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There is nothing normal about STC treatment centers. It is unique in its organization and structure. The staff at STC are trained in reading moods, testing the reliability of information, and adept at detecting lies. It was thought that a drug and alcohol treatment center located in the middle of a party town like Newport Beach would never succeed. Plus, the logistics of sober houses spread over several blocks and interwoven with party houses didn't seem to indicate a healthy environment. Add to the odd mix clients mobility, easy access to alcohol and drugs, and lack of apparent supervision, and STC becomes a frightening place to send your children for help.

What surprises skeptics is that STC not only functions more efficiently than most in-patient treatment centers, but that it also allows the clients to recover in "the real world" which is the kind of environment they will eventually face. It is remarkable that STC clients are not only able to maintain sobriety, but they do so for a much longer time than they do coming from other treatment centers. The sheer numbers of former STC clients that stay in the local Newport Beach community makes STC an unusual facility and a successful one.

To try and duplicate the structure and operations of STC would be close to impossible (perhaps more possible with this report, but very unlikely). The geographic coincidences, the strong recovery community in the area, the knowledgeable staff of former STC clients, and the sophisticated network of communications, all work to create a recipe part brilliance, part devotion, and part divine intervention, or luck, if you prefer.

In the future, further studies must be conducted within successful treatment facilities to aid in the creation and redesign of programs that are not as successful. Former Governor Gray Davis of California, in association with Professor Allen Mobley of the University of California Irvine, is conducting a study of the most unique and successful treatment programs in correction institutions across California. We need the same type of research effort to analyze the treatment centers across the country. Better rehabilitation will benefit society. Programs, like the one at STC, need to be reproduced in other communities, if at all possible.

The benefits of the STC living community have yet to be fully investigated. It is apparent from this study that clients at STC benefit from being involved in the outside Newport Beach community. It is evident that many clients choose to stay in the community because of the connections that they have made at the Club. The length of stay is also a determining factor in the effective treatment of the clients at STC. The longer the client's stay at STC, even if it is the minimum 90 days, the greater the knowledge the staff will have of the client's behavior and recovery progress. A quantitative research study would also be necessary to further validate the statistical success of treatment at STC.

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Labels: Spy-Games

The Club is a building located within STC territory. Recovery meetings are held all day long, every day of the week. There are many clubs like this one, but chances are that the general community which hosts one of these clubs is unaware it exists. They are not secret clubs, but they treasure anonymity. The Club is an unmarked, two-story building that has three meeting rooms. At any given time during the day, a recovery meeting is in progress. The first meeting of the day begins at 6:30am and the last one normally ends at 9:00pm. STC clients are required to attend certain meetings at this club during the week. These are considered "outside meetings" and STC has absolutely no financial interest or control in the club, yet it is one of the biggest pieces of the STC puzzle.

Clients ride their bikes to meetings at the Club and mix socially with the recovering members. Sponsors are obtained. These sponsors have no affiliation with STC, but the chances of the sponsor knowing about STC, or having once been a client at STC, are 95%. This is the point in the research where STC is shown to be an anomaly. One of the main reasons why STC would be impossible to duplicate is this proximity to the Club and the recovery community that has built up around the club.

In contrast to other treatment facilities, STC clients have a tendency to remain within a fifteen-mile radius of STC and the Club after they have been discharged from STC. This results in a recovery community consisting of countless former STC clients. This is not common. Of course, part of the lure is that Newport Beach is arguably one of the most beautiful places to live in the country. In addition, most of the client's come from outside the state of California. Many clients who had chosen to remain in town after treatment said that they liked the weather in California better than where they previously lived. However, the most common reason given by former STC clients for their decision to stay in the Newport Beach area was the recovery community.

Labels: Spy-Games

The network of communications at STC is the key to its effective functioning. To ensure that information between staff members runs smoothly, there are countless intelligence reports, memos and briefings. Meetings are held continuously throughout the week to discuss each client's progress and treatment plan. Each Case Manager, along with other staff members who are a part of the team, has earned a California Addiction Treatment Certificate from an accredited college. This means that in addition to having knowledge the recovery process, each one also has two years of specialized training and education in drug and alcohol addictions. This advanced education, coupled with the Case Manager's own experience in recovery, is what enables STC to succeed in treating the alcoholic and addict where others have failed, even though they hold multiple advanced medical degrees and graduate degrees in psychiatry and psychology.

