In addiction treatment, staff members referred to as “techs” typically are defined by who they are and who they are not. Techs are not counselors. But they are the people who generally spend the greatest amount of time with patients in residential treatment programs, ensuring the logistics of treatment go smoothly.
Because of that close contact, they become the “heart and soul” of treatment, says Bob Ferguson, founder and CEO of the Colorado-based men’s treatment facility Jaywalker Lodge. Thomas McDermitt, senior director of clinical administration at Caron Treatment Centers, calls techs the “heartbeat” of the program. And Deni Carise, PhD, chief clinical officer of Recovery Centers of America (RCA), calls them “leaders.”
All three administrators say that without techs, there would be no treatment.
Empathy and professionalism
Out of 46 employees at Jaywalker Lodge, 21 are techs, which shows the level of importance they play in the program. The actual job of techs mainly involves day-to-day logistics, says Ferguson. For example, Jaywalker’s techs make sure patients are following their daily schedules.
But they also serve important roles in the early stages of treatment. For example, they might pick up newly arriving patients at the Denver airport, which is four hours away from campus. Some patients might be shaken when they arrive, says Ferguson, so the techs must step into a role that is far beyond just a transportation driver.
“You need a certain amount of intuitive empathy, of thinking on your feet to make sure every client arrives under the safest and best possible condition,” Ferguson says. “You don’t get two chances at a first impression. When you’re met at the airport and you’re filled with the anxiety of the fear of the unknown, it’s important that you are taken care of in a way that makes you feel comfortable.”
The techs also might need to stop by the local detox in Denver with a patient to have a blood alcohol test administered, for example, instead of going to directly to Jaywalker. But almost all of the techs at Jaywalker are former patients, says Ferguson, so many are familiar with the comprehensiveness of the recovery process and can offer empathy. While no rule requires that techs be in recovery, it is a trend among treatment centers.
Because techs rotate on site 24 hours a day, they also have a responsibility for contributing to security. Techs might be called on to handle de-escalation incidents that require more than direct clinical care. They are responsible for adherence to policies about self-harm and suicide and how to respond should something go wrong on an experiential activity.
“Our three largest buildings are located in downtown Carbondale,” in an open-community model, says Ferguson. “With this model of care comes responsibility on the part of the tech staff.”
Model of recovery
Techs also act as role models for a life of recovery.
“We function in a way that honors and respects the individual, but puts the health of the community first,” says Ferguson.
Instead of the self-centered, self-destructive, isolating behavior of addiction, techs live “structured consciousness,” he says. The simple act of getting up in the morning may be new to someone who has been addicted for some time. “No good sober day starts at 11:30 in the morning,” says Ferguson. “You have to get up, make your bed and clean up your room, not because it’s a moral virtue, but because it’s about other people—not just you.”
The positive attitude is conveyed as part of “milieu management,” not enforcement of rules.
“If you create a police state with consequences and penalties, you don’t get the benefits,” says Ferguson. “The techs are the ones modeling healthy recovery.”
He adds that techs see a lot of things that the counselors don’t, which could be helpful to the facility in enhancing recovery and building rapport with patients.
“Recovery doesn’t keep bankers’ hours,” he says. “It happens at night, it happens when guys come back from a meeting, it happens when they get a call from a girlfriend and they’re heartbroken, it happens on weekends when counselors aren’t around.”
Conflict at the community level
The close, comfortable relationship comes with cautions, however. Some patients leave treatment and stay within the local area to pursue a sober lifestyle near the place where they got well and to remain involved in alumni activity, says Ferguson, adding that there are 140 locally based alumni from Jaywalker who interact with the program on a weekly basis. There are 100 meetings a week near the facility.
However, patients and techs might run into each other around town. Good treatment programs should have strict policies on outside relationships and even on the extent to which techs can be “friends” on social media with current or former patients.
At Jaywalker, the average age of the patients is just over 24. “They don’t have a wife and two kids patiently waiting for them to return home,” says Ferguson. “They’ve achieved 90 days of sobriety for the first time, and they want to stick around.”
At Wernersville, Pa.-based Caron Treatment Centers, techs are referred to as “counselor assistants” (CAs). Caron has different units—adolescent, young adult, adult and senior—with different staffing patterns. Adolescent units have a higher tech-to-patient ratio than other units. The CAs help patients arrive at scheduled activities on time, are with them if they wake up in the middle of the night, and can be available to just sit down and listen to them, explains McDermitt.