The YWCA offers a number of valuable programs in its mission to empower women. From counseling to childcare services, women know that the YW is a place where they can receive support as well as learn how to take charge of their own lives. The YW, in existence nationally since 1858, serves over 700,000 women and children annually and is in 300 communities across the country. One branch, located in St. Joseph County, in South Bend, has found a unique way to improve and enhance their Chemical Dependency (CD) program.

WHY THE JOURNEY BEGAN

A few years ago while reviewing programs offered at the St. Joseph YW, newly hired Executive Director Linda S. Baechle was concerned that the language used in the CD program did not align with what was used in the Domestic Violence (DV) program. Because many women enrolled in one program were also enrolled in the other (abused women often use alcohol or drugs as an escape) it was important that the two programs were similar in content, language and philosophy.

Although the emphasis on power and control is essential for recovery, Baechle was concerned that the CD 12-step program (see 12 steps below) contained language that was ‘at war' with the philosophy of the DV program. “Words like ‘codependency' which figured largely in the existing Chemical Dependency program are an anachronism in the Domestic Violence treatment world,” she says. Victims are often labeled codependent and told they must be getting something out of an abusive relationship or they wouldn't stick around. “Another problem was that the 12-Step Program was telling women to surrender themselves to a higher power when we were trying to teach them not to surrender, to take responsibility for what was going on in their lives,” she says. They came to realize that philosophically the two programs didn't align and that they needed to find a CD program that used the same language and philosophies as the DV program.

HOW THE JOURNEY BEGAN

Baechle began doing extensive research on choosing a new model for their CD program, including talking to colleagues and peers. At a meeting held in Indianapolis with the Department of Mental Health and Addictions, she heard about a 16-step program developed by Charlotte Kasl, Ph.D. that had some of the qualities she was looking for; a program geared toward women that addressed abuse issues, an underlying factor in many women's addictions. And while the old 12-step model focused on middle class white men, Kasl's program worked for all ethnic groups. After reading information from Dr. Kasl's Web site and ordering her books, Baechle got in touch with Dr. Kasl who was very helpful and supportive of the approach the YW wanted to take with her program. She gave the YW license to adopt her 16-step program any way they saw fit. At the same time Karen Sommers, Executive Director, Oncology Services, at Memorial Hospital of South Bend, told Baechle that she had heard that holistic treatments, such as acupuncture and healing touch, were showing promise in the treatment of addictions. This was in alignment with the 13 th step in Kasl's 16 step program which emphasized ‘taking steps to heal our physical bodies, organize our life, reduce stress and have fun.” And from this the Women's Journey: 16-Step Model of Chemical Dependency Treatment for Women (see below), using integrative healing therapies, was launched in late summer of 2003.

WHO IS CHARLOTTE KASL?

Charlotte Kasl, Ph.D., creator of the 16 Steps for Discovery and Empowerment model and the author of several books, was a licensed psychologist in Minnesota for fifteen years and is now a licensed professional clinical counselor in Montana . She interviewed counselors and those in recovery in treatment programs across the country as research for her empowerment model. As a result, programs for battered women, pregnant and addicted women, Native Americans, African-American, addicted teens and women in prison throughout the United States and Canada have adopted her 16-step program.

CHARLOTTE KASL'S 16 STEPS FOR DISCOVERY AND EMPOWERMENT

1) We affirm we have the power to take charge of our lives and stop being dependent on substances or other people for our self-esteem and security.

2) We come to believe that God/Goddess/Universe/Great Spirit/Higher Power awakens the healing wisdom within us when we open ourselves to the power.

3) We make a decision to become our authentic selves and trust in the healing power of the truth.

• We examine our beliefs, addictions and dependent behavior in the context of living in a hierarchical, patriarchal culture.

• We share with another person and the Universe all those things inside of us for which we feel shame and guilt.

• We affirm and enjoy our intelligence, strengths and creativity, remembering not to hide these qualities from ourselves and others.

• We become willing to let go of shame, guilt, and any behavior that keeps us from loving ourselves and others.

• We make a list of people we have harmed and people who have harmed us, and take steps to clear out negative energy by making amends and sharing our grievances in a respectful way.

• We express love and gratitude to others and increasingly appreciate the wonder of life and the blessings we do have.

• We learn to trust our reality and daily affirm that we see what we see, we know what we know and we feel what we feel.

• We promptly admit to mistakes and make amends when appropriate, but we do not say we are sorry for things we have not done and we do not cover up, analyze, or take responsibility for the shortcomings of others.

• We seek out situations, jobs and people who affirm our intelligence, perceptions and self-worth and avoid situations or people who are hurtful, harmful or demeaning to us.

• We take steps to heal our physical bodies, organize our lives, reduce stress and have fun.

• We seek to find our inward calling, and develop the will and wisdom to follow it.

