Transitional Living for Drug and Alcohol Rehabilitation

Transitional living is a restructuring of an old concept. The early centers for living were known as Halfway or Three-Quarter houses and usually were in existence for the provision of shelter for people who were caught up in the disease of alcoholism. Below is a Transitional Living Program that is located in Texas.

"At STAGES of Recovery, we believe that young adults need support in multiple areas to make their experience of recovery successful. The lessons learned and attitudes developed in the first six months of recovery form the foundation from which young adults can successfully pursue a sober and productive life as adults. STAGES of Recovery provides young men with the information, skills, and life lessons needed to achieve their recovery, academic, and career goals. Through a unique progression of increasing responsibility and opportunity, residents of the STAGES program build self confidence, develop practical life skills, learn the value of community service, and get back on track with their educational goals. Visit Us at www.stagesofrecovery.com"

Of British Design

The most earnest beginning of Transitional Living began when in 1878 through the "holiness" teaching of William Booth and wife Catherine who began the Whitechapel Christian Mission in London's East End to help feed and house the poor. The mission was reorganized along military lines, with the preachers known as officers and Booth as the general. After this the group became known as the Salvation Army

Salvation Army

The Salvation Army is a Protestant Christian church known for its thrift stores and charity work. It is an international movement that currently works in over a hundred countries....

.
(ref: http://www.spartacus.schoolnet.co.uk/REbooth.htm)

The U.S. Transitional Program

The birthing of the "half-way" house concept became popular during the United States great depression

Great Depression

The Great Depression was a severe worldwide economic depression in the decade preceding World War II. The timing of the Great Depression varied across nations, but in most countries it started in about 1929 and lasted until the late 1930s or early 1940s...

 which began in 1929. With an enormous increase in the use of alcohol, and introduction of opiates from the Far East and Asiatic countries society in general began to resent the presence of these "drunks" (as they called them) in public. This protest along with the efforts of the Women's suffrage, and like groups, sparked the prohibition by the Federal Government on any alcoholic production, distribution, use or sale. Oddly enough drug use was not a consideration, as a matter of fact it was a largely accepted social practice that permitted use of such drugs as opium and heroin. This "drunks protest" also caused the development of an unofficial industry of half-shod, shanty structures for the intoxicated (see drunkenness

Drunkenness

Alcohol intoxication is a physiological state that occurs when a person has a high level of ethanol in his or her blood....

) that were given the name "flop-houses" where the "proprietor" would charge inflated prices for use of squalor spaces or rooms to allow the renter to find sobriety. This extortion concept of "sobering-up" continued until post World War II.

The A.A. Influence

In 1934 a man known as Bill W.

Bill W.

William Griffith Wilson , also known as Bill Wilson or Bill W., was the co-founder of Alcoholics Anonymous , an international mutual aid fellowship with over two million members belonging to 100,800 groups of alcoholics helping other alcoholics achieve and maintain sobriety...

(William Griffith Wilson, 1895–1971), self admitted himself to a hospital for help with his drinking problem. He then became associated with the Oxford Group

Oxford Group

The Oxford Group was a Christian movement that had a following in Europe, China, Africa, Australia, Scandinavia and America in the 1920s and 30s. It was initiated by an American Lutheran pastor, Frank Buchman, who was of Swiss descent...

 and shortly after that met Dr. Bob Smith (doctor)

Bob Smith (doctor)

Robert Holbrook Smith was an American physician and surgeon who co-founded Alcoholics Anonymous with Bill Wilson, more commonly known as Bill W. He was also known as Dr. Bob. He was born in St. Johnsbury, Vermont, where he was raised, to Susan A. Holbrook and Walter Perrin Smith...

 (Robert Holbrook Smith, M.D, 1879–1950) who too was a member of the Oxford Group. Together they formed the organization known as Alcoholics Anonymous

Alcoholics Anonymous

Alcoholics Anonymous is an international mutual aid movement which says its "primary purpose is to stay sober and help other alcoholics achieve sobriety." Now claiming more than 2 million members, AA was founded in 1935 by Bill Wilson and Dr. Bob Smith in Akron, Ohio...

with its concepts set on the Spiritual matters and on scripture (ref.http://www.dickb.com/index.shtml) with basic program design from the Oxford Group. This program was designed to help the individual "admit" and "act" to their drinking problem. With group support and selection of an individual "Recovery Sponsor" one might come to sobriety. The two designed the A.A. Big Book (ref. Big Book Online: http://www.recovery.org/aa/bigbook/ww/ to provide "standards" for recovery. Through it one can establish a path to walk on toward finding God and sobriety. The only major revision made to the original text is that the individual must come to an understanding of God, as they know Him, so as to develop the Spiritual relationship and surrender to His will. Within the Big Book are personal stories and testimonies of a variety of personalities and social standings to show that the disease is not a respecter of persons, status, gender, or race/ethnicity.

