Page 15 - Delaware Medical Journal - December 2017
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CASE STUDY
PROJECT ENGAGE
Launched in 2008, Project Engage is a collaboration between Brandywine Counseling and Community Services (BCCS)
— a major provider of addiction treatment in Delaware — and Christiana Care Health System (CCHS) — one of the largest health care providers in the US mid-Atlantic region. This innovative program utilizes Engagement Specialists (ESs) who are peers in recovery from drugs and/or alcohol use as a key component for a successful peer-driven intervention program. The ESs work in a and outpatient clinics.
The mission of Project Engage is to help CCHS patients return to healthy productive lives by getting them on the road to recovery. The ESs serve as care coordinators to assist patients in accessing care for their SUD in the fragmented and complicated drug treatment continuum. Peer specialists acting as a concierge service to assist patients obtain what they need — getting them into detox, inpatient, mental health treatment, and the like is another key component for a successful peer-driven intervention program. Getting patients the appropriate care can avoid future health care through Medicare and Medicaid. The ESs have helped more than 5,000 patients at Christiana Care resulting in an average annual savings of approximately $6,000 per patient.6
According to Rita Landgraf, the former Secretary for the
step in treating any disease is to engage the patient in treatment. For people impacted by addiction, Project Engage shows how important it is to involve people with shared life experiences
in order to gain their trust and support them as they begin their treatment. Peers offer the living proof that treatment does work and people do live in long-term recovery.”6
PEER SUPPORT IN MEDICAL SETTINGS
“For generations, physicians, nurses, social workers, psychologists, welfare workers, and other service professionals barely masked their contempt for the alcoholic and addict.”4 The use of peer support helps to support the interdisciplinary health care team
in patient care. Because people with lived experience know the language of addiction, patients feel more at ease and not judged. This often results in having people with lived experience being able to elicit a more accurate history of the patient’s SUD use, serve as a liaison between clinicians and patients, and assist with
discharge planning. “Through peer support options, the health care community provider can reach individuals who might not be currently using their services. Peer supporters can also serve as a liaison between the individual and a psychological health professional, helping the professional to better understand the experiences...and needs of the individual seeking services.”7
The goal is a continuum of mental health and SUD treatment, accessible through traditional and non-traditional settings. Consistent with this goal, it is important that the patient be a partner in their service delivery decisions by customizing their own care based on their individual choices.8
Peer supports utilize early engagement strategies, such as motivational interviewing, to assist the patient identify strengths
and assets rather than faults and problematic issues. Utilizing a strength-based approach provides an opportunity to empower the patients to identify their own strengths and resources, both inside and outside, and to achieve their own goals.9 “Peer support is an intervention that leverages shared experience to foster trust, decrease stigma, and create a sustainable forum for seeking help and sharing information about support resources and positive coping strategies.”7 Utilizing people who are in recovery from substance use disorders helps to break down resistance from hospital patients. Experientially credentialed peer counselors — a key component for a successful peer-driven intervention program — trained in early engagement strategies can forge therapeutic relationships with hospitalized patients helping them initiate and sustain recovery.8
THE JOURNEY OF IMPLEMENTATION
Collaborations in the behavioral health arena are becoming increasingly popular. There is a continued emphasis on the replication and implementation of emerging best practice models of care.10 To learn more about Project Engage, Terry Horton, MD, creator of Project Engage, and Peter Booras, one of the ESs, were invited to Pittsburgh to provide a presentation on Project Engage.
After the visit, the Pittsburgh partnership decided to pursue the Project Engage model. On behalf of its project partners, AHCI engaged with BCCS and CCHS in a contractual agreement to provide: 1) a webinar highlighting the overview in peer specialist recruitment; 2) a two-day on-site peer-to-peer training; and 3) a learning collaborative of one-hour monthly technical assistance calls for up to one year. In time, three Peer Navigators (PNs), people in long-term recovery from substance use disorders, were hired and placed in three separate hospital facilities in Allegheny County.
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