Engaging recovery community increases continuation in treatment

The National Alliance of Recovery Residences (NARR) was founded in 2011 with a mission “to support persons in recovery from addiction by improving their access to quality recovery residences through standards, support services, placement, education, research and advocacy.”

NARR’s 2017 Best Practices Summit featured consultant George Braucht and Paige Miller, Compliance Officer at Hope House, who shared the results of a NIATx change project led by Neil Campbell of the Georgia Council on Substance Abuse and Mr. Braucht.

Hope House, led by Executive Director Karen Saltzman, provides residential and intensive outpatient substance use and mental health disorder services in Augusta, Georgia for women and women with children. 

Problem: Lack of meaningful engagement with the internal and external recovery community was limiting access to recovery housing.

Change Project Aim: Increase continuation in residential treatment.

Changes

1.     Cycle 1: Offer experienced peer support on evenings and weekends

2.     Cycle 2: Include families in treatment from the beginning

3.     Cycle 3: Promote use of person-first language among staff and clients

4.     Cycle 4: Engage the recovery community to lead recovery workshops and host on-site meetings

Results

• Reduced unplanned transfers (discharges) from 40% to 30% within the first 30 days of treatment.
• Achieved 30 days of occupancy in all 42 apartments.
• Increased monthly income from apartments substantially.
• Maintained 100% occupancy of apartments from November 1, 2016, through January 31, 2017—the holiday season when many transfers (discharges) typically occur.
• Reduced unplanned transfers by 30%

Promising Practices Adopted:

• Attracted professionals who value person-centered recovery and associated practices
• Hired a peer workforce and implemented groups and individual recovery check-ins; of eight peers on staff, six are certified
• Scheduling: Revised campus schedule to add structure and supports in the evenings and on weekends
• Staff professional development onsite: Implemented a monthly Munch & Learn
• Implemented a Residents Council; repeated Psychological Sense of Community Scale results show increases in trust and belonging among residents

“For the systems administrators, the increase in revenue provided some breathing room and opened the creative flood gate to the idea of “Munch and Learns” for staff development and weekend activities that would not have been financially possible previously,” says Braucht.

The change cycles had an impact on Hope House staff at all levels of the organization, increasing engagement and collaboration between clinical and peer staff.

 "Working together, both peer and clinical service provider groups began valuing each other's contributions, developing a "we" approach that evolved from the earlier "us and them" dynamic."

For residents, the main benefit was better connections with both one another and with external recovery communities.

"That helped operationalize the concept that people move from isolation in a substance use/mental health disorder to life-enhancing connections in recovery," comments Braucht.

Lessons Learned

• The organization benefitted from increased family participation in activities, including family sessions and item drop-off days.
• Individuals are now setting their own goals and taking responsibility, and getting credit, for more of their recovery process; skills that will likely extend beyond their stay.
• Implementing more mental health supports helps everyone, not just individuals who identify as being in dual recovery. Volunteers lead activities 6 days per week on site, including all-recovery meetings, workshops, physical activities, and other support groups.
• Harm has been reduced, and the sense of community increased with individuals entering and staying in treatment as well as among the “senior” residents.
• Hope House has improved its financial bottom line.

Hope House has sustained, and improved upon, the changes that made, while maintaining its residential occupancy census.