Taos Pueblo Healing to Wellness Court Program

• TAOS PUEBLO HEALING TO WELLNESS COURT PROGRAM
• PROGRAM DESCRIPTION
• PLANNING & IMPLEMENTATION
• PROGRAM OUTCOMES

Summary: Taos Pueblo’s Healing to Wellness Court Program is a partnership between Taos Pueblo Tribal Court and Taos Pueblo’s Wellness & Recovery Program (WRP). The Wellness & Recovery Programis a holistic,science-based, outpatient treatment program for tribal members suffering from addiction and other related behavioral health issues. Clients of the program can be referred via the Tribal Court, the State Court, or through other avenues, such as self-referral or family referral. The program works with clients, offering individualized treatment programs that include individual counseling, MAT, group sessions, auricular acupuncture, biofeedback, and cultural traditions. Clients progress through 7 stages: 1 – 3 being the most intensive and requiring the client to take part in weekly Wellness Court sessions. In stages 4-6, clients attend Wellness Court twice a month. In Stage 7, clients plan their aftercare and attend monthly Wellness Court sessions. If clients progress seamlessly, they graduate in 9-months. However, it is acknowledged that relapse and other issues can and do come up throughout the clients journey, and that this may delay their progress.

Tribe:

Taos Pueblo

Program Running Length:

The Taos Pueblo Healing to Wellness Court Program started September, 2014.

Contact:

Mark Mash, Ph.D.
P: (575) 758-6900
F:  (575) 758-3346
[email protected]
P.O. Box 1846
Taos, New Mexico 87571

www.taospueblo.org/cms/taos-pueblo-tribal-court

Location:

Taos Pueblo, the northern most Pueblo, is located outside the town of Taos.

Land Characteristics:

Taos Pueblo has a high desert climate, sitting at just above 7,000 feet above sea level. Taos Pueblo is nestled at the base of Taos Mountain and the Pueblo’s 99,000 acres encompass mountainous terrain, a river valley, pasture lands and a high desert terrain which extends out to the Rio Grande Gorge west of the Pueblo. Sweeping views of the landscape reveal the surrounding mesas, canyons and mountains.

Population:

There are approximately 150 tribal members who live in the Pueblo village full-time.However, over 1,900 members live on family allotments surrounding the Pueblo village.
The Wellness & Recovery Program was developed to address the need of the Pueblo for a holistic wellness program that addressed addiction and related mental and medical health issues.The program works with adults and their families who are suffering from addiction and other co-occurring mental health issues. Clients of the Wellness & Recovery Program may or may not be involved in the criminal justice system.The Wellness & Recovery Program has its roots in effortsbegun by the tribe 15-20 years ago to address substance abuse problems. The transformation into an intensive, science-based, structured program with groups 6 days per week and 3 evenings per week occurred in September of 2014.The Wellness & Recovery Program’sgoal is to offer holistic, science-based, and culturally specific treatment to tribal members suffering from addiction and other related mental health issues.The Taos Pueblo Healing to Wellness Court is a partnership between the Wellness & Recovery Program and the tribal court to provide treatment and court supervision to persons suffering from compulsive or problematic use of alcohol and other drugs as a condition of supervised probation. The Healing to Wellness Court program offers an alternative to incarceration or jail for those who have been convicted of a crime related to addiction. The Taos Pueblo Healing to Wellness Court also provides the same treatment and court supervision opportunities to tribal members, not involved in a criminal case, who suffer from addiction. These individuals enter the Wellness Court by way of a Petition for an Adult in Need Care usually filed by concerned family members, social services or law enforcement.

