Posts Tagged ‘substance abuse treatment’

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A Fresh Way In: Reflections on Therapeutic Horse Riding at Crossroads for Women

September 22, 2009

Emily Van Strien, LADC, a counselor at Crossroads for Women, worked with clients at Riding to the Top Therapeutic Riding Center in a pilot project that combines substance abuse treatment and therapeutic horseback riding. The project was funded in large part by the PRBB Foundation, along with assistance from the Edward H. Daveis Benevolent Fund and additional underwriting from Riding to the Top to complete the project. Below are Emily’s reflections on the project.

When I was told last winter that I would be the counselor at Crossroads for Women Halfway House participating in a therapeutic horse riding grant that had been secured with Riding to the Top, I wasn’t initially 100% clear as to how the two modalities fit together. I was accustomed to group therapy conducted on couches with regulated climate and white boards. I knew next to nothing about what therapeutic horse riding entailed, its versatility and capacity to touch deep emotional places in people.

What stands out most for me when reflecting back over the eighteen sessions are the metaphors that arose spontaneously, thus evoking unexpected insights into so many areas of our clients’ lives. I remember one morning Duke being particularly nudgy, pushing his way into one woman’s space even after she held up her hands asking him to back off. We laughed, but then used it as a learning moment of what to do when receiving unexpected attention, perhaps at a meeting from a man who doesn’t seem to take a hint.

I remember one particular woman, convinced the horses didn’t like her, describe having a breakthrough of insight into the relationships in her life when she was asked to look at her interactions with the horses from a different angle. She was asked to consider that the horses simply received and reflected back, much like a mirror, that which she put out. She identified her lifelong struggle with low self-esteem and how she often projects her feelings of dislike for herself onto others.

Another time,  we were observing one of the horses nosing around a pile of another horse’s manure. Out of nowhere,  a client pointed to it and said, “That’s how I feel when I’m in the depths of my addictions. Like my face is in s—. That’s how low I stoop.”

During one of my favorite exercises, “Temptation Alley,” the women would struggle to guide the horse through a course laden with hay, grain, carrots and other horse delights. Time and again, each woman would experience the strength of the animal’s pull, very much like the power of her addiction, and experience in her body the necessity to receive help from her community in order to keep the horse on its path.

I loved seeing women overcoming their fears of the large animals and moving from a place of anxiety to comfort. One woman described experiencing the feeling of compassion when being in close physical contact to the horses; she shared how she’d never felt herself let down her guard when loving something before then.

Another powerful moment would come during the lesson about the acquired behavior of cribbing, a compulsive and destructive behavior the horses learn from one another for the purpose of releasing endorphins and easing stress. Michael and Kate, the Riding to the Top facilitators, would gently share their experience of rehabilitating traumatized horses who “have their buttons and ways of dealing” just like humans. Seeing themselves in the horses again, several clients eluded to feeling less judgmental for being an addicted and/or traumatized woman. During those moments in the arena, something eased up for a while.

When the experience at Riding to the Top came to a close, I was struck with how many opportunities I had as a facilitator to observe our clients’ leadership skills, her creativity, her ability to take direction, maintain boundaries, handle frustration without giving up, identify and then interrupt her self-defeating thinking and behavior, to trust her instincts and be present in the moment.  Participating in the weekly sessions at Riding to the Top was more than just a chance for the clients and myself to get out of the house and off the couches. It was a fresh way into the heart. As a facilitator, I was left with the knowing that it doesn’t matter if it’s a group room or a horse arena, growth and healing can occur anywhere and anytime and it does.

~ Emily Van Strien, LADC

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Therapeutic Horseback Riding Helps Women in Substance Abuse Treatment

February 13, 2009

TeddyCrossroads for Women has teamed up with Riding to the Top in a pilot project that combines substance abuse treatment and therapeutic horseback riding.

Therapeutic riding has been shown to help facilitate the confidence, self-esteem and problem solving skills of children and adults with physical, emotional and / or learning disabilities.

The curriculum for the program, which takes place at Riding to the Top’s facility in Windham, Maine, focuses on specific recovery skills such as relating to others in healthy ways, identifying thinking distortions and managing feelings without using drugs or alcohol. While the program is still in its early stages, clients have been able to talk about everything from thinking errors and distortions, safety, body language, boundaries, getting needs met, problem solving, strengths, survival skills and relating to others in healthy ways.

