Concurrent Disorders and Addiction Treatment

Concurrent Disorders and Addiction Treatment at Last Door

Last Door has partnered with Psychologist Linda Robbins & Dr. Paul Stein, M.B.B.S. FRCPC (Psychiatrist) to enhance mental health and addiction recovery services to residents.

Trauma Backgrounder:

The integrated treatment program delivered by the Last Door Recovery Society is based on the premise that long-term recovery requires long-term treatment. The most recent research for 2010 based on our 165 clients highlights three important stats. Those clients who complete or continue in recovery (108) do well in both return to work (95%), return to family (92%), only 10% return to nicotine use. The more important stats for this discussion are that only 17% returned to drug use and only 7% returned to jail. These stats are consistent with the research done in Connecticut where there are clearly documented correlations between length of treatment and recidivism. Specifically in a study conducted in 2010 by the Connecticut Department of Corrections it was confirmed that clients in long-term care (4-6 months) do twice as well as clients in short or Tier one care of typically 30 days. Only 17% of the clients in long term care re-offended with significant reductions in severity of criminal activity. (Connecticut Department of Corrections, Recidivism, 2010) Government Agencies, health care providers and insurance underwriters in an effort to promote economic gain, have distorted good science (made the figures measure the meaningless) and reduced emerging models of successful treatment to extended detox or outpatient “psycho-educational” programs.

Understanding military culture, paramilitary cultures, firefighters, police officers and pilots has long been a hallmark of treatment at Last Door and an essential reason why all the pilots and firefighters that have completed our program have returned to work to complete successful careers with recovery periods well in excess of 10 years for some clients. The assessment and screening process includes an awareness of the symptoms of PTSD including intrusive images, nightmares and other arousal, avoidance and numbing as well as the depression of alcohol use and cognitive difficulty. The complete review by the medical director will separate physical symptoms from emotional and psychological origins of the assessed symptoms. The treatment of trauma at Last Door is a continuing integration of the whole person into recovery. In the case of concurrent issues including head-injury, trauma and addictions the Last Door team has been successful for the past 25 years addressing emotional, spiritual and existential issues to help clients acquire new coping skills and handle the issues of human suffering and death in the face of natural and unnatural forces.

For example with the military culture: A key issue is anger/fear management. While some of the psychological preparations for combat require heightened aggression the return to civilian life requires the management of grief, violence, sadness, anxiety, powerlessness and loss of control. Fear and stigma often make return to civilian life difficult with heightened anger directed at the agency that employed them. The co morbid diagnosis of addictions and trauma presents a challenge that is best addressed by residential in-patient treatment followed by on-going community support will help build a foundation for on-going recovery.

The continued inclusion of practiced respect in our residential addictions treatment program assists those clients with concurrent aggressive and violent tendencies to identify those core issues whether a history of antisocial behaviour, personality, peers or attitudes as well as struggles with family, relational, educational, employment and secondary key functioning issues (origin, intellectual functioning, anxiety, trauma and injury). From date of admission all clients are focused on three key issues – no crime, no violence, no using. This simplification permits a focus for all our group work, individual counselling and referral activities.

Because new behaviours are practised in residential settings and monitored by staff and peers the daily interactions permit observation and adjustment with immediate rewards and checks. In the course of treatment clients learn to identify abusive behaviours, the underlying values and beliefs, the defects of character, the consequences of their behaviours, the exact nature of their wrongs, make those behavioural adjustments necessary to switch from defects to assets and then review their interpersonal relationships and the assets in those relationships on a daily basis. The practised living of those skills in community not only performs the educational component but also the behavioural adjustment and practice necessary for lasting change.

The Last Door has spent 28 years developing a peer model recovery community that not only addresses addictions but seeks to address the underlying defects of character that give rise to the breakdown of interpersonal relationships and the subsequent relapse, psychosis and chaos. The clinical team is certified and each clinician has a minimum 6000 hours of supervised training in residential treatment and counselling assisting recovery for career, medical, family or corrections clients. Our co-parenting, family and partner groups focus on relationship issues and the elimination of aggression coupled with the positive introduction of self-respect, responsibility, parenting and empathy. Our clients spend 18 hours per week in process group work addressing individual and inter-personal issues and approximately 6 hours per week in one-to-one counselling. In the course of the 5 month residential treatment that works out to 360 hours of group work, 120 hours of individual work. The program covers the key addictions, aggressive behaviour, violence, self-esteem, trauma, family, anxiety and relapse-prevention issues at levels that outpatient programs can never attain. The program design, development and delivery is driven by a team of recovering persons, certified clinicians experienced with the 12 core functions, masters level clinical supervisors, medical doctors, addictions specialists, psychologists and psychiatrists.

To view services offered please click here on our addiction services link

“We acknowledge the financial support of the Province of British Columbia”