What is your job title?
My job title is Senior Counselor. I work for St. Cloud Hospital Recovery Plus.

What is the target population? The target population that I work with is women in primary chemical dependency treatment. We also have a relatively new program called Family Unity that targets women who are pregnant or men and women who have children. We allow these women to bring their children with them to treatment and reside with them at the residential housing facility. These women also receive parenting education and classes and meet weekly with a parenting counselor. The age group of women I work with is women ages 18 through approximately age 55. We have adolescent programs that address the needs of younger girls and we also have specific programs to address the needs of older women. I chose to work with adult women in primary treatment because I felt a stronger connection with adult women versus children. I did two internships at Recovery Plus and truly felt like I was meant to work with the women in primary treatment. I felt like I wanted to help adult women and give them coping skills to handle their disease of addiction. I also feel like I have more patience to work with adult women. What is the mission statement at the agency? The mission statement of our agency is: As a Catholic, regional hospital, we improve the health and quality of life for the people we serve in a manner that reflects the healing mission of Jesus
What services are provided and how are they provided? There are many services that are provided at Recovery Plus. We have a primary residential chemical dependency treatment program for women, men and older adults, a primary outpatient chemical dependency treatment program for women, men and older adults, aftercare programming and Relapse Prevention programming (called Phase II and III). As I mentioned earlier, we also have a Family Unity program. This program was developed for men and women who have children or women who are currently pregnant. We provide parenting education and groups on a weekly basis. We also have parenting counselors who meet with clients on a weekly basis. This program allows the clients to have their children reside with them at the residential housing facility. Daycare is provided. If the clients are currently involved with child protection and do not currently have custody of their children, we help facilitate visitation with their children, whether supervised or unsupervised visitation. We also can accommodate overnight visits when approved. We also help reunite mothers and fathers with their children who may be in a foster care setting or not currently in their custody. We also have medical services available for our clients. We have a medical doctor on staff, a nurse practitioner on staff and a registered nurse on staff. We also have a psychiatric nurse practitioner that spends 1-2 days per week at our facility to meet with clients regarding their psychiatric needs and possible medications. We are considered a dual disorder facility/program, which means we are a chemical dependency treatment program with a mental health component. As part of our treatment program, we encourage and recommend that clients with mental health needs address these needs while in treatment and recovery. We have many therapists on staff who provide individual therapy sessions for our clients in the treatment program and also for people within the community who are not current or former patients in our program.

What is your most common clinical issue? Most common clinical issues: One of the most common clinical issues I see as part of my job as an alcohol and drug counselor is unaddressed or inadequately addressed mental health issues. Many clients come into primary chemical dependency treatment and have never been treated for an underlying mental health issue or diagnosis. They may not have realized they have any mental health issues; they could also be in denial of any mental health issues or may not have had the financial means or insurance to follow up with a physician regarding mental health issues. Sometimes clients may be admitted to our program and do not have their current psychiatric medications with them or have not taken their psychiatric medications for a substantial amount of time. We do not force our clients to take any medications if they chose not to, but we encourage clients as part of a holistic approach to chemical dependency treatment, to address all areas of recovery, including mental health, spiritual health, physical health, emotional health, etc. Another common clinical issue I see commonly is lack of housing. Many clients come into the treatment program homeless or are in the process of losing their housing. They often have their children with them also. This makes it vitally important to make finding and obtaining safe and sober housing a large part of their treatment plan. Housing is often difficult to find due to most of our clients currently being unemployed and not having the financial ability to pay rent or mortgage payments. Some housing options we use on a regular basis are halfway house programs, sober housing facilities, community housing agencies such as Catholic Charities, felon friendly landlords who are willing to rent to clients with a criminal history, and sometimes our clients may have family members who are supportive and sober and who may allow the client and/or children to reside with them upon treatment completion. Most people do not have many family or friends who are willing to do this due to the behaviors they have displayed while active in their disease of addiction. In terms of halfway house programs, there is only one halfway house program for women within the St. Cloud area. This program is also provided through the St. Cloud Hospital and provides services for single women, women with children and pregnant women. The waiting list for this program is often long due to the strong demand for programs of this nature. There are many other halfway house programs within the state that we refer to but they often will only take single women without children. There are only three programs within the state that will take women with their children in a halfway house setting. Obtaining housing for the women I work with is often quite a challenge.

