The Portage Therapeutic Community

François BourdonAllan Farkas

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The Therapeutic community

Today we will present you the therapeutic community

We will show you the tools we use to help our residents acquire skills and competencies that will support them in their reinsertion in the community.

Phases &WorkshopsCompetenciesPASS EvaluationEducationOutreach Research Results

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Portage phasesPortage Program works with different phases based on acquisition of competencies

Phase 1 through 6

In each of those phases the expectations and responsibilities increase with the status of the resident in the community

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ExpectationsThe residents are expected to acquire skills and competencies. These expectations grow at each phase change.

Phase 1

Get to know your environmentGet to know the people in the communityGet use to the schedule

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Phase 2Phase 2Learn basic expectationsIntegrate in the communityUnderstand the basic tools of therapyFollow the structure of the program Participate in groups and meetingsPut the tools of therapy in practiceParticipate in all workshop

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Phase 3

Be responsible and a model in the community

Accomplish the tasks for witch you are responsible

Show leadershipFollow treatment planTransfer competenciesMaintain a balance between your

recovery and your role in the community

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Phase 4Be a leader in the community

Prepare your exit plan

Be a role model

Help new members integrate in the community

Work on positive networking during outings

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Phase 5Reintegrate in the community and your

family

Be a support to the community and your peers

Be a role model

Attend aftercare groups

Reinforce your positive network

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Phase 6Practice a positive lifestyle

Go back to school or work

Attend aftercare meetings

Have a personal inventory of your own progress

Reintegrate with family and community

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Competencies

Demonstrate objectivityAbility to take initiativesDemonstrate empathyExpress self in an appropriate mannerActive participation in treatmentEncourages othersPlanned and orderlyShows consistencyDemonstrates reliability and is trustworthyEnergetic and enthusiasmDemonstrates good problem solving and

decision making abilities

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Competencies

High level of team workAbility to prepare structured activitiesAbility to conduct structured activitiesAssist well in conflict resolutionAbility to ask for helpDemonstrates accurate self-awarenessTransfer of learningAccepting of supervisionAbility to communicate effectivelyHas developed realistic goals and objectives

for post treatmentDemonstrates social adjustment

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Workshop Topics Who am I?

• Feelings: Part 1 Identify feelings Taking responsibility for and expressing

feelings• Feelings: Part 2

Controlling behavior Building relationships

• Separating feelings, thoughts, attitude and behavior

• summary of positive qualitiesCommunity as method

• Community meetings (Morning meeting, night meeting)

• Safe community• Coaching and coaching board• Importance of belonging/only as strong as the

community

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Workshop Topics Self-help/mutual help

• Helping myself by helping others/positive engagements

• Relationships • Empathic confrontation

Practical aspects• Role of cleanups in therapy/how to do a

cleanup• Relationship between school and therapy• Competencies • Belief system: Philosophy

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The PASSA tool designed by the research departmentThe purpose is:

to measure the progress made by the resident from the beginning of therapy to its conclusion, including the aftercare phase.

to help clinical staff members measure the acquisition of the 21 competencies/skills.

to assess the clients’ progress.The PASS must not be used to compare

residents. The results of the pass must be used as part

of the monthly treatment plans of the resident

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The PASS Using the following scale, which ranges from

Strongly Disagree (1) to Strongly Agree (7), please circle the number closest to the way you rate the client now for all statements. Please provide a fair and honest evaluation of the client.

1 The client is organized and orderly. 1 2 3 4 5 6 7 2The client behaves in a consistent way. 1 2 3 4 5 6 7 3The client is reliable. 1 2 3 4 5 6 7 4 The client participates actively in his/her recovery. 1 2 3 4 5 6 7 5 The client demonstrates the ability to plan structured

activities. 1 2 3 4 5 6 7 6 The client demonstrates the ability to lead structured

activities. 1 2 3 4 5 6 7 7 The client uses his/her acquired skills in different

situations (transfer of learning). 1 2 3 4 5 6 7 8 The client takes initiative. 1 2 3 4 5 6 7 9The client expresses himself/herself appropriately. 1 2 3 4 5 6 7 10 The client encourages others. 1 2 3 4 5 6 7 Strongly Disagree 1 2 3 4 5 6 7 Strongly Agree

Please circle only one number per statement.

