Hello future resident!

I personally invite you to visit LeMont Michel – the beautiful home we’ve built right at the bottom of Little Cottonwood Canyon near Sandy, Utah, along the aspen-lined banks of Little Cottonwood Creek.

Although LeMont Michel is indeed a beautiful house, it is important to remember that it is just a house. The brick and wood and marble are not really what make LeMont Michel special. What makes life here so special is the fellowship built by the men who live here, and the program they work inside the house. We designed this program to give them the best possible chance of getting through the difficult period of early recovery, and to help them find that a life of sobriety can be full of joy and meaning.

Inpatient treatment and detoxification are important. They are about healing. But life at LeMont Michel is about performance. This is where the rubber meets the road, and residents put their new sobriety skills to work – to apply their recovery tools and meet the stressors and challenges of normal life.

That’s why we call our program applied recovery.

applied recovery is more than just sober living. It is an individualized, evidence-based, person-centered approach to planning out the first year of sobriety for people who have completed either primary treatment and/or detoxification from drugs and alcohol.

You’ve probably heard that addiction is a chronic disease – much like diabetes or asthma. applied recovery is a form of disease self-management. It uses the same principles that doctors and nurses use to help other patients with chronic diseases learn how to manage their conditions successfully and lead long, healthy lives. We think people with addictive disorders are no different from other patients with chronic diseases, and that they can have the same chance at success and live the same kind of long, healthy lives if they are given the same kind of support.

applied recovery draws on over three decades of lessons learned in the treatment of professionals with drug and alcohol problems – people like pilots, doctors, and lawyers. The whole point of these impaired professional programs is to ensure workplace safety by making it easy for people with drug and/or alcohol problems to self-report for treatment and begin long-term monitoring of their recovery within a context of positive peer support and respect for their value as professionals. These programs strive to return the recovering professional to his/her job and family, link him/her with the recovery resources of his/her home community, and provide on-going support and monitoring as his/her sobriety skills develop. These programs have been immensely successful. They have saved many careers and lives. It is a fundamental assumption of applied recovery that if this same support is given to all persons seeking recovery, they too will enjoy similar success rates.

So what exactly is applied recovery?

applied recovery is disease self-management

It is important to understand that applied recovery is not treatment. In fact, no clinical services are offered at the LeMont Michel facility itself. applied recovery is a form of disease self-management whereby the staff at LeMont Michel link residents to the clinical services available in their community, encourage them to utilize those resources as well as attend mutual support groups such as Alcoholics Anonymous, monitor symptoms of their addiction and signs of relapse, and provide peer support for rapid and effective problem-solving and decision-making.

The definition of “disease self-management” is a new term in primary care medicine. It refers to a shared effort between clinicians and patients to create a set of integrated and comprehensive health care interventions for people with chronic conditions that require self-care. Disease self-management helps patients learn and practice the day-to-day tasks they must carry out to life a healthy life with a chronic illness.

Disease self-management programs are applicable to almost every kind of chronic disease including diabetes, asthma, heart and kidney disease, depression, and chronic obstructive pulmonary disease (COPD). These programs have been shown to minimize the effects of the chronic disease in question, improve the quality of life of patients with chronic diseases by increasing their self-efficacy and satisfaction, and decrease health care costs by improving patient compliance with treatment and decreasing emergency room visits and re-hospitalization.

applied recovery is patient-centered.

