Change a life: Intake Day

What it Takes to Change a Life (CAL)

Dr. Joseph White & the FFL Team

Intake & Orientation

After someone has been accepted into the MentorWorks Program, the life-changing journey begins with a staff member picking them up from prison or jail, checking in with their probation or parole officer, and beginning the intake and orientation process. As noted in previous blogs, much effort has gone into preparing for this day so that clients have a successful transition from incarceration. Once at the MentorWorks offices, the client and staff go through the entire MentorWorks Healthy Transition Home Handbook (including house rules, program expectations, etc.) and sign the contract stating they will follow the rules. They complete their individualized Success Plan and create their “My Sobriety Plan” (fill-in-the-blank essay based on their Success Plan) to guide their efforts. Clients work through questions, learn about the program in detail, gain a sense of boundaries, get assigned to a home and room, and get connected with program staff. The program supervisor schedules their intake assessment with a counselor to determine level of care and to assist with developing their treatment plan and individualized intensive outpatient program schedule. Finally, they meet with a case manager to identify health, medical, and employment needs, as well as anything else they need assistance with (resources, etc.).

Many clients transitioning from incarceration have significant physical, dental, and mental health care needs. Most have no way to pay for them and typically fall through the cracks because they don’t qualify for traditional medicaid and have no way to pay for these critical services. They either do without or ultimately end up self-medicating. Fortunately, the Utah legislature passed the Targeted Adult Medicaid (TAM) program to reduce the number of uninsured adults, provide an avenue for needed services, and minimize emergency room visits, among other things. TAM serves individuals who are “chronically homeless, involved in the justice system through probation, parole, or court ordered treatment needing substance abuse or mental health treatment, [or] needing substance abuse treatment or mental health treatment” (2017). Medical, dental, and treatment needs are covered by TAM at no cost to the individual. If applicable, clients are enrolled in TAM at intake. Clients also receive basic necessities like a fresh linen kit and access to food, clothing, shoes, etc.

Casey T (personal communication, January 31, 2022) needed medical treatment for chronic pain but wasn’t able to get it because he couldn’t afford insurance. As such, he turned to street drugs to treat his pain and became addicted shortly thereafter. When he began his recovery journey at MentorWorks and Redwood Recovery, TAM legislation had just passed and made it possible for him to get the life-saving medical care he needed, including medically-assisted treatment and eventual tapering off support. He even was able to obtain an inhaler for his asthma.

Building Independence

One of the first steps clients take in rebuilding their lives is finding employment. Employment is important because it provides structure and independence. “Those at the most risk for mental health challenges after job loss are those for whom unemployment is an immediate threat to survival. People with fewer financial resources and those who perceive more financial strain from unemployment are less satisfied with their lives” (Pappas, 2020). Finding employment can be difficult, especially with a criminal record. However, case managers, staff, mentors, and program peers provide support and nearly all clients find adequate entry level work. As they gain success in early recovery and develop good work habits, they often transition to better paying positions or better jobs.

Growth & Progress Indicators

Establishing early, easily achieved indicators is helpful to set clients up for success. Redwood Recovery and MentorWorks growth and progress indicators help clients identify and anticipate relevant, recovery-oriented steps that move them toward developing stronger recovery anchors. The ultimate goal is to stay sober and live healthy lives. Both programs work hand in hand to help clients achieve their goals. The MentorWorks healthy transition homes invite clients to work through 7 “Riser Levels.” RISE stands for Recovery in Sober Environments. The Redwood Recovery Outpatient program invites clients to work through 7 “Progression Levels.” While the levels are similar, there are distinct aspects related to healthy living and being a peer support (Risers) as compared to processing key aspects of recovery and changing mindsets (Progressions). In addition to the incentive and energy associated with taking steps toward improving and being recognized for it, a benefit to the overlapping growth indicators is that it helps clients interact with peers in both sober living and outpatient settings who become important support systems and central to their recovery community.

MentorWorks Riser Level 1 is “Mentee.” Sober-living clients create a sobriety plan, identify triggers, begin participation in their recovery program, and commit to regular drug testing. They create their “My Sobriety Plan,” employment-seeking plan, and are willing to accept peer support. One of the important facets of this phase is to create a list of unhealthy associates and remove them from their social media and contact lists. Finally, clients consider spiritual activities related to gratitude, meditation, and/or connecting with a Higher Power.

Redwood Recovery’s Progression Level 1 is “Soil.” In addition to aspects of Riser Level 1 (Mentee), clients in Soil complete an assessment and begin developing a treatment plan. In addition to individual counseling and group sessions, this level involves connecting with recovery mentors. These clients may not be ready to fully engage in groups but they begin attending and get acclimated. They may be defensive, depressed, or exhibit anti-social attitudes but recognize the need for help. They work to get medications balanced and search for a primary care provider (if needed). Soil is all about developing the fertile ground where a seed (Progression Level 2) can grow. Soil and Mentee are completed within the first few weeks of the program.

The Garden of Life

Before planting the first seed in our gardens, the ground had to be dug up and prepared. Heavy machinery helped turn over the clay and soil to loosen it up. Nutrient-rich topsoil and fertilizer were added to prepare the ground for seeds. A drip system was installed to water the ground efficiently. Once the garden area was prepared with fertile soil and a watering system, the process of planting began.

Similarly in life, individuals must do the work of preparing themselves for change, making decisions to leave old habits, behaviors, people, places, and things behind that were the breeding ground for addiction to grow in their lives. Doing the work to ensure fertile ground is vital to success in gardening and in life. As clients begin the journey of recovery, they are invited to create a “Success Plan” that will produce fertile soil, provide sustaining water, and create an environment where a newly planted seed can grow. It is a privilege to observe this beautiful change process as clients contemplate, prepare, and take action to begin their recovery journey (see Prochaska & DiClemente, 1983).

Our Invitation

There is much to do at intake and during the first week in the program. There are rules to learn, people to meet, jobs to find, family members to contact, etc. It can be overwhelming. Gordon S (personal communication, January 17, 2022), a recent graduate, reflected back on his first day in the program, dealing with that initial overwhelming feeling and his overall experience in MentorWorks. He said he felt completely supported through the entire process and knew that “at any time [he could] call anyone up and they [would be] supportive.” Mentors and volunteers make a tremendous difference in their kindness and support as they connect with clients and offer encouragement. Reach out to loved ones in recovery, share our social media posts, or share a real story of recovery and support in the comments section below.

See Other Blogs in our “Change a Life” Series:

References

Pappas, S. (2020, October 1). The toll of job loss. American Psychological Association. https://www.apa.org/monitor/2020/10/toll-job-loss
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390-395.
Targeted Adult Medicaid Program. (2017, July 1). Utah Department of Health Medicaid. https://medicaid.utah.gov/targeted-adult-medicaid-program/