Looking In From the Outside

An experienced Recovery Coach from the States paid our Hay Farm clinic a visit and gave us an account of his observations that we are happy to share with you. We thank Dr. Ronald W. Hill for his kind and insightful thoughts.

Recently I had the privilege and pleasure of visiting the PROMIS residential treatment facility in rural Kent. As a counselor from New York City, I was curious about how drug and alcohol treatment was approached and carried out in the UK, as compared to treatment in the United States. I was delighted at what I witnessed at PROMIS for several reasons. However, before I go into the details of my experience at PROMIS, permit me to digress a little to give some idea of my background, working in treatment.

During my 20 year career I worked in a variety of treatment centers, with diverse patient populations. Those treatment centers included Hazelden and Cornerstone Medical Arts in Manhattan. Before moving to New York I worked in Portland, Oregon on the west coast at Lakeside-Milam, The Springbrook Institute and the DePaul Center.

I also spent 3 years as a counselor at a treatment center located inside a prison, and 3 years as an Assessment Specialist for NADAP, also in Manhattan. I mention these treatment centers to indicate that I have had quite a variety of experiences working in treatment.

The positive features that I noticed first about the PROMIS facility in Kent was the intimate size of it’s patient population and the cozy home-like atmosphere. The setting is a former farm with beautifully remodeled buildings that still keep a classic country feel. (And, I was assured that PROMIS provides transportation to their facility from anywhere in the UK.) These two features can be credited to the fact that PROMIS is still a family run treatment facility.

The residential facility for PROMIS contains 14 beds. The staff includes 9 counselors, an astonishing ratio of patients to professional staff. The medical staff evaluates, treats and supervises the detoxification process. PROMIS has a fine facility that includes a gym, art therapy room, several residential buildings and a cozy and comfortable group room. A Jacuzzi and sauna are also available to help ease the pains and physical discomfort associated with the detoxification process.

The chef provides both healthy and delicious meals, adjusting the menu to meet the individual needs of each patient. The meals are taken in the old farmhouse in a dining room where patients and staff share their meals together at a communal table.

There were a wide variety of patients in treatment over the weeks that I visited. Many came from the London area, but various parts of the UK were also represented. There were also Americans, French and Italians. For patients not fluent in English, PROMIS will arrange an interpreter. Such was the case with an Italian patient, who understood a great deal, but had difficulty speaking English.

The clients I met were from many walks of life as well, with a wide variety of ages and occupations represented. Interestingly, PROMIS provides the opportunity for a “top-up,” so former patients can return to treatment for a day or two.

Topping-Up is an essential part of the PROMIS multifaceted aftercare program. Patients return for top-up sessions, as they, in consultation with their counselors, desire. Patients may choose the most convenient PROMIS clinic to where they live, and stay at the clinic as many days as they would like.

In addition to the top-up program, PROMIS also has full outpatient and aftercare programs in London. Patients have the opportunity for overnight stays at that clinic as well. Again, in coordination with the clinical staff, the patient can choose the right time to return. Each aftercare plan is individualized depending on the patient’s needs.

Recovery is a continuous learning process. As each patient becomes accustomed to living a clean and sober lifestyle, various needs arise. With a holistic treatment approach, PROMIS provides the patient going through these recovery changes various forms of help, such as career coaching, meditative practices and couples therapy.

Much thought and care has been given to the development of the treatment schedule at PROMIS, including, as mentioned, art therapy, as well as meditation sessions, Psychodrama and music therapy. Every morning the patients do a check-in group session, sharing how they have felt during the past 24 hours and what their therapeutic goals are for the day. Thus, everyone, from the beginning of each day, is focused on treatment and recovery. In the evening various relaxation techniques are employed, including, Shiatsu, a traditional Japanese massage therapy, to help the patients sleep soundly.

PROMIS also provides individual care for new patients in need of detoxification. The doctors and nurses of the medical staff closely monitor the detox process. The medical staff continues to monitor the physical well-being of each patient throughout treatment.

Once physically stable, the patient joins the group sessions. In addition to traditional group therapy, each patient is assigned to a primary counselor who meets with the patient in individual sessions on a regular basis.

For myself, as a veteran clinician, the most exciting aspect of PROMIS goes beyond the scheduled sessions and various therapies, to how the entire staff treats each patient as an individual, and not just a list of symptoms. Because of its intimate size and dedicated staff the overall atmosphere is not only welcoming and comforting, but many members of the staff are themselves in recovery.

An unfortunate trend seems to be creeping through the treatment industry in American, more and more qualified counselors, themselves recovering from addictions, are being replaced by social workers and psychologists.

Thus the element of trust and identification with a fellow addict or alcoholic, the cornerstone of A.A. and other 12-Step Fellowships, is slipping away from treatment in America. Not so at PROMIS, where most of the staff, while being trained and experienced professionals, are themselves in recovery. They share their experience, strength and hope with their patients, in a prudent and effective manner. Thus, therapy is solution based, illustrated and underlined at times by the real life experiences of the staff.

I dare not leave out the important fact that treatment is not just confined to the PROMIS campus. Staff members escort patients on regular outings, including golfing, bowling, and even hovercraft rides. Thus, patients begin to experience how to have fun in recovery. Patients are also given the opportunity to attend and experience various 12-Step meetings, including A.A. and N.A. Attending these meetings gives them a good introduction to 12-Step recovery, should they choose that path.

If this sounds like unapologetic praise for PROMIS, it is. PROMIS lives up to its name, the promise of a fulfilling life in recovery, as demonstrated by it’s dedicated professions. From the first day I visited PROMIS, and as I continued to return each week, I developed the clear understanding that here was a staff of counselors who were enjoying the fruits of a clean and sober lifestyle, and passing it on.

Over the weeks I witnessed extraordinary changes in the patients as they at first struggled with the detoxification process, and the fact that they were in treatment. Many patients went from isolating in their rooms, to joining groups, to being actively involved in groups, to becoming inspiring leaders. It was obvious that these patients had found hope in the promise of a new way of living. Their smiles and laughter, both in and out of groups, spoke volumes to the good works of the PROMIS residential treatment center.

Ronald W Hill, Ph.D.