There are many roads to recovery, and every recovering person can find their own way if their choices are respected and supported. applied recovery respects the preferences, needs and values of each individual resident. The resident sets his own sobriety goals, and LeMont Michel staff work with each resident to customize his own treatment plan. As part of that shared decision-making process, every resident has unfettered access to the medical information and clinical knowledge they need to make informed decisions about their recovery plan.
applied recovery also recognizes the meaning of the statement “addiction is a disease” - namely, that people in recovery are patients, in every sense of the word. So AR rejects the old style of heavy-handed confrontation and coercion that dominated treatment of the past, and would never be allowed in any other area of medicine. The program believes that the same ethical principles that apply to the treatment of other patients apply to the treatment of people in recovery. So at LeMont Michel we do not speak down to residents. We don not try to dominate them. We feel these practices only reinforce the stigma against recovering persons, and do little to restore their capacity for making healthy choices.

applied recovery is safety-focused.

applied recovery understands that relapse is an unfortunate but expected feature of the recovery process. So applied recovery homes utilize daily drug testing and breath analysis for alcohol. We don’t do this to “catch” the addict doing something “bad.” That’s not the spirit of applied recovery. We test frequently to provide the safest and most supportive environment possible at LeMont Michel. If a LeMont Michel resident does relapse, this is detected quickly before dire consequences can develop, and handled definitively but in a clinical, not punitive, manner.
We have built safety into the program at LeMont Michel. In its publication Improving the Quality of Health Care for Mental and Substance-use Conditions, the Institute of Medicine emphasizes the need to reduce medical mistakes and prevent injuries to patients from the healthcare that is intended to help them. For a resident at LeMont Michel to relapse to drugs or alcohol and not have the staff detect it is a medical mistake – something equivalent to a patient in an intensive care unit having a heart attack and the doctors and nurses not knowing it. Such a situation is dangerous and can result in a relapse having far more serious and perhaps permanent consequences than necessary.
So applied recovery is designed to reduce risk and ensure safety by placing greater emphasis on elements of care that prevent mistakes such as undetected relapse. This is why we put such a strong emphasis on daily testing for drugs and alcohol. We perform these tests to the highest standards of reliability and accuracy. For these same reasons, applied recovery homes utilize a strict and highly-controlled protocol for the safe administration of medications. And as part of their stay at LeMont Michel, all residents will compile an Electronic Medical Record documenting all past and present treatments as well as evidence of the effectiveness of their current efforts.

applied recovery is evidence-based

In the past, very little of what went on in addiction treatment centers was backed up by good scientific evidence. This is changing. The expectation in medicine is that clinical decisions should be made according to the best available information from research. This is called evidence-based practice.
We feel a moral obligation at LeMont Michel to make sure that the care we provide is actually proven to help people in early recovery. So applied recovery shares the same commitment to evidence-based practices that other areas of medicine hold themselves to. Our staff members use the best available information in assisting residents to formulate their treatment plan, recommending research-proven therapies such as cognitive-behavioral therapy and motivational interviewing. And applied recovery measures its outcomes in real-time, taking daily assessments of symptoms, recovery skills and attitudes as well as daily testing for drugs and alcohol.

applied recovery is fair

Early sobriety is an emotional time for addicts. They can be very sensitive to situations they perceive as unfair. applied recovery homes strive to be as structured as possible without being stifling, and transparent and upfront about all rules and procedures. These rules are not arbitrary and capricious. Their rationale is explained; they are not dictated. Testing is done not to police residents, but to support them. Fee and refund policies are straightforward and similar to those at other healthcare facilities such as hospitals and clinics. Additionally, applied recovery understands that corruption is a very real danger in sober-living environments, so it takes special care to have protective mechanisms in place to protect patients.

applied recovery is eclectic.

In listing principles of effective treatment, the National Institute for Drug Abuse points out that no single treatment is appropriate for all individuals, and that counseling, behavioral therapies and medication can all be an important part of an effective recovery plan. There are many pathways to recovery, and there is no wrong door to enter recovery.
We agree. So applied recovery homes are set up in ways to help members coordinate and launch their own individualized aftercare plans. Residents, with guidance from staff, find their own path to recovery, with daily drug testing and symptom monitoring as a guide to whether or not their path is working. AR homes are community-based and provide access to those community resources that are best suited to the needs and preferences of the resident – twelve-step support, faith-based programs, or medication assisted recovery to name just a few. Pathways to recovery are often highly personal and grounded in the individual’s social, cultural, and spiritual values. At LeMont Michel, we help each resident find the path that is best able to help them change on their own terms.

