Guest blog from Elaine Miller, Senior Group Coordinator, Cyrenians Addictions Recovery Service
“This week’s guest blog from one of our colleagues, Elaine Miller, who is leaving to pastures new. Elaine has been part of the team delivering our community rehab programme with great success – another example of Cyrenians’ commitment to innovation and collaboration, this time with West Lothian Alcohol and Drug Partnership. Here she gives a wee insight to their work.” – Ewan Aitken, Chief Executive, Cyrenians
In January 2016 I was commissioned by Cyrenians to design and deliver a community based rehabilitation programme to manage addiction with my colleague Kevin Smith. The programme was commissioned by West Lothian Alcohol and Drugs Partnership (ADP) to offer the recovery community an alternative to residential rehabilitation. On my first day I was handed a document with a basic idea and structure for a programme. Kevin and I got to work and added some specific content based on our experience of working in the field. We agreed that the programme would be a combination of psychoeducation, cognitive behavioural therapy, relapse prevention and developing a robust ‘move-on plan’.
The first eight weeks of the rehab programme we developed is based on the delivery of therapeutic interventions delivered by qualified therapists, enabling clients to develop a tool-kit to manage addictive thoughts, feelings, behaviours and negative self-beliefs, focussing on managing anxiety, low mood and anger etc. We selected these areas because research has found a correlation at around 22% comorbidity with substance misuse, anxiety and low mood. We aim to assist clients in moving towards a substance free life through building an understanding of their addiction, confidence and self-esteem. The clients are peers, encouraged to bond as a unit and support each other through the ups and downs of recovery. We take the approach of a therapeutic community, ensuring that our participants are cared for by us (the programme facilitators) and each other. We encourage open, honest and sometimes challenging feedback, and anecdotally we have found that the relationships formed in the rehab are ongoing in the community.
The rehab programme has developed organically through continued feedback from the participants. For example, the participants felt there was a gap between referral and the group starting. To bridge this gap we designed a pre-treatment programme to enhance motivation, which runs for four weeks before the rehab programme. We encourage people who have already graduated in the programme to come back and deliver this pre-treatment programme along with one member of our Recovery Service staff team. Our participants have engaged really well with this peer-led approach and the graduates tell me they get loads out of passing on the recovery message. The groups have found the pre-treatment programme to be beneficial as they have begun their bonding before meeting the facilitators, which in turn helps the team to get the work started more quickly. Moreover, the members of the group can see there is an ongoing role for them in the delivery of our rehab programme which encourages them to continue to build the West Lothian recovery community.
In the last four weeks of the programme we introduce our participants to what is available in the community, such as education, employment and volunteer opportunities within and outwith Cyrenians. The programme engages with local services such as Remploy, Social Bite, and West Lothian College. These organisations are invited to run a session during the programme to promote opportunities available to the participants after the programme ends. We were delighted when one of our group members was offered a two year contract with Social Bite and another secured a full time place in college as well as volunteering 2 days a week helping us to deliver the rehab programme.
Our team work in partnership with West Lothian College to offer group members a qualification in basic adult education. We encourage the group to complete this piece of written work to evidence their learning, and we are delighted that every member who has engaged in the programme has attained the award. This is a great achievement as some of our participants did not complete school and have never before completed a qualification, and therefore this is useful for building confidence in moving on in the community.
There are some challenges with sustaining recovery in your own town, that is, all of the individual’s triggers are all around them. Therefore we encourage the peer group to contact each other to offer support when required. Anecdotally, group members tell us they love the structure and routine and fear the programme coming to an end, as this means they go back to the humdrum of their everyday lives. They are afraid of relapse at this point and therefore it is essential to assist our graduates in developing a robust ‘move-on plan’ to keep them safe and substance free. Our facilitation team are committed to recovery and offer ongoing support though our aftercare sessions. This helps maintain the recovery momentum. Our data shows 78% of our graduates complete the rehabilitation programme.
The development of the programme was academic until we had our 12 group members in the room bringing our work to life. Watching the group members grow and learn a little more about who they are over the duration of the rehab programme brings me great joy. The group develops a strong therapeutic bond with myself and Kevin and we are privileged that they feel secure enough to share some of their lives with us, the good with the bad. There is nothing more inspiring than sharing the graduation event with the group and I have had the great privilege to organise these events over the last eighteen months. The graduation allows us to invite friends and family of the group along with the other professionals who support the recovery in West Lothian to celebrate in their success. I have the job of master of ceremonies for these days and there is never a dry eye in the house.
We are delighted to say we are now working with group five and we are on schedule to graduate with eleven participants on the 2nd of November 2017.
13th October 2017