• We accept the ups and downs of life as natural events that can be used for lessons for our growth.

• We grow in awareness that we are sacred beings, interrelated with all living things, and we contribute to restoring peace and balance on the planet.

THE PROGRAM

Women's Journey is a six to eight week intensive residential and non-residential program allowing women to begin self-care in a way that empowers them to process recovery issues and receive support from peers and staff. Women are encouraged to bring their children if they have any. The program focuses on self-empowerment through psycho-education, group therapy, holistic healing treatments, nutrition education and parenting support. Holistic treatments include yoga, meditation, acupuncture, massage, music, healing touch, art therapy, drumming and journaling. Women in the program are required to attend a set amount of meditation, group, parenting, journaling, letting go, sober activities, goal-setting and life skill classes each week. They must have two holistic services per week (appointments are set each Monday during group sessions). After starting with just five days a week the program has expanded to seven days. There is also a long-term after-care group with at least a one year commitment.

HOLISTIC HEALING TREATMENTS

Yoga : Yoga's benefits include relaxation, enhanced flexibility, improved health, increased energy and strength, increased impulse control and control of both negative emotional thoughts and cravings and a better attitude.

Drumming : Drumming consists of beating a drum in a group set to the rhythm of one's name, played along to music or her own beat. It leads to relaxation, stress reduction and self-expression.

Massage : Through massage, levels of dopamine, the pleasure transmitters are increased, which is helpful during withdrawal and the early stages of recovery when dopamine levels are usually low. It also promotes circulation of blood and lymphatic fluid as well as helping bring her into contact with both body and mind, allowing her to identify and manage triggers and cravings.

Acupuncture : Acupuncture helps ease symptoms of withdrawal and stabilizes moods, it calms but also energizes and assists with relaxation.

Healing Touch and Reiki : Clears toxins from the body, mind and spirit, working with the energy field and clearing toxins within the body, bringing it into balance.

THE STAFF

Many of the holistic practitioners were brought into the program through Karen Sommers' connection to Memorial Hospital . Susan Merry, hired as the holistic services coordinator, manages the schedule for clients and practitioners as well as reviews time sheets for practitioners before they are submitted to Memorial Hospital , a donor of the program, for payment. Practitioners say that having a holistic services coordinator is helpful for them because in past jobs they often reported to work without any one on site to help coordinate their services. Other Memorial staffers working at the YW include healing touch practitioners as well as a massage therapist, an acupuncturist and an art specialist. It's very important that they know how to connect with people as well as provide a service. “Our clients love the practitioners,” says Susan Merry. “They make all the difference in the world. Their spirit is what they give to the clients and that's huge.”

There is a staff meeting once a week to emphasize communication among practitioners and case managers. It helps to keep track of what's going on and allows everyone to touch base with each other in an informal way.

STATISTICS

The original CD program was started at the St. Joseph YWCA in 1985, one of only three such programs in Indiana, the only one in northern Indiana . In 2003 over 1200 women and their children were served at the YW, of which over 180 women (with 280 children) were in the CD treatment program (compared to about 470 women and 420 children in the DV program). Approximately 50 percent of women in the DV program are also enrolled in the CD program. Their typical client is a woman in her 30s, usually with children. A high percentage of the women are minorities (typically African-American) and cocaine is one of their major drugs of choice. Since implementing the 16-step program, they have seen a 500 percent increase in enrollment in after care programs. Some clients have even started their own 16-step groups when their treatment programs are completed. This is important because, according to Linda Baechle “You don't go through an aggressive 45 day program and come out cured. You always need ongoing support.” They have also seen a 12 percent increase in women completing the program; 41 percent of those who started, completed the program. The national average is 43 percent; but, because they are treating the most at-risk population of those who are chemically addicted (women are harder to treat than men, African-Americans are harder to treat than Caucasians, unemployed and homeless individuals are more difficult to treat) and this is their target group, they are very pleased with the results. A local university and nursing school are using the treatment program for research studies which will bring publicity to the program as well as provide them with further statistical data. They are hoping the new CD program will also interest the federal government, which is looking for programs that provide both substance abuse and domestic violence treatment on the same site.

FUNDING

Because most clients don't have the funds to pay for the program, the YWCA has relied on outside sources for financial assistance. They found support from two places: a private donor and Memorial Hospital . When Karen Sommers, from Memorial, became involved in the holistic part of the new CD program she and Reg Wagle introduced to a private donor to the concepts of this pilot program. She set up a luncheon with Linda Baechle and the donor so she could present a plan and budget for a prototype. Memorial Health Foundation had provided funds for another collaborative program involving the YWCA, the DOVE Project (DOmestic Violence Ends). (For more information about the DOVE Project visit www.qualityoflife.org and look for the DOVE learning history.) That successful connection proved that the two organizations could work well together. Memorial funds the administrative functions, and the private donor has funded the holistic services that make this model unique. The YWCA is always applying for grants for funding. Baechle is continuously applying for them in the hopes the grants will help pay Memorial back for some of the services they have donated. Although Memorial has been an important partner in the CD program, its developers and implementers know that the funding won't last forever. Says Susan Merry, “Memorial's philosophy is ‘We'll give you the seed money to take care of yourself and see how you can make the program grow.' We know it's not something that will last forever so we're always looking for other sources of funding.”