The Wellness & Recovery Program (WRP) is a nine-month program that is divided into 6 levels of intensive out-patient care and an after-care/step-down level 7, that works with the client as they transition out of the program.The WRPhas three distinct phases:Early Recovery, Recovery and Wellness. Early Recovery and Recovery phases correspond with levels 1-6; theWellness phase is level 7. Early Recovery (levels 1-3) happensas clients are entering the program andbegin facing their addiction. It focuses on enhancing motivation for change and for learning the skills needed for sustained recovery. In the second phase, Recovery (levels 4-6), clients focus more on overcoming their addiction, identifying and utilizing coping skill and maintaining their wellness. Once the client is ready, they enter the Wellness phase (level 7), which lasts for three months. Here theywork on their transition out of the program, focusing on building and strengthening sobriety skills and maintain whole-body wellness (physical, mental, emotional and spiritual). There are three main “tracks” in the Wellness phase for clients to choose from, however clients can focus their goals in more than one track: (1) Health and Wellness; (2) Career and Job Readiness and (3) Adult Living (housing, transportation, healthy relationships, etc).

Movement through the phases is based off of “compliance” which is measured on an individual basis by the client’s meaningful engagement in their identified treatment planand documented sobriety. Four weeks of compliance are necessary in order to advance to the next level. A primary requirement for compliance, that remains constant for levels 1-6, is participation in “Core Groups” which happen twice a week in addition to a monthly “Family Night”. Core groups cover a range of topics associated with social support, relapse prevention and wellness. The monthly Family Night offers a space for families to come and heal together in a welcoming, sober space.

Throughout a client’s journey through the Wellness & Recovery program, their individualized treatment plans can include a range of services. All clients take part in individual and group counseling, in addition to education around addiction and relapse prevention. Other supportive services includeauricular acupuncture, therapeutic yoga, art therapy, Heart Rate Variability (HRV) biofeedback, EEG neurofeedback, and PEMF neuro-therapy.

The WRP program is designed to support traditional culture and practices. Clients are given full credit for any sessions missed due to traditional obligations. Most of the WRP staff are from the community so clients can peak in their Native language as desired. Clients are encouraged to reflect upon how their traditional practices can support their recovery and wellness while also considering how their addiction impacts their involvement in traditional culture and the community.

In order to ensure a client’s progression through the program as well as their compliance with their probation terms, the Healing to Wellness court is held every Tuesday. Before Wellness Court, program staff meet with the Wellness Court Judge Eisenberg, to go through the list of clients, their compliance levels and important notes such as results of random UA’s. After the debriefing, Wellness Court is held and each client appears in front of the judge to discuss their status, their progress, any setbacks and their terms of probation. Rather than a traditional court appearance, the Wellness Court appears more like a conversation between the judge and the client. Because the Judge is aware of the each client’s progress, issues and successes, he is able to personalize his conversation, sometimes speaking in the traditional Tiwa language when he feels it needed. Appearance in court is required and can only be excused by the Judge. Failure to appear can result in the issuance of a bench warrant and revoking a client’s “compliance” status.The Wellness & Recovery Program is overseen by the Taos Pueblo Behavioral Health Services. The compliance of the clients, and the terms of probation that need to be met are co-administered by the Taos Pueblo Tribal Court Judge, the court’s probation officer, the client’s case workers and the WRP director.Eligibility Criteria – any tribal member who is struggling with addiction can enter the WRP. The Wellness Court is open to clients who have been convicted of a crime as a result of their addiction, via the tribal or state court, or those who have received an “Adult in Need of Care” referral.

            Referral Process – participants can be referred to the program by the Taos Pueblo Tribal Court or the State of New Mexico, Taos County Magistrate Court. This is possible through the MOU that was developed between the State Court and the Taos Pueblo Tribal Court. Additionally, the Adult in Need of Care Program allows concerned individuals, families and friends the ability to refer clients to the program who are not involved in the criminal justice system.

            Supervision and Compliance – progression through the program is based on “compliance” status. Program attendees are required to attend meetings and actively participate in the program in order to be listed as “compliant”. Clients are also required to take random UA’s and attend Wellness Court sessions. Those clients who are referred by the courts must also comply with their other probation requirements to progress.