11 The client accepts to be supervised. 1 2 3 4 5 6 7 12 The client demonstrates the ability to work within a

team. 1 2 3 4 5 6 7 13 The client communicates effectively. 1 2 3 4 5 6 7 14 The client demonstrates the ability to integrate

socially. 1 2 3 4 5 6 7 15 The client demonstrates the ability to be objective. 1 2 3 4 5 6 7 16 The client demonstrates the ability to be empathetic. 1 2 3 4 5 6 7 17 The client demonstrates the ability to make

decisions. 1 2 3 4 5 6 7 18 The client demonstrates the ability to solve

problems. 1 2 3 4 5 6 7 19 The client demonstrates the ability to ask for help. 1 2 3 4 5 6 7 20 The client demonstrates the ability to resolve

conflicts. 1 2 3 4 5 6 7 21 The client knows who he/she is and where he/she is

at. 1 2 3 4 5 6 7 

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TREATMENT PLAN

Behaviours and issues to be explored

Goals Objectives Means/method Measured outcome

1- Drug addiction & other dependencies

2- Health

3- Personal development

4- Social skills

5- Family

6- Legal issues

7- Education

8- Outings & requests

9- Specific behaviours

Resident’s name___________________Date of birth: ____________________Admission Date: _________________

Counsellor who completed the plan: _______________Case conference chair person: ____________________

Plan completed: __________Revision on: _____________

Educational model The Portage Educational Model exists

because we worked to become affiliated with the local school authority. Portage is able to act as a consultant to the school board in pilot projects; and some of the Portage methods are applied in their Alternative programs.

In effect our residents become mentors with peer students working hand and hand to mentor high school students at risk

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CLASSROOM OUTREACH

• The process gives our adolescents a sense of pride and the ability to reach a goal that is good and positive. That they have the passion for this is the why of the Portage experience.

• The concept of our outreach program also includes our adolescents giving personal, testimonial presentations to school assemblies which promotes many competencies that are acquired in the program.

PORTAGE EDUCATIONAL MODEL IN THE TC AND OUTSIDE

Integrating outside the therapeutic community(TC)

Portage partners with the local school authorities on several levels

Acts as a consultant with the coordinator of substance abuse inside the school and parts of our program is applied in alternative program settings

Portage’s educational work and goals is to engage and develop diverse young people so they can impact their lives, their families and communities positively.

PORTAGE EDUCATIONAL MODEL IN THE TC AND OUTSIDE

A very important way this is accomplished is by putting these adolescents in contexts with their peers outside of the facility, while they remain part of the program and continue their therapy. This process enhances the acquisition of competencies

Putting the problem out on the table relieves some of the shame and stigma attached to admitting to a sense of loss, (a break up with a girl friend or boy friend, a sense of sadness (not meeting their parent’s academic expectations or - an addiction).

EducationAt Portage peer-on-peer accountability is

paramount, and each resident is held responsible for their personal contribution within the community.

The Portage adolescent programs believe that academic education is an integral part of the recovery process for teenagers with drug and alcohol addictions and behavioral disorders.

StatisticsAll youth admitted at Lac Écho between January 2003 and March 2008 and having received at least 15 days of treatment have been invited to participate in a research project (77.9% have been contacted). Questionnaires were filled up to October 2008. Boys represent 60.2% (n=127) while girls represent 39.8% (n=84). The average age at admission of those who answered was 16.0 years old.  

Description of youth: _______________________________________________________________________________________________________________

Polydrug users: 75.6% Committed a delinquent act criminally punishable: 91.6%Cannabis use: 89.5% Arrested or charged with an offence: 58.1%Amphetamines, speed or Ritalin use: 55.8% Suspended or expulsed from school: 87.4%Hallucinogenic use: 53.6% Five or more psychological problems: 86.5%Cocaine use: 43.2% Reported to LPJ: 62.6%Previous treatments for alcohol or drug use: 53.9%

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  Study results:

Number of days of use of illegal drugs in a month

________________________________________________________________________________________________________________________

Number of days in treatment Before treatment 7.5 months after treatment 14.5 months after treatment

________________________________________________________________________________________________________________________

15 to 60 days 20,1 days 10,5 days 13,2 days

(n=61)

61 to 180 days 21,8 days 7,8 days 8,7 days

(n=69)

181 days and more 22,2 days 3,1 days 5,0 days

(n=79)

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Study results:

Before treatment 7.5 months after treatment

14.5 months after treatment

0

4

8

12

16

20

24Number of days of use of illegal drugs in a month

15 to 60 days 61 to 180 days 181 days and more

Num

ber

of

days

of

use

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Study results:Percentage of youth abstinent of illegal drugs in last 30

days____________________________________________________Number of days 7.5 months after 14.5 months

after In treatment treatment treatment___________________________________________________________________________________________________________________________________________________________________

15 to 60 days 37.7% 32.8% (n=61)

61 to 180 days 58.0% 44.9% (n=69)

181 days and more 79.7% 65.8% (n=79)__________________________________________________________________________________ • 25

Study results:

15 to 60 days (n=61) 61 to 180 days (n=69) 181 days and more (n=79)20%

30%

40%

50%

60%

70%

80%

90%

Percentage of youth abstinent of illegal drugs in last 30 days

7.5 months after treatment 14.5 months after treatment

Per

cen

tag

e

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Study results:If youth use drugs for between 20.1 and 22.2 days in a month before entering treatment, they use drugs for between 3.1 to 13.2 days a month after treatment depending on time spend in treatment. Those who use the least are those who stay longer in treatment. Abstinent rates of all illegal drugs after treatment range from 37.7% to 79.7% depending on time spend in treatment. Those who are the most abstinent are those who stay longer in treatment. 

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