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The Extension, Inc. is a semi-independent residential, CARF-accredited, THOR-approved, ASAM Level 3.1 substance use disorder treatment program for individuals, aged 25 and older. The organization has an 80-bed campus for men and a 24-bed campus for women; both campuses are located in Marietta, Georgia. All treatment services are provided onsite at both campuses. The Extension, Inc.’s treatment program is a nine-to-twelve-month program, based on a program participant’s progress toward established treatment goals.

The program also extends itself to meet the needs of participants who may need treatment for longer periods of time, in situations in which the participant has had difficulty meeting treatment goals within a nine-to-twelve-month time frame. The Extension, Inc.’s program is consistent with American Society of Addiction Medicine (ASAM) 3.1 level of care, which is considered a clinically managed low-intensity residential treatment level of care.

The program operates and provides supervision to program participants 24 hours a day, 7 days a week, including weekends and holidays. Program participants are required to actively participate in a minimum of twelve (12) hours of treatment services per week, as identified in the individual’s Individualized Service Plan (ISP).

The defining characteristic of the residential program is that it serves individuals who are in need and are thus placed in a safe and stable living environment in order to develop sufficient recovery skills. Longer exposure to treatment intervention is necessary for appropriate participants to acquire basic living skills and master the application and demonstration of recovery skills. The purpose of the program is to demonstrate aspects of a positive life and recovery environment.

The Extension's

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ORIENTATION PHASE (First 30 Days)

Group Training 17 hours weekly

Group Counseling 7.5 hours weekly

Individual Counseling 1 hour weekly

Peer Support 7.5 hours weekly

Total 33 hours weekly

PHASE I (60-120 Days)

Group Training 8 hours weekly

Group Counseling 2.5 hours weekly

Individual Counseling 1 hour weekly

Family Counseling 1-2 hour weekly

Peer Support 7.5 hours weekly

Total 20 hours weekly

PHASE II (120 Days)

Group Training 6 hours weekly

Group Counseling 5.5 hours weekly

Individual Counseling 1 hour weekly

Family Counseling 1-2 hour weekly

Peer Support 6.5 hours weekly

Total 20 hours weekly

Program Components

The Extension recognizes that each individual brings unique strengths, needs, abilities, and preferences to their journey. By combining individuality with evidence-based interventions, and well-defined standards of care, individuals served by The Extension will experience the best possible recovery outcomes.

The Extension and its credentialed personnel utilize evidence-based practices and modalities including but not limited to:

Matrix Model

Process Groups

Gorski Relapse Prevention Planning

Individuals participate in developing a self-focused, written plan designed to alert them to the progressive warning signs that reactivate denial and cause pain, making use of alcohol or drugs seem like a good idea. Through this process, the individual becomes aware of underlying reasons and beliefs that have led to their decisions to use alcohol or drugs. Counselors use clinical techniques to operationalize the nine basic principles that underlie this relapse prevention planning model. Physical, psychological, and social stabilization are operationalized through the discovery of self-regulation. As the individual integrates a specific and realistic understanding of relapse warning signs, management is possible and change is likely. A comprehensive follow-up plan includes continued participation in mentoring other residents through the same process.

Early Recovery Education Group

Life Skills

Counselor led 25-30 week of practical life skills, including: Toxic Relationships (including relationships with self and others, rights in a relationship, codependency, boundaries, and skills in healthy relationships) , Money Management (including debt resolution, budgeting, saving, and credit management) , Effective Communication (including communication styles, stress management, and habits of effective people), Physical Health/ STD’s(including preventative education, recognition of various conditions, and safe sexual practices), and Employment (including resume, cover letter and thank you letter writing, job interviewing, and networking). The goal is to increase basic competency in areas covered. Progress is measured by administration of pre and post tests for each of the five core components of curriculum.

Anger Management for Substance Use Individuals

Anger Management is a Certified Anger Management Specialist-led 10 to 12 week course designed to increase awareness of anger cues and the ability to effectively manage unhealthy expressions of anger. Course topics include:

Definitions of anger
Family dynamics as origins of anger
Anger as a habit
Monitoring anger
Events and triggers of anger
Physical, emotional, behavioral and cognitive cues of anger
Importance of self-talk in reduction or promotion of anger
Anger as a choice
Communication styles of passive, aggressive and assertive
Effective communication
Aadaptive coping and relaxation skills.
Progress is measured by administration of post testing for accurate comprehension of course learning objectives.

Conflict Resolution

Physical Health and Social Skills Promotion

Physical Health and Social Skills Promotion is a counselor-led recreational activities designed to encourage individuals to rediscover hobbies, develop new interests, plan, organize and enjoy physical movement while engaging in development of heightened social skills.

Activities include social, recreational and leisure events such as softball, yoga, retreats, lake day, and Java Jam. Sober retreats, community and local events provide diverse exposure to physical, social activities where consumers can apply learned therapeutic strategies that may enhance a sustained physical and recreational routine at point of discharge.

Helping Men and Women Recover

Expected Program Outcomes

Acceptance, hope, a sense of being in a good place, the right place.

