Using Drug Tests in Residential Recovery Programs

Drug-TestCertainly, drug testing is an important tool for managers of residential recovery programs.  Dishonesty is one of the hallmarks of addiction. So, keeping those who have expressed a desire to change accountable is a good thing.  But, is it possible to overdo it?

Another critical element of the recovery process is building trust between staff and clients.  In a residential program where the level of daily interaction is so intense at times, this is doubly important.  Programs really work in an effective manner when residents truly take ownership of their own personal recovery processes.

With these thoughts in mind, allow me to offer a few suggestions about ways to use drug testing most effectively in the residential setting.

A. Not the only means of maintaining a drug free program –  While it is of utmost importance that a recovery program be kept “drug free,” it is especially cruel to use drug testing as a means of enforcing abstinence if there are no other active programs to support people in pursuit of a life of sobriety.  Doing this is truly setting addicts up to fail.  Testing can be most useful when there is an on-going program of recovery-oriented activities in place.  Even then, drug testing should be a rare practice for the recovery program.

B. Generally, it is best conducted when there is a good reason to suspect that  use of drugs or alcohol has occurred – There may be some situations where routine drug testing of every program resident should be conducted.  One instance might be when a client returns from a weekend or longer period away from the program.  However, over-testing can actually work against developing an atmosphere of trust among the staff and clients.  If we are operating a program where there is a systematic monitoring of the clients’ progress, there will usually be indicators of problems before the actual use occurs.  Relapse is a process — no one is working a solid program of recovery one day and drunk the next.

C. To maintain a commitment to “rigorous honesty” – An atmosphere of truthfulness is the most necessary ingredient for a successful addiction recovery program.  The first requirement for entering into the program must be a sincere desire to become free of mind-altering substances.  This means that those who “get high” will be immediately expelled from the program.  The knowledge that program participants who are suspected of using them will be tested is an “insurance policy” that lets all involved know that they will be held to their word concerning a commitment to recovery.  Those involved in the program with a sincere desire for a new life can be reassured that their efforts toward recovery will not be undermined by disruptive, uncommitted, and dishonest people, whose use of drugs or alcohol will be discovered.

D. To provide predictable consequences for using – Consequences are the addict’s salvation!  In other words, people continue to abuse alcohol and drugs as long as they feel the benefits outweigh the costs.  It must be clearly understood by all who enter the recovery program that any use of alcohol or drugs results in expulsion from the program.  They must also understand that this consequence is applied equally to all program participants — no exceptions.  This could be followed by a demotion to “transient” status or referral to another facility.  Usually, after 30 days, the client can be reassessed for reentry to the program.  The consistent application of this policy will actually promote a commitment to sobriety among program participants.  If it is not followed through with consistently, staff members will be accused of favoritism or the program participants will assume that the staff does not take the use of alcohol and drugs seriously.  The worst possible situation is to give them the impression that everyone has at least one drunk “in the bank.”  We can be assured that they will use it!

 

Aftercare Strategies for Addiction Recovery Programs

deskFor Christian programs that work to help addicts, the primary goal is to help them to become integrated into two vital communities – the Church and the recovery community.  If our goal is truly to work ourselves out of a job, then we must make sure we are spending enough time and energy preparing our clients for life after our programs.  If we don’t, we have done them a great injustice.  No matter how success we are with newly sober clients, they will still leave or programs as struggling baby Christians. We must be sure that these new believers knows where to find help when they experiences struggles, even 2, 5, 10 years and more in the future, no matter where they live.

A. Focus on building healthy relationship skills – At rescue missions and Salvation Army centers there’s a lot going on in the areas of life skills, employment, literacy and education. However, an often-neglected aspect of preparation for life after the program is helping the residents to develop and maintain healthy relationships. Getting involved with the wrong people is a major contributor to relapse.  On the other hand, getting in with the right people – those who will lend support and encouragement –is a major factor in successful recovery.