            Termination Criteria –Typically, clients are subject to a graduated sanction process when they are not compliant. Sanctions are based on not participating and/or failure to maintain sobriety based on positive UA’s or missed UA’s.  Motions to Revoke Probation can be filed depending on the number of sanctions. Based on the number of sanctions, a motion to revoke probation can result in termination from the program. Participants may also be required to drop in their level or to restart the program.The Wellness & Recovery program is funded through the Taos Pueblo Health Community Services Division. The Taos Pueblo Tribal Court is funded by the Bureau of Indian Affairs.noneThe Wellness & Recovery Program and the Taos Pueblo Tribal Court have a partnership in establishing and maintaining the Taos Pueblo Healing to Wellness Court. In addition, the Taos Pueblo Healing to Wellness Court, which includes the WRP, has an MOU with the Taos County Magistrate Court to provide tribal court supervision of tribal members who are on New Mexico state probation through the Magistrate Court. Finally, the program coordinates client care and transfers to various in-patient recovery and detox programs throughout the nation.Part of what makes this program so successful is the ability to individualize client’s treatment, really meeting clients where they are at. This allows the clients to progress as quickly or slowly as they need, leaving room for missteps along the way. In addition, the ease of communication between staff and departments makes the program easier to navigate and more efficient. There is a seamless transition between the court and behavioral health services, allowing for clear communication between staff and removing the barriers often faced by clients when dealing with different departments. Finally, the dedication of the staff and the integration of the cultural and community values to the program have helped it to thrive. Staff are willing to do what it takes to helps clients succeed and thrive, even if that means staying late or doing home visits to the clients.The greatest challenge is breaking up or disrupting the generational abuse of alcohol. Many of the clients come from families with a history of alcohol abuse and these clients have children who are now subject and witness to their abuse of alcohol. By supporting clients in sustaining lifelong recovery, it is hoped that they are the last generation to abuse alcohol and their children are spared from alcohol abuse.Much has been learned over the past 5 years. Every case of success and every instance with a less desirable outcome is used as an opportunity to consider what helped and what could have been done better.The prominent lessons learned include: (1) There can be no sustained progress in battling addiction without consistent, random monitoring of sobriety. For years, UAs were done only twice a week and clients who appeared to be doing well and reported sobriety were actually cheating the system by simply timing their use to avoid the scheduled UAs. Many clients who begin with little or no progress later report they turned things around once they realized they “couldn’t beat or cheat the system” by timing their use or by submitting false specimens. (2) The bedrock of any successful program is helping clients attain and sustain the motivation for change. Quite simply, the program must enhance through guided self-reflection and peer support for the client’s desire for health and sobriety. (3) Motivation, though necessary, is often not enough to make the desired changes. Three factors often set the stage for relapse and low compliance: (a) a chronically stressed autonomic nervous system which leads to vulnerability to stress, associated health problems, and increased cravings for use; (b) low executive functions, such as poor impulse control, low organizational abilities, and poor short term memory, are often the result of chronic abuse and, in turn, set the stage for a continued downward spiral; and (c) a lack of stable, sober housing makes it almost impossible for those early in their recovery to stay sober. The WRP program has evolved in large part to better meet the challenges of these three factors.Over the past 5 years, approximately 200 individuals have come through the Healing to Wellness Court Program. We currently have 5 participants through the MOU with magistrate court, 32 through Tribal Court probation, and 9 through the Adult-in-need-of-care process.On any given week, generally 80-90% of the clients (both on probation and AINC) are sober and fully compliant with their treatment. Over the course of treatment, about one third do very well from the start and complete the program with no sanctions and full compliance; another third finish with 2 to 4 lapses but generally stay on track and finish fully successful. The remaining third includes those who are referred to a higher level of care as part of their treatment and the 10% who never get sustained traction. Of those who complete residential treatment, the overwhelming majority relapse within days or a few weeks after returning home.The community has been extremely supportive of the WRP. Its success is recognized and as a result, it is well respected. In addition, the county and state governments have also been supportive, signing an MOU with the tribe that allows tribal defendants in the state system to take part in the Taos Wellness Court and Wellness & Recovery programs rather than going through state-run programs.Below are testimonials from two clients