Bill W. would bring "drunks" to his own home and help them sober up. Dr. Bob would use a strong spiritual approach through hospital admissions. The A.A."12 step program" was (and is) the standard for not only Alcohol recovery groups and meetings but it began to gain acceptance in the medical and mental health fields and today other addiction programs such as Narcotics Anonymous, Cocaine Anonymous, Overeaters Anonymous and man other groups have adopted the 12 Step approach. The standards established by the early A.A. members are still the foundation of most transitional living and other addiction recovery groups.

Progress not Perfection

Going back to the post World War II era, the returning military personnel from Europe and Asia were faced with many problems and unemployment was one of the major issues. With social readjustment and dramatic technology changes many of the G.I.'s could not adjust and many found relief through alcohol consumption that lead to abuse. However, with the gratitude and appreciation of society for the service provided to protect the nation there was the development of a "different view" on alcoholism as many employers found their best workers "had drinking problems". The provisions for "employee care" increased, mainly through the manufacturing industry and union efforts, for better insurance coverage’s and medical care for the employees and their families.

The main thrust of today's transitional living found a firm footing in the late 1960s. The philosophy then was to have a "central" location that could provide adequate, safe, and supportive housing for, mainly, the alcoholic.

As the progression of illegal drug use in the 1980s increased many traditional houses that were designed for alcohol issues found that they were receiving more and more "dual use" (drug and alcohol) clients. As the medical community became more acutely aware of the problem the Government (both Local and Federal), especially the Department of Health and Human Services, saw that dramatic intervention and support had to be made.

In the early 1990s research and statistics started to be heavily utilized. The results found that if the Transitional Living programs would (or could) increase their base program to include social education information and skills, as well as recovery issues, that A.O.D. (Alcohol and/or Drug) relapse

Relapse

Relapse, in relation to drug misuse, is resuming the use of a drug or a dependent substance after one or more periods of abstinence. The term is a landmark feature of both substance dependence and substance abuse, which are learned behaviors, and is maintained by neuronal adaptations that mediate...

 would be greatly reduced. Many of the larger facilities, mostly industry supported, revised their venue for recovery and they found that it indeed increased the productivity and reduced use and abuse of drugs and alcohol significantly along with a very significant “relapse” reduction. The business and social effects were markedly improved and major funders through grants and foundations recognized this more and more. As late as 1995 there were approximately 83% of the requesting Transitional Houses granted funding from Private or Government grants and gifting.

With the advent of 9/11 and other natural and human disasters the philanthropic community has understandably re-directed most of their monies towards “human relief efforts” nationally and worldwide. This has had a very serious effect on a majority of not-for-profit Human Service organizations and has prompted the closing of literally thousands of smaller transitional living programs that were having a positive effect in their community. The "giving" void is not only apparent from the established grants and foundations community but from local governments, Christian churches, and the citizenry as a whole.

The societal outlook on Transitional Living programs has been, more recently, narrowed to the domestic issues such as Women’s or Spousal Abuse and children’s abuse and neglect issues. This is primarily due to the “epidemic” use of “street drugs” ranging from “home laboratory” produced Crack Cocaine and Meth (Methamphetamine

Methamphetamine

Methamphetamine is a psychostimulant of the phenethylamine and amphetamine class of psychoactive drugs...

) to “date” and “cosmetic” drug use and the ill-gotten notion that there is "no-hope" for those who use these drugs. It is true that these “new” manufactured drugs have a far more addictive rate than say those of the “peace” era of the 1960s, but there should also be understanding that this should be a cause for more intense rehabilitation programs and the formation of better judicial applications through Drug Courts (ref. Drug Court description:http://www.whitehousedrugpolicy.gov/enforce/drugcourt.html) and legal diversion programs.

