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First Step House Philosophy
Specific Treatment Modalities and Approaches
Combining Qualified Counselors with Effective Therapy: First Step House (FSH) treatment
strategy combines the talents of highly skilled, professional counselors using Rational Emotive Behavioral Therapy (REBT) with other proven
therapy techniques to assist clients' recovery from substance dependence and abuse. Therapeutic modalities include group therapy, individual
counseling and psycho-education.
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Developing Therapeutic Rapport: Treatment strategy places a great emphasis on developing strong
therapeutic rapport between counselors and clients. All FSH clients are assigned a case manager when they enter treatment. Case managers provide
an individualized, problem-focused approach to treatment and integrate treatment as needed with other service professionals and agencies
such as the Salt Lake County Health Department, Valley Mental Health, Vocational Rehab, Fourth Street Clinic, etc. Clients meet with case managers
on a regular weekly basis and as needed for individual therapy. Clients have 24-hour access to clinical and administrative staff for crisis
management, consultation and problem solving. Rapport is based on respect for the client as an individual and on FSH's strong belief in each
client's potential to change and grow.
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The FSH community is a therapeutic agent that introduces and
enforces appropriate social values and behaviors into the everyday life of its clients. Staff members are chosen not only for their professional
skill, but also for their ability to serve as positive role models for all clients. Behavioral reinforcement in the form of explicitly stated house
rules, responsibilities and sanctions serve to shape client behavior. Clients attend a weekly community enhancement group in which problems
within the FSH community are discussed and problem-solving strategies are utilized.
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Developing Feelings of Support: FSH strategy seeks to instill within each client a feeling of
strong support within the services as well as in the clinical sector of each client's residential experience. Great emphasis is placed on such
support-related items as food quality, the upkeep of facilities, grounds and equipment and on the respectful treatment of all clients.
Once each week, First step conducts a general house meeting for all clients to provide updates on current activities, to discuss current issues and to give awards for individual acts of service or other client accomplishments. These house meetings also give clients, as a group, the opportunity to discuss their concerns with First Step House directors.
FSH maintains an open door policy that permits each client easy access to both clinical and administrative staff.
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Maintaining Abstinence: The FSH treatment program is an alcohol/drug-free program. Breath analysis
and urine testing is conducted on site both randomly and for cause to insure abstinence is maintained.
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Education and Employment: FSH strategy emphasizes education and/or employment as key factors in
the recovery process. The Department of Vocational Rehabilitation provides a counselor to extend vocational rehabilitation services to FSH clients.
Many otherwise unemployed, uneducated clients find employment and/or re-enter schooling as a result of this service. Horizonte Instructional
Training Center provides GED education and testing for those not having completed their high school graduation requirements. All clients
who enter FSH are expected to have part time employment within two weeks of entry and are provided free newspapers and telephone use for
that purpose.
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Motivational Enhancement and Motivational Interviewing: It is not unusual for a client to feel
resistant or ambivalent towards changing their lifestyle. FSH strongly believes in each client's potential to change and grow. Motivational
Interviewing is a counseling technique that helps people clarify and resolve mixed feelings about changing a habit or behavior so they can
successfully make a desired change. The role of the counselor is to guide the client through self-exploration and to increase awareness of current
behaviors including consequences and the impact of these behaviors on personal goals. In addition, the counselor facilitates discussion
of steps needed for successful goal achievement. Some of the main strategies used to enhance motivation include:
- Reflective listening
- Affirming and acknowledging the person's viewpoints and struggles
- Developing discrepancy between current behavior and personal goals
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Summarizing what the person is saying and eliciting "change talk" that indicates the person is considering and hopeful about the possibility
of making change
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Relapse Prevention: FSH realizes the importance of relapse prevention. Relapse prevention and
related issues are addressed throughout the duration of treatment. The Life Skills program helps clients become aware of the relapse process.
Clients are taught to recognize relapse triggers that may relate to changes in behavior, attitudes, feelings thoughts or a combination.
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Assumption of Personal Responsibility: FSH treatment intervention, philosophies, and
environment focus on helping the clients learn to assume personal responsibility. Clients are given the opportunity to make choices and reap
consequences not only in the residential community but also in groups, classes, work, and their non-program activities.
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