It is important to note again that 90% of the staff are former clients at STC. They know the routine, and they know most of the people in the local recovery community. So when clients attend meetings at the Club, they are surrounded by people who were or are clients or staff members at STC.

Clients are still required to get the usual AA sponsor, or mentor, outside of STC. The recovery community in Newport is the largest in the country according to Alcoholics Anonymous' Central Office in New York. Orange County, specifically Costa Mesa, has more recovery houses than any other place in the world. Because of the enormity of the community anonymity is almost nonexistent, which is another anomaly of STC. Everyone seems to know everyone else, if not by first name, than by face. If someone were to attend one of the thousands of recovery meetings that happen every day in Orange County, even for the first time, he/she would find it impossible to go unnoticed. There are "regulars" at every outside recovery meeting in the area. STC sends its clients to an outside AA meeting I will refer to as the Club.

Labels: Spy-Games

The typical client at STC takes pride in his or her ability to outwit the program. The sad fact is that any client in any treatment facility, no matter how physically restrictive the facility is, will drink and use if they really want to. Alcoholics and addicts are notorious for being able to inebriate themselves in the most unlikely of places. A prison guard at Orange County Jail once informed the researcher that prisoners make alcohol out of any fruit they get their hands on. There are a number of stories at STC about clients drinking mouthwash, perfume and rubbing alcohol in an ignorant attempt to get high. The client who really wants to drink or use at STC will find a way to do so, no matter what restrictions and surveillances are utilized. But the object of the game for the staff at STC is to catch the client when they do, and then enforce consequences.

STC has recently implemented drug and alcohol urinalysis testing for every client, three times per week. The client is informed at the last minute about the test and is most often unaware of when the test will occur. On top of this mandatory testing throughout the week, a client is tested whenever he or she returns from a pass, or if they are suspected of being under the influence by a staff member. The obsessive drug and alcohol testing at STC is their solution to the problem of too much freedom. Constant random testing does not seem to alleviate relapses among the clients, but it does prevent them from getting away with it.

The alcoholic's cunningness and his cold-blooded ability to tell lies often makes the game of treatment a loosing battle. In researching the ability of a client to avoid being caught under the influence, I interviewed Slick Rick who admitted to the staff he had been using drugs while in the program. What was even more unusual than his voluntarily relapse admission was his ability to completely deceive the entire staff. Not only did he pass countless urinalysis testing, he also showed no outward signs of being under the influence. Normally, the staff, recovering alcoholics and addicts, is able to detect the smell of alcohol on a person's breath from across a room, or notice symptoms of drug use by looking at a person's eyes, but Slick Rick never missed a meeting and never presented any symptoms. The staff was baffled.
Despite constant inquiries and interrogations, Slick Rick was unwilling to admit how he had accomplished this. Only after I approached him and asked if he would allow me to interview him did he confidentially reveal his sorcery.

Every Tuesday morning at 6:30am, the house parents and Case Managers meet to discuss the clients. During this meeting the House Parents, or House Agents as they will be called for the purposes of this report, give their account of each individual client's progress. The House Agents actually live with the clients and so they are privilege to information about the clients that no other staff member is privilege to. Time spent with the clients in their everyday existence at STC is what makes the field agents the most valuable information sources. The House Agents, drivers, and meeting monitors also have tickets they can issue that are called "write-ups," a very useful weapon in negative reinforcement.

The write-up can be compared to a traffic ticket. If the field agent witnesses any infraction, the client who committed the infraction is written-up. Infractions can include everything from leaving a coffee cup on a table in the morning, to fraternizing with a female or male client. The write-ups are important to the case managers because it lets them know if their client is misbehaving. Every bit of information about a client's actions is gold for the analysts at STC. A write-up for a missed meeting for instance, sends a warning flag up to half-mast. Two write-ups for the same behavior sends the warning flag to the top; and three write-ups for missing a meeting sounds an alarm. The consequences for being written-up the first time involves deducting half the amount of money the client receives as an allowance three times every week (usually $75 per week). Two write-ups result in no allowance; and three write-ups require the client to attend extra meetings.