Here are some of the things the women have said so far:

  • “I feel instantly calm when I am near the horses. I have a deep feeling of comfort and relaxation.” (from a woman with severe anxiety)
  • “I was scared of the horses and didn’t think I’d want to get close to them. But, I wanted to tell my daughter that I touched the horse so she’d be proud of me. And I got to tell her that.”
  • “I caught myself excuse-making and catastrophizing. I changed my thinking, and I was able to get on the horse.”
  • “When I was on the horse, I felt proud. I felt myself sitting up taller and relaxing and enjoying the experience.”

The collaboration started in January 2009 and will continue for one year. Participants include clients from Crossroads for Women’s halfway house and Children And Mothers Program (CAMP) – halfway house programs.

Crossroads for Women offers Maine’s most comprehensive treatment for substance abuse and co-occurring mental health issues specialized for women only.

Riding to the Top’s mission is to provide therapeutic riding services to children and adults with physical, cognitive and/or emotional disabilities.

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Positive Incentives Help People Stay in Treatment Longer

July 22, 2008

Those in the substance abuse treatment field sometimes use contingency management to increase client retention. Contingency management is, essentially, a positive incentive program for clients to help keep them in treatment longer. And the longer those are in treatment, the more effective that treatment is and the more likely they will complete treatment. While some may argue that contingency management sounds a whole lot like bribing, those who use such a program have seen favorable results, including Crossroads for Women.

What is key to these type of programs is that incentives are positive. We use positive reinforcements every day by giving away awards and prizes to kids, adults and even pets for doing something good. In contrast, there are many negative contingencies related to substance abuse treatment. Getting arrested, going to jail, paying a fine, being mandated into treatment or being fired from a job are some examples. Thus, in order to be effective in a treatment setting, incentive programs must be positive and relate directly to a desired behavior, such as showing up for a group or counseling session.

As part of the Strengthening Treatment Access and Retention-State Implementation (STAR-SI) grant in Maine, Crossroads for Women has implemented such a program with the aim of increasing client retention during the first 30 days of treatment in its outpatient and intensive outpatient programs. For a period of 18 days, clients were allowed to choose a small gift from a gift basket if they attended 3 sessions in one week at the intensive outpatient program (IOP) level or after their 4th session in outpatient counseling. The most popular gift was that of inexpensive, handmade earrings generously donated by Visibility in Portland, ME.

Comparing the retention rates between the pre- and post-incentive program dates, retention increased from 55% without the incentive program to 78%  during the period the incentive program was implemented. When broken down by program, outpatient counseling showed a bigger jump in retention from 33% to 71%, while IOP retention rates rose from73% to 82%.

Research has shown that such contingency management can be effective in increasing attendance in treatment, client retention and a reduction in substance use. Due to the positive results in its own test, Crossroads for Women is looking to continue such a program in the future.

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Early Prenatal Care and Substance Abuse Treatment Key for Pregnant Addicted Women

July 11, 2008

Everyone knows that women shouldn’t smoke, drink alcohol or use drugs while pregnant. For some women, though, these things are harder to give up than you’d think, even when they know there’s a human being developing inside their tummy. A recent study reports good news about pregnant women who also struggle with addiction.

The study involved 49,000 pregnant women in Kaiser Permanente’s prenatal care program. Reasearchers looked at the use of multiple substances among this population including cigarettes, alcohol, marijuana, methamphetamines, cocaine and heroin. Of the population, 2,073 women were enrolled in Kaiser Permanente’s prenatal substance abuse treatment program called Early Start.

The study’s findings showed that the outcomes for addicted women who received substance abuse treatment in conjunction with prenatal care were very similar to those women who did not use such substances. These positive outcomes were shown for mom and baby. The risk of complications normally attributed to substance use in pregnancy, such as low birth weight, preterm labor or delivery and stillbirth, were virtually the same in the non-addicted women and the women in the substance abuse treatment program.

This research shows that with early prenatal care and substance abuse treatment, pregnant women can have the same results as a women who doesn’t smoke, drink or use drugs in pregnancy. It also shows that addicted women who become pregnant need to reach out for help as soon as they find out about their pregnancy. While not many doctors offices have a program that includes both prenatal care and substance abuse treatment, many treatment agencies, like Crossroads for Women, will work in conjunction with a pregnant woman’s doctor, to ensure the healthiest pregnancy possible.

Read more

From WebMD: Kick Addictions for a Healthy Pregnancy

From Newswise: Treatment for Cigarette, Alcohol & Drug Use During Pregnancy Dramatically Improves Outcomes for Mom and Baby

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