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First City Recovery Center Accredited

First City Recovery Center
Mailing Address: 317 W Jefferson Street, Kokomo, Indiana 46901, United States
Phone: 877-595-3330
Admissions: Chris Cosgrove
Admissions Phone: 877-595-3330
Marketing Contact: Chris Cosgrove
Marketing Phone: 877-595-3330
Membership Type: Provider
About This Organization:

Program Descriptions

FIRST CITY RECOVERY CENTER
High Intensity Residential Services and Outpatient Program Descriptions

First City Recovery Center, LLC (FCR) offers High Intensity Residential Services, and outpatient services in the form of Partial Hospitalization (PHP), Intensive Outpatient (IOP) and Outpatient (OP) levels of care, and the clients in all our streams have the goal of long-term abstinent recovery. 3.7 Medically Monitored High Intensity Inpatient , High Intensity Residential Services correspond to ASAM 3.5, Partial Hospitalization L.O.C. approximates ASAM PPC-2R Level II.5, Intensive Outpatient L.O.C. approximates ASAM PPC-2R Level II, while Outpatient L.O.C. approximates ASAM PPC-2R Level I.

Counseling, case management and psycho-education are needed for all clients within our care and FCR will, therefore, offer substance abuse counseling and case management across all our treatment streams, delivered in a client-centered manner by qualified and supervized professionals, in accordance with IAC 4.4-2-4 and 440 IAC 4.4-2-4.5 Uniform criteria for programs that are certified as outpatient.

Definitions

"Treatment" means a broad range of primary and supportive services, including identification, brief intervention, assessment, diagnosis, counseling, medical services, psychological services, and follow-up, provided to persons with alcohol, tobacco and other drug problems. The overall goal of treatment is to reduce or eliminate the use of alcohol, tobacco and/or other drugs as a contributing factor to physical, psychological, and social dysfunction and to arrest, retard, or reverse progress of associated problems.

ASAM 3.5

High Intensity Residential Services Called Clinically Managed High-Intensity Residential Services for adults, this level of care provides 24-hour care with trained counselors to stabilize multidimensional imminent danger and prepare for outpatient treatment. Patients in this level are able to tolerate and use full active milieu or therapeutic communities.

High Intensity encompasses residential services that are described as co-occurring capable, co-occurring enhanced, and complexity capable services, which are staffed by designated addiction treatment, mental health, and general medical personnel who provide a range of services in a 24-hour treatment setting. A detailed description of the services typically offered in this level of care, the care setting and how to identify what patients would benefit best from these services based on an ASAM dimensional needs assessment begins on page 244 of The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions (2013).

This is a highly-structured 24-hour recovery environment provided in combination with medium-to-high intensity professional clinical services. Treatment is specific to maintaining abstinence and preventing relapse while vigorously promoting personal responsibility and positive character change in an safe, structured, residential setting.

In accordance with the Indiana Health Coverage Programs (IHCP) Bulletin (BT201801), the minimum admission criteria for FCR High Intensity Residential Services must meet the ASAM criteria for Level 3.5 Residential Services. Called Clinically Managed High-Intensity Residential Services, this level of care typically provides a 24-hour living support and structure with available trained personnel, and offers at least 14 hours of clinical service a week. Residential Treatment is defined as an intensive therapeutic service which includes overnight stay
and planned therapeutic, rehabilitative and didactic counseling to address cognitive and
behavioral impairments for the purpose of enabling the beneficiary to participate and benefit from
less intensive treatment. This level of care corresponds to community residential care in a setting that provides 24-hour structure and support, residents have an opportunity to develop and practice their interpersonal and group living skills, strengthen their recovery skills, reintegrate into the community and family, and begin or resume employment or academic pursuits.

High Intensity Residential services encompass residential services that are described as co-occurring capable, co-occurring enhanced, and complexity capable services, which are staffed by designated addiction treatment, mental health, and general medical personnel who provide a range of services in a 24-hour living support setting. A detailed description of the services typically offered in this level of care, the care setting and how to identify what patients would benefit best from these services based on an ASAM dimensional needs assessment, begins on page 222 of The ASAM Criteria: Treatment

Outpatient (OP): A service offered at a licensed, outpatient facility, which provides regularly scheduled individual, group and/or family counseling for less than nine hours per week. This care approximates ASAM PPC-2R Level I. Outpatient programs offer person-centered, culturally and linguistically appropriate, comprehensive, coordinated, and structured treatment services and activities. Our Outpatient Program consists of a scheduled series of structured, face-to-face therapeutic sessions organized at various levels of intensity and frequency in order to assist the persons served in achieving the goals identified in their person-centered plans. Our outpatient program may prevent or minimize the need for a more intensive level of treatment, such as Intensive Outpatient Services, Partial Hospitalization Programs or Residential Care. Outpatient programs may address a variety of needs, including, but not limited to, situational stressors, family relations, interpersonal relationships, mental health issues, life span issues, psychiatric illnesses, and substance use disorders and other addictive behaviors.

