The Professional Recovery System
Introduction
The Professional Recovery System (PRS) is a specialized model of treatment for the chemically dependent professional, and appropriate others who would benefit from our approach. The PRS is administrated by West Michigan Addiction Consultants, PC (WeMAC) in Grand Rapids, Michigan, and is based on a model of treatment that was established by G. Douglas Talbott, MD, in Atlanta, Georgia, in the late 1970's.
The general philosophy and aim of the PRS is to provide a phased, step-down reintegration of the newly recovering adult addict into his or her home, employment and community, in such a manner that long-term recovery is more likely to occur. The phased approach of the PRS will allow certain appropriate patients to live in a supportive recovery environment and receive a more intensive level of outpatient care during the first few months of his or her recovery. Most patients who require the phased approach given by the PRS will usually remain in the program for a minimum of four months. Each patient's needs and progress are assessed by the treatment team on a weekly basis, and exceptions to the usual length of stay are based on these clinical determinations.
Patients who would be most likely to benefit firom treatment in the PRS would be those who are highly functioning, highly defended, and highly enabled by others around them. They may also have a high risk of relapse because of a greater level of pathology from their disease or because of a lack of a supportive home or work environment. Those who have already received treatment in the past and have relapsed are also appropriate for treatment in the PRS. Although the PRS is able to treat any person who fits these descriptions, those who are in the helping professions, such as medicine, dentistry, nursing, pharmacy, law or business, are particularly appropriate for this model of treatment. Persons who are likely to suffer significant losses from a relapse should strongly consider treatment in the PRS, because this model of treatment results in a two-year recovery rate of 80-85% for those who complete the treatment program and continuing care recommendations. This success rate is significantly higher than the results from more traditional short-term treatment models.
The Phases of the PRS:
Phase One: Inpatient Treatment
Phase One consists of inpatient treatment in an appropriate facility. It may include traditional elements of detoxification (if necessary), education, group therapy, and continuing care planning. Phase I is usually bypassed, with the patient entering directly into Phase II. Duration of Phase I: variable.
Phase Two: Intensive Outpatient & Recovery Residence
Phase Two moves the patient to a supportive home-like environment in the Professional Recovery Residences. These are well-appointed apartments a short distance from the WeMAC office. While living "off campus," the patient continues treatment in a 30-hour-per-week intensive outpatient day treatment program at the WeMAC office. They are expected to attend AA/NA meetings or health professional support group sessions every day of the week. All patients living in the Recovery Residences will attend a weekly community-living group session for their community. In order to address the special needs of women and men, weekly gender-specific therapy groups are available during both Phase II and Phase III.
The goal of the Recovery Residence is to provide a supportive, family-like, setting which will provide the patient with the opportunity to learn effective, family-oriented, coping skills that can aid them after their return to their own home. The community-living group sessions are designed to facilitate this process and to address problems that may result from living together in the Recovery Residence. The patient's family will be encouraged to be involved in weekly family treatment sessions at WeMAC during Phase II. The patient's first overnight therapeutic leave may occur in Phase II, if approved by the community and staff. Duration: minimum of eight weeks.
Phase Three: Mirror-Image Therapy (Placement)
In the third phase of the Professional Recovery System the patient will remain in the Recovery Residence, and attendance in the Intensive Outpatient Program will decrease. His or her day-to-day activities will be more flexible and patient-specific. For instance, the Phase III patient will be placed in a nearby addiction treatment facility, where he or she will function in a supervised capacity as a volunteer. This will allow each patient to confront his or her own defenses as they are encountered in others who are being treated for addiction. With the insight that this "mirror-image therapy" brings about, the patient will come to see how his or her own defenses have served to keep the addiction active. The weekly Recovery Residence therapy sessions still will be attended during Phase III. Longer therapeutic leaves will be possible in this phase, if approved by staff and community. This is consistent with the goal of gradual reintegration of the patient into his or her home and community. Duration: at least 60 days.
Phase Four: Continuing Care
Prior to discharge from the PRS, the patient will develop a continuing care contract with the assistance of the PRS staff. This contract will name certain persons who will be instrumental in helping the patient maintain his or her recovery, such as a personal physician, a sponsor, and a continuing care supervisor. A schedule of planned attendance at AA/NA meetings also will be identified. If the newly-recovering patient is a health professional, he or she will name a specific health professional recovery group that will be attended, if available in the home area. The Continuing Care Contract will cover a minimum of twenty-four months following discharge from the PRS.
Summary
The treatment program described above will give the recovering addicted patient a smoother reentry into his or her home and employment. Even though most patients will spend a minimum of four months away from home, the eventual outcome should more than justify this absence. The Professional Recovery System offers a treatment option that addresses the special needs of health and other professionals, while at the same time addressing the similar pathologies that can be experienced by anyone with the disease of addiction.
