Recovery Center Experience

I completed my internship at Just Believe Recovery Center in Jensen Beach. JBRC has been open for approximately two years. They offer men’s, women’s, and outpatient programs. The men’s and women’s PHP(in patient) program is an average of 30-45 days. The Intensive outpatient program is an average of three to six months. It is a Florida model program, with separate residences for the men, women, and a coed outpatient residence. JBRC also offer halfway houses for clients once they complete outpatient treatment. My experience with the procedure and policy at JBRC has revealed to me a very big hearted program. For example, once a client’s insurance drops to an outpatient billing rate they are still allowed to complete PHP level of treatment before
going to transitional living and treatment. The staff is very caring and professional. I feel very blessed to now be a part of this exceptional team.
I was supervised by Pamela Stierwalt, Clinical Director of JBRC’s men’s program and an adjunct teacher for the Human Services program at IRSC.
My experience with this company has been very fulfilling and educational. A normal day in treatment for the clients I worked with was as follows: Wake up at 7:00am, medication, breakfast, showers, and chores. Then at 8:00am they have a goals/ meditation group to prepare for the day. 9:00am Clients drive to the center for treatment. 9:30am clients have study time until first group begins. 10:00am -12:00pm Clients attend various groups, while therapists meet with individual clients for one on one sessions. Lunch is from 12:00pm-1:00pm. After lunch clients attend caseload group for two hours, which is where each therapist meets with all of their clients for a group session. Clients discuss and process individual treatment plan work such as sharing their life story, reading impact letters from family members, and “negative consequences of my addiction” assignment just to name a few. After caseload, clients drive back to the residence where they are offered the option to go to the gym, watch TV, or rest before dinner. Dinner is served at 5:00pm, after dinner chores are done and clients prepare for a trip to an outside AA/NA meeting. After returning from meeting clients have phone time, medication, and free time till bedtime which is at 11:00pm during the week. There is nothing I would change about this program. Although, I am sure that the
more knowledge I acquire things will be revealed to me, because nothing is perfect.
My clinical skill set has grown. I am very confident in my ability to effectively facilitate group therapy. Through this internship I have become comfortable with facilitating groups. When I began I experienced a lot of anxiety about the public speaking aspect. The biggest thing I believe that helped me progress was the improvement of my clinical skill set. Through practice and application I can now come up with open ended questions on the spot. When I began this journey I had a fear of not having anything to say. I would try to prepare a very structured plan and include a worksheet. I have found out through my training and experience thus far, that many times the plan is good, but the clients take it where it needs to go, and I just need to facilitate to ensure that the discussion stays on an effective therapeutic path. The thing I have run into the most is the telling of war stories. When this occurs I encourage the client to only express the feelings that these behaviors and situations cause them to experience. The population is fluctuating on a regular basis and this results in many different stages of recovery participating in the same groups. It has been my experience that this is sometimes a positive because the clients who are further along in their recovery can and usually are very encouraging and share their path which can help someone else. On the other hand, it can be a challenge because of the different levels of denial, acceptance, and willingness. I am very fortunate to work in a voluntary program so there is little resistance.
My first learning objective is to run two groups a week.
The first one is a recovery themed group. I facilitate a discussion on early recovery in a 12-step program. We discuss and process subjects such as, the first three steps and any breakthroughs or barriers, the importance of finding a compatible sponsor, the qualities of an effective sponsor, and breakthroughs and struggles in finding a higher power. The second group I facilitate is relapse prevention. Our program is set up on a six week schedule. For example on week three of the rotation, I ask clients to write a list, to give to their support network of close friends and family, of the possible signs of relapse that may not be apparent to them, but can possibly be identified by their outside support network. I also ask clients to make 911 cards, these are three by five index cards that clients write relapse triggers on one side and coping skills on the other. Clients then can keep them handy by placing them in their wallets, glove boxes, or pockets in early recovery and beyond. Week five I present the idea of boredom in early recovery and discuss and process positive and healthy ways to counteract. I also bring to discussion planning for situations of any sort that may come up such as, vacations, family gatherings, and concerts at which the client might have used in the past, but would like to attend in their new found
sobriety.
My second learning objective was to complete biopsychosocial interviews. This was one of my favorite tasks because this is when you get to know the client. At first just like in the group setting I was nervous, but after shadowing a few interviews and then completing a few on my own I became very comfortable. The more interviews I completed the more I found my clinical skills improving. For instance, finding the right opened ended questions to get the client to open up. When I would ask them to describe their childhood and adolescence I would get a lot of “goods and normals”. I learned that instead I would say “describe to me dinner time” or “did you go on family vacations” and so on. I found that as my skills grew it became very natural and automatic to ask open ended and information gathering questions. I felt intimidated at first doing the summary and clinical impression. The more I completed the more I felt comfortable. One of our therapists on staff gave me an outline that was a great help. I was consistently asking for feedback which I feel helped me tremendously. When I first began doing the interview it would take me a good hour and a half to two hours to complete, and another two hours to finish the summaries and impressions. By the time I finished my internship hours I could finish an interview and complete charting in two hours.
I also had the chance while interning to shadow some of the utilization review team at JBRC. It was very interesting to me to see how the insurance approval process works. It is my understanding that there is a pre approval for admittance into the program. Then insurance company will approve between 3-7 days at a time. The job of utilization review is to call back the insurance representative to prove that the client requires more treatment. This is how I learned that the company has a heart and is not just about a profit. If the client is not approved at the PHP(in patient) rate they are dropped to an IOP (intensive out patient) rate, but they stay in PHP treatment until it is determined that they are ready for the IOP phase of treatment. It was interesting and I believe I benefited in learning some of this aspect of treatment providing, but I am more than happy to stay on the clinical side of things.
JBRC offers all of its employee’s access to My Learning Pointe an online education tool that offers many different courses. As an intern I was assigned approximately 25 clinical and ethical courses to complete. Some of the courses I completed were as follows: Addiction counselor ethics, Psychiatric medications, Anger management, DSM5: Overview of changes, Dialectical behavioral therapy, Motivational interviewing, and so on. I am able to use the completed courses to obtain my certification in addiction counseling from the Florida Board of Certification. Also these course certifications can be used for CEU’s once I received my certification.
EMDR (Eye Movement Desensitization and Reprocessing) therapy is also offered in this program. This therapy is used to treat PTSD and trauma. I have interviewed numerous clients that have been through this therapy and they have all reported an overwhelmingly positive response. Although they report that it is very emotionally draining, every client reports it is effective. I am looking into the training required to obtain certification to treat with this therapy. This internship has definitely solidified that I have chosen the correct path in my career pursuit. I am very happy and blessed every day that I get to wake up and go to work to help the sick and suffering. I myself am a recovering addict and obtaining my education and now working in the field I feel has definitely given me so much insight and furthered my healing faster than if I had not chosen this path. I am also aware that my recovery is just that my recovery and that everyone’s looks different. It is very important to me to develop the clinical skills so that I may be able to “teach a person to fish instead of just giving them a fish”. I am so excited to continue my education in this field. I look forward to learning more specifically about all of the different theories and practices so that I may develop my eclectic therapeutic approach. It is my passion to take the knowledge and skills I learn and obtain to help as many of the afflicted as possible. I believe that anything is attainable if you believe.