applied recovery is family.

applied recovery understands that no one gets sober alone. Social support is critical in the first year of sobriety. The group acceptance and reinforcement of shared values in recovery that come with any strong family are a major part of the program.
The applied recovery program and life at LeMont Michel create a sense of family with weekly activities that foster a sense of belonging and acceptance. It is in this nurturing, safe environment that addicts in recovery can accept support from people who they know care about them, and can give support to people they care about. Every member of the family in an applied recovery home is important. Each person contributes special strengths and gifts. All are appreciated in our family. Our program seeks to create a feeling of family in each resident – a family that understands and loves them, one that has watched them work hard and grow, and one that is proud of their accomplishments.

applied recovery is home.

applied recovery understands that when trying to do good work in early recovery, the setting matters. LeMont Michel reflects our commitment to provide an environment that is conducive to creating a solid sobriety. Run-down environments degrade both respect for the house and the motivation to stay sober. But pleasant surroundings – a comfortable bed, a new kitchen, a clean bathroom - allow the addict to come home each evening to a house they are proud of and can call their own. applied recovery shows respect for its residents by providing homes that are tidy and in good repair. Not all applied recovery homes will be as opulent as LeMont Michel, but they all help residents feel comfortable and cared for so they can get down to the task at hand.

applied recovery is community.

Every community in the United States, no matter how small or remote, contains a population of recovering people. They don’t always make themselves known, but they are there – living, working, raising their families, and leading fulfilling lives. AA is one place to find these people, but not the only one. After giving up drugs and alcohol the world can be a lonely place for the newly sober addict. The local recovering community is vital to welcoming the addict back into a normal life.
A major task of applied recovery is to put its participants in touch with their local recovery community. They need to see how other addicts stay sober, solve problems, and live happily. People in early recovery need good role models. They need a pathway out of the pain and shame that can hit the addict hard in their first year as they start to realize just how much damage they did in their addiction. A strong recovery community can counter a common but dangerous tendency in newly abstinent addicts to isolate.

applied recovery is spiritual

applied recovery works from the position that a meaningful and rewarding life free of drugs and alcohol requires more than just treatment, medication and abstinence. That’s just sobriety. applied recovery shoots for actual recovery.
The importance of meaning and purpose in the recovery process is the very heart of AR philosophy. The key objective of applied recovery homes, and all that goes on in them, is to create an environment that fosters the addict’s spiritual growth: finding meaning in their suffering, forging a personal purpose out of that suffering, rediscovering one’s own values and holding oneself accountable to those values – these go beyond what mere medicines and therapies offer.
applied recovery does not reject the use of medications - quite the contrary, it embraces any tool that has been shown to relieve the addict’s suffering and increase their likelihood of remaining in recovery. But AR also understands that treatment for addiction will never involve only the mere prescription of medications.
Research clearly supports the effectiveness of things like cognitive-behavioral therapy in the treatment of addiction. But much of what goes on in the brain of an addict is pre-cognitive. And addiction is more than just a set of behaviors to be modified.
It is our contention that we can tinker with the genetic, the reward, the memory, stress and the choice levels of addiction brain processing all we want. We can ease symptoms. We can even stop craving. We may even be able to erase drug memories someday. But the only thing that will truly change the addict’s deep, emotional attachment to their drug, and the personal meaning they give it, is something deeper, more personally, more emotionally, and more spiritually meaningful. The only way to compete with the meaning that drugs have for the addict is to validate that meaning, and then help the addict find a greater meaning from things in recovery – in other words, a higher power.
Thus, AR emphasizes that spirituality—that which is deeply, personally meaningful--is an indispensable component of a long-lasting, penetrating, stable and resilient recovery. This meaning will be highly specific to the individual. To achieve this, applied recovery seeks to return those things in the addict’s life that give them meaning. applied recovery strives to help the addict restore their power of choice, which in turn restores hope in the effort to obtain those things that are deeply spiritually meaningful.