The paperwork at STC is critical to keeping track of a client's progress. There are forms to be filled out for everything including money, deviations from the normal schedule, passes to leave STC for any period of time, progress reports from Case Managers, progress reports from house agents, and progress reports from the clients themselves. All of these reports must be signed by the Director of Operations, the Program Director, and the client's Case Manager.

Even more important than the paperwork is the communication among the staff. The Motorola two-way cellular phones every staff member is issued are the most important communication instruments utilized at STC. Instantly, staff members can communicate. The loud beeps that signal a staff member to answer his or her radio produce a symphony of annoying noises throughout the day at the Center.

Also important to communication and client intelligence is a new computer program, developed specifically for case managers at treatment facilities. The program is similar to the White House's internal e-mail system called PROF. It is designed to allow case managers throughout STC to communicate internally about their clients. Progress reports are written directly into the system from the Case Manager's computer and other Case Managers are able to access the reports. Only Case Managers with special clearance have access to these files because they are highly confidential.

Labels: Spy-Games

Understanding the types of clients STC must deal with on a daily basis is one more step towards understanding why surveillance and constant intelligence information is necessary. The clients are not unusual; in fact they are typical of the breed of humans called alcoholics. To call them a breed, or refer to them as psychopaths is not politically incorrect, or even unscientific for that matter, because the characteristics of the psychopath and the alcoholic are eerily similar. Robert Hare's Psychopathy Checklist is currently the most popular diagnostic tool for measuring criminal psychopathy. Although the diagnostic term "psychopathy" is no longer used in the psychiatric field, Hare's characteristics remain a useful diagnostic tool. The behavioral characteristics on Hare's Checklist of the psychopath are: Glibness, superficial charm, grandiose sense of self worth, pathological lying, conning, manipulative, lack of remorse or guilt, shallow affect, callous, lack of empathy, failure to accept responsibility for actions, promiscuous sexual behavior, lack of realistic goals, poor behavioral controls, high need for stimulation, prone to boredom, and irresponsibility. According to John Burnham M.D., a psychiatrist practicing in Newport Beach, who works with many recovering alcoholics and addicts, "these characteristics could easily be applied to the alcoholic and addict."

The typical alcoholic or addict at STC is white, middle to upper class; between the ages of 18 and 45, and educated to some degree (many current clients during this research study had their undergraduate and graduate degrees). These are general characteristics of STC clients, but the diversity can be extremely varied at any given time. No matter what the nationality, education, or financial background of the client, the psychopathology described by Hare can be applied to almost all of them. Because the alcoholic has these traits, the counselor treating the alcoholic must be highly trained in lie detection, criminal behavior, and psychosocial deviance to effectively treat the alcoholic. To find a counselor who is equipped with all of these attributes might sound impossible, but fortunately there are people who can beat the alcoholics at their own game, namely other recovered alcoholics.

Labels: Spy-Games

"In the end, intelligence (the spy kind), boils down to people,". In jails, prisons, psychiatric hospitals and other treatment centers, surveillance is not as difficult and does not require as much skill as it does at STC. Because rehabilitation is spread over the Newport Beach peninsula, and because clients are given a mountain bike and freedom to roam, information gathering and monitoring turns into a spy game. Intelligence and control are the most unique and uncharacteristic aspects of STC. It is a game knowing what clients are doing and how their treatment is proceeding. Rehabilitating alcoholics and drug addicts is a tricky business. Generally accepted, although not scientifically proven, the only way to treat an addict is with another addict. This is "one alcoholic talking to another alcoholic." There are many reasons for this, but the main ones is why that if a staff member is an alcoholic/addict, he or she has all of the behavioral characteristics of the addicted psychopath, as noted earlier, and he or she is capable of fooling the most skilled psychiatric profiler. "It takes one to know one" is perfectly applicable to the client/staff relationship at STC. Even more beneficial to the staff's intelligence and surveillance gathering ability is the fact that 90% of them were also clients at STC. The staff therefore are inherently skilled at deciphering the alcoholic/addict's behavior and dismissing their lies. But even with these acquired superpowers, beating the alcoholic/addict at his or her game is a gigantic undertaking not easily achieved in a facility as geographically complicated as STC.