• “My ongoing journey through recovery would not have been possible without the help and guidance of the Taos Pueblo Wellness and Recovery Program for which I am eternally grateful. The last relapse that I had experienced was earth-shattering, experiencing suffering on a scale for which I had never believed possible or imagined myself going through. The extreme trauma left me in state of utter despair and once I was in a stable mental and physical state, I visited the office of Taos Pueblo Behavioral Health. That initial visit was the first step towards my embracing of life after addiction and learning how to live in this world once again. On a weekly basis, I kept appointments with clinical staff who provided me with the support and guidance I so desperately needed. The regimen gave me a sense of normalcy in a life that had been turned on its head. My sobriety involved me burning down my entire way of life that had failed me so spectacularly and finding a new way forward. The way I viewed myself, the world around me, and my place in this life all had to be replanted anew and the ashes of my former self provided fertile ground for a new beginning. Week by week and month by month, I rediscovered my passions and the self within that had been buried for years under my addiction. The help I found in the Wellness and Recovery Program was invaluable to guiding me through this life-changing process and since that time nearly two and a half years ago, my life has never been better. This is no hyperbole, this is my truth and one that I live every day with a true sense of gratitude, joy, and hope. I now work for the Wellness and Recovery Program as a Peer Support Worker and am actively seeking my CPSW accreditation. It is my desire to help others find their own way out of that darkest of places within addiction using what I have learned through my own recovery. Finding and maintaining sobriety after addiction is one of the most challenging things a human being can ever experience but together with others, it is possible to love life once again.” – NS (past client)
• “My name is Alex and I am an addict in recovery. I was abusing drugs and alcohol for nearly 6 years before I had been placed under an Adult In Need of Care through social services and tribal court. It was then that I was ordered to work with a therapist from behavioral health, attend the Wellness and Recovery Program and enter in Wellness Court.  In the beginning I wanted nothing to do with any of them. I was constantly missing appointments and not following through with what I was supposed to be doing through any of their programs. Almost 2 years ago, my life was completely in shambles. I lost my job, lost custody of my children, my family wanted nothing to do with me and I spent numerous times in and out of jail. I was still actively using drugs and because of this the judge ordered me into inpatient treatment. Reluctantly, I entered a 45 day rehab. I was so stuck in my addiction that I was sitting on that plane only hoping that going to treatment would satisfy the court and my family. That I would go, get it over with and come back to doing the same stuff I had been doing, using drugs and alcohol. I had no intention of staying clean and sober. I got kicked out because I had still been exhibiting those old using behaviors. Leaving treatment, I was thinking “f*** them, I don’t need their piece of paper to keep me clean”, “I’ll show them!, “I can do it on my own!”. The reality was, I couldn’t do it on my own because up until then my way wasn’t working. But that day, I realized I wasn’t alone. I had my sober sisters and brothers in treatment. They supported and encouraged me. I wanted that, I needed it, that endless support. I looked for that here, at home, when I got back and it brought me back to the Wellness and Recovery Program. It was here where I found what I needed. My counselors and peers helped me navigate through life without the drugs. I threw myself into the program and everyday was a bigger blessing than the day before. I saw my therapist weekly, attended group sessions and was in Wellness Court where I spoke with the judge on a weekly basis. Being able to physically see the judge and knowing that he was concerned and vested in my recovery gave me a sense of accountability, it helped me be responsible where otherwise I was not. When I completed a year clean and sober, I was hired within the recovery program to intern. After interning for a year, I was hired on as a peer support worker. I’m now hoping to gain my CPSW licensure and continue working with people like me.

As of now. I have 21 months clean and sober. I have a job that I love. I have regained full custody of my children, I am happy, and healthy. I will forever be grateful for the behavioral health team, social services and the judge. They have done for me what I couldn’t have done for myself and they have supported me and never given up.” – Alex (past client)

Program Description PDF