
Capstone’s program breaks down into three phases, each comprised of therapeutic goals that build on one another. As a resident makes progress through the program they must complete one phase before moving on to the next one. A resident will remain in a phase of the program until completes its objectives. Progressing from phase to phase is based on a set of behaviors and expectations that relate to each resident’s ownership of the treatment experience. Residents need to make progress in their therapy, behavior, attitude, and ownership.
We do not expect an overnight behavior change, it is a slow process. One former resident called Capstone a “crock pot”, a very good metaphor for pace of change expected. There are specific expectations and objectives that need to be met to progress from phase to phase however; lasting change occurs slowly and in increments that often are three steps forward followed by two backwards. We look for net gain over time and allow for each individual resident’s pace of growth and difficulty of struggle.
The staff evaluates the progress each resident and/or family in order for them to move on to the next phase. Each distinct phase is detailed below as well as specific general goals that need to be met in order to progress (additional specific goals may also be set for each individual resident within any phase when deemed productive). At any point if a resident is not ready to move to the next phase, or is in a trend moving in a negative direction, the resident and family would be clearly informed. Residents will know if their “trend” of behavior is moving in the direction of not completing a phase and they will be given ample opportunity to turn the trend around.
OUTDOOR ADVENTURES:
This part of the treatment process overlaps with all other treatment phases but, becomes more specified and intense following family week.
“Displacement Therapy” refers to the process of our residents (1) discontinuing drug culture activities, (2) which produces an internal vacuum or emptiness in the absence of drugs, sex, etc., and (3) learning the how to do and enjoy God-blessed activities and relationships, then deliberately filling the vacuum before the old life sneaks back in. This is critical in their recovery process.
Our strategy for developing interest and competency in activities that can be utilized to fill this void permeates much of what we do while they are in treatment. These activities include canine therapy, relationship building, board games, workday skill development, the weight workout, etc. These specific activities are utilized in an effort to help residents develop passions in which they are skilled that can replace their old life behaviors.
The highlighted categories of Displacement Therapy are called Outdoor Adventures which include (1) rock climbing/rappelling, (2) caving, (3) canoeing/kayaking, (4) fishing, and (5) hiking/camping. We spend most of our time in Displacement Therapy working on and teaching these activities. It is our goal to not only for residents to participate in these activities but also for them to learn how to do them on their own and to be competent in doing so. This increases the odds that residents will take these pursuits home with them and switch them out with the drug culture activities. Each Friday throughout their treatment process, they will be engaging in one of these activities. Following family week, they will have an entire week of what we call “Adventure Intensive Week”. The goal of this week is to enable the resident and their cluster to have a week focused on building skills in these and other potential areas within a small group. This week will be more involved in the teaching and training in these areas in an effort to help build interest in activities that a resident can take home with them.
PHASE I
The goal of this phase is to discover the core problems that need to be addressed for each resident and family and to begin formulating and implementing a therapeutic game plan in order to address all of these core issues. These are the specific goals that must be accomplished to move from Phase I to Phase II:
a. Development of treatment plans and treatment goals
b. Finish detoxing and getting their head cleared so they can begin to think and feel
c. Presentation of all core concepts and begin applying them to self and family
d. Naming of arrows and core issues related to self and family
e. Begin developing a trust relationship with their Personal Therapist
f. Working relationship with staff
g. Complying with and understanding program rules and guidelines
h. Understanding of why they were admitted to the treatment program and beginning of taking responsibility for past and current actions
i. Resident growing in his ability to name and discuss issues with therapist as well as increased ability to communicate and identify real issues
j. Understanding the phases of treatment and complying with program guidelines in the three areas of readiness to move on the next phase
k. Bonding with puppy and taking ownership for care and training of puppy
l. Beginning of understanding about addictive patterns and issues
Length: This phase begins at admission and transitions to Phase Two during the course of Family Week.
Description: During this phase, the individual therapist and the therapy staff work together with the resident and his family to begin discovering the core problems that must be resolved to win the battle against alcohol/drugs and its subculture, as well as the co-occurring issues. The resident is introduced to specifics about the program and expectations while in treatment. Below is a breakdown of the therapy that each resident and family receive while in the treatment program at Capstone:
1. The resident receives a minimum of 4 hours of individual therapy each week. The Capstone Core Concepts are taught to the resident during this phase. The Core Concepts introduce the residents to the therapy model utilized at Capstone and direct the work done in individual therapy sessions.
2. The resident participates in 12- 15 hours of group therapy per week.
3. The parents receive a minimum of one (one hour) phone family therapy session per week (unless a face to face session is possible). During Family Week the families will receive over 35-40 hours of family therapy. The total number of family hours during the treatment process is over 60.
4. Each day the resident will spend 1.5 to 2 hours with their puppies. At least an hour of that time is spent in Canine Therapy or “puppy time” in which the resident trains, plays, and connects with their puppies. The residents have a time in the morning and in the late afternoon where they care for their puppies’ needs for food, water, health, and a clean kennel.
