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Finding an Evidence-based Practice for Heartland House

Guest post by Robert Cook

Heartland house evidence-based practice

Heartland House is a residential treatment program that serves men recovering from substance use disorders and related co-occurring conditions. When we began looking for an evidence-based practice to implement in our program, we found the research was really difficult – there were a lot of options we could choose from.

We spent over a year researching and reviewing the evidence-based practices we found. Ultimately, we selected The Change Companies®Interactive Journaling®, which is truly innovative. We were looking for something that encourages clients to self-correct, is person-centered, engaging, methodical and solution-oriented – focused on self-discovery. The Change Companies® was clearly our answer.

Interactive Journaling® supports clients to get into action by explaining the stages and processes of change. Through self-evaluation in their own words, the clients are the experts. Using the stages of change, the Journals emphasize knowing where you are and lead participants to express their own reasons for change.

The service plan starts with each resident’s unique answer, stressing the importance of getting the most out of treatment through their own goals. The clients share with us from the ground up about their strengths and areas to improve. Ultimately, they create a bond with their change team and hold themselves accountable for the outcome of their change plan.

What we were looking for at Heartland House

All the other evidence-based models we looked at didn’t support such a client-driven model, but The Change Companies® does. We needed something that really matched our program. We are non-timebound, and our clients map their own change plan with the help of their change team. This is strictly person-centered care, meaning any materials we use to supplement our program have to align. The Change Companies® worked closely with us for over a year to help us find what truly fits our program.

How clients work with the Interactive Journals

Interactive Journaling® is an evidence-based practice that really helps clients work with and for themselves. The Journals are set up for the client to develop a clear vision of what actions they need to take toward change. They also help us support clients on their road to recovery and build a change team with them. Their change team could consist of family members, therapists, counselors, doctors or anyone they choose who supports leaving their addictive life.

Interactive Journaling® helps create a foundation of mutual support and encourages participation in the community of like-minded groups. It also integrates seamlessly with everything else we do at Heartland House. Each change team helps create a collective plan with the client to navigate their recovery, and we help them implement their plan and stay accountable. We partner with our clients and develop strategies by examining what has worked for them in the past, what hasn’t and what they might try now to accomplish their goals.  

How employees work with the Interactive Journals

Many of the evidence-based practices we found are cookie-cutter programs. There isn’t any latitude in presentation or the fidelity they want from using the practice. The Change Companies®, however, has parameters for the facilitator to follow but leaves a lot of room for our staff to, essentially, practice their art.

Evidence-based treatment programs

We encourage and support each employee’s passion. It is important to us that our facilitators are also able to work in a person-centered environment. If the clients were focusing on a person-centered recovery program within the confines of strict fidelity to an evidence-based narrative, that would defeat the purpose and freedom of a non-timebound program.

It is imperative that we are good stewards with our limited resources. Individually-tailored services allow us to treat each client uniquely, and Interactive Journaling® supports our philosophy.  

What this might look like is, facilitators may choose to break their groups into triads, lead experiential games or create individualized assignments. They may also bring their own skills and experience into their groups based on what has worked in the past – and the unique needs of the men in their groups.

By using Interactive Journals, we really do support the freedom of our counselors. They can bring their passions and individual abilities to make necessary changes and support productive, meaningful lifestyles for the residents. Surprisingly, we are attracting licensed professionals to volunteer here because of this.

How the Interactive Journals work uniquely with Heartland House’s program

Since Heartland House is a non-timebound program, a client’s length of time for treatment isn’t set at 28 days, or 90 days or six months, but for the time that is needed to create and test their change plan (in testing, we identify areas in need of strengthening prior to transitioning to a lower level of care). The Interactive Journals allow our self-paced program and review to continue on an ongoing basis. Instead of having a set program, with certain tasks to be checked off at one week, two weeks, 28 days and so forth, our clients have the opportunity to set their own goals and adjust them as need be.

How Interactive Journals have impacted our outcomes

We are very transparent about measuring our outcomes. In fiscal year 2018/19, 68% of all program attendees successfully transitioned to a lower level of care – home with outpatient services and/or mutual support, or a supportive living environment (Sober Living) with outpatient and/or mutual support. Another advantage to using The Change Companies®’ products is that when the population of clients shifts, we can shift with them by bringing in different Journals that meet the needs of the group.

Our residents have responded very well to Interactive Journaling®, which is evidenced by our outcomes. The Change Companies® has been an enormously positive addition to the Heartland House program, and we are sure the relationship will continue into the future. The measured outcomes of our clients are evidence enough that these products are helping change lives, one man at a time.