Intensive outpatient (IOP): A service offered at a licensed outpatient facility that provides a range of treatment sessions. Services include clinical intensive substance abuse counseling and psycho-education (didactic) sessions. Services are provided in a structured environment for a minimum of nine hours of counseling per week for adults. This care approximates ASAM PPC-2R Level II. Intensive outpatient treatment programs are clearly identified as separate and distinct programs that provide culturally and linguistically appropriate services. The intensive outpatient program consists of a scheduled series of sessions appropriate to the person-centered plans of the persons served. These may include services provided during evenings and on weekends and/or interventions delivered by a variety of service providers in the community. The program may function as a step-down program from partial hospitalization, detoxification/withdrawal support, or residential services; and may be used to prevent or minimize the need for a more intensive level of treatment; and is considered to be more intensive than traditional outpatient services.

The Joint Commission defines Intensive Outpatient Services as ‘an environment offering an organized day or evening program that may include assessment, treatment, care, services, and rehabilitation for individuals not requiring 24-hour care.’

Partial Hospitalization (PHP): A service offered at a licensed outpatient facility that provides a broad range of clinically intensive treatment services in a structured environment for a minimum of 20 hours per week, during day or evening hours. Treatment includes substance abuse counseling, educational and community support services. Programs have ready access to psychiatric, medical and laboratory services. This care approximates ASAM PPC-2R Level II.5 and is appropriate for clients who are living with unstable medical and psychiatric conditions.

The Joint Commission defines PHP as “An environment offering an organized day or evening program which may include assessment, treatment, care, services, and habilitation for individuals not requiring 24-hour care. For behavioral health, this may be a structured, ongoing program that typically meets two to five time a week for two to five hours per day.”
In compliance with IAC 4.4-2-4.5, FCR has specific minimum admission criteria for each level of outpatient care, including the following:

(1) The client has a documented history of current excessive use of alcohol or other drugs.

(2) The client is experiencing significant functional impairments in one or more of the following areas:
(A) Activities of daily living.
(B) Interpersonal functioning.
(C) Psychological functioning.
(D) Ability to live without recurrent abuse of chemicals.

(3) FCR shall consider whether the client has adequate support systems to foster recovery.
(4) There are no presenting medical or unstable psychiatric conditions that would preclude the consumer's participation in this level of treatment.
(5) A more intensive level of treatment is not indicated from the intake and assessment. 


FCR shall refer any client to appropriate treatment, or link with another program with special expertise if:
(1) There are medical or unstable psychiatric conditions that would preclude the client’s participation in this level of treatment; or

(2) A more intensive level of treatment is indicated from the assessment.


Treatment

Counseling, case management and psycho-education are needed for all clients within our care and FIRST CITY RECOVERY CENTER will, therefore, offer substance abuse counseling and case management across all our treatment streams, delivered in a client-centered manner by qualified and supervized professionals.

"Counseling" means the utilization of special skills and evidence-based practices to assist individuals, families, significant others, and/or groups to identify and change patterns of behavior relating to substance abuse which are maladaptive, destructive and/or injurious to health through the provision of individual, group and/or family therapy by licensed or credentialed professionals or approved counselors in training. Counseling does not include self-help support groups such as Alcoholics Anonymous, Narcotics Anonymous, and similar 12-step programs.

"Evidence based practices" means interventions and approaches supported empirically through systematic research and evaluation.

A multi-disciplinary approach
FIRST CITY RECOVERY CENTER practices a multi-disciplinary approach to all its activities in support of the client. Clinical decisions regarding placement, discharge, transfer between levels of care and other treatment issues are based on a multidisciplinary team review of each client. Documentation of the multidisciplinary team review with the recommended course of action shall be in the client's chart and include team members' signatures. The multidisciplinary team shall, at a minimum, consist of the medical director or physician, the Clinical Director, the Housing Manager and the client's primary substance abuse counselor.

FIRST CITY RECOVERY CENTER shall provide or coordinate the following services for every client as appropriate to the client's treatment plan:

1. Vocational and educational counseling and training;
2. Job placement for clients whose plans of care indicate a need for such services; and
3. Referral to legal services rendered by an attorney, licensed or otherwise authorized to practice law in Indiana, when such services are related to the client's treatment.