Each of the sober houses is monitored by a staff member during the day. Routine checks of the house are called "sweeps." The sweeps are designed to monitor attendance at scheduled group meetings and required activities. The Field Agent goes from house to house to catch truancy and to check on the cleanliness of the houses (a mandatory rule a STC is organization and cleanliness). If a Field Agents finds a client at home, he or she is immediately confronted and ordered to go to the designated activity. Sweeps occur everyday at 9am, 12pm, 3pm, 10pm, and 11pm.

In addition to theses sweeps, each meeting, whether held at the Center or at the local AA club, is monitored by a Field Agent. If any of the STC clients are missing, a phone call to the client's house is made and a field agent is sent immediately dispatched. Whether the client eventually attends to the meeting or not, he or she is "written-up" by the Field Agent. In this way, every staff member is made aware of the client's deviant behavior.

The owner of STC, who started with only a few houses, has set the tone of communications. "The meeting starts before the meeting. If you want to know what's going on around here, then you show up before the meeting." This statement can be applied to all staff meetings. A great deal of information is gathered about clients while staff employees are standing around the coffee pot waiting for one of the many staff meetings to begin. "We keep more people in the loop than in most places," the owner comments.

Mark is a new marketing representative at STC who previously worked at The Betty Ford Center and has, like many others, come to regard STC as an amazing facility. "At first I was skeptical, as many people are from other facilities, about how organized and structured STC is." Rick who is working in the STC marketing department after working at another treatment facility in the area, says, "Most other recovery programs, or professionals, view STC as a bunch of halfway houses where people use during the day and fake it at night. Now I know that it's not like that at all. It's highly structured and full of potential."

Gathering surveillance on clients at STC is a large part of the program's success. Clients are carefully, consistently monitored in their natural environment, and usually unaware they are being watched. This is possible due to the panoptical surveillance posts within the Center. From the Executive Director's second-story office, one can look down onto the patio area where clients congregate to smoke and talk. Not only can everything be observed, it can be heard.

All of the Center's windows are tinted to a mirror like shine on the outside, making it impossible for people to see what is going on inside. The staff knows what's going on outside the office without the clients knowing they know. Even sexual liaisons, forbidden, can be discovered. A casual glance, a too-long look, even body language can and is noted for information to help the recovery process. Observation of the client's behavior at outside meetings is also an important part of monitoring clients and gathering intelligence. The meeting monitors can watch the client's interact during meeting breaks at the Beach Club (the outside meeting place) and observe client's interactions, loners who are not connecting with the group, and clients who attempt to leave the meeting early, or arrive late.

Another factor that aids surveillance is the proximity of the staff's private living quarters to the STC community. The Field Officer Director and Director of Intelligence, for lack of a better term, lives next-door to one of the sober houses. Other staff members live either within the peninsula, or close by. This creates an unusual and beneficial situation. Often a client will be shopping at a grocery store, buying coffee at Starbucks, or riding his or her bike on the boardwalk and come into contact with an off-duty staff member. It's easy to come into contact with two to three staff members who are doing the same thing. Sometimes the client does not know the staff members are watching, which gives the staff member a distinct advantage. In any field study or research situation, the best behavioral information is gathered when the subjects have no idea they are being studied.

Labels: Spy-Games

A client may be referred to STC from a primary care facility (e.g. The Betty Ford Center) and literally brought to the doorstep. With his/her belongings in duffle bags and the ubiquitous cigarette dangling, the clients are admitted. The intake process requires extensive paper work, pictures taken with a Polaroid, and meetings with directors and their particular Case Manager. The initial questionnaire provides the first intelligence information on specific addictions and personality issues. The client must reveal which drugs are preferred, how often, and in what form (intravenously, orally, or inhalation), in addition to providing basic information like age, sexual history, family systems, and so forth.

