At the Washington State DSHS Co-Occurring Disorders and Treatment Conference, held in Yakima last October 16 – 17, Sound’s STAR program received the 2017 Exemplary Service Award as Innovative Program of the Year. This is the second time the groundbreaking program has received the award, having won in 2009 after the program was initiated in 2008. The reason the program, whose acronym stands for Substance Abuse Treatment and Recovery, has garnered repeated recognition, according to David O’Neal, the Director of Sound’s Intellectual and Developmental Disabilities program, is that “this program integrates three disciplines (mental health, addiction issues, and developmental disabilities) and blends funding from each to create a model of true systemic and funding integration.”
Now widely recognized as a model that is beneficial and effective, the dual diagnosis approach treats clients with mental health and substance abuse issues holistically. The STAR program offers a crucial and added level of specialized support for clients dealing with developmental disabilities or low IQs, along with their substance use and mental health issues.
O’Neal, who has led the program since its inception, has focused his career on cognitively impaired clients, noting that, “Whether these impairments are caused by genetic disorders, traumatic brain injury, medical problems, or long-term drug use, this population is often identified as suffering from mental health or substance use disorders, impacting their ability to access services.”
“We adapt best practice materials and techniques that have proven effective in working with dual diagnosis populations to serve individuals with intellectual and developmental disabilities as well,” he says. ““I think those adaptations are successful with all populations. Our staff are trained in identifying the underlying vulnerabilities that IDD contributes to and working that into their knowledge of MH and SUD treatments.”
The STAR program includes providing “single-door access” to anyone in crisis, whether they have a mental health diagnosis or not. The STAR treatment is available at Sound’s Capitol Hill and Tukwila locations and is available to King County, Medicaid, the Department of Developmental Disabilities-enrolled adults (who are 18 or older) with substance use issues. The program’s approach includes aggressive outreach, unique programming, and behavioral reinforcement. The program’s services include:
- Stabilization and substance abuse assessment, including autism assessment and IQ tests
- Outreach services
- Individualized treatment tailored to the client’s cognitive needs
- Groups offering a range of fun, informative therapeutic activities
- Teaming and case management support services
- Clients with qualifying mental health issues will be offered support through Sound’s Community Networks Program
- Intensive case management for developmentally disabled clients
- 24/7 Crisis services
Persephone Brooks, co-presenting with O’Neal at the conference, has been a part of his team for three years. Her experience with the program, however, goes back an additional two years. Brooks was an intern as a practicum student, and worked on a volunteer basis after graduation. For the past three years, she’s been on staff with Sound as a Substance Abuse Disorder Counselor.
“I’m so excited about what I’m doing!” she declares.
As part of the STAR program, Brooks works with her IDD caseload in multiple ways.
“Some individuals I work with on a regular basis,” she says. “They know they have a problem and want my help.”
Brooks also does outreach, encouraging participation by clients, and educating care providers who are looking for support working with the IDD population. Working with a cognitively impaired population is complicated by the fact that, within the group, there is a wide range of cognitive abilities.
“We have them explain the program to each other. We use role-playing, video, anything that can make learning into a game,” effuses O’Neal. “We teach ‘Let’s have a fun quality of life.’ It’s very different from a punitive, disciplinary approach.”
Working with a set of materials put together for neurotypical dual-diagnosis clients, Brooks took on the task of simplifying it, adapting it to less cognitively able clients.
“Concepts like ‘What is a relapse’ can be too complex for my clients,” explains Brooks. “We start with what they are willing to work on. If they don’t really know how much they’re using, we start with a calendar with stickers, so they can understand their issues.
O’Neal and Brooks work from a model of mutual respect with their clients, modeling healthy boundaries and accountability, where each individual is innocent until proven otherwise. “This is not ‘street respect,’” notes Brooks. “This is socialized respect based on clear communication.”
At times and as community needs dictate, STAR is asked to engage in special projects. After the 2014 Marysville-Pilchuk High School shooting, for example, the program worked for two years with special needs students and a tribal counselor to help the students deal with the terrible event
“Students with limited cognitive ability sometimes have a difficult time separating themselves from events,” explains O’Neal. “We tried to encourage safety, connection, and positive identity – which is what leads to individual healing, and which this population often needs help gaining.”
There’s a definite note of satisfaction in his voice as he recalls that the Sound model of care was accepted as a model by the county, and may have contributed to influence the county.
“When we started, King County was using an abstinence-based approach to substance abuse treatment. That was unsuccessful at engaging people and counter to our philosophy of positive psychology and rewarding each success. We used a harm-reduction model. Two years later, all of the county programs had begun switching to the harm-reduction approach.”
This is the kind of innovative thinking that has received recognition for O’Neal, his team, and Sound.