The treatment plan, designed for the individual, sets out the path for growth. It is malleable and r esponsive to changing needs and circumstances. It is established with the assistance of the client, and is reviewed to monitor progress and modify, if necessary. Ownership of the recovery process is the client's.

Typical to so many clients is a history of trauma and abuse. Male and female groups are segregated in order to remove barriers to disclosure and healing. Intergenerational substance abuse, with the accompanying learned behavior, is common. Clients born to addicted moms often experienced complications at birth, and developmental problems later on. Appropriate pre and post natal care was too often ignored with resulting, and lasting, mental and physical health issues.

Professionally trained and committed staff assesses each potential client, and matches that client with the type and level of services required. Where the social learning model is indicated, admission into the residential program is expedited. Where opioid substitution therapy is indicated, the client will be referred to methadone maintenance. Where the level of function permits an outpatient placement, that is accomplished. Although Straight & Narrow offers many services, it maintains strong affiliations with peers, hospitals and other human service agencies in order to insure that no client will have his/her needs unmet.

Twelve step meetings are seen as complementary to the services at Straight & Narrow. Consequently, participation is encouraged and coordinated. Where requested, spiritual guidance is coordinated through existing community resources.

The range of services at Straight & Narrow is unusual in that it reflects a "quasi managed care" model that allows for movement and exchange of information within one organizational context. The existence of a detoxification and primary care facility enhances the organization's capacity to coordinate care under the same aegis and philosophy, minimizing fragmentation of both individual and care.

The abuse of alcohol and/or other substances is viewed as indicative of inadequate psychosocial development. Self control and discipline are compromised, with reduced capacity to tolerate frustration and delay gratification. Both science and experience support the designation of addiction as a disease or illness chronic in nature, and characterized by relapse. While abstinence may be the "ideal," therapeutic progress is measured in ways, which address areas of weakness or deficit, as these contributed to a weak foundation.

Chronic illnesses require ongoing treatment, as extinction of symptoms is a rarity. This notion does not sit easily with a public that expects that addicts will be "fixed," and addiction "cured." The phenomenon of relapse is not the exception. It is the rule. It is not a requirement, and it is not inevitable. However, it is the Straight & Narrow position that longer periods of abstinence, decreased drug and/or alcohol use or use of less toxic substances, and more timely attempts at intervention are indicative of progress.

The ability to establish and maintain healthy interpersonal relationships contributes to adaptive cognitive and emotional functioning, and, as such, is viewed as a success indicator. Educational advancement, children returned to mothers, achievement of independent living and acquisition and maintenance of employment are indicative of success, as well.

Common to so many who present at Straight & Narrow is a pattern of under and unemployment. With chronic drug and/or alcohol use, one's ability to be productive is compromised, at best. Moreover, poor work histories and work skills have contributed significantly to feelings of worthlessness, alienation and isolation, which exacerbate a self image already eroding.

At Straight & Narrow, the psychosocial interventions are augmented by the integration of work into the daily regimen. Work assignments are designed to be both demanding and meaningful, providing not only structure and supervision, but also a real service to communities in New Jersey through Meals on Wheels and Recycling. There are work assignments, as well, which support activities within the treatment facilities. Expectations are high and responsive to the Straight & Narrow view that each of us has a significant contribution to make, and that we are interdependent.

Clearly, accomplishment and its rewards have been elusive for those who are enmeshed in addiction. Moreover, membership and collegiality fuel motivation and self efficacy. Social Support Networks emerge. Concretely, skills and habits acquired from this experience prepare the client for job acquisition and employment success. Although self sufficiency is a common outcome measure, it is best achieved when work is integrated into the range of services provided.

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