How are your provided services funded? Our services are funded through several different funding sources. Consolidated funding through the county/state, also called Rule 25, is a common route of funding for my clients. This route of funding requires the client, prior to admission to any program, to meet with a social worker through their county of residence and complete a Rule 25 assessment. This assessment will assess their level of care needs and the social worker will then make a recommendation to an appropriate treatment program. We also accept private or commercial insurance plans. These insurance plans most often require the client to complete a chemical dependency evaluation with a licensed alcohol and drug counselor prior to admission to the program and follow the recommendations from that assessment. We also accept state funded insurance plans, also called PMAP plans. These plans also require a chemical dependency evaluation to assess the client’s current needs and formulate a recommendation for an appropriate level of care. We also accept self-pay when clients have the financial means to pay for treatment out of pocket. For those clients who do not meet criteria for the above mentioned routes of payment, the St. Cloud Hospital also provides charity care services. These services are managed through the business office and the client needs to complete an application and provide financial documentation with their last three months of income and family size. Then a decision is made through the business office what percentage of the client’s care will be covered by charity care funds.

What are the reasons for admittance/discharge of your clients? The reasons for admission are many. Some clients are completely self-referred and have made the decision to come into treatment due to their own concern about their use of substances. Some clients are court ordered through probation or the court system due to legal consequences they have suffered as a result of their chemical use. Some clients are referred to treatment through a child protection recommendation due to the impact their use of substances has on their ability to be a healthy, productive parent. Some clients come into treatment as a result of an intervention done by family or friends based on concerns about their ongoing substance use. Some clients are also referred to treatment by medical practitioners or hospital facilities due to the impact their substance use is having on their physical or mental health. Some of our clients are also on a commitment or stay of commitment through the state due to their inability to make healthy decisions for themselves. There are several reasons for discharge from the program. The first would be a complete discharge. This happens when a client has completed all requirements and expectations of the treatment program and has a continuing care plan in place. There is also a type of discharge called against staff advice, which is a type of incomplete discharge. This happens when a client chooses to leave the program against staff advice at anytime during their treatment programming. Often this happens at the residential housing facility in the evenings and the client chooses to leave the program without discussing this choice with a staff member. Another type of incomplete discharge is at staff request. This type of discharge happens when the treatment team makes the decision that the client’s behavior or choices are not allowing them to benefit from the treatment program at this time or their behavior is having a seriously negative impact on their peers. When this type of discharge occurs, the treatment staff will make a recommendation for follow up or ongoing care at another facility or program. Another type of discharge is a transfer. This occurs when it is found that the client’s needs would be better served at another facility and a transfer is arranged by treatment staff to another program.

What are some positive things about your profession? Negative? I find many positive things within my job as a chemical dependency treatment counselor. I truly enjoy seeing the day to day changes in the clients and their ability to change the way they think and behave. It is amazing to see them using the coping skills and strategies we teach as a way to maintain recovery from drugs and alcohol addiction. It is also amazing to see the women learning how to parent their children effectively and in a healthy way. Some of the women in the program are so eager to learn and want better for themselves and their families. The hardest or most difficult areas in my job as a chemical dependency treatment counselor are when certain clients do not want to make changes in their behavior. It is hard to see clients continuing to make the same choices and suffer the same consequences as a result. All we can do is offer the tools, knowledge and skills and hope that the client chooses to use them in a healthy way. Due to the nature of addiction as a disease, many times clients will relapse and come back into the treatment program. This gives the client the opportunity to learn something new, make new choices or continue in the same pattern of behavior as before.
What is an everyday challenge for you?
The biggest everyday challenge I have in my profession is the emotional impact some of the client’s situations, histories or current issues have on my own emotions. I am a very compassionate person and I think this can be an asset for a chemical dependency counselor. But it is also something I need to be aware of to prevent the blurring of boundaries between myself and the clients and also to prevent me from taking my clients’ issues home with me at the end of the day. Self-care is something I need to remind myself of often due to the nature of my profession.