Samarpan Implementing the Gorski-CENAPS Model of Relapse Prevention

In January 2023, Samarpan was delighted to welcome Roland Williams MA, MAC, LAADC, NCACII, CADCII, ACRPS, SAP CENAPS President, CEO, and Director of Training to our residential facility in Mulshi, Pune. Over a period of Five days, Samarpan staff was provided with world-class, relapse prevention-specific training as part of the ongoing commitment to professional and organizational development.

Roland has traveled extensively across the world, consulting and training in multiple residential and outpatient treatment services, and is a well-known and respected Substance Abuse Expert having been in the field for over 30 years. He has also published a number of books on recovery and working with African Americans.

Whilst he was here with us at Samarpan, we asked him a few questions about his work, and also his experience of Samarpan.

1. Can you tell us a little bit about the CENAPS model and the 5-day training?

The Gorski-CENAPS Model of Recovery and Relapse Prevention (The CENAPS Model) is a comprehensive system for diagnosing and treating substance use disorders, co-occurring mental disorders, personality disorders, and situational life problems. The CENAPS Model integrates addiction-specific treatment methods with state-of-the-art cognitive, affective, behavioral, and social therapies.

Terence Gorski developed the 5-Day Advanced RPT Training for clinicians to better address the relapse process and increase support for their relapse-prone patients. Ranked among the most comprehensive and effective training for behavioral health professionals, RPT is for those who wish to advance their clinical skills through a proven, evidence-based approach. Training staff will utilize their current skills and integrate them with powerful techniques to help their clients identify and manage high-risk situations as well as core personality and lifestyle warning sign patterns that lead to the recurrence of alcohol and other drug use in the critical early stages of the recovery process. About Advanced Relapse Prevention Therapy Training.

2. How will this training benefit Samarpan staff?

Staff will learn how to use evidence-based clinical interventions to teach their clients/patients to Develop an RPT Treatment Plan - personalizing the standard treatment plan for RPT. Build Conceptual Pyramids -develop a conscious way of thinking and problem solving that describes each problem. Actively Listen - a communication process to increase understanding and remain engaged. Recognize and lower stress through Relaxation Response Techniques and how to Bookmark Hot Issues that activate stress-related defensiveness.

Staff will learn how to teach their clients/patients how to use standard procedures in groups (or individual) sessions that help them stay on track and engaged in treatment with segments on Group Opening, Presentation, and Closure Procedures. Staff will learn how to teach their clients/patients how to identify and clarify their Presenting Problems, review their Life and Addiction History, and Recovery and Relapse History to understand the core pattern of personality and lifestyle problems that created pain and problems and how to make a commitment to complete the RPT process.

Staff will learn how to teach their clients/patients to identify, examine, understand, relate, and manage Warning Signs that can lead to relapse through segments on Warning Sign Review, Initial Warning Sign List, Warning Sign Analysis, Final Warning Sign List, and Critical Warning Signs, and Warning Sign Management. Staff will learn how to teach their clients/patients Recovery Planning including how to develop a schedule of recovery activities that can support the ongoing identification and management of the core personality and lifestyle problems that lead to relapse.

3. What can clients expect from the implementation of The CENAPS model?

Better treatment outcomes, including but not limited to less recidivism, improvement in participation in recovery-based lifestyle, and increased awareness about their own relapse warning signs.

4. Lots of clients often have trouble maintaining recovery, you have discussed The Fresh Start program at Samarpan - and introduced that...what does that entail, and who will this be for?

The Fresh Start Program will be specifically for the Relapse Prone client, those who have a history of being actively abstinent and engaged in recovery-related activities who have repeated relapses despite a strong desire to abstain.

5. You have traveled all over the world, working with various treatment centers, what is your take on The Samarpan program and its approaches to treatment?

Samarpan is a beautiful and incredibly affordable program, with great potential to be the best program in India, and could compete with any other treatment center worldwide. In time Samarpan has the capability of delivering the full continuum of care, from detox, residential, Intensive Outpatient, 1 on 1 counseling and sober living a Family Program, and an Alumni Program. Samarpan has some very skilled and dedicated staff members. The schedule and curriculum in the residential program are robust and clinically sound. It’s very impressive what the team has done so far in such a short amount of time. I haven’t had the opportunity to learn enough about the Out-Patent program yet.

6. Additionally, you have spent a lot of time with the clinical staff at Samarpan in the last week, what are the strengths of the team?

Martin Peters and Obi Unaka are both seasoned, skilled hard-working treatment professionals, who work very well with the staff and clients. The clinical staff I met are at various levels of experience in addiction-specific treatment, however, all seem eager to learn and most importantly very compassionate, professional, and dedicated. Overall, I was very impressed with every staff member I met at the residential program, from facilities, the kitchen staff, the administrative staff, and the clinical staff. All were very kind, warm, and welcoming to me, each other, and the clients. The program has very good human “energy”.

7. With your experience, what are some of the important things that a program should include and what types of modalities should programs offer?

The full continuum of care: detox, residential, Intensive outpatient, 1 on-1 counseling, sober living, a Family Program, and an Alumni Program.

8. What do you hope to achieve from your week in India, and what does a CENAPS Centre of Excellence entail?

First of all, I wanted to visit a country that has always fascinated me. Secondly, I was excited to play a part in bringing an evidence-based treatment model to India. And also, I looked forward to seeing my old friend and colleague Martin and getting to spend more time with Obi. Professionally I wanted to share these powerful clinical techniques with the clinical team because I know they are effective in saving the lives of clients struggling with addiction-related issues.

