Magazine article Behavioral Healthcare Executive

The Importance of Role Models: Even the Way Staff Members Dress Affects Clients' Potential to Recover

Magazine article Behavioral Healthcare Executive

The Importance of Role Models: Even the Way Staff Members Dress Affects Clients' Potential to Recover

Article excerpt

At its core, the clinical potency of residential drug treatment is based on the program's ability to reflect a natural, if not ideal, world, where order, social convention, rules, authority, moral codes, and multiple levels of interpersonal discourse are embedded in daily experience. Often described as a microcosm of the real world, the therapeutic community (TC) offers the addict such an opportunity to live and learn in a functional world, one which few of its typical inhabitants have ever consistently experienced. Rather than rehabilitation, the TC model more closely approximates "habilitation," since "right living" is new to the majority of its clients.

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To maximize the positive, growth-enhancing qualities of a TC, staff members--including those with recovery histories and those who have not been addicts--must serve as critical role models. Through observing and interacting with a range of role model staff, clients are exposed to multiple perspectives that inevitably impact who they want to become. Role model staff inspire, challenge, check, and motivate clients to look at themselves and realize they can become far more than what they have been. There is no curative factor more powerful or essential to the TC than role modeling. In a highly functional TC, top-down role modeling--from senior managers, to directors, to line counselors--can be felt and witnessed throughout the program. Program efficiency can largely be measured by the consistency, reach, and transparency of staff role modeling.

Staff as Change Agents

Most vibrant, healthy, and potent TCs have a broad-based staff, reflecting diversity of all kinds: gender, race, economic, intellectual, and academic. Clients have the opportunity to learn from multiple role models and determine what particular behaviors, attitudes, appearances, and ways of life most suit them. Because a lack of exposure and opportunity often characterizes the lives of hard-core addicts, the TC serves as a social antidote.

Given broad acceptance of these basic principles of TC functioning, a critical management challenge routinely presents itself: how to manage staff who have been hired under these tenets yet behave in ways antithetical to the TC's clinical culture. I am, of course, not speaking of flagrant violations of human resource policies or, worse, unethical behaviors. Rather, I am addressing the more subtle planes of behavior and attitude that can contradict the broad clinical mandates of a program.

One example frequently cited in the psychotherapy literature entails staff self-disclosure. This is particularly relevant for counselors in recovery themselves--a critical component of the TC model--who often are faced with the dilemma of when, where, and how many personal details they should disclose to a client. When is such disclosure therapeutic (e.g., in forming a therapeutic relationship or breaking down denial) versus self-gratifying or self-aggrandizing for the counselor? And when a counselor reveals present-day behavior that contradicts his status as a role model, is not his potency as a change agent in the client's treatment experience diminished and compromised?

One of the most nuanced dilemmas in managing a treatment program entails staff appearance. In the world of the residential TC, appearances of all kinds play important roles. Order, discipline, respect--"right living"--are reflected in the cleanliness and physical integrity of the therapeutic environment and its staff. Contrary to the typical spaces where the addicted individual "resides," the TC represents how best to live in an orderly world. …

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