A general description of the Portage substance abuse treatment program for mentally Ill chemical abusers (MICA) in Quebec. www.portage.ca

1. The Portage Program

2. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Portage Programs
• Therapeutic Community Approach
• Video – Portage in Québec
• MICA Program
Summary

3. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Québec (since 1973)
• Adolescent Programs
• Adult Programs
• Mother and Child Program
• Mentally Ill Chemical Abusers (MICA) Program
• Employment Reintegration Programs
• Ontario (since 1985)
• Adolescent Program
• Atlantic (since 1996)
• Adolescent Program
• British Columbia (since 2009)
• Adolescent Program
Portage across Canada

4. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Voluntary admission
• Treatment based on self-help, peer support,
role-modelling
• The community is the therapist
• Highly structured and safe residential
environment
• Residents acquire competencies through
• Participation in groups and activities
• Taking on various roles and responsibilities
• Interacting with their peers, who serve as role models
Therapeutic Community
Approach

5. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
Video:
Portage Residential Programs
in Québec

6. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Established in 1995 – located in Montréal
since 2000
• Long-term substance abuse rehabilitation
centre
• Orientation phase (5 weeks)
• Residential phase
• Highly structured (6 months)
• Transition period (2-3 months)
• Supervised apartment phase (6 months-2 years)
• Aftercare services
• Continuum of Care
Mentally Ill Chemical
Abusers (MICA) Program

7. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Men (18+) with substance abuse problems
and a chronic psychotic disorder (primarily
schizoprenia)
• The individual must be mentally stable before
starting therapy
• Must have a psychiatric team already in place
and available to follow them throughout
treatment at Portage
Clientele

8. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Eliminate abusive consumption of
drugs/alcohol
• Greater comprehension of mental illness
• symptom management, medication compliance
• Decreased hospitalisations
• Develop skills and aquire social aptitudes
• Improve interpersonal skills and family
relationships for better social support system
• Social reintegration: back to school, work, or
volunteer work
Treatment Objectives

9. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Modified TC at MICA to deal with
• Psychiatric symptoms
• Cognitive impairments
• Level of functioning and motivation
• Concentration difficulties
• Emotional numbing
• Inability to converse
• Apathy - lack of energy
• Social withdrawal
Modified Therapeutic
Community

10. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Phase 1 (Orientation): Welcome and
introduction to therapeutic community
• Phase 2: Integration, competency acquisition,
introspection and application
• Phase 3: Taking on responsibilities,
autonomy, exit plan preparation
• Phase 4: Exit plan implementation and social
reintegration (family, school, work, activities)
• Phase 5: Maintenance of acquired
competencies (in supervised apartments)
Program Phases

11. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Intense and highly structured
• Adapted to the individual’s level of
functioning
• Acquisition of competencies
• Ex: lead structured activities, take initiative, encourage
others, communicate effectively, be empathetic
• Community and psycho-educational groups
• Life-skills workshops
• Sport and cultural activities
Programming

12. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Identifying symptoms and their triggers
• Relapse prevention
• Social skills
• Identifying and managing emotions
• Stress management
• Basic life skills
• Conflict resolution
Psycho-Educational Groups

13. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• 6:45 am – 9:00 pm
• Morning meeting
• Psycho-educational group
• Seminar/Workshop
• Lunch
• Sport or cultural activities or workshop
• Community groups
• Dinner
• Night meeting
• Free time
A Typical Day

14. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Intervention Plan
• Made by resident and caseworker
• Setting goals, objectives and establishing means
• Revised on a monthly basis
• Follow-up by phone
• With medical team and family
• Resident’s progress, objectives, and goals are discussed
on a monthly basis
• Case Conferences
• With resident, caseworker, medical team, and family
• Discussion of resident’s progress, objectives, and goals
• Every 3-4 months, or as needed
Case Management

15. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Supervised Apartments (6 months – 2 years)
• Transition period
• Continued but limited participation in residential program
• Preparation to once again become an active member of
society - school, work, volunteer
• Support groups and community dinners
• Individual meetings
• Participants are responsible for taking their medication
and managing their finances
• Aftercare follow-up (length based on individual need)
• Support groups
• Individual meetings
Social Reintegration

16. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Family reunification groups
• Bi-weekly support groups
• Family meetings
• Family Days
Family Services

17. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Multi-disciplinary team
• Counsellors, social workers, recovered addicts who have
completed the Portage Program, and others
• Team responsibilities
• Ensure the physical and psychological safety of residents
• Supervise, guide, counsel, and teach new skills and
competencies
• Ensure that medical and psychological needs are
satisfied
MICA Team

18. I have the right to be happy and to be treated with care and understanding . I have the right to be safe . I have the right to say what I feel
• Participants who complete the MICA
Program are able to
• have a better understanding of their mental illness
• manage their medication and symptoms
• reduce the frequency of crisis hospitalisations
• identify their addiction and mental illness
vulnerabilities to prevent relapse
• increase their participation in the community
• reintegrate society – school, work, volunteer
Results

19. The Portage Program
514-935-3431
www.portage.ca