There was a time—the very brief time that marked the heyday of the rehab center in the 1970s—when service work, or volunteering, was considered an essential, therapeutic part of treatment for substance use disorders. Several studies on the value of volunteering were conducted and published. But, as addiction researcher and historian William White tells Addiction Professional, “The use of volunteers was phased out as part of the professionalization of addiction treatment in the 1980s and 1990s.”
Now, volunteering is coming back. The reason, say many treatment providers: It works.
“Our programs use service both with residential clients and alums to promote recovery,” says David Sack, MD, chief medical officer at Elements Behavioral Health. Sack recommended that we talk to Patricia Meyers, executive director of alumni and client services at Promises Treatment Centers in Malibu, Calif., who he says “has kicked this up to an entirely higher level.”
Says Meyers, who has been in recovery for 21 years, “It’s about the effect of altruism and empathy on decreasing impulsivity.”
At Promises, as soon as a patient in residential treatment is medically cleared, “We start talking to them about their participation in service,” says Meyers. Promises partnered with Heal the Bay, an organization based in Santa Monica, to have patients help “adopt a beach” by keeping it clean. “It’s part of our core philosophy in terms of giving back to the community,” Meyers says.
But for such service work to have an effect, staff “from the top down” need to embrace the idea, she says. “If I didn’t have the team talking to the clients about this, about this is who we are and what we do, the clients wouldn’t do it,” she says.
Many Promises patients are well-to-do people who have not done volunteer work before. As one said to Meyers recently, “'What am I, in jail? I’m not going to go out and clean the beach.’”
Meyers, who has been at Promises for years, recalls that “back in the day, all the clients had chores. It wasn’t even a consideration that you would say no.” She adds, “It took me a while to get everyone on the same page.”
When Addiction Professional spoke to Meyers in the spring, she was getting ready for the yearly “hunger walk,” in which patients and alumnae walk to raise money for a food bank.
Helping low-income patients
Promises also started a foundation—not owned by Promises anymore but still connected to the organization—that runs the Miriam’s House program for low-income women to stay together with their children while in treatment. Current Promises patients, and alumnae, help provide child care at the house when the mothers are in 12-Step meetings, Meyers says. Current Promises patients have to have been in treatment at least 30 days before they can volunteer for this work, which is first feared and then coveted by patients.
“The nature of the disease of addiction is self-centered,” says Meyers. “My whole thing is to get people to stop thinking about themselves the whole time.”
Bringing these patients from the high-end Promises campus to Miriam’s House does that. “These women have nothing,” Meyers says of the Miriam’s House residents. “It is profound what happens—Promises clients would never have met women like this in their lives.”
Some patients and alumnae don’t do any volunteer work. “They write a check,” says Meyers. “The problem is, people are more and more removed from having high-touch relationships.” While donations are always helpful to treatment programs, giving of oneself is more meaningful in terms of recovery, Meyers suggests.
Keeping it optional
At Jaywalker Lodge, a men’s-only residential program in Carbondale, Colo., volunteering is indeed voluntary—but everyone wants to do it as a result. “We’ve always had a very robust volunteer program,” says founder Bob Ferguson.
All of the service programs are optional, so no one is forced to participate, says Ferguson. But that hasn’t always been the case. “I’m old school—everybody on the bus,” he says. “But we learned over time that if we just put up a sign-up sheet, and gave the guys a choice, then everybody would sign up.”
If volunteering is required, it “feels punitive,” says Ferguson. “It’s ironic,” he says. “Our guys volunteer to put on an orange vest and clean up the highway, because they want to. There are people in the corrections system who have that as a punishment.”
Jaywalker is located in a town, a small mountain community. “We’re not a secluded sanctuary in the hills,” says Ferguson. “This makes integration with the local community natural and necessary.”
Jaywalker also conducts a weeklong trip to the Pine Ridge Lakota Native American reservation in South Dakota, offering it three times a year. An 18-hour drive, the trip is an “educational and cultural immersion” opportunity, Ferguson says. No one is forced to go. There are eight patients, two staff members and two alumni. This is done with patients who are out of their first 90 days of active treatment and are in the transitional phase, working or going to college part-time but still residing in the area.
At Pine Ridge, the patients work with a volunteer organization called Remember, living in a bunk house with gender-separate sleeping rooms and a large dining room. “Our men are integrated with church groups and graduate students from around the country,” says Ferguson. “They work very hard during the day, getting handicapped ramps on trailers, doing winter insulation, building bunk beds. At night, a speaker from the reservation comes and talks to them.”
There are also volunteer opportunities back home in the Carbondale area. For example, 10 men sign up to feed the homeless in Glenwood Springs, about 20 minutes away. “The chef helps them cook up a gigantic meal,” says Ferguson.