Introduction to the Navy MORE Program Implementation of a

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Introduction to theNavy MORE Program
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• Implementation of a credible, research-based,
  effective recovery management system as part of
  the core initiative to improve the SARP continuum
  of care and treatment outcomes
• The Navy MORE program will build valuable long-
  term supportive treatment relationships with
  patients beyond their initial therapeutic
  experience.

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• What is Navy MORE?
• Web- and phone-based recovery support program
• Patient education and support
• Starting during treatment to 12 months into
  recovery

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• Evidence-Based Practices Utilized in Navy MORE
• Twelve Step Facilitation
• Cognitive-Behavioral Therapy (Relapse Prevention)
• Motivational Enhancement Therapy
• (Stages of Change)
• Community Reinforcement
• Contingency Management

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• Goals of Navy MORE
• Achieve higher recovery success rates
• Experience shorter episodes of relapse
• Experience improved quality of life by tailoring
  continuing education and support to individual
  needs
• Experience improved mission readiness by allowing
  patients to work on recovery across the country
  and around the world

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• What Navy MORE Is Not
• A substitution for primary treatment
• A substitution for meetings or fellowship
• An online therapy group
• A substitute for facilitated outpatient support
  groups (e.g., weekly continuing care groups)
• A substitute for individual therapy for
  co-occurring disorders

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• Who Will Participate in Navy MORE?
• All patients diagnosed as substance dependent
• Includes retirees, family members, and those
  facing discharge from the military

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• What Are the Core Engagement and Retention
  Strategies Used in Navy MORE?
• Mandatory registration of all dependent patients
• Introduction to Navy MORE and enrollment during
  treatment
• Motivational assessments and tailored content
  based on these assessments
• Regular follow-up calls and confidential emails
  from a Recovery Coach
• Seven personalized modules completed at ones own
  pace
• Social networking site

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Core Components of the Navy MORE Program

• Personal home page
• Assessments
• Recovery modules
• Progress checks
• Journal
• Workbook
• Commitments
• Serenity
• Relapse prevention plan
• Library of resources
• Fellowship
• Case Management Solution (CMS)

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• How Does Navy MORE Work?
• Track and record patient progress over 12 months
• Produce an interactive, tailored learning module
• Address specific recovery challenges identified
  in the assessment
• Generate flags to alert Recovery Coach

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• How Does Navy MORE Work?
• Patients in residential and IOP will be signed up
  for Navy MORE by the Recovery Coach
• Recovery Coach will be the only staff with access
  to the Navy MORE patient information
• IMPACT, continuing care and outpatient SARP staff
  need a familiarity with basic module content to
  support patients in their Navy MORE program

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• Does It Work?
• This information is based on the Hazelden MORE
  program outcomes.
• Module users have significantly better outcomes
  than non-module users.
• Predictive models suggest a positive relationship
  between module use and outcomes, even when
  controlling for motivation levels.
• Taken together, the data on module users and the
  predictive models suggest a positive relationship
  between use of the modules and outcomes.

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May 06April 07 discharges
May 07Dec 07 discharges
Does It Work? This information is based on the
Hazelden MORE program outcomes..
Continuous abstinence rates of module users vs.
non-users
May 06April 07 discharges
May 07Dec 07 discharges
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• Satisfaction
• This information is based on the Hazelden MORE
  program outcomes

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• Satisfaction
• This information is based on the Hazelden MORE
  program outcomes.

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• Navy MORE Module 1
• Make home environment safe
• Explore understanding of Step 1 and apply to life
• Strengthen focus on spiritual things
• Practice planning time and creating routines
• Identify high-risk situations
• Identify and practice strategies to handle HALT
  and stress
• Take steps to find or foster relationship with a
  sponsor

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• Navy MORE Module 2
• Get connected with a Twelve Step fellowship
• Explore understanding of Step 2 and apply to life
• Strengthen network of support
• Challenge negative thoughts
• Develop a plan for avoiding and dealing with
  triggers
• Develop skills to identify and manage emotions

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• Recovery Management
• The initial treatment episode is only the
  beginning ongoing care is critical to maximize
  sustained long-term abstinence.
• In general, continuing care is related to
  improved substance use outcomes following
  treatment. (Donovan, 1998 McKay, 2001 Moos
  Moos, 2003)
• Several studies show the longer the continuing
  care duration over time, the better the outcome.
• While the first six months are critical, initial
  research suggests even longer durations of care
  may be of benefit. (McKay, 2005)
• Navy MORE access to patients provides an
  opportunity for 12 months of support for
  sobriety.

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• Key Factors for Navy Purchase of MORE
• Scalability
• Accessibilitysupport travels with you
• Ships
• Bases
• Deployments
• On leave
• Less stigmatizing
• More candid

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• Customizations for Navy MORE
• Navy Language
• Information on Suicide PTSD
• Customization of technology
• Service development delivery
• Suicide Prevention Hotline
• Online Recovery Support Groups
• Training Navy Recovery Coaches

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• Role of the Recovery Coach
• Assist in the shift of focus of treatment from
  stabilization to long-term recovery maintenance
• Support, encourage, and guide for 12 months
• Post-stabilization monitoring
• Assessment flags
• Contact by phone calls (blue flags), email
  reminders, or push messaging
• Third-party contacts

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Role of the Recovery Coach

• Provide education and linkages to recovery
  communities and resources
• Refer back to modules, send articles, provide
  Twelve Step resources
• Assist with the transition from leaving treatment
  to returning to duty
• First blue flag call within 24-72 hour window

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• Role of the Recovery Coach
• Within the Case Management Solution (CMS),
  Recovery Coaches are notified of relapses and
  risks of relapse by a red flag system
• Early intervention
• Available to clients in crisis to help them
  develop plan to get through safely
• Provide additional resources

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• Role of the Recovery Coach
• Coaching is customized to meet the needs of the
  individual client
• Meet each client where he or she is at
• What is the client willing to do
• Help the client maximize personal potential
• Build self-efficacy
• Challenge the client
• Stretch the client out of comfort zone
• Rise to the challenge

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Recovery Coaching Tools

• Push messages
• Email reminders
• Case Management Solution (CMS)
• Flags to inform if not engaging or struggling
• Track when contacts are needed, make notes, and
  plan calls
• Reporting features

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• Navy MORE Tour Video