HOGAR CREA, INC.: A PUERTO RICAN ALTERNATIVE FOR THE

HOGAR CREA, INC.: A PUERTO RICAN ALTERNATIVE
FOR THE TREATMENT OF DRUG ADDICTION
J. J. Garcia Rios, B.A.
*
SYNOPSIS
Hogar Crea, Inc. (Home for the Re-education of Addicts)
is a non profit organization established in 1968 for the
prevention and treatment of drug addiction in all its
manifestations.
It is a homelike community for the growth
and re-education of the character, based on the active
communal participation in the treatment offered and in the
administration of the Home.
It gives services to addicted
persons of both sexes in its 65 Homes located throughout the
island of Puerto Rico.
At Crea the addict is viewed as
having a sociopathic personality and the treatment is
directed toward the strengthening and reconstruction of the
addict's character by providing a series of therapeutic
activities to be carried out in the homes, which will lead
the addict to obtain his re-education and become a
productive citizen.
INTRODUCTION
In the 1960's, drug addiction hit Puerto Rico in
epidemic proportions.
It was already a big problem for
decades in the United States and other countries of the
world which were trying to find a solution for the same. At
this time the age limit of drug users was lowering steadily
and including, increasingly, the most precious members of
society: the adolescents. The addict was described as being
usually young and more talented than the average person.
This made the community and the government more alert about
finding a solution to this problem.
Addiction, in most places, was considered as a legal
problem and the solution proposed was, usually, repressive.
International and domestic legislation was issued, but
little was done to provide treatment to the addict since it
was the general thought that the addict could not be cured.
Nevertheless, in the United States some private sanitaria
did accept addicted persons for treatment.
However, these
clinics had problems offering the treatment and were forced
to close.
The second mayor response to the addiction
problem was the establishment of 2 U.S. Public Health
Service Hospitals: one at Lexington in Kentucky and the
other at Forth Worth in Texas. These hospitals were used by
*
President & Founder, Hogar Crea, Inc., Hogar Crea
Internacional, Saint Just, Puerto Rico 00750, U.S.A.
509
our government for some time to give treatment to Puerto
Ricans with problems of addiction. Addicts also used these
facilities on a voluntary basis.
After the Second World War the problem of addiction had
an
overwhelming
growth
and
many
institutions
were
established to give treatment to addicted persons.
The
White House Conference on Narcotics and Drug Abuse in 1962
brought new alternatives for the solutions of this problem.
In 1961 our Puerto Rican government realized that something
should be done to solve this problem and established the
Program Cisla (Centro de Investigaciones sobre la Adiccion)
based on the premise that the "addict could be cured unless
proven otherwise."
Though this program had good results
that proved the hypothesis that the addict could be cured,
it lacked consistency, dedication, and the essential vision
that the community
should be wholly involved in
the
treatment and solution of this problem.
In March 1964,according to official sources of
the
Commonwealth of Puerto Rico and the Federal Government of
the United States and territories, the Commonwealth of
Puerto Rico had the greatest number of addicts in proportion
to its population, 1 per 250 vs. 1 for each 320 residents in
New York, the state with the highest incidence. By the year
1968, many observed that although the "era of rehabilitation
of the addict" was
ushered in with high hopes, it
had
resulted in little significant impact on the recividism
rate.
On the other hand, traditional methods of criminal
prosecution, incarceration, and rehabilitation had little
impact on subsequent drug-taking and associated criminal
behavior.
Having learned by my own experiences that the addict
can be cured and feeling that something should be done to
cope with this apparent hopeless situation, I decided to do
something about it and, eventually, was able to bring Hogar
Crea, Inc. into being.
Hogar Crea, Inc. (Home for the
Re-education of Addicts) is a Puerto Rican alternative for
the prevention and treatment of drug addiction in all its
manifestations.
It was established and incorporated as a
non profit organization on May 28,
1968.
Its name
"hogar"— in English "home"— means hearth.
In our homes the
addict perceives human warmth.
He/she also finds love,
respect, obedience, and the sacrifice of one for the other.
Our home is the home that the addict did not have in his
formative years so that he could develop a healthful
personality;
in our home he will grow socially and
emotionally sound and develop the character and other
510
capacities which will help him obtain his re-education. All
Crea Homes are reconstructed and rehabilitated by the
residents; this gives them a sense of belonging and makes
them feel proud of the job they have accomplished.
They
also do all the cooking, cleaning, and laundry thus teaching
them to share home responsibilities.
Through our experience treating addicts at Crea, we
have learned that it is in the home, in the family, where we
find the roots of the personality disorders which lead
persons to indulge in drug addiction