5. Three days per week, residents workout on weights and cardio exercises for 1.5 hours.
6. Two days per week are adventure therapy days. One day on the ropes course focusing on therapeutic goals and one day off campus participating in Outdoor Adventure activities as a part of Displacement Therapy. The time on the ropes course is designed to help residents learn to problem solve, work together as a team, communicate, set and achieve goals, and learn to handle stress and discomfort in new more productive ways. Our goal in teaching the residents to fish, rock climb, cave, train their dogs, etc. is to help them find new hobbies and interests that they can enjoy after treatment.
PHASE II
The goal of this phase is to focus on the process of therapeutic healing on the issues already discovered. If other issues emerge they are added to the therapy treatment plan. This phase overlaps with Phase I during Family Week as well as Adventure Intensive Week and Relapse Prevention. These are the main goals that must be achieved in order to move on to Phase III:
a. Participation in Family Week and all of its components
b. Willingness to take ownership of resolving past hurts- both those done to him and those he’s done to others
c. Main therapy issues are on the table for the resident and family
d. A game plan is being developed for dealing with each specific issue and the resident has a deeper understanding of how these issues have influenced his life and his addiction
e. Compliant with staff and program guidelines
f. Participation in weight work out and being physically ready to begin more intensive outdoor adventures and relapse prevention
g. Willingness to productively be confronted and to confront others in the group when needed
h. Taking good care of puppy and completing training requirements
i. Consistent behavior when with the day staff as well as the night staff
j. Understand the underlying issues related to their involvement in the drug culture
k. Process family week and discuss related issues at a deeper level
l. Willingness to ask for help
m. Development of a working relationship with other residents and with their cluster
n. Developing new patterns of behavior
o. Follow all safety and general guidelines set by staff
p. Participate in solo, complete all solo work, and follow all solo rules
q. Initiate conversations with staff and residents
r. Have a deep understanding of what brought them to treatment and the drug culture and what it will take to get out
s. Be open to spiritual conversations and what role a relationship with God may play in their lives
t. Willingness to confront self and group members when needed
u. Ownership of actions
Length: From Family Week to the completion of Adventure Intensive Week. Description: This phase begins during Family Week and ends when the resident completes his Adventure Intensive Week. The therapist, resident and family begin to put together the “puzzle pieces” that help to understand and discover the core issues related to substance abuse and addiction. Core issues are discussed and a game plan formulated to deal with each particular issue.
A. Family Week: Family Week is the transition point to the core therapy phase and is the most significant week of the program. Parents come to Searcy, Arkansas, stay in a hotel and participate in over 35-40 hours of individual family therapy and multi family therapy Monday through Friday beginning at 8:00 am and ending at around 5:00 (or until finished) each evening.
1. Monday, all of the Capstone Core Concepts that the residents have been learning are presented to the parents.
2. Tuesday, Wednesday, and Thursday morning the parents have a parent only session from 8:00 a.m. until 9:00 a.m.
3. Tuesday morning the sons and the parents join together for a very important multi family therapy session.
4. Tuesday afternoon, Wednesday, and Thursday consist of individual family therapy beginning with the parents only and then adding the son to the sessions.
5. Friday begins with a multi family session and concludes with a parent only “Game Planning” session on Friday afternoon. Game Planning begins the preparation to leave Capstone after graduation with a plan and a confidence. It also consists of continuing to work on core therapy issues as well as making decisions about the future and work on the behavioral contract and overall game plan.
B. Processing Family Week and preparation for Adventure Intensives and Relapse Prevention:
1. Processing Family Week: this is the second week in the core therapy phase and includes processing Family Week and the continuation of therapy related to the core issues named prior to and during family week.
2. Preparing for final phases of program: following Family Week residents begin to transition into Relapse Prevention. Core therapy continues in their group, family, and individual sessions. If residents complete Phase II they may begin Phase III. During this time residents also will be participating in more focused adventure activities where they will be given more responsibility and ownership. The group is expected to be transparent and willing to confront if necessary and each resident is expected to be able to look at themselves in the mirror and assess where they are at in their treatment process and in their life. Each resident is expected to gain confidence through leadership and wilderness opportunities as well as to find ways in which they can help their group.
3. Solo - During this phase residents will also participate in solo experience at Capstone. The purpose of the solo experience is for residents to reflect on their time in treatment, prepare for relapse prevention and graduation, and to learn to handle time alone.
a. A base camp is set up for staff like the hub of a wagon wheel. Residents’ individual campsites are set up about 50 yards away in the formation of the spokes on the wagon wheel where the solo staff can see the residents at all times.
b. Each resident has his 50ft. x 50ft. area to stay in, his tent and equipment, his food supply for three days, and his Solo work.
c. Each resident’s therapist prepares three days of Solo therapy work. The Solo work is checked before a resident returns from solo.
PHASE III
One goal of this phase is for the resident and his cluster get prepared to graduate and make a successful transition into life outside of the protection of Capstone. During this phase, residents focus on their addiction/compulsive chemical abuse and the development of their Weekly Game Plan Booklet. This booklet is basically their personal success strategy. The booklet includes their inclusive relapse prevention plan.
