somewhere.”
The little things
Darwin Corley, program director of Cazenovia’s New Beginnings, a residence that facilitates recovery from chemical dependency, almost left the field because of that lack of real progress.
“I was working in Queens in New York City and it was just a joke. Group therapies and cars double-parked and dope dealers hanging out outside. Forty people sitting in a group with only three group facilitators. Before people even get outside they’re smoking up and walking over empty bags and crack vials.”
Corley sees the difference between his old job as an addictions counselor in New York City and his current role every day. “There’s a relationship of mind, body and spirit here. There’s an excitement that every day you get up and it’s good before you even open the door.”
“They’ve got to follow our rules and regulations – not the same ones they lived under in their own households – so it’s a definite commitment”
Bill Burgin,
Clinical Director of Cazenovia Recovery Systems
Pletcher, is motivated by the daily opportunity to help in all kinds of ways, even the smallest.
“One of the things that draws me to residential is that you get to see the clients every day and they come to you even for the little things,” she says. “Even something as simple as, ‘Do my shoes match my shirt?’ They ask you for help.”
“There’s a certain sense that this is home,” says Joy Rothberg, program director of Visions Place. “This is where they live. We try to make it that way—so that they see this as their house. So that they can make it their own comfortable place.” Residents in Cazenovia programs learn right away that comfort comes with responsibility. They are required to commit to a minimum of three months of treatment and may need to stay for as long as two years.
“They’ve got to follow our rules and regulations—not the same ones they lived under in their own households—so it’s a definite commitment,” Burgin says. And he says most residents are willing to make that commitment.
Everyday responsibilities for residents include such chores as washing dishes and cleaning the kitchen and the bathrooms. Pletcher says that it’s the residents’ house so they have to keep it clean. “Most of them take pride in it.”
The pride can show when new residents arrive. “Often, they don’t have a lot of stuff with them,” according to Pletcher. “We bring them in, kind of get them acquainted with the place, take them up to their room, get their stuff put away and then have them meet with their counselor to take care of all the intake paperwork. We try to get them into a group [therapy session] and the residents are really good about welcoming them. They’ll take them around and show them what the place is all about. This is home for them.”
Emergency contact
And having a home can be the beginning of a new life. Rothberg tells the story of a resident who had abandoned everything before finding her way to Visions Place.
“She had really had no family contact for about two years because she was using and on the streets. Her family didn’t want to have anything to do with her and, at that point, she didn’t really want to have anything to do with them. After being here for about a year and being clean for the entire time, she decided to contact a brother she hadn’t seen for two years. A counselor helped her deliver the letter to her brother’s last-known residence and, an hour and a half later, he called her. They spent most of the day together. When everyone first comes here we ask for an emergency contact. This resident hated that question because she didn’t have an emergency contact. When her brother left, she said, ‘I have an emergency contact now.’ And that was just an amazing thing because she’d been alone for so long.”
Good clean fun
Cazenovia runs a residential program for recovering addicts getting ready to return to fully independent living. Some residents of this program are now employed and have savings accounts.
Activities are an important way to rediscover that it is possible to be clean and sober and still have fun
Suzanne Bissonette, executive director of Cazenovia Recovery Systems, says that the most recent resident to finish with the program left with $6,000 in a savings account. “It’s a real achievement that they can walk away with a large sum of money and not use it on drugs and alcohol,” Bissonette says.
Successes can appear unexpectedly. Burgin remembers a particular outing: “We had a resident who signed up to go on the Miss Buffalo boat ride, but then he didn’t want to go. He just wanted to stay asleep. But later that day, he guided the whole Miss Buffalo—both residents and perfect strangers—in singing the ‘Gilligan’s Island’ theme song. Then he came over to Joy and me and thanked us. I don’t care what job you have or what you get paid, you can’t get any better reward than that.”
He says that activities are an important way to rediscover that it is possible to be clean and sober and still have fun. When Cazenovia added Visions Place to its progams, it included an activities coordinator, something they hadn’t tried before. Recreational activities are a regular part of the program and Visions Place even has a ceramics ‘wing.’
Rothberg says that recreational activities are important to many of the residents who, as she puts it, “had probably never spent time doing much more than getting high.” One client brought to court a ceramic pig she’d made because she wanted to show it off.
Taking the long view of his continuing residence at Visions Place, Jim offers an appreciation that social workers can hang onto for the hard days.
“I appreciate all the people who want to work in the field because people like me need people like that.”