The Case Manager quickly becomes a most trusted friend or the worst enemy within days of admittance. He or she will be the one to processes the information the client provides and produce a written assessment that becomes part of a permanent dossier, the first step in "intelligence gathering."

After the initial in-take sessions, the client is placed into one of 13 houses STC manages. An "intake house" holds clients who have less than thirty days of sobriety. Client placement strategy is elusive to say the least. Only the Director of Operations has the authority to move clients from one house to another, and sometimes there seems to be no rhyme or reason for the moves. A client may be relocated three or four times during their 90-day stay. Problems with house mates can be a reason for changing, power struggles account for a few, but in most cases, the Directors oversee the progress and confers with the House Parent as to where the client would be most successful in his bid for sobriety.

The Director of Operations oversees all decisions and all special operations, backs all the tactics of his "field agents." The term "field agent" will be used to describe any staff employee who is not involved in the clinical side of treatment. It is interesting to note the length that the D.O. will go if forced to defend one of his staff members. In an effort to manipulate, clients have become skilled in lying and spreading misinformation to parents in order to achieve their own goals. STC is adept at running through the obstacle courses thrown up by disenfranchised addicts and their enabling parents.

This brings up the issue of parental involvement. Much of the clinical and operational staff's time is spent on dealing with parents. There are times when it is necessary for parents to receive more clinical attention from a client's case Manager than the client receives. More often than not, it seems the parents need treatment as much as their addicted children.

Labels: Drug-Addiction-Rehab, Spy-Games, teen-drug-abuse

The treatment center is a 90-day residential facility owned by Larry Smith and his wife Linda. Underneath the umbrella of STC are varied treatment programs specializing in specific addictions, such as eating disorders, depression, and sexual/chemical addictions. The program began as an extended care facility, but has since evolved into a multi-functional, highly successful rehabilitation program. The unique setting coupled with highly enviable success make STC worthy of investigation.

The program is fundamentally unique because its facilities are scattered throughout a beach community well known for wild parties. Primary care facilities for drug and alcohol treatment are usually places in remote areas and clients are restricted to the facility's grounds.

The Betty Ford Center is in the middle of a desert area surrounded by brick walls and guard gates at every entrance. Promises of Malibu is perched on top of a mountain top at the end of a long, gated driveway surrounded by thick, impenetrable shrubbery. In contrast, STC is an open facility located within the city of Newport Beach, California. Accordingly, clients can’t be confined to the grounds of the treatment center. There are no walls, no gates and no guards to keep them from leaving the city or entering the local bars and clubs. But despite this geographical spaciousness and freedom, STC is able to monitor its clients effectively.

STC is divided into individual sober-living houses along a one-mile stretch of beach front property anchored by the agora of the "Center". Each of the 80 clients must travel every day to the Center for group sessions, individual counseling, and various required activities. Throughout the 90-day rehabilitative process, the Center is the hub of the clients' re-entry therapy and discipline.

STC' title as "extended care" drug and alcohol treatment means that the length of stay is longer than other rehabilitation centers offer. For example, the Promises and The Betty Ford Center are both 28-day treatment programs, whereas STC is essentially a 90-day program. In addition, the clients enter STC after their stay at a 28-day primary care facility like Promises or Betty Ford. It should be noted that for the addict, "ninety day treatment" is a gross misnomer, and at STC, the average client stays at least six months. Many remain for over a year to ensure their recovery.

Labels: Spy-Games

The method of inquiry involves observations of the daily operations of the staff and clients at the facility. Interviews of the staff and clients, as well as information gleaned from the facility's archives, some of which included opinions on the treatment center written by the clients after being discharged (names and places changed to protect anonymity). Direct observations, as well as case studies will be used to determine the effectiveness of the program. The term "addict/alcoholic" will refer to those persons who have an alcohol problem and/or a drug problem commonly referred to as "dually addicted."