Client And Family Education: all FIRST CITY RECOVERY CENTER clients and their family, if applicable, or legally authorized representative will be provided information regarding the following:

1. Community agencies and resources available for support services, health care facilities, including but not limited to, the identification of resources for prenatal care, services for the treatment of HIV infection, vocational rehabilitation centers, and legal and social service agencies; and
2. The availability of support groups and referrals, when appropriate, to programs including but not limited to Narcotics Anonymous (NA), Nar-Anon, Alcoholics Anonymous (AA), Al-Anon, and Alateen.

Peer Support, or Mutual-Help Programs

Although these groups do not form part of services provided at FIRST CITY RECOVERY CENTER, all clients shall be supported and encouraged to attend mutual aid groups. The most popular, widely used mutual-help models are 12-Step recovery programs, such as Alcoholics Anonymous (AA), NA, MA, and Cocaine Anonymous (CA), which have been effective in helping people remain abstinent from substances and can be important augmentations to therapy. They are sources for social support, peer identification, relapse prevention, and treatment reinforcement, and they provide role models for successful recovery. Members of support groups gain strength and security from others who understand and share their concerns and who offer practical strategies for surviving “one day at a time.” Peer support groups as provide the long-term support necessary to reinforce addiction recovery.

The Treatment Program

High Intensity Residential Program

An Individualized treatment/recovery plan, including discharge and relapse prevention will be developed with each client prior to the beginning of High-intensity residential treatment reviewed on an ongoing basis, adjusted as medically indicated, and signed by the treatment team including the individual

Length of treatment at all levels of care is individualized and based on clinical criteria for admission and continued treatment, as well as the client’s ability to benefit from individual treatment/recovery goals. It is appropriate to retain the client at the present level of care if:
1. The client is making progress but has not yet achieved the goals articulated in the individualized treatment plan. Continued treatment at this level of care is assessed as necessary to permit the client to continue to work toward his or her treatment goals.
OR
2. The client is not yet making progress, but has the capacity to resolve his or her problems. The client is actively working toward the goals in the individualized treatment plan. Continued treatment at this level of care is assessed as necessary to permit the client to continue to work toward his or her treatment goals.
4. The client is still unable to live independently without the 24-hour residential supervision provided at this level of care
AND/OR
3. New problems have been identified that are appropriately treated at this level of care. This level of care is the least intensive level of care at which the individual’s new problems can be addressed effectively.

Life Skills and Self-Care
An integral part of our Residential Program includes social activities that promote healthy community integration/ reintegration; development of community supports, parenting, employment, job readiness, how to use public transportation, hygiene, nutrition, laundry, and education.
We wish our clients to build recovery that promotes social, family and community integration and our program will encourage and facilitate peer support; recreation/exercise; leisure activities; family visits and involvement in mutual aid groups.
Medical Services
Physician monitoring, nursing evaluation and support, psychiatric services and medication storage, management and observation are all available within the residence. Medical specialty consultation, psychological, laboratory and toxicology services are available through partnership services. available on-site.
Toxicology screening is used for the purpose of tracking ongoing use of substances when this has been established as a part of the treatment plan or an identified part of the treatment program. (This may include onsite testing such as portable breathalyzers or non-laboratory urinalysis).

Individual Counseling for High Intensity Residential LOC

Definition and qualifications of individual counseling staff: The treatment of an emotional disorder, including a substance use disorder, as identified in the DSM through the use of established psychological techniques and within the framework of accepted model of therapeutic interventions such as psychodynamic therapy, behavioral therapy, gestalt therapy and other accepted therapeutic models. These techniques are designed to increase insight and awareness into problems and behavior with the goal being relief of symptoms, and changes in behavior that lead to improved social and vocational functioning, and personality growth. Individual Therapy must be provided by: Licensed Clinical Psychologist, Certified Nurse Practitioner-Psychiatric and Mental Health (CNP-PMH), Advanced Practical Nurse-Psychiatric and Mental Health (APNPMH), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), or Licensed Marriage and Family Therapist (LMFT). 1 hour = 1 unit.

Frequency of individual and group counseling for First City Recovery Center High Intensity Residential Clients

Dependent upon medical necessity, High Intensity Residential clients receive a minimum of 14 hours per week of group therapy, including one individual session each week.

It is more effective for High Intensity Residential clients to receive their treatment on a daily basis, rather than blocks of groups, ensuring therefore that they receive daily support and treatment.

Daily Two-hour Sessions are provided within the residential facility. Clients will also spend time and be invited to join additional groups and sessions within the main treatment facility, where more staff and fellow clients are present. This is an important factor of effective addiction recovery – the concept of being within a supportive community where problems can be shared. However, at least two sessions per day will also take place within the residence.

