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Chris Allen
Apr 18, 2011

Pre-Treatment Change

What happens when you plan a vacation? Do you get excited about the upcoming trip you are getting ready to take? Of course you get excited! If you don’t, there’s probably something wrong and what you’re taking probably shouldn’t be considered a vacation. You probably plan your itinerary with regards to what you will see, who you will visit, what foods you will eat, what memories you will make, and what you will pack.

I know that when we plan trips, Jen and I are very excited about what we will see and do. We become very excited about what we will soon be experiencing together. In actuality, she does most of the research and in turn, I get excited about what she’s planning for us. My biggest contribution is driving and ensuring that our dogs make it to the kennel.

What about Counseling? Do your clients get excited about going to Counseling, or do they feel pretty defeated by the time that they enter your office? What about the goals that they develop prior to your first session? Are they well developed goals, or do you spend a few sessions trying to figure these things out with your clients?

I’d venture to say that your Clients probably do not put the same amount of effort and excitement into planning a counseling experience. Am I right?

In my research for V&B, I’ve come across numerous articles describing the concept of pre-treatment change. In short, most articles and the data being described indicate that clients who report the greatest amount of pre-treatment change have a better chance of completing counseling end ending on the agreed upon termination date. Those reporting the most pre treatment change are more than likely you most “invested” clients in the counseling process.

At the Vine and Branch (V&B), here is an example of what I see pre-treatment change looking like.

Let’s take this fictitious couple as an illustration. I will call them Jim and Fran. As time permits, I am writing an example of a three week stay for Jim and Fran Smith at the V&B.

A retired couple leaves the Army after 25 years of service. There are all kinds of issues that need to be worked through for Jim and Fran. Fran learns from a friend about V&B because her friend’s Pastor spent three weeks at the V&B observing and learning about working with Veterans. Fran decides to check out V&B on a whim as she plans for her family’s summer vacation.

Money is tight for a vacation, especially now that Fran and Jim are only living off of his retirement income, so options are kind of limited. They live in Chicago now with their oldest son while Jim and Fran look for work. Both are in their mid 40’s and not ready to fully retire. During her search of the V&B website, Fran notices that V&B is located on a huge ranch in TX. (hypothetical here). In her mind, Fran also realizes that they need some kind of help, but she doesn’t know how to approach her husband about the idea of “talking to someone.” She says to herself that Jim’s never been the type to ask for help from anyone, not even their new Pastor. The old friends that Fran and Jim used to talk to, people in the military, are scattered all across the United States and have seemingly moved on with their lives.

Fran further explores V&B’s web site and discovers that the three week standard vacation does not cost a thing! They could actually arrive at a cabin that’s fully stocked with food when they get there. There’s fine dining, massage therapy, horseback riding, hunting, fishing, gardening, quilting, and a host of other outdoor and indoor activities to be enjoyed for absolutely free. There are even healthcare and entertainment industry professionals that live on site who are there to help, people who understand what they are going through.

Fran decides to take further action and arrange a meeting with her friend’s Pastor. They belong to a different Church in town, so Jim agrees to have lunch with Fran and her friend’s Pastor. Everyone in the neighborhood calls him “Pastor Rick.” Pastor Rick served several years in the Army and left years ago to become a full time licensed minister. In his own congregation, Pastor Rick has several Veterans. Some of them have become very close friends. He noticed that over time some of them needed more guidance then he knew how to provide. Pastor Rick knows that V&B has a 3 week training program for Pastors and decided to attend a few years ago. The information he provides to Fran and Jim is based off of his experiences while attending as a member of V&B’s “Best Practices Group.”

During a 3 week rotation on the Best Practices Group, of which there was a visiting Marriage and Family Therapist, Shift Supervisor for a national trucking company and a former V&B guest. The Shift Supervisor and MFT Counselor were never in the military but were interested in Veteran’s issues for differing reasons. The trucking company’s workforce is largely comprised of Veterans and the MFT would like some professional development.

Pastor Rick describes how members of his Best Practices Group were able to immerse themselves in V&B’s welcoming and comforting atmosphere. They were permitted to actively participate in V&B’s outdoor activities, groups, and professional treatment staff discussions. Additionally, the V&B Best Practice members were able to provide insights and observations to V&B Staff Members at the end of their 3 week visit.

Pastor Rick saw lives changed. He now had a better understanding of what he can do to help members of his congregation. The Shift Supervisor better understood the complexities and dynamics of his employees and was able to provide a different cultural insight into V&B guest’s lives. The MFT was able to share and receive concepts with both V&B Counselors and its guests. Equally as important, these people are tied into V&B’s continuity of care effort.

The visit goes surprisingly well with Pastor Rick, so Fran and Jim decide to explore V&B’s website together this time. In doing so, they see a link for V&B network contacts. To their surprise, there is a counseling practice 20 minutes away that’s affiliated with the V&B. Let’s call the practice “New Hope.”

With encouragement from Pastor Rick, Fran and Jim schedule an initial office visit with a Counselor at New Hope. They meet with a PLPC by the name of Caroline. Caroline knows about the V&B because she earned clinical hours while assisting her Supervisor as part of V&B’s Equine Outreach Group. With Fran and Jim’s permission, Caroline conducts a standard initial clinical assessment.

This one time visit with Caroline serves multiple purposes: first, enough background information is gathered during this interview to send to the V&B clinical staff. Prior to Jim and Fran’s arrival, V&B Staff will have some prior knowledge of their future guests. They will use what they learn from Caroline’s initial interview to form an initial “vacation plan.” (I know it sounds corny, but I’m researching the concept of what this will look like.)

Secondly, Caroline makes a three week reservation with Vine and Branch. Availability is limited, but Caroline is able to secure a reservation for the next month. Jim and Fran are excited about their upcoming vacation and start to talk about what they want to achieve and about being able to relax in a place where people understand what they are going through. “Pre-treatment change” is already starting to happen b/c they are taking action, and people around them care and are taking action. Jim and Fran are also impressed by their experience with Caroline and decide to follow up with her when they return from their V&B experience.

Sound possible to you?

Chris Allen is an Army Officer currently serving in Afghanistan who counsels Soldiers on a volunteer basis and will pursue licensure upon his return. He is passionate about developing counseling practices that best address Veterans and their families. Blog comments are not representative of the Army or Department of Defense.

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