THE CHALLENGES

Although the transition from the 12-step program to the 16-step one has been relatively smooth, naturally there have been some bumps along the way. The planning process took about nine months, from initial meetings to implementation of the new program and from the time they approached the donor to the time the 16-steps began was about six weeks. Partnerships are always challenging, especially when it comes to finding the right individuals and organizations to approach. “There's always a fear in partnerships between a small entity and a large entity, says Baechle. “The small entity may be afraid to approach a large entity (like a hospital) because they're afraid they may not have a voice. That they'll be swallowed up.” But they shouldn't be afraid to try, she says. Particularly if they find a hospital like Memorial that is forward-thinking and open to community projects. Her advice is to research hospitals, know who it is you're proposing a partnership with and establish relationships within the hospital system. (For more information about Memorial's philosophy and approach to collaborative, learning-based community change visit www.qualityoflife.org and read the “tithing,” “CHAG,” and other learning histories.)

The CD organizers were concerned at first that clients would be resistant to holistic services because many may not have had a lot of ‘positive' touching in their lives and be resistant to it, not to mention the prospect of having acupuncture needles stuck into them. But that hasn't been a problem; they've had overwhelmingly positive responses from the women involved (see comments below).

There was also a concern that the initial one year funding commitment from Memorial wouldn't be enough. Procuring a longer funding commitment is important in a startup project because it usually takes longer than a year to get up and running and to get data to show success. At least a two year start up time is the minimum needed for a project like this, says Baechle.

It was important to the success of the program that all of the staff members of the CD program experience the holistic treatments themselves so that they could relate to the clients how helpful the services could be, but it did create some jealousy among other program staffers who thought their clients would benefit from them as well. This can pose a challenge and merits open discussions among the entire organization.

Another suggestion is to have a definitive plan in place before starting the 16 steps, clearly defining rolls and responsibilities for staff members. This doesn't mean things can't change and evolve but starting out with a plan will help the plan run more smoothly. Ask ‘Why are we doing this? Why did we decide to use this program to begin with?' Figure out what is expected from all of those involved in your new program before it begins. “Our program is running very well now but I think we could have benefited from this kind of planning beforehand,” says Susan Merry.

FINAL WORDS FROM A CLIENT OF THE PROGRAM

The following are excerpts from a Women's Journey participant:

“The YWCA is my saving grace. I have learned how to recover and live with the deadly disease of addiction. The YWCA is a home for women where dreams are realized. The Women's Journey Chemical Dependency group has become the framework of my recovery. The holistic program is amazing. Because addiction is 90 percent psychological, 10 percent physical, the whole person must be treated. I have found success and healing through yoga, art therapy, massage, Reiki, acupuncture, drumming, healing touch, meditation, goal setting, journaling and more. Not enough can be said for the effects of holistic treatments to achieve health and wellness in recovery. They have given me the privilege to make the decision to turn my life around. To own a new feeling of belonging, self-love and hope for a brilliant future and to know that I can stay sober one day at a time.

THE 12 STEPS OF AA (THE OLD MALE-ORIENTED MODEL)

• We admitted we were powerless over alcohol – that our lives had become unmanageable.

• Came to believe that a power greater than ourselves could restore us to sanity.

• Made a decision to turn our will and our lives over to the care of God as we understood Him.

• Made a searching and fearless moral inventory of ourselves.

• Admitted to God, to ourselves and to another human being the exact nature of our wrongs.

• Were entirely ready to have God remove all these defects of character.

• Humbly ask Him to remove our shortcomings

• Made a list of all persons we had harmed, and became willing to make amends to them. All.

• Made direct amends to such people wherever possible, except when to do so would injure them or others.

• Continued to take personal inventory and when we were wrong promptly admitted it.

• Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.

• Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.

STEPS ON THE ROAD TO RECOVERY

The steps vital to recovery from addiction include:

Step 1: We affirm we have the power to take charge of our lives and stop being dependent on substances or other people for our self-esteem and security.

Step 2: We believe that asking for help awakens the healing wisdom within us when we open ourselves up to the power.

Step 3: We make a decision to become our true selves and trust in the healing power of truth.

Step 4: We examine their beliefs, addictions and dependent behavior in the context of

living in a toxic culture.