Minimum Frequency of First City Recovery Center High Intensity Residential Counseling/Therapy Services:

Individual: One hour per week minimum.
Group: Two (2) hours per day minimum.
Family: To be included during course of treatment as clinically indicated.
Psycho-education: Didactic sessions: 8-hours/week minimum.
Supported Housing Living Skills sessions:4 hour minimum.
Family education and information sessions as clinically indicated.

A typical individual counseling session might include any of the following activities:

• Reviewing how a client feels, is coping with cravings, or is changing his or her lifestyle
• Dealing with interpersonal and family issues that often arise when one member of a family makes such a significant change in behavior.
• Reviewing drug test results and what they mean
• Identifying emergencies and deciding how to address them
• Reviewing the treatment plan
• Identifying measurable goals and reasonable timeframes
• Reviewing progress in achieving goals, including abstinence and related behaviors
• Discussing legal concerns, such as reporting to probation officers and complying with the terms of probation or parole
• Discussing family concerns
• Providing liaison services (e.g., with physicians, courts, social service agencies)
• Addressing routine issues (e.g., transportation, childcare).

Group Counseling in FIRST CITY RECOVERY CENTER High Intensity Residential Program

Definition and qualifications of group counseling staff: Counseling provided on a group basis to clients which uses group processes and supports to: motivate the client for recovery from addictive disease, facilitate skills for the development and maintenance of that recovery, improve problems solving and coping skills, improve intra and inter personal development and functioning, and develop relapse prevention skills. Session content and structure are designed in accordance with client’s treatment plan. Group counseling can be delivered by a CADC, an alcohol and drug counselor intern or credentialed intern under the supervision of a qualified clinical supervisor.
Our High Intensity Residential program is a comprehensive schedule of group activities. (Full group program descriptions are available from the Clinical Director).

The High intensity residential program of group activities within the residential setting center: (8 hours groups per week). Each group shall be a minimum of two-hour duration.

At least two two-hour sessions per week, shall be conducted with a focus on ‘living skills’ – the skills necessary for independent living = and will include the following topics and sessions

FCR Partial Hospitalization L.O.C.

Clients who have chosen our services for their recovery journey will be offered Partial Hospitalization, Intensive Outpatient or Outpatient Treatment at FCR. A Partial Hospitalization Program, or PHP program, is designed for individuals who need, and will benefit from, structured programming but do not require 24-hour supervision or medical assistance.

Clients who are appropriate for FCR PHP level of care require a near daily structured program to promote progress through the stages of change because of little treatment engagement or escalating use or impairment, or no awareness of the role of alcohol, and/or other drugs play in his/her present problems. The appropriate client may experience mild withdrawal, or is at risk of withdrawal and would have minimal prevention skills and needs near daily monitoring and support, with access to medical, nursing and laboratory services. Biomedical conditions and complications would be negligible or stable but would be distracting from treatment at a less intensive level of care. Such problems are considered manageable at Level 2.5, without requirement for residential treatment. Essential to this level of care is that the client welcomes recovery and understands relapse but needs daily structure to maintain therapeutic gains.

Typically, clients who have been in an inpatient or residential program step down to this level of care, as it continues to provide a high amount of structure and support, while allowing more community interaction. Medical management, nurse practitioners, and access to doctors and psychiatrists is still available to clients throughout the program, and they will participate in therapy groups, structured activities and aftercare planning.

An Individualized treatment/recovery plan, including discharge and relapse prevention will be developed with each client prior to the beginning of PHP treatment, reviewed on an ongoing basis, adjusted as medically indicated, and signed by the treatment team including the individual.

The goal of PHP is to stabilize symptoms, including mood disorders, depression and/or anxiety, and help clients to transition to a lower level of care.

Length of treatment at this level of care is individualized and based on clinical criteria for admission and continued treatment, as well as the client’s ability to benefit from individual treatment/recovery goals. It is appropriate to retain the client at the present level of care if:
1. The client is making progress but has not yet achieved the goals articulated in the individualized treatment plan. Continued treatment at this level of care is assessed as necessary to permit the client to continue to work toward his or her treatment goals.
OR
2. The client is not yet making progress, but is engaging in the treatment plan and responding to this intensity of treatment. The client is actively working toward the goals in the individualized treatment plan. Continued treatment at this level of care is assessed as necessary to permit the client to continue to work toward his or her treatment goals and ensure management of symptoms.
AND/OR
3. New problems have been identified that are appropriately treated at this level of care. This level of care is the least intensive level of care at which the individual’s new problems can be addressed effectively.

Frequency of individual and group counseling for FCR PHP Clients
Clients who choose our services will usually start at a PHP Level of Care. This is the most intensive level of care for an outpatient setting. Dependent upon medical necessity, PHP clients receive a minimum of 20 hours per week of group therapy and one individual session each week. Some clients may receive 25 hours per week. The typical client schedule will be for 5 structured sessions of individual or group activities each day for five days a week.

