Michael Liimatta

How do we measure success at rescue missions?  (Part One)

I frequently ask staff members, “How is your mission doing?”  The answer is usually about numbers:  meals served, nights of lodging, food boxes distributed and so forth.  Sometimes I hear about growing budgets, additional staff members, new facilities, etc.  However, when asked about the purpose of their mission, the most common response is “evangelism and discipleship.”  While today’s missions offer a wide array of programs, most have not lost sight of their most important distinctive – fulfilling the Great Commission.  (Matt.28:19).  We need to put forth some special effort, though to establish that we are indeed doing this.

Preaching the Gospel and making disciples sets rescue missions apart from other social agencies working with the homeless.  Yet, some don’t keep a written record of decisions for Christ at their facilities.  Few know what percentage of their program graduates go on to gain at least one year of sobriety.  Not many know if their graduates remain committed to a local church or participate in support groups.  Unless graduates, themselves, make an effort to stay in touch, most have no on-going process for determining how many of their graduates currently live responsible Christian lives.

Counting bed nights is easier than determining how successful we are at making disciples.  However, if we are meeting the needs of those we serve, there ought to be concrete evidence of changed lives.  Regular follow-up efforts can provide us with accurate records that will help us to determine how successful we are at desired results through our programs.

For rescue mission recovery programs, here are a few items to address in annual or bi-annual follow-up efforts by phone or through the mail:

• Continuous sobriety after program completion
• Regular participation in support groups
• Employment and training obtained after graduation
• Christian growth and involvement with the Church
• Improved personal and family relationships

Benefits of doing follow-up on program graduates include:

A. Program Evaluation – The population we serve is changing.  They are younger than ever and they have a host of problems that we didn’t see just ten or fifteen years ago.  If we are to truly meet their needs, we must understand them.  Understanding how our graduates do after they leave our facilities will help us to improve our programs.

B. Showing continuing concern for graduates  – A follow-up contact from the mission can be a real opportunity to encourage graduates, especially for those who may be struggling.

C. Substantiating fund-raising claims – “Compassion fatigue” is a phenomenon in bigger metro areas like New York and Los Angeles.  It is becoming more evident in smaller cities, too.  It can be summed up in this statement, “OK, now that we’ve spent all these millions of dollars on the homeless, what have we got to show for it?  Homelessness is on the increase!”  They need to know that the homeless really are changing at  our missions.  We need real numbers to back up our claims.

D. Taking advantage of “Charitable Choice” – With sweeping changes in the welfare system, Christian organizations will receive government funds without having to compromise on their spiritual emphasis.  Missions that choose to pursue some of this money will have more success if they can show the concrete results of their efforts.

E. “Witnessing to the world” – Does Christ really change lives?  I believe He does!  You can’t survive very long as a mission worker if you don’t.  Having concrete numbers to substantiate this fact is a genuine testimony of God at work in our fallen world.

If you are interested in learning more about this subject, contact IUGM’s Education Department.

February 1998

We want to lengthen our drug/alcohol program from ninety days to 42 weeks. Is this too long a time to expect a man to stay on a program?

Unlike programs that rely on government or insur­ance funds, rescue missions have no funding constraints to restrict how long an addict can remain in their programs. Because there is no set formula how long it will take people to put their lives back together, it is best to avoid setting definite time limits for pro­grams. When a program has a set 90 day length, often on about day 80 the residents’ minds and hearts are already out the door. Even though we might feel they need more time in the program, when graduation day is not far off, it is extremely difficult to convince them to stay any longer.

Goal Oriented vs. Time Oriented – Instead of limiting programs to a certain number of days or months, it is best to divide them into definite phases that are goal oriented rather than time oriented. Some mission programs use three phases based on the Twelve Steps: Phase I – Steps 1-5, Phase 2 – Steps 6-9, Phase 3 – Steps 10-12. Others use different activities or accom­plishments to determine when residents move to the next phase. This approach creates a sense of movement, with genuine bench­marks of achievement for participants to work toward. A string of such successes can promote greater self-esteem and commitment to completing the program.

The Key to an Individualized Program -Personalized goals and objectives are best developed after an in-depth intake and assessment process. Taking time to identify par­ticipants’ needs in this manner communicates that the program staff is committed to really knowing them and will work with them on a personal basis. With this type of system, how long an indi­vidual will stay in the program can be addressed by saying, “We ask all those who come into our program to make a commitment of at least 90 days. Most stay anywhere from 6-8 months.” We can say this because people grow at different rates. Some can accom­plish their treatment goals and objectives in a shorter time period, while others with more issues in their lives to work on may need a longer stay. Contact IUGM’s Education Office for information on computer programs br assessment and case management.