applied recovery is hard

applied recovery asks a great deal of its members – more than most other treatments for addiction. Whether it involves school, job or volunteer work, the day of an applied recovery member is busy for the simple reason that idle time is dangerous for people in early sobriety. The person who wants to cruise through early sobriety or find a living situation in which drug use might be an option will not enjoy life at LeMont Michel. But those who work its program can rest assured they are doing more than any other participant in an aftercare support program. They will be proud of the work they have done to solidify their recovery.

applied recovery is fun

Addiction is a disorder of the brain’s reward system. Drugs and alcohol disrupt both the brain’s ability to feel normal pleasures and to respond to normally pleasurable things. Recovery involves restoring the brain’s “pleasure sense” by practicing the things that make life enjoyable - pleasures that were forgotten in the midst of drug and alcohol use. Good food. Close friends. Enjoying the outdoors. These are not just frills. These are the things that the human brain is meant to sense and enjoy, and they are integral to recovery. We have a name for this process of “practicing pleasure” to strengthen recovery. We call it Hedonic Rehabilitation.
We believe that stripping the addict of pleasure the way boot camps, strict and Spartan treatment programs, or jail do runs the risk of permanently damaging the brain’s hedonic system. Hedonic Rehabilitation is an active process of re-introducing and actually practicing all the pleasures life has to offer in an effort to restore the brain’s ability to enjoy life and leave drugs and alcohol behind. In this way, recovery is most satisfying. It is in the context of meaningful activities that drugs begin to loose their grip and more meaningful and pleasurable activities percolate to the top.

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The short-term goals of the applied recovery program at LeMont Michel are:

• To provide an unbroken transition from inpatient treatment (e.g. a 30-day residential treatment, or inpatient detoxification) to community-based residential support;

• To provide twenty-four-hour-a-day, immediately accessible social support from staff and fellow residents to help the participant in the early period of recovery;

• To reinforce recovery concepts introduced during inpatient treatment, and help participants practice recovery skills as they meet the challenges of being newly sober that arise as they re-enter their normal life activities;

• To link participants with community-based sobriety-support resources such as addiction physicians, therapists, and mutual-aid meetings such as Alcoholics Anonymous;

• To enable participants to attend appointments, mutual-aid meetings, therapy sessions and other activities that support recovery by providing information and transportation as available;

• To assist participants in developing and initiating a recovery plan for the first year of sobriety, including a pro-active plan for relapse should it occur;

• To perform daily testing for drug and/or alcohol use in order to ensure a safe residential environment, to detect relapse quickly, and to document successful efforts at abstinence;

• To educate participants in recovery topics such as pain management in recovery, sleep hygiene, stress management, proper diet, infectious disease awareness and control, and exercise;

• To document the whereabouts of each resident several times a day as a means to detect relapse quickly;

• To provide a healthy social and residential alternative during times of family strife and social pressures to drink alcohol or use drugs;

• To secure participants’ medications from theft and diversion, and to assure proper administration and ingestion of medications according to the doctor’s prescription;

• To reintroduce participants to activities that are enjoyable and rewarding and part of an alcohol- and drug-free lifestyle.

The long-term goals of the applied recovery program at LeMont Michel are:

• To transition participants back into their original home and work environments with strong recovery skills in place;

• To follow participants well into their first year of recovery until the brain healing process during post-acute withdrawal is complete;

• To help build the strength and vitality of the local recovery population;

• To document participant’s achievement of long-term sobriety while in sober living facility;

• To help participants become adept at detecting early relapse signs, seek treatment early in the relapse process, or immediately after relapse occurs;

• To decrease long-term health consequences of alcohol or drug abuse;

• To return recovering persons to lives of productivity and happiness;

• To fight stigma regarding addiction, and pessimism about chances for long-term recovery;

• To decrease the cost of treatment for addiction and lower barriers for entry into treatment.