The Gorski-CENAPS Center of Excellence designation is reserved for those treatment providers who evidence exemplary Relapse Prevention services through the use of the CENAPS Model of Treatment. Although any provider may seek this designation, only those who meet the rigorous standards for endorsement will be officially recognized. Our mission is to collaborate with treatment providers who are committed to fully implementing the Gorski-CENAPS® Developmental Model of Recovery and Relapse Prevention. Our commitment is to recognize, support, and assist our CENAPS® Centers of Excellence (COE) partners reach as many people in need of recovery and relapse prevention as possible and to provide them with Evidenced-Based treatment protocols.

Objectives

• (A). To complete a comprehensive review of the provider of CENAPS Model Services to assure that the Center of Excellence Criteria has been met. This includes a review of policy, procedure, program design, and documentation.
• (B). To provide In-service training and consultation to help the potential Center of Excellence to identify and correct deficiencies in meeting the Centers of Excellence Criteria.
• (C). To establish an ongoing collaborative relationship between the CENAPS Corporation and the CENAPS Center of Excellence in order to:
1. (1). Ensure the comprehensive utilization of the CENAPS Model of Treatment
2. (2). Complete applied research studies that evaluate the strengths and weaknesses of the CENAPS Model
3. (3). To help design and field test new adaptations of the CENAPS Model that can improve the delivery of relapse prevention services.

The exclusive benefits of becoming a Center of Excellence are:

• 1. Gorski-CENAPS Name. Centers of Excellence are allowed to use the Gorski-CENAPS name in advertising their treatment center. Only Centers of Excellence share this benefit.
• 2. Customized Program Manuals. The Centers of Excellence will be provided with a complete set of clinical manuals that will be customized for their use. These clinical manuals will be used as the basis of developing the science-based manualized treatment approach that will become one of the hallmarks of the Centers of Excellence designation.
• 3. Marketing. The reputation of the CENAPS Corporation will set The Centers of Excellence apart from their competitors and aid in publicizing the program to local, regional, and national marketplaces.
• 4. National Exposure. CENAPS executive staff members speak to thousands of professionals at conferences and workshops each year and will refer to the Centers of Excellence clinical programs whenever appropriate.
• 5. Preferred Referral. As a result of CENAPS extensive lecturing and publishing commitments, The CENAPS Corporation routinely receives requests for treatment referrals for relapse-prone patients. The Centers of Excellence would be the preferred referral.
• 6. Advertising. The Centers of Excellence would be given the privilege of placing an ad in the Gorski-CENAPS annual Recovery and Relapse Prevention Catalog. This catalog is of excellent quality and is mailed to over thirty-five thousand people annually.
• 7. Website Listing. The Centers of Excellence would be listed on the Gorski-CENAPS Centers of Excellence page of the CENAPS Website. Listing would include the year of Center of Excellence designation, program address, phone number, and link to the program’s website.
• 8. Marketing Advice. CENAPS executives will advise the marketing department at The Center of Excellence on how to effectively market this program and would provide whatever administrative consultation is desired within the context of the agreed-upon time commitments.

9. Often people in India question the cost of the program at Samarpan, in your view could you explain costing and compare it to other treatment providers?

The exact same program you are providing in the US or UK would cost at least 4-5x as much. Samarpan Residential provides all licensed and/or certified clinical staff, 24-hour nursing, initial medical, psychiatric, psychological, nutritional, fitness, substance abuse, and psychosocial assessments on all clients. The treatment is delivered in all luxurious private rooms, with a full commercial gym, wonderful chef-prepared meals, and an art studio in a beautifully landscaped safe, and clean environment. There is a significant overhead to provide all of these services and amenities and as such the costs for treatment will reflect that. Treatment need not and should not be punitive and this program offers a treatment experience that is comparable to all of the other services in India that recognize that although cheaper more affordable options are available some clients want the best possible and are willing and able to pay for it. As a side note I don’t think the program is charging enough and financially this is more a “labor of love” and is most likely losing money.

10. What have been the highlights of your week at Samarpan?

I fell in love with this amazing country and was struck by the kind spirits of most of the Indian people I met. Seeing the diversity of the landscape and the people was fascinating to me and I wish I had more time to explore as there is so much more to see. My week at Samarpan was great, it went by so quickly, the staff was fully engaged, professional, and receptive to learning, The active participation of the program directors Martin and Obi and the other clinical staff members in a full five-day training while also treating clients before and after each day was admirable. Finally, it was great to see how well the team worked together and I could see the potential for more collaboration with the residential and outpatient program.

We were delighted to have Roland with us, and Martin Peters Director of Residential Services said “Roland is an exceptional trainer as well as being a globally recognized expert in the field of substance abuse residential treatment. It was a highly enlightening week of training, which will increase the skill level of our staff, and improve the delivery of international standard evidenced-based treatment in India. Throughout the week, we have also had the opportunity to review and reflect on our program and make some new changes, as well as introduce The Fresh Start Program for clients who have a history of chronic relapse. We are delighted to be the only treatment center in India to offer such a program, and have staff trained in this model, and are eagerly working towards gaining a Centre of Excellence Accreditation towards the end of 2023”.

Obi Unaka, Deputy Director of Residential Services stated, “It was a pleasure and an honor to have Roland come over to India to deliver the CENAPS RPT training to our staff. His infectious and collaborative training style enabled all attendees to grasp the concept of this model and assisted our staff in being able to adapt the model to the culturally sensitive Indian landscape.”

For more information on Gorski-CENAPS go to www.cenaps.com