Effectiveness

#1. To Whom the Indicators Is Applied: Individuals served in the program.

Outcome Rationale: As The Extension’s program is a collaborative effort of many partner agencies, successful outcomes will require all agencies to work toward a common goal. Outcome measures apply to all Extension programs unless specified. For each outcome area, a lead or “responsible” agency/program is identified. The lead agency is responsible for the identified outcome. However, all Extension partner agencies have responsibility for the total success of the program.

Measurable Objectives:

Upon successful completion of The Extension’s residential substance use treatment program: 100% of program participants shall be employed upon discharge.

Upon successful completion of The Extension’s residential substance use treatment program: 70% of program participants shall transition to independent living.

87% of the program participants who complete the program, and who we are able to contact, to self-report that they have maintained their recovery, have stable housing, are employment and not received new legal charges during the 24-month tracking period following completion.

Method of Measurement: Data captured via KIPU electronic medical record.

Frequency of Measurement: Monthly and quarterly reports will be completed.

Utilization: The results will be used to evaluate the effectiveness of treatment and to assess any need for program changes.

Efficiency

#2. To Whom Will the Indicator Be Applied: All individuals served in the program.

Outcome Rationale: Providing a higher percentage of individual engagement with services overall.

Measurable Objective:

To maintain an occupancy of 90% of men’s beds and 90% of women’s beds to insure 100% reimbursement and meet contractual requirements.

Method of Measurement: Individuals meeting criteria will be assessed and admitted into treatment, if appropriate. Data captured via KIPU electronic medical record and HMIS systems.

Frequency of Measurement: A daily census is kept for tracking purposes. The Director of Quality Assurance & Regulatory Compliance will complete a monthly report of individuals enrolled in services. The Director of Administration will submit a report to DBHDD for reimbursement.

Utilization: Information will be reviewed for program planning and development.

Access to Services

#3. To Whom Will the Indicator Be Applied: Prospective individuals seeking admittance to the program.

Outcome Rationale: Individuals requesting services will be seen in a timely manner.

Measurable Objective:

Priority for admission will be given to individuals who report that they currently use substances intravenously. Individuals who report that they currently use substances intravenously will be admitted within 14 business days.

Method of Measurement: The initial contact is documented in the KIPU CRM when an individual completes a Pre-Screen assessment. Clinical staff will review the completed Pre-Screen assessments and individuals who meet criteria and are appropriate for the program’s level of care will be admitted to the program. If a bed is not available, the individual will be placed on the waiting list, provided with interim services and resources. Individuals who do not meet criteria or are not appropriate for the program’s level of care will be provided with resources for further treatment.

Frequency of Measurement: Pre-Screen assessments will be reviewed by clinical staff on a biweekly basis.

Utilization: The program director will review admissions monthly to ensure that individuals are being prioritized in accordance with program policy and federal mandates.

Customer Satisfaction

#4. To Whom Will the Indicator Be Applied: Active individuals in program.

Outcome Rationale: High customer satisfaction is an indicator of an individual -centered approach and results in a higher percentage of individual engagement with services.

Measurable Objective:

90% of individuals surveyed will report that they are satisfied with services received.

Method of Measurement: Individuals are given satisfaction surveys to complete.

Frequency of Measurement: Surveys will be completed upon discharge.

Utilization: The results of the Individual Satisfaction will be reviewed to determine changes necessary for ensuring a higher level of individual and family satisfaction.

Family Services

Recovery is a journey that affects everyone. Your family never needs to walk through it alone.

Family Services Brochure

All individuals participating in The Extension, Inc.’s residential substance use treatment program participate in the Reconnecting Families program, funded through generous support of the Amerigroup Foundation, which is comprised of family education and if appropriate: family therapy/counseling.

Family education, or training is a therapeutic interaction shown to be successful with identified family populations, diagnoses and service needs, provided by qualified staff. Services are directed toward achievement of specific goals defined by the individual and specified in the Individualized Service Plan (DBHDD, 2023).

Family training provides systematic interactions between the identified individual, staff and the individual's family members directed toward the restoration, development, enhancement or maintenance of functioning of the identified individual/family unit. This may include support of the family, as well as training and specific activities to enhance family roles; relationships, communication and functioning that promote the resiliency of the individual/family unit.

Family counseling provides systematic interactions between the identified individual, staff and the individual's family members directed toward the restoration, development, enhancement or maintenance of functioning of the identified individual/family unit. This may include specific clinical interventions/activities to enhance family roles; relationships, communication and functioning that promote the resiliency of the individual/family unit (DBHDD, 2023).

Specific goals/issues to be addressed though these services may include the restoration, development, enhancements or maintenance of:

Cognitive processing skills;
Healthy coping mechanisms;
Adaptive behaviors and skills;
Interpersonal skills;
Family roles and relationships; and
The family’s understanding of the person’s mental illness and substance-related disorders and methods of intervention, interaction and mutual support the family can use to assist their family member in meeting therapeutic goals (DBHDD, 2023).

All services are facilitated by licensed staff, in the evenings, on weekends, and virtually to the convenience and benefit of family members and individuals served.