An important cause of relapse for many newly sober addicts is the tremendous stress they experience because of inadequate relationship skills which hinder their efforts at forming healthy relationships. The truth is, most addicts grew up in dysfunctional families. They already struggle with codependency long before their first use of drugs or alcohol. Getting high for many, provides a temporary release from their lack of self-confidence and toxic shame issues that handicap them in their relationships with others.  Guess what? Just because they stop using alcohol and drugs, all of this doesn’t automatically go away. Sobriety gives them a chance to finally begin to work on these issues. If they don’t, their chances of success are greatly diminished.
B. Take advantage of resources offered by theChurch – The Church certainly offers a lot to recovering people by pro­viding both spiritual and social support. SRI Gallup’s 1992 survey of recovery from homelessness concluded that spirituality (a growing relationship with Christ) was the number one factor that contributed to the success of those they studied. They noted, “This spirituality seems to not only strengthen a person individually, it also seems to be the basis for commonality in building relationships with other people.” So, we must be intentional about connecting mission program participants to a solid, healthy relationship with the Body of Christ, which is often one of the most difficult challenges we face in mission programs.

The solution lies in identifying those fellowships in our community that are most “recovery-friendly” and to cultivate relationships with them. This could involve personal visits with their leaders, luncheon meetings and tours at the mission, and training programs specifically geared toward helping both pastors and lay people to understand and support our people as they become involved in their congregations.
C. Connect with the Christian Recovery community – There is still another extremely valuable resource out there that has yet to be fully understood and utilized – the Christian who are themselves in recovery! There is a wonderful phenomenon afoot that has been loosely called the “Christian Recovery Movement”. It has been manifested by literally thousands of support groups springing up in churches around the globe where Christ is the “Higher Power.” These groups are to be found in practically every major city of North America, and in some overseas – Celebrate Recovery, Overcomers Outreach, Alcoholics for Christ, Alcoholics Victorious, etc.

There are no better people to serve as a “bridge” between the mission and the Church than believers who are themselves over­coming addiction. They can relate in a very special way to the struggles of mission clients, because they’ve been through many of them. We must find these people by visiting support groups our­selves, contacting large churches in our cities to see if they have such programs, and in some cases sponsoring such groups ourselves. Find such groups in your area using the Christians in Recovery Resource Database.

Like churches, support groups vary significantly, one from an­other. So, I encourage mission program personnel to never send people to groups we have not personally visited. And, it’s impor­tant to meet with the leaders of these groups to get to know them personally and help them to become familiar with the mission and its recovery program.

 

Excerpted from Rescue Magazine June 1997

 

Work Therapy in Residential Recovery Programs

work2Rescue missions depend on labor provided by people in their programs to do a variety of tasks that are essential to their operations.  Men and women in recovery programs can be found in kitchens, performing housekeeping and maintenance tasks, providing office support, and driving trucks to pick up donations. Certainly, we value the services they provide. 

Equally important, though, is the need to give additional meaning to their efforts by creatively using their work assignments to invest in their lives.  What follows is a list of some ways this can be accomplished:

A. Develop a purpose statement for rescue mission work projects – We need to have a definite philosophical basis for every activity in which we involve program participants that is both spiritually sound and “therapeutic.”  In other words, we need an official statement that establishes the fact that we are not just looking for free labor, but rather that the work they do really is intended to help them.  If  people in our programs feel used, they are certain to shut themselves down to the recovery process. The mission is there for the clients, they are not there for the mission!

B. Develop a written, individualized plan that makes their work projects an important part of the rehabilitation program. The most effective means of clarifying and monitoring the goals and objectives we set for program participants is to use a written recovery plan.  This written plan identifies the various issues they will work on while with in the program. It should also ties all of the significant activities in which they participant be involved and states exactly what is to be accomplished through each of them.  The work performed by the resident, if is truly rehabilitative in nature, will help them to work on such goals as developing new, healthy attitudes toward work and responsibility, becoming more employable by acquiring new job skills, etc..

C. Use work assignments to teach essential Biblical concepts of work and stewardship In 1995, Roper Starch surveyed employers about hiring the homeless and those on Welfare.  They discovered that employers believe the right attitude is 10 times more important than work skills in entry-level employees. They cited interpersonal skills such as dependability (90%), honesty (89%) and the ability to follow instructions (86%) as far more essential than technical skills like typing (11%), prior work experience (15%) and knowledge of office systems (14%).

