Pre-contemplation is the first stage. We gather information with a biopsychosocial and withdrawal assessment. A treatment plan is written and coordinated with case management. Substance abuse issues are assessed and both history and consequences are mapped. The focus is on managing withdrawal, identifying and responding to biomedical conditions, stabilizing emotional, behavioral or cognitive complications, developing readiness to change, providing supervision to prevent relapse and reducing identifiable risks associated with the recovery environment. Students in Pre-contemplation and Contemplation see their decisional balance start to shift as they encounter change processes such as consciousness raising and self-reevaluation in treatment.
Students move on to Preparation as they begin to recognize the negative consequences of their substance abuse and make plans to change. They engage in other change processes such as stimulus control and counter-conditioning. Concurrent progress with co-occurring disorders and other domains is typical and is supported with psycho-education and skill building. In the Action stage, students commit to a plan of substance abuse recovery. They test their skills and gradually reenter the community through therapeutic leave such as home passes and other structured activities. In Action and Preparation, our clinical work includes cognitive behavioral coping skills therapy, twelve-step facilitation and the behavioral change processes that stimulate self-efficacy. The final stage of Maintenance continues long into the future as the student builds a life in recovery.
More information on this approach is available in the Treatment Improvement Protocol Series from the Substance Abuse and Mental Health Services Administration. Of special interest are TIP 35:Enhancing Motivation for Change in Substance Abuse Treatment Programs and also TIP 42: Substance Abuse Treatment For Persons With Co-Occurring Disorders.
Transition Support and Aftercare
Our transition support is informed by the principles of normalization. The movement from a residential drug and alcohol environment back to home, school and community is intentionally incremental. The process begins as residential care is structured to include involvement with other Outside In residential students who have not been identified as having substance abuse problems. The process expands to include off-campus community service and therapeutic home passes. Growth and positive development continues as students join our own BSA Venturing Crew and participate in stimulating experiential activities. As discharge is anticipated, home passes are increased. Community-based aftercare services are initiated to coordinate community reintegration and family stabilization.
An aftercare plan is developed for every student within 30 days of admission, updated quarterly and finalized when the date for discharge is set. Aftercare services, which typically include outpatient treatment, are identified and coordinated with the participation of referring agents and parents/guardians. We prepare our students for the transition back to home, school and community by increasing family involvement in case planning and through therapeutic home passes. We facilitate school re-enrollment or coordinate GED and vocational classes.
Engaging the Family
Pathway Residential recognizes the family disruption so often present in situations involving substance abuse, especially when a youth enters residential care.Pathway Residential actively engages the family in the development of the skills and competencies necessary to promote recovery and healthy family functioning. Addiction counselors identify family strengths and develop interventions targeting the needs of both youth and family. Residential care and recovery is supported by family sessions, both on-campus and in-home, promoting positive family development. Reintegration and transition support become the focus as discharge approaches.
Balanced and Restorative Justice
Outside In embraces the philosophy of restorative justice and the principles of a balanced approach that equally recognizes and seeks to address the needs of the community, the victim and the offender. We stress the development of student competencies to increase the opportunities they will have to live productively. Delinquent students in Pathway Residential are held accountable for their offenses. They write victim impact statements and have the opportunity to accrue funds to pay restitution. They are also actively engaged in community service to give something back to the communities whose norms they have violated.
Education
Outside In operates a licensed on-campus private academic school offering coursework for residential students. All students are assessed upon entry to determine current levels of achievement. Instructional strategies are developed to provide grade level appropriate work and individualized remediation where necessary. Small group instruction allows abundant teacher feedback. Our highly structured environment motivates students to attempt new levels of mastery. Students acquire new levels of confidence regarding academic success and a fresh perspective on the benefits of education as they accrue credits toward graduation or pursue the GED.
Please note: Outside In is not licensed to operate secure facilities. Adjudicated students who leave without permission (abscond) violate the Order of the Court and are reported to police, parents and referring agents. Outside In bears no responsibility for the actions of such students or their safety once they leave our premises. When such students are apprehended it is typical for them to be returned to Pathway Residential.