Having found several occasions to commemorate their treatment facility's 50
th anniversary in 2007, leaders at Little Hill-Alina Lodge are viewing the past with few regrets and looking ahead with a consistency of purpose. Amid all the new research discovery that some say is transforming the addiction treatment community, this New Jersey-based center believes there is more evidence than ever that its founder's vision of long-term residential treatment for those she called “reluctant to recover” must continue to be put in practice.
“If you really understand the Big Book, its ideas have always been aligned with the work of good docs,” Alina Lodge Executive Director Mark Schottinger said in a recent interview with Addiction Professional, describing how Alina Lodge's past meshes well with treatment's future. “The neuroscience actually backs up Mrs. [Geraldine O.] Delaney's ideas about [treatment as] the ‘tincture of time.’” Schottinger describes the ideal for treatment as “a quilt with both spirituality and science.”
2007 has been a year of celebration for the Blairstown, New Jersey organization. Besides holding a 50th anniversary gala and a June picnic that commemorated the late Mrs. Delaney's birthday, Alina Lodge sponsored events in many cities across the country with an alumni network that remains fiercely tied to the organization. Alumni make up about 80% of Alina Lodge's donor base—strong evidence of the impact the organization has had in its niche area of long-term treatment for those who have experienced failures in other attempts to get well.
“We're definitely the Mayo Clinic of bad cases of addiction,” Schottinger says in characterizing Alina Lodge's longstanding national reputation. “People will say about our program, ‘Before you die, try this.’”
Schottinger and the Alina Lodge staff are happy taking one consistent approach to treatment and executing it well. Long-term residential treatment is the cornerstone of the agency's services. An aggressive fundraising effort makes this possible in the face of funding restrictions on longer-term stays. In fact, Alina Lodge staff hasn't wrestled with insurance requirements for some time—Delaney made the decision to get out of that game way back in the 1980s.
“One of the problems in our field is that everybody sounds the same,” Schottinger says. “If you go around and ask 40 people about their services, they all do what we do. Programs all want to say that they do everything.”
Yet Schottinger says what distinguishes the Alina Lodge model is that clients and program staff truly do not know how long any client will stay in the program, as the duration of services truly depends on the client's progress. He calls the indeterminate length of stay the facility's “Coca-Cola formula,” the secret to years of success.
Residential stays generally range from about 7 to 14 months and require intense client work that is rooted in 12-Step principles. “Our treatment days are longer than a typical day in a 30-day center,” Schottinger says. “People are in treatment for 14 hours a day for days and months on end.” Personal responsibility is at the heart of Alina Lodge's vision for recovery, and it manifests in everything from the daily class sessions to an exercise routine to a dress code for dinner.
Because of the rigors of the treatment experience, it also takes a special kind of clinician to work at Alina Lodge, Schottinger believes. While at many centers the typical clinician will experience a turnover in caseload 12 times a year, the clinician at Alina Lodge is usually working with the same clients for a year or more. Many of these clients present special challenges in that they have grown “treatment-wise” and are consumed with a sense of entitlement, fueled in part by their past failures in other programs.
“Our staff must have an intangible persuasive ability to follow the client through his own hell to get better,” Schottinger says. “Just the mechanisms of the craft of counseling are not enough.” He adds, “80% of the people who work in the field couldn't work here very easily.”
Not standing still
While Alina Lodge leaders know it is important for them always to honor the past in what they do, they also welcome positive changes in the field that can help make their programs stronger. Schottinger says one area in which the organization has advanced significantly in recent years involves the integration of mental health expertise in order to do a better job in addressing co-occurring psychiatric disorders.
Alina Lodge also has engaged in aggressive capital fundraising in order to upgrade services. Two projects that were completed this year thanks to a $14 million capital effort are the 10-acre Haley House property, a halfway house for women across the street from the main campus, and the Geraldine O. Delaney Meditation Center and Chapel.
Fundraising remains central to the agency's goal of keeping costs down for clients (Alina Lodge actually eschews the use of “client” in favor of “student” to describe individuals in its program). “After 50 years, our rate is $235 a day, while a lot of other facilities are in the range of $500 to $2,500,” Schottinger says. A $7,300 nonrefundable fee for the first month is collected at admission; medical and psychiatric services are billed separately.