A well-conceived work program is a very effective vehicle for helping program participants develop a health attitude toward work.  A part of the formal curriculum of our programs, we need to instruct residents in the scriptural principles that show them God’s perspective on their labors. They need to understand that our work, our talents, and our time all belong to God, since they were given by Him.  Stewardship involves our accountability before God and others who have blessed us – for instance donors whose generosity enables the mission to continue its work.  Both staff and residents are  responsible to them and to God for taking care of the facilities and equipment that have been entrusted to them.

D. Use work assignments as career training opportunities To assist them with future employment, we must do all we can to help residents to learn real job skills through their work projects.  One example of this is the rescue mission who send all of the program men working long-term in their kitchen to the food safety course sponsored by the National Restaurant Association. While this may involve some investment in staff time and possibly the expense of outside training opportunities, it will have definite payoffs.  The same can be done for office and maintenance work.  We need to be creative about using work done at the rescue mission to help them prepare for gainful employment after they complete our programs.

E. Develop a system of rewards for work well done To avoid the appearance of an employment situation with wages being paid, we cannot use monetary rewards.  Legally, stipend amounts should be kept exactly the same for all program participants at a same level or phase of your program – regardless of the actual hours they work or the quality of their labor.  However, there are certain privileges that can be granted, a private room, for instance, or extra free time, or even certificates or awards given out each month to good workers.  The goal is to make sure that we provide them with a pay-off for putting their hearts into doing a good job.  This is a lesson many have never learned.

Some Words of Caution

 A. Avoid anything that would imply an employee/employer relationship between the resident and the rescue mission. – This starts in the initial intake session, where residents are asked to sign an agreement indicating that they understand that some hours of work will be a part of their recovery program. And, that this is a part of their rehabilitation and does not constitute an employee/employer relationship for which they will receive wages.    This also means avoiding the use of terms like “staff” and “wages” when referring to the work residents do.  It is more appropriate to  call money they receive a “stipend”, “sustenance allowance” or simply a “gift.”

B. Remember that it takes a full 30 days to completely detoxify from alcohol and drugs – During the first few weeks we need to be careful about what types of work assignments we give them.  They will have problems with logical thinking, short-term memory, and motor coordination.  Avoid jobs that could be potentially dangerous to people who are in their early days of sobriety such as work on ladders, handling of potentially hazardous materials, etc.

C. Don’t let program participants “hide” in their work – We often use the term “dry drunk” to refer to people who put down the bottle but never begin a life of recovery.   Without drugs or alcohol, addicts will often become compulsive about other activities as a way to manage their emotions.  This could include things like work. TV, exercise, etc.  So, we need to be watchful about program participants who seek overly eager to work, which may indicate a desire to stay busy in order to avoid working on themselves.

D. Don’t give them authority over other program participants – The Apostle Paul warns Timothy to avoid giving new converts too much authority too quickly, lest they fall into pride and other snares of the devil. ( I Tim 3:7).  For recovering addicts, grandiosity is a major problem. It is very easy for them to take the focus off of themselves and onto controlling others.  This can result in an abuse of the authority we give them, which can create all sorts of problems among people in your program. My recommendation: only paid staff members should be given authority over program participants.

 E. Don’t give them assignments that subject them to unnecessary temptation.  For instance, too much exposure to people still living on the streets and using alcohol and drugs or too much contact with unstable people of the opposite sex.

F. Hire those who have proven their worth. –  It is very tempting to “missionize” talented people by keeping them “in the program” indefinitely.  A better arrangement is to fill important positions (cooks, drivers, etc.) with individuals in a latter phase of a program who become actual temporary employees of the mission.  These individuals will naturally be more stable and dependable.  Minimum wage requirements may be met by combining cash payments with the established “fair market” value of the housing and meals that are provided.  In most cases, the mission is then only responsible for the FICA withholding and matching payments, since non-cash compensation is usually not subject to state and federal employment taxes.  Not only will this arrangement reward those who are doing well in their recovery, it also assists them to begin re-establishing an employment record.