Minimum Frequency of PHP Counseling/Therapy Services:

Individual: One hour per week minimum.
Group: Twenty (20) hours per week minimum.
Family: To be included during course of treatment as clinically indicated.
Psycho-education: Didactic sessions: 20-hours/week minimum.
Family education and information sessions as clinically indicated.

FCR Intensive Outpatient L.O.C.

Clients who are appropriate for FCR Intensive Outpatient level of care program have met the essential treatment objectives at a more intensive level of care and require the intensity of services provided at ASAM Level II.1 in at least one dimension. Those clients who have met treatment goals and engaged effectively in the PHP level of care will most commonly move into Intensive Outpatient, as they will have experienced structure and treatment for an effective period of time.

An Individualized treatment/recovery plan, including discharge and relapse prevention will be developed with each client prior to the beginning of intensive outpatient treatment reviewed on an ongoing basis, adjusted as medically indicated, and signed by the treatment team including the individual

Length of treatment at this level of care is individualized and based on clinical criteria for admission and continued treatment, as well as the client’s ability to benefit from individual treatment/recovery goals. It is appropriate to retain the client at the present level of care if:
1. The client is making progress but has not yet achieved the goals articulated in the individualized treatment plan. Continued treatment at this level of care is assessed as necessary to permit the client to continue to work toward his or her treatment goals.
OR
2. The client is not yet making progress, but has the capacity to resolve his or her problems. The client is actively working toward the goals in the individualized treatment plan. Continued treatment at this level of care is assessed as necessary to permit the client to continue to work toward his or her treatment goals.
AND/OR
3. New problems have been identified that are appropriately treated at this level of care. This level of care is the least intensive level of care at which the individual’s new problems can be addressed effectively.

Minimum Frequency of IOP Counseling/Therapy Services:

Individual: One hour per week minimum.
Group: Six (6) hours per week minimum.
Family: To be included during course of treatment as clinically indicated.
Psycho-education: Didactic sessions: 2-hours/week minimum.
Family education and information sessions as clinically indicated.

Frequency of individual and group counseling for FCR Intensive Outpatient Clients

Dependent upon medical necessity, intensive outpatient clients receive a minimum of 9 hours per week of group therapy and one individual session each week. Some clients may receive 15 hours per week.

It is more practical for intensive outpatient clients to receive ‘blocks’ of group activity, making their trip to the facility more productive, and groups are therefore scheduled in blocks of 3 hours, 6 days per week, to ensure that clients are able to meet their target group participation, while respecting their work and family responsibilities. This reflects Indiana Administrative Code 440 IAC 4.4-1-1, which defines intensive outpatient services as “a milieu of treatment, with a combination of counseling and education activities consisting of sessions at least two (2) hours in length, occurring at least three (3) days per week for a minimum duration of four (4) weeks per consumer.”


Intensive Outpatient Services, corresponding to ASAM criteria 2.1, typically consists of 9 or more hours of service a week, typically between 9 and 15 hours in 3-hour slots. It is an organized outpatient service that delivers treatment services Monday thru Saturday.

Individual Counseling for PHP and IOP

Definition and qualifications of individual counseling staff: The treatment of an emotional disorder, including a substance use disorder, as identified in the DSM through the use of established psychological techniques and within the framework of accepted model of therapeutic interventions such as psychodynamic therapy, behavioral therapy, gestalt therapy and other accepted therapeutic models. These techniques are designed to increase insight and awareness into problems and behavior with the goal being relief of symptoms, and changes in behavior that lead to improved social and vocational functioning, and personality growth. Individual Therapy must be provided by: Licensed Clinical Psychologist, Certified Nurse Practitioner-Psychiatric and Mental Health (CNP-PMH), Advanced Practical Nurse-Psychiatric and Mental Health (APNPMH), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), or Licensed Marriage and Family Therapist (LMFT). 1 hour = 1 unit.

A typical individual counseling session might include any of the following activities:

• Reviewing how a client feels, is coping with cravings, or is changing his or her lifestyle
• Dealing with interpersonal and family issues that often arise when one member of a family makes such a significant change in behavior.
• Reviewing drug test results and what they mean
• Identifying emergencies and deciding how to address them
• Reviewing the treatment plan
• Identifying measurable goals and reasonable timeframes
• Reviewing progress in achieving goals, including abstinence and related behaviors
• Discussing legal concerns, such as reporting to probation officers and complying with the terms of probation or parole
• Discussing family concerns
• Providing liaison services (e.g., with physicians, courts, social service agencies)
• Addressing routine issues (e.g., transportation, childcare).

