Dual Diagnosis Task Force

Serving the Needs of People with Dual Disorders

Joseph A. Rogers, President and CEO, Mental Health Association of Southeastern Pennsylvania Jeanie Whitecraft, Program Director, The Friends Connection

The Friends Connection is a peer support and counseling program for people with mental illnesses and substance abuse disorders. On the theory that individuals with mental illnesses become involved with illicit drugs and alcohol out of a sense of loneliness, boredom and stigmatization, the Friends Connection counteracts these negative factors by providing friendship, counseling, social support and meaningful leisure activities. The program’s philosophy is that recovery will begin once individuals experience hopefulness and support.The Friends Connection (TFC), a program of the Mental Health Association of Southeastern Pennsylvania, was designed in 1989 in conjunction with the closing of Philadelphia State Hospital, when the dollars followed the patients into the community to provide them with community-based services and supports. Little was known at that time about how to treat individuals with both mental illnesses and substance abuse problems. Very few drug-and-alcohol rehabilitation programs dealt with this issue, and nothing was available for people who resisted involvement in traditional treatment approaches. The Friends Connection was developed to help bridge these gaps.The original Friends Connection was in Philadelphia. In January 2001, the project expanded into Montgomery County, Penn. At the same time, TFC is about to embark on the final year of a four-year study, funded by the Center for Mental Health Services of the Substance Abuse and Mental Health Services Administration, to determine the effectiveness of consumer-operated service programs.There is already much evidence to back up the program’s effectiveness. For example, after Friends Connection’s first year of operation, empirical evidence showed a substantial decrease in hospitalizations for individuals receiving services from the program. Assessments continue to indicate that individuals experience longer and longer periods of sobriety. Most are in recovery, and some have achieved total abstinence. All individuals have expanded their social networks, as well as their leisure interests and skills. A great deal of the program’s success is based on its ability to stay with a person for the length of time it takes to ensure recovery.TFC hires staff who are in recovery and matches them with clients who are still embroiled in their addiction. Acting as positive role models who know both the ravages of substance abuse and the serenity of recovery, the staff, respectively, befriend their assigned consumers and engage them in clean and sober fun. The staff talk candidly about their own lives and struggles, and encourage the consumers to do the same. The peer counselors are not just healthy role models; they are paid staff who offer reliability, consistency, and accessibility to a client population where establishing trust can be a long and arduous process. Once the relationship is established, the “friends” attend 12-step meetings as well as leisure activities together. The program also provides supports for people who are looking for housing or work.The Friends Connection is a program without walls. It supplies support when life is at its most tempting and its highest risk for using drugs or alcohol. The staff show the clients that life can be better without the negative support of chemical dependency. The program teaches principles of recovery in action: how to get through drug-infested neighborhoods without stopping at bars, and how to find activities that are clean and sober. It’s a lot easier for someone to stay clean in a protected environment, such as the average 28-day program or seven-day detox, than out there having to deal with all the temptations; the program serves as the angel on the shoulder that whispers the more positive things in people’s ears as they are out there on the streets.Entering into a program of recovery from addiction then becomes a clearly defined and peer-supported objective for the consumer, who is helped along this path by the staff of peer counselors. Peer counselors receive intensive initial and ongoing training and supervision. All time that is spent with a consumer is carefully planned in advance, and documented using approved record-keeping procedures. The Friends Connection philosophy incorporates the multi-disciplinary team approach to Intensive Case Management (ICM), and defines itself as a component of ICM.The program’s approach is one of patience and education. If someone “picks up,” the program does not pass judgment. When clients are not high, staff make an effort to help them identify their need to “use.” Sometimes a consumer is able to identify it, sometimes not. This is when the staff will process with them what they can do for help the next time they get the urge to “use.” This could be anything from going to a 12-step meeting to talking to a friend or staff person or calling their peer counselor.The Friends Connection knows that relapse is part of the recovery process; so whatever challenge the consumer faces, the program keeps coming back and trying a new approach.

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