Phase III for parents is so they can work on the Two-Year Finish Strong Game Plan. This vital document is a specific plan for the two years post discharge; it has an offensive strategy and a defensive strategy. The defensive strategy includes a behavioral contract with a tiered system of consequences, aimed at equipping the graduate to take full responsibility for his life, and a very tight drug screening protocol. The offensive strategy focuses on the continued building of relationships, especially within the family. Another vital objective of this phase is called “Big Logistical Decisions” which targets the environment to which the graduate will return. Our rule-of-thumb is that, if the environment were an Olympic bar in the weight room used for the bench press, it must not be too heavy for the graduate to lift.
These are the goals that must be accomplished in order to graduate from the Capstone program:
a. Processing of Relapse Prevention work
b. Compliant with Capstone program guidelines
c. Continued effort in treatment- a “continue to grow” mentality
d. Willingness to comply with behavioral contract and aftercare expectations
e. An awareness of what has to be different in their lives in order to maintain a life change
f. Completion of relapse prevention groups
g. Identification of main triggers and a strategy to deal with each
h. Identification of main anchors and ways to feed the good dog in his heart
i. Ownership of actions
j. Displaying maturity within the group setting and with other residents
k. Increased willingness to look at self in the mirror
l. Taking more ownership in groups for the direction of the session as well as other activities outside of therapy
m. Complete the personal Weekly Game Plan Booklet
n. Completion of Family Retreat
These are the main relapse prevention goals that must be accomplished in order to graduate from the program:
i. Participate in all Relapse Prevention groups
ii. Have a deep understanding of the daily Relapse Prevention Plan and the Escape Plan
iii. Knowledge of displacement and a daily plan for ways to displace the drug culture
iv. Understanding and acceptance of addiction, triggers, cross-addiction, cross-tolerance, etc.
v. Develop an emergency card call list
vi. Ownership of their addition and future recovery
vii. Process the contract and game plan
Length: The completion of Adventure Intensives Week until graduation Description: This phase focuses on relapse prevention and addiction recovery. The resident participates in intense relapse prevention groups designed to increase their knowledge of addiction and their range of coping skills. Residents will complete a comprehensive personal game plan book in which they discuss daily strategies to remain sober and live a life that is healthy, fruitful, and fulfilled. The residents will process through their behavioral contract with their therapist during this phase as well as participating in Relapse Prevention groups. These groups are designed to help prepare residents to face the challenge of being out of treatment. The final week begins with the family retreat. This occurs on the Monday and Tuesday prior to graduation. Parents work with the therapists and other parents to role play and trouble shoot the contract, game plan and problems that may arise as the son returns home. This phase is completed on graduation day which occurs Tuesday afternoon.
Family Retreat
Parents return to Capstone for all day Monday and Tuesday practice for the game plan, including contract implementation. Time is spent in multi-family groups with other parents and in individual family sessions with the primary therapist. Capstone assures parents that they when they graduate they will be leaving with a Game Plan that works to Finish Strong. On Tuesday afternoon, following the completion of Family Retreat, a graduation ceremony is held.
Graduation: A ceremony to honor the resident and the parents for completion of the program.
a. Therapists, staff, parents, family, and residents convey their thoughts and feelings to each other.
b. The individual therapist makes some presentations to their residents.
c. Graduates write their names on the wall.
d. Goodbyes are said and the family gets the resident’s puppy and departs for home to begin the Two Year Finish Strong Game Plan.
PHASE IV
The goal of this phase of treatment is to complete therapy goals and practice the game plan until it becomes a basic lifestyle change that allows both the graduate and the family to live lives that are healthy, fruitful, and fulfilled. During the first part of this phase, Capstone assists the graduate and their family in the transition home in anchoring the family to the Game Plan. Working the Game Plan, which includes the contract, for two years, is the landmark to work towards. It is at this place where the Titanic turn in the graduate’s life direction has gone 180 degrees from where it started at admission to Capstone.
The specific goals within this phase are:
a. Adhering to the contract and game plan
b. Calling and asking for help when needed
c. Commitment to the 12 T’s
d. Tortoise on a triathlon mentality (slow and steady)
e. Phases of game plan
f. Utilizing relapse prevention strategies as outlined in personal game plan book
g. Solidifying a support network
h. Continuing to grow in being their true selves and in understanding of their purpose
i. Weekly 50 minute phone sessions with the resident’s Personal Therapist for 3 months after graduation
j. Two Family Reunions within the first year following graduation – therapy with Personal Therapist
k. One-day Family Intensive back at Capstone during the 4th month post discharge
l. Relapse Prevention Tune Up at Capstone for resident and his graduating cluster during the 4th month post discharge in back-to-back days with the Family Intensive
m. Monthly emails check ins by the Personal Therapist for two years
n. One year comprehensive drug test kit which includes supplies for twice weekly urinalysis, alcohol breathalyzers, and adulteration testing. Included in the kit is a stamped self addressed result card to be sent to Capstone every two weeks.
Length: 2 years post graduation Description: This is the phase following treatment. It is a two year phase that includes following the behavioral contract and game plan. The phase includes the Aftercare Program which Capstone provides at no cost (see Aftercare Program link).