FCR places great emphasis, within our program, to the provision of psychiatric support. Addiction can never truly be treated unless its root cause is eliminated. Most addicts suffer from underlying mental health issues which often go undiagnosed and untreated. Addiction as well as mental disorders are treated at the same time.

FCR Outpatient Level of Care

FCR outpatient service provides regularly scheduled individual, group and/or family counseling for less than nine hours per week. This care approximates ASAM PPC-2R Level I. This service is appropriate for clients progressing from out Intensive Outpatient Level of Care. Clients entering our outpatient level of care have demonstrated, through involvement in our IOP program or successfully completed an OTP, IOP or Outpatient Detoxification Levels of Care with another provider and demonstrated that they have willingly engaged in their treatment plan as a proactive, responsible participant and that they have minimal relapse potential, with some vulnerability, and have developed fair self-management and relapse prevention skills. The client is still in need of ongoing support as their environment may not be supportive of addiction recovery but, with clinical structure, the clients will be able to cope most of the time and move forward with their recovery. As is central to FCR’s philosophy of care, the client has made the informed choice to request ongoing support and meet the criteria for it.

An Individualized treatment/recovery plan, including discharge and relapse prevention will be developed with each client prior to the beginning of outpatient treatment reviewed on an ongoing basis, adjusted as medically indicated, and signed by the treatment team including the individual

Length of treatment at this level of care is individualized and based on clinical criteria for admission and continued treatment, as well as the client’s ability to benefit from individual treatment/recovery goals.

Minimum OP Counseling/Therapy Services:

Individual: in a full session, this includes face-to-face for one (1) hour.
Individual: in a half-session, this includes face-to-face for thirty (30) minutes.
Group: minimum sixty (60) minutes of face to face contact.
Family: in a full session for one (1) hour or a half-session for thirty (30) minutes. To be included during course of treatment as clinically indicated

Individual counseling in Outpatient Level of Care

Definition and qualifications of individual counseling staff: The treatment of an emotional disorder, including a substance use disorder, as identified in the DSM through the use of established psychological techniques and within the framework of accepted model of therapeutic interventions such as psychodynamic therapy, behavioral therapy, gestalt therapy and other accepted therapeutic models. These techniques are designed to increase insight and awareness into problems and behavior with the goal being relief of symptoms, and changes in behavior that lead to improved social and vocational functioning, and personality growth. Individual Therapy must be provided by: Licensed Clinical Psychologist, Certified Nurse Practitioner-Psychiatric and Mental Health (CNP-PMH), Advanced Practical Nurse-Psychiatric and Mental Health (APNPMH), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), or Licensed Marriage and Family Therapist (LMFT). THC HRM.01.06.03
1 hour = 1 unit.

Outpatient clients will receive a minimum of one individual counseling session each week, but more sessions can be provided when needed.

It is important to note that when a client is at the outpatient level of care, which is the least intense level of care offered at FCR, the client will be living a largely independent life and hopefully will be employed or in education and rebuilding their lives and relationships. A typical individual counseling session at an outpatient level of care might therefore take the form of case management and coaching as well as offering therapeutic support with the issues that typically present to someone in early recovery. Sessions may therefore include any of the following activities:

• Reviewing how a client feels, is coping with cravings, or is changing his or her lifestyle
• Dealing with interpersonal and family issues that often arise when one member of a family makes such a significant change in behavior and may be living at home with an abstinent lifestyle.
• Reviewing drug test results and what they mean
• Identifying emergencies and deciding how to address them
• Reviewing the treatment plan
• When needed, supporting the client with advice, information, guidance and referrals to find employment or education opportunities.
• Identifying measurable goals and reasonable timeframes
• Reviewing progress in achieving goals, including abstinence and related behaviors.
• Discussing legal concerns, such as reporting to probation officers and complying with the terms of probation or parole
• Discussing family concerns
• Reviewing and, where necessary, revising the client treatment plan to address ongoing problems.
• Providing liaison services (e.g., with physicians, courts, social service agencies)
• Addressing routine issues (e.g., transportation, childcare).

Group counseling in Outpatient Level of Care

Definition and qualifications of group counseling staff: Counseling provided on a group basis to clients which uses group processes and supports to: motivate the client for recovery from addictive disease, facilitate skills for the development and maintenance of that recovery, improve problems solving and coping skills, improve intra and inter personal development and functioning, and develop relapse prevention skills. Session content and structure are designed in accordance with client’s treatment plan. Group counseling can be delivered by a CADC, an alcohol and drug counselor intern or credentialed intern under the supervision of a qualified clinical supervisor.

Outpatient Group Activities

Outpatient clients need to take control of their recovery and their schedules and must provide their keyworker with their work schedules and book themselves into the ongoing group activities at FCR.

