BRIDGES INC.
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What do the suns mean?

Each program focuses on orientation and safety, recovery, and community integration within the social rehabilitation framework, and within a length of stay appropriate for that program. 
  • Each phase encourages restoration or establishment of essential psychosocial development necessary for an increased level of independence. 
  • Each phase offers opportunities for clients to develop expand or enhance their wellness and ability to manage their independence.   
  • Clients will develop and progress through phases at their own pace, within the time constraints of their individual program and determined length of stay.

Because each client is uniquely challenged and treatment is client driven, each client will experience treatment through one, two, or all three phases
  • Program staff is trained to assess where the client is and promote client’s self determination toward recovery and independence.
  • The program phases allow clients to experience gradual development of self and achievement, through defined treatment goals and specific activity, outcome expectations, and movement/progress through the program.  
  • Phases assist the staff in approaching treatment and evaluating clients’ individual progress to determine and inform discharge planning.

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Phase I:
Orientation and Safety

Phase I emphasizes safety (security, shelter, protection) and orientation (knowledge of where they are, who they are living with, the routine of their new environment and of their agreement with cooperative transitional living).  There are many adjustments to living in a treatment community many of which take time to understand.  Promoting safety in a therapeutic community starts with individuals feeling safe and practicing respect of one another (including staff).  Phase I includes making a connection to treatment and being in attendance.  The program will encourage the client to develop a sense of safety (in their new room, with a roommate, in the therapeutic community and with staff).  Program staff works to establish and build rapport, lending to treatment retention and achievement. 

Phase I ensures a comprehensive needs and services plan is developed, specifically addressing:

  • Basic needs are met (food, clothing, shelter)
  • Any history of self harming behaviors and the immediate development of a safety plan
In this phase activities, treatment, and planning may address any one or more of the following:

  • Compatibility with the program and his/her living environment (ensuring a level of comfort in the bedroom, with roommate, and other)
  • Personal needs can be met
  • Communication – staff and client/teaching communication in order to ensure that you are heard and respected
  • Establishment of a routine and structure – Introduction to structure and the new environment
  • Mutual respect
  • Comprehensive medication evaluation and ongoing review of effectiveness-
  • Introduction to daily living skills development
  • Working together to support self involvement
  • Awareness of the community – the milieu and the external community environment
  • Motivation
  • Coordinated treatment planning
  • Introductory to the treatment team
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Phase II:
Recovery

During this phase of treatment, the client has already demonstrated feeling safe in the therapeutic community and has developed (or is beginning to develop) a sense of trust in others as it relates to the treatment plan.  The client is engaged and participating in the program and has identified areas for continued stabilization and recovery.  It is at this phase that the client will begin to develop or restore trust in self and/or others and in the process of recovery.  Phase II will encourage social skill development, daily living skill, rehabilitation and overall functioning through a more challenging approach.  Groups are designed to encourage more interaction, including some which may be client driven and support a positive peer culture.  Client participation in the peer culture is self motivated and encouraged; support groups such as 12 step education and meetings are integrated into the program.

Phase II examines the treatment plans and specifically addresses:

  • Any changes in identified need and/or goals
  • Progress and/or lack of progress in treatment 
  • Any current self harming behaviors and /or relapse prevention 

In this phase activities, treatment, and planning may address any one or more of the following:
  • Medical stabilization including ongoing medication evaluation and management (utilizing external resources), reviewing preventative wellness, stabilizing medical/physical health issues
  • Psychiatric stabilization including:
  • symptom management- gaining the ability to manage symptoms, while maintaining housing and socialization in the community (i.e. knowing when he/she is delusional, having a plan for reducing anxiety, identifying triggers and knowing how to avoid them, understanding his/her own diagnosis and medication
  • therapy/other mental health services (may be provided by outside practitioners)
  • Increased degree of socialization
  • Reduce isolation 
  • Increase coping skills and problem solving- more appropriate communication/less fighting
  • Increased ability to communicate own needs and ask for help
  • Manage emotions
  • Increased degree of sobriety/some “clean time”
  • Have a plan to manage sobriety and/or relapse prevention plan
  • Increased coping skills
  • Know triggers/change routine to detach from triggers
  • Continue development of daily living skills
  • Case management and resource development and linkage
  • Introduction to WRAP (Wellness Recovery Action Plan)

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Phase III:
Discharge Planning

In phase III, the client’s participation in the therapeutic community is significant and consistent.  The client’s positive experience of community is encouraged by staff.  Strong alliances in the therapeutic community increase self esteem and support the client as they make their way towards self sufficiency.  The client is very active in treatment and discharge planning. 

Clients in phase III show an ability to understand and begin to develop their own Wellness Recovery Action Plan.  They demonstrate a desire to practice independence in the larger community and are encouraged by on-going support.   Clients are supported in developing an exit plan, helping the process of transition from residential treatment to independent living. 

In this phase activities, treatment, and planning may address any one or more of the following:

  • The practice of learned independent living skills such as taking public transportation, accessing community support, vocational, educational and/or social opportunities and managing self care (including the ability to take care of his/her own living space)
  • The client and client partners’ work to develop the best matched discharge plan possible based on the client’s abilities and expressed desires.  Discharge planning includes ongoing treatment planning and inclusion of client partners and other collaterals
  • Significant Case management- Individualized rehabilitation treatment plans that may include education/vocational/employment or other activity and safe, affordable housing 
  • Building of healthy support system
  • Family, friends, 12 – step sponsor, therapist, other
  • Self Advocacy and communication 
  • More medication independence (including understanding of the importance of steady self administration, responsibility, and communicating with the doctor
  • Making appointments for self, with staff assistance as needed 
  • Development of WRAP and particularly a “crisis plan”

Clients in each phase may participate in regular evaluations and will participate in case review/case conferences.  A coordinated treatment plan continues to play a significant role in guiding treatment and will be augmented as needed with the client and client partners.   Client partners are always encouraged to participate and are invited to the team meetings and/or case conferences. 

Successful matriculation of phases will be highlighted in community meetings as part of the therapeutic peer culture which is dedicated to promoting wellness and independence.

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