Leaders at Kirksville, Mo-based Preferred Family Healthcare largely came up empty when looking for examples of how other programs incorporated use of smartphones into the treatment schedule for their young, technology-dependent patients. Nearly all other addiction and mental health treatment programs still were banning cellphone use outright in their residential settings, so Preferred Family Healthcare leaders had to devise their own strategy for the patients residing in their young-adult program in St. Louis.
Preferred's approach strikes a balance between keeping patients engaged in treatment and not cutting them off completely from their coveted contacts on social media. The vehicle for staying connected is found during the young-adult unit's “Tech Time,” which takes place from 9 to 9:30 p.m. each evening.
“Our young adults are on Twitter, Facebook, Instagram, and probably a number of things I'm not even aware of,” says Cori Putz, vice president of substance abuse treatment. “This is the way they're primarily connecting with peers.”
Those who enter treatment in the 16-bed Advance residential program sign a contract that outlines the terms and responsibilities associated with participating in the half-hour period each night. Preferred leaders say the effort is working on many levels, from serving as a pleasant surprise to residents who figured they'd have no phone use whatsoever while in treatment to becoming a learning tool as patients encounter developments in their social circle as they proceed through early recovery. The organization is now considering extending the policy to its other treatment programs.
“These young people are using technology almost 24/7, sometimes even having messages interrupt their normal sleep,” says Jim Wallis, Preferred's vice president of community development. “This is also teaching them that they can live without a connection 24/7.”
Living by rules
Among the patient contract provisions is a promise to place tape over the camera lens on the individual's phone, to maintain all patients' privacy. Also, new patients generally have to wait several days before they start participating, so that they can first demonstrate stability in the program.
A pair of workers monitor the room where Tech Time takes place, watching but not controlling patients' online activity. Individuals who do not own a cellphone may use one of Preferred's laptop computers during this time.
Staff members never demand that a patient take steps on social media to de-friend a potentially bad influence, or to take down a photo that may be misinterpreted, but they constantly look for opportunities to educate, says Putz.
“There are a lot of choices to be made in recovery,” she says. “We never say you have to do something, but at least we don't ignore it.”
In one situation Putz witnessed, a counselor studied media images of women with a female patient and then compared those to the patient's own social media posts, to help her understand how her depictions might be perceived and if any could place her in a risky situation.
In most cases, patients stay mindful of what the rules for usage are, appreciate the opportunity to stay connected, and live by the contract. On a few occasions the staff has had to re-orient someone to the contract provisions, but the facility has not had to revoke anyone's Tech Time privileges as a result of abuses, the staff reports.
Pre-implementation concerns, ranging from early departures from treatment on the advice of a social media friend to the possibility that contacts would be used to get drugs brought into the facility, simply haven't materialized, says Putz.
“It has actually been a great motivator,” she explains. “When someone is having a real-life issue, it presents opportunities to practice conflict resolution. Sometimes, a more artificial [treatment] environment doesn't allow us to address these things.”
The 9 p.m. time frame allows patients to conduct an end-of-day check-in with their friends and loved ones, much as someone would do after work with their e-mail and/or social media accounts. “We experimented with a lot of different times,” Putz says. “We tried it closer to dinner, but people were rushing through their meals to get to it.”