Trilby Hoover, Executive Director of Sheepgate Services Aftercare Support writes about Monitoring Services

Posted on January 8, 2008

Monitoring a Healthcare Partnership for lasting Results

Successful change in people who overcome addiction is the outworking of some of the key internal conditions resulting in different outward actions.  The internal conditions are honesty, open mindedness and willingness. A major focus of primary treatment is to stimulate these intangible conditions and strengthen their role in the clients’ decision making process again. Monitoring services take the skills that were established (and successful) in primary treatment and transfer them into a plan for daily, weekly and monthly activities (within the “real life” process of transition- returning to everyday life).

We all know that “everyday life” is tricky to negotiate once addiction has developed. Everyday life…it’s just, well, it’s so daily! The role of monitoring is to develop the accountability plan for abstinence and sober-living skills through a time limited relationship with ongoing monitoring of tangible key indicators for success.

In the monitoring structure, monitoring professionals are available to clients as a resource but are not providing ongoing coaching or case management. The role is one of providing the structure and documentation for monitoring an aftercare plan (with timely communication of indicators consistent with relapse process). In many cases, monitoring professionals are working in partnership with mentoring or transitional care professionals. Monitoring professionals also work directly with stakeholders, primary care providers and other professional case managers implementing treatment recommendations and communicating outcomes systematically. From our perspective, the case-monitor comes from the position of partnership for responsible health care. This model is inclusive, informing the process without judgment. The information we provide always includes the identified patient and attempts to protect this individual from performance measures associated with shame, through education and communication.

Let’s use the example of the health indicators for diabetes versus unstable blood sugar levels. An individual engaged in a process by following professional recommendations which include routine doses of medication, utilizing a food plan to control blood sugar levels and incorporating regular exercise. In this scenario, the process of monitoring helps to provide information to guide the care plan for optimal health benefits. In a situation where there has been a test indicating high blood sugar level absent other indicators of a disease process, responsible health care would include monitoring the diet and other key indicators to inform the treatment plan in the absence of improved test results. When we apply this model to the conditions associated with substance abuse versus addiction, monitoring helps to maintain a healthy behavioral structure following treatment. The client’s ability or condition resulting in unwillingness to maintain abstinence is significant information in the diagnosis and treatment planning process. A motivated healthcare partner will recognize that the use of substances will likely impact the ability to maintain stable behavior whether substance abuse is the primary or secondary condition. Agreeing to a period of abstinence as part of any behavioral aftercare plan is a reasonable goal for achieving stability in one’s personal and professional life. The results inform the process.

Monitoring is a common tool used in mainstream healthcare. It is a cost effective, adaptable tool. We offer this structure for use with individuals recovering from addictions and related behavioral health issues. We invest in recovery for the “long-haul”. Monitoring helps to maintain the focus on what is important as we move toward that goal.

For more information about Trilby Hoover and the Sheepgate Services Aftercare Monitoring Services please visit:  www.sheepgateservices.org