This question came from the IUGM’s Internet E-mail Discussion List. Other responses were:

“When a man receives Christ, he is a new creation, but he still carries a lot of baggage from the old life. To quote Jerry Dunn, author of God Is For The Alcoholic, you can get rid of the stinking drinking in two days (detox), but it takes two years to get rid of the stinking thinking.”’ (Michael Fishback, Bakersfield Rescue Mission)

“I have come to the conclusion, after 22 years of observa­tion, that programs must be custom designed to the individual. Some need 6-8 months and others need one year or more. Alert case workers [manage] the process of moving the client into the next phase of recovery… either a job, college or trade school and! or private living conditions outside the mission.” (Frank Jacobs, Miami Rescue Mission)

“The rule of thumb at Mel Trotter Ministries is one month of treatment for every year of addiction.” (Bill Dodge, Grand Rapids, MI)

“Our program is 12 months long and is divided into 4 phases, each one goal driven with a specific minimum time required. This is about a minimum for an addict/alcoholic to reach middle to late recovery, and have established a relationship with Christ, and The Body. About 60% of all men who enter our program stay to completion. I think one of the keys is to make the program increasingly challenging, and rewarding, so the program member stays alert, and interested.” (Bill Roscoe, Redwood Gospel Mission, Santa Rosa, CA)

“We increased our minimum time on the program to ten months. (The maximum time can be tailored to the individual.) Increasing the length of time on our program brought fewer gradu­ates for a while, but the quality of graduates increased tremen­dously, and the number of relapses and returning clients decreased.” (David Ganzert, John 3:16 Mission, Tulsa, OK)

To participate in this discussion list contact Michael Liimatta (Liimatta@iugm.org), Director of Education for W the IUGM.

March/April 1997

Smoking is the most preventable cause of death in our society.  It is responsible for about 419,000 US deaths each year.  Smoking accounts for 1/3 of cancer deaths. It is a major cause of heart disease and cancers of the lungs, mouth, pharynx, larynx, esophagus, pancreas, uterus, cervix, kidney, and bladder.  The average smoker shortens his life by fifteen years!

Nicotine and Addiction to Other Drugs & Alcohol

In 1988 the US Surgeon General reported that nicotine is just as addictive as heroin and cocaine. A “hit” of nicotine reaches the brain in seven seconds, twice as fast as a  syringe of heroin injected into the vein.  Recent studies have shown an irrefutable link between smoking cessation and success in drug treatment.  Some have indicated that alcoholics and drug addicts who also stop smoking are up to eight times more likely to remain clean and sober!  For this reason, practically all major hospital-based treatment facilities are now “smoke free”.

There is an important spiritual principle in all of this.  Paul says, “I will not be mastered by anything” (1 Cor. 6:12).  Having one habit that maintains “mastery” over me means I don’t have complete victory in my life.  This is a foothold in my life for “the enemy” that makes me more susceptible to other forms of temptation — like using alcohol and drugs again!

Practical Ideas for Recovery Programs

A.  Make your building a “smoke free zone“ -  Every year  thousands of nonsmokers die from inhaling “passive smoke”.  So, setting up a special smoking area either in the building or outside will avoid risking the health of mission workers, visitors, and clients.

B.  Let the staff show the way – Mission employees must be good examples by not smoking themselves. For those who do smoke,  it might appropriate to pay for whatever help they might need to stop.  Dividends of a “smoke free” staff include a lower rate of absenteeism and lower health-related insurance expenditures.

C.  Make smoking cessation a definite component of your long-term program - Stopping smoking should not be a requirement for entrance into a mission recovery program.  It may be appropriate, though, as a prerequisite for graduation or for moving into a latter phase of the program.  Just like other addictions, smokers need special support from classes, support groups, counseling, and other activities.  A number of recovering addicts have actually told me that quitting alcohol and drugs was easy compared to quitting cigarettes.  There are many good resources available including smoking cessation classes in the community,  literature, and videos from a varitety of health organizations.  It many be possible to arrange for someone from one of them to do regular presentations on the topic for your residents.

D. Recognize the symptoms of nicotine withdrawal –  Physiological symptoms include: decreased heart rate, increased blood pressure and brain wave changes.  Those who quit smoking often experience impaired physical coordination and a decreased ability to concentrate. Severe cravings for tobacco, sleep disturbances, irritability, anxiety and gastrointestinal disturbances also may occur.  So, they need a lot of support and encouragement as they work through all this.

F.  Make sure residents are stable in sobriety before trying to quit smoking – A mission long-term residential program is a special supportive environment.  This makes it a great place to tackle nicotine addiction.  Still, newly sober people should be reasonably stable in recovery before attempting to quit smoking.  For some, trying to quit toosoon can be stressful enough to cause relapse.  So, I recommend at least six months to a year before attempting it.

Organizations that Provide Resources for People Who Want to Quit Smoking

• American Cancer Society
• American Lung Association
• American Heart Association Office on Smoking and Health
• Centers for Disease Control and Prevention - link to their “How to Quit Smoking” section
• National Cancer Institute

Local chapters and affiliates of these groups as well local hospitals are a potential sources of free literature and other educational resources and can point you to smoking cessation classes in your area.

Most statistical information for this article was taken from Smoking or Health  – It’s Your Choice by  Cathy Becker Popescu and J. M. Carey, American Council on Science and Health, New York, NY 1992  (select the link to access the PDF version)

NOTE:  If you have found approaches that have been especially successful, we want to hear about them!  Please contact me.

May/June 1996