The PROGRESS not PERFECTION header at the start of this segment means that there, like disease, will probably never be a cure for drug addiction, but like a disease, drug and alcohol addictions can be treated. The progress is with an individuals Spiritual and Recovery program and will bring perfection in endurance, stability, patience, understanding and most important, sobriety

How does a Transitional Living Program work?

There are two major categories of Transitional Living Programs. One is the “Shelter” concept that provides the basic needs for nutrition, comfort, and sleeping space that may also provide a Spiritual message or is regulated by specific founding organizational requirement that are “target” specific such a the homeless, this type of Living program is usually a very short term stay. Another shelter concept provides all of the above with the addition of security and life skill helps such as a Women's shelter

Women's shelter

A women's shelter is a place of temporary refuge and support for women escaping violent or abusive situations, such as rape, and domestic violence....

that has in place specific provisions for issues concerning children, legal and protective services. These programs are usually very flexible on “stay” time as each case is treated independently. The Shelter concept is usually funded by outside sources and do not require the Resident to pay a fee or charge for services offered. The second Living category is “Rehabilitation” centers that have a program policy and procedure for issues that are “specific” in nature (i.e. Addiction Recovery, Diet and Food Issues, etc.). The Rehabilitation programs involve services that are established to meet the needs of the particular issues of the admission. Some social issues can fall on the fence line between a “shelter” need and a “rehabilitation” need (i.e. the example given in the case of Battered Women).

In essence most Transitional Living programs that range from Battered Women to Addiction Recovery have the same operational and development standards.

The majority of Transitional Living Centers are self-supporting. In other words they have no affiliation or obligation to outside sources other than the required reporting of financial and operational record maintenance to various government or grant giving organizations. With the self support status the Living Center usually charges a nominal rent or fee (some are set on sliding fee scales, some are established with monthly rates and yet others find support finances for each particular individual) that will afford the applicant a safe, clean, secure environment with balanced meals and a specific "care plan" to help bridge learning and application towards their recovery that is geared for their purpose and program.

Most Living Centers, regardless of their specific service, have in their program areas that will help better support the person through their specific needs be it from recovery or protection. Some of these areas are educational advancement opportunities, job skills training opportunities, "life skills" workshops and classes, and specific classes or meeting that are directly associated to their issue. The weekly or monthly dollar value "rent" varies on venue, location, program purpose, design, intensity and provision, plus any professional involvement or assistance requirements. Transitional Living stays or residency can vary from very short term to extended time stays (1–2 days to up to 2, and in some cases, 3 years). Obligatory financial issues such as rent, transportation, and personal care items are the responsibility of the individual Resident even though several programs may provide all or part of the above through donation or designated grants funding.

A "Resident" could mean an individual or family depending on the program design. This Resident is self-admitted or via family/friends, referral (i.e. another Transitional Center), or court order. Most programs have admission requirements and an "entry" intake instrument. For example an Alcohol and/or Drug Living Center may administer a "standards" tool known as the A.S.I. (Addiction Severity Index) that measures and presents domestic, addiction, and social understandings and personal "life" issues. The majority of Living Centers use their admissions intake information received from the client to aide them in the design of "personal" or "individual" Care Plan of that particular client or family. The Resident agrees to abide by the Living Standards of the Living Center, which is verified through a binding legal rental agreement or standard of acceptance agreement between the Center and the individual.

Depending on availability of personnel, materials, and finances a Transitional Center may offer its Resident's gratis workshops in money management, child care, domestic skills such as cooking and housekeeping, job skills classes, self advocacy, crises intervention, social skills and to provide social and cultural events.

Finally, the intent of the Transitional Living Center is to provide a place where the person can re-establish their self worth, re-discover their place in society, and find compassion and love through Spiritual discovery and a genuine understanding of personal relationships. The bulk of the Centers try to maintain a "home" atmosphere where a family type relationship is developed between the Resident's, Staff, and Volunteers. The Transitional Living Centers of today go far above and beyond the term "Half-Way" in proving that half-way is not good enough and "complete" is the goal to strive for.

External links

• Academic House, Transitional homes for men with an emphasis on learning to stay clean and sober through education and 12 step programs founded in the AA tradition,Austin, Texas
• Haven Place, A Women's Transitional Living Center in Houston, Texas
• Stephanie Brown Treating the Alcoholic; a developmental model of recovery