Labels: Spy-Games

It is a full moon on a Saturday night in Newport Beach, California. Every crime except murder increase during a full moon and tonight is no exception. Jim, a tattooed and weathered man in his late fifties, or maybe is early thirties, its hard to tell with recovering drug addicts and alcoholics, is sitting at his station in a building which has come to be known simply as the "Center" when his Motorola cell phone/two way radio beeps loudly. Jim reaches into his holster, pulls out his cell phone and holds it up to his ear in one swift motion. He presses down on the talk button and waits for a beep. "Yeah, this is Jim." Another loud beep. "This is Mark, I'm over at the 48th Street house and there's no sign of Scott." Jim sighs, "It's still only ten minutes past curfew, swing by on your way back from sweeps and check again." Beep. "I asked his roommates if they knew where he was and they were being quiet about it." Jim's mind starts racing and he immediately shifts gears. "Alright, I was worried about this. I think he went off with Sabrina after the meeting tonight. They were acting strange, and I knew something was up." Beep. "So what do you want me to do?" Beep. "Search his room, leave a note on his bed for him to call me, and make sure you keep your phone on. I'll get back to you."

Jim sits back in his chair and thinks for a moment before dialing a number on his phone. "Hey, this is Jim, is Sabrina there? She isn't. Where is she? You don't know." Jim's tone takes on a knowing sarcasm. "You know where she is, so just tell me. Is she with Scott? That's what I thought." Jim switches back to his radio and beeps John, another field agent who is always out on the streets patrolling the local area. "Yeah John, this is Jim, I need you to hunt down Scott and Sabrina, it looks like they're running. Remember that Scott has overdosed on Heroin three times before he came to us so be ready." Beep. "I think I know where to look for them. I'll take care of it." John signs off. Not twenty minutes go by before a John's signature black Chevrolet pulls up in front of the Center and Scott and Sabrina, two white, middle-class twenty year olds, spill out onto the sidewalk. John gets out of his car smiling as Sabrina vomits into the gutter. "Where did you find them?" Jim asks. "They were trying to hitchhike their way back from a bar in the next town. They didn't put up much of a fight. They knew they were caught. It looks like Sabrina just tried heroin for the first time." Sabrina moans as she bends over at the waist in anticipation of further rebellion from her stomach. Jim beeps someone with his radio and only a beat goes by before Mark's voice can be heard. "Did you find them?" "Yeah John just brought them back, but they're going to need a ride to detox." "I'll be there in five minutes." Jim slips his phone back into its holster with a smile. Then, turning to Scott and Sabrina, he says, "You should know by now that you were going to get caught. Now you'll have time to think about your actions at the Ranch." Jim looks at Scott who is hanging his head in shame. Sabrina looks worse. Jim bends down to check her vitals. "I feel like I'm going to die," Sabrina manages to get out. "Not tonight you won't. You'll be alright," Jim says. Within ten minutes, two field agents pull up in front of the Center. The man loads Scott into his car, the woman takes Sabrina. Within the next hour, both clients will be packed and moved out of their houses in Newport Beach. They will spend the next week in two different lock down facilities specializing in harder to reach Steps Treatment Center clients. A strangely unique drug and alcohol treatment facility, STC takes pride in their covert tactics and control measures.

When The Betty Ford Center is mentioned in conversation, most people know what it is. And lately, Promises in Malibu has been featured in the media because of its famous clients. But these are just two of the many 28-day inpatient drug and alcohol rehabilitation facilities that have sprung up all over the country. One of these is the low-profile STC, a unique facility that began in 1986 and is now one of the largest and most complicated rehabilitation centers in the United States. The facility boasts one of the highest success rate in the country. But there are questions about the effectiveness of a program that is as enigmatic and unrestrictive as STC. To many outside observers in the recovery industry, STC is a mystery, called into question ever since its inception many years ago. This is the subject of the inquiry: How does the treatment program work? Does the open format work as effectively as they claim it does? An investigation of the inner organization will discover whether this type of drug and alcohol rehabilitation program can maintain the kind of daily observation and monitoring that other facilities find imperative to treating the addict.

Labels: Drug-Addiction-Rehab, Spy-Games