They are also invited to attend IOP groups, where they can interact and support other clients in our community and ensure that they are able to take full advantage of any sessions of topics that they may have missed during IOP. Clients in the outpatient modality are a great resource for this group and have much to gain from offering their experience and support to new clients.
These will be provided daily and facilitated by members of the clinical teams of each modality.

In accordance with First City Recovery Center policies First City Recovery Center shall:
1. Develop an individual client treatment plan for every client based on the assessment of the client and in conformance with the individual client’s recovery goals and needs, requiring Informed Consent from the client.

2. Initiate the development of the client's treatment plan upon the client's admission, and shall enter the client's treatment plan in the client record at least after three visits following admission, not to exceed 30 days.

3. First City Recovery Center Shall reassesses individuals served, as needed. The scope and intensity of any further assessments are based on the individual's functioning; the setting; the individual's preferences for care, treatment, or services; and the individual's response to care, treatment, or services provided. Each client may be reassessed for many reasons, including the following

The Community Group

This is not a billable session, but an important aspect of the residential experience at First City Recovery Center. Our treatment facility is a community of people not only sharing a common problem, but a common solution. It is important that clients not only learn to live with other people in a collaboratitve, respectful way, but that they also feel that they have an active role in the delivery of our treatment. FIRST CITY RECOVERY CENTER values the opinions and experience of its service users, therefore, we offer this opportunity for our clients to have their say and influence the program and how the treatment programme is delivered within our residential setting.

Daily community meetings address the day to day issues that arise through community living, such as cleanliness, meals and interpersonal conflicts. It is also an opportunity for the housing staff to inform the clients about the itinerary of the following day and events happening within the Centre.

It is led by a housing support worker, but all clients are invited to become involved. Typically, it will start with a check in, followed by a report on any practical issues. Clients also take the opportunity here to discuss any needs regarding maintenance, washing, shopping, etc. Any specific needs clients may have are also discussed, such as visits, outside appointments and so on.

It typically ends with a daily reflection from Alcoholics Anonymous and a short moment of silence to meditate on their recovery.

Process Groups

Group therapy is a powerful tool for growth and change. In our process groups, the residents meet face to face to share their struggles and concerns with a FIRST CITY RECOVERY CENTER therapist. The power of process groups lies in the unique opportunity to receive multiple perspectives, support, encouragement and feedback from other individuals in safe and confidential environment. These interpersonal interactions can provide group members an opportunity to deepen their level of self-awareness and to learn how they relate to others.

Process groups are typically unstructured. There isn’t a specific topic for each group session, but some of the groups may be focused on a particular theme or the group may decide together that they would like to discuss and explore a particular theme that is prevalent to them (such as relationships, loss or parenting). Members are welcome to bring any issues to the group that they feel are important, and the primary focus of therapy in the group is on the interactions among group members. Members are encouraged to give support and feedback to others, and to work with the reactions and responses that other members’ contributions bring up for them.

At a more informal level, without in-depth processing of material, such matters are dealth with daily in the community group, but it is our experience that a process groups works very well on Monday mornings to both process the events of the weekend and to set a serious focus for the week ahead.

The Individualized Recovery Plan

An Individualized Treatment Plan is a structured, often multi-disciplinary and task orientated individualized care plan, which details the essential steps in the care of a person with drug or alcohol problems, and describes the main focus of treatment and care. The Individualized Treatment Plan involves the translation of the needs, strengths and risks identified by the assessment into a service response. It is used as a tool to monitor any changes in the service users situation and to keep other relevant professionals aware of these changes. In order to be effective, the client must be fully engaged throughout the assessment and care planning process and be actively involved in the formulation of the Individualized Treatment Plan. CTS.03.01.03 EP 1 and 2

An Individualized Treatment Plan should:
• Set the goals of treatment and milestones to be achieved (taking into account the service users views and goals).
• Indicate the interventions, plans and which agency and professional is responsible for carrying out these interventions (these interventions should always be negotiated with those they name).
• Contain goals that are expressed in a manner that captures the client’s own words or ideas
• Build on the client’s existing strengths
• Contain criteria and process for the individual's expected successful transfer and/or discharge, which have been discussed with the client
• Make explicit references to Risk Management and identify the risk management plan and contingency plans.
• Identify information sharing (what information will be given to other professional/agencies and under which circumstances).
• Require the informed consent of the client

Where an individual has been difficult to engage in treatment and rehabilitation, the plan should identify a plan for promoting and enhancing their engagement.

It should also:
• Identity their review date (the date of the next review meeting should be set and recorded at each meeting).
• Identify circumstances where other reviews may be necessary.
• Reflect the cultural and ethnic background of the client, as well as their gender and sexuality

Each IRP shall include, at a minimum, the following:
 CTS.03.01.03 EP3

1. Each client’s own stated Recovery Goals.
2. Client problems to be addressed. 

3. Specific goals - with identified steps to achieve the goal - written in terms of measurable criteria for proposed outcomes of each identified problem in the following areas:

• Alcohol/Drug and Prescription Medication
• Offending behaviour
• Physical and Mental Health
• Social Functioning (Accommodation, Finances, Diet, Hygiene, etc.)
• Relationships (Partner, Parents, Children, Friends etc.) FIRST CITY RECOVERY CENTER clinical staff coordinates care with the client’s identified family and other significant support persons. The family of the individual served is involved in the development of the treatment plan when clinically appropriate. Family involvement is documented in the record of care.
• Education, Training and Employment
4. Therapeutic activities and their frequency.

5. Referrals for needed services that are not provided by FIRST CITY RECOVERY CENTER.

6. Staff persons responsible for working with each identified goal.

7. Plans for involvement in appropriate support groups.

8. The client's signature indicating that he or she has reviewed and understands the contents of the service plan and any revisions thereafter.

9. A copy of the outpatient client schedule (see below)
10. A client schedule agreement (see below)
Progress Mapping
FCRC will periodically reevaluate each client’s progress toward achieving the IRP’s objectives. Based on the progress review, a determination would be made whether changes should be made to the Individualized Recovery Plan.
A care plan is not a one-off document (like a discharge document or progress report) but a living record of the changing needs/risks/goals and outcomes for a client while with us. They should be continually updated when new goals, needs etc. are identified. It should provide a snapshot of where a client is in their journey and where they currently want to go. This is a very important document and responsibility for keeping it up to date lies with the keyworker.
Our Individualized Treatment Plan goals have been divided into:
Short term (0-12 weeks), which must identify goals that are targeted to be achieved while still in intensive treatment with us.
Medium term (12-36 weeks). This represents goals a client may have for outpatient or aftercare and all goals for the first few weeks after treatment.
Long term (36 week plus), which represent long term plans and aspirations that the client may wish to begin to think about already.
When we are recording and setting goals for a client, we need to think of them as SMART goals in the following manner
• Specific - Well defined / Clear to anyone that would read the care plan. Do you know exactly what you want to accomplish with all the details?
• Measurable - Can you quantify your progress so you can track it?
o How will you know when you reach your goal?
• Agreed Upon - Agreement with all the stakeholders what the goals should be, and Achievable - Goals must achievable. The best goals require you to stretch a bit to achieve them but they are not impossible to achieve
• Realistic -Within the availability of resources, knowledge and time Almost certainly your goal is realistic if you truly believe that it can be accomplished. In our work, we must also think of the ‘R’ as representing:
• Relevant - Is your goal relevant to the purpose of your stay with FIRST CITY RECOVERY CENTER ?
• Time-Based Does your goal have a deadline? Goals must have a clearly defined time frame including a starting date and a target date. (‘abstinence’ ‘to be happy’ or ‘get fit’ are not examples of SMART goals).

Mission Statement:

Mission Statement

First City Recovery’s mission is to provide best practice community-based treatment services to help all persons served to meet their full potential as independent and fully productive individuals.. We respect each client’s choice in whether they wish to follow a Medication Assisted Treatment program or an Abstinence approach to their own recovery. We are committed to supporting, educating and enriching, through collaboration, training and leadership, all our clients, their families and the communities we serve and championing addiction recovery. Our mission is one of quality care, education and community support for each patient and their families and significant others.

The objectives of our mission are achieved in the following manner:

• Provide direct services, education, support and advocacy for clients, family members, the community we serve, and significant others who are involved with his/her care;
• Meet the individual needs of each client without regard to race, color, national origin, religion, sex, age, handicap, veteran status or ability to pay.
• Respect the client, his/her family and significant others as individuals, assuring his/her right for confidentiality, respect and dignity.
• Maintain optimal standards of professional practice leading to the highest possible quality of care.
• Integrate client/family education into all plans of care.
• Meet the needs of all referral sources and stakeholders in the most prompt, professional manner possible.
• Promote and encourage professional growth of all staff.

Licensing Body:

DMHA

Treatment Type: Inpatient Detox, Intensive Outpatient Program (IOP), Outpatient Treatment, Partial Hospitalization Program (PHP), Residential
Specialty: All Gender, Domestic Violence, Dual Diagnosis/Co-Occurring Mental Health, Eating Disorders, Family Program, Pain Management, Professionals, Sex Addiction, Trauma/PTSD
Number of Beds: 11-24 Beds
Year Founded: 2020
46901
317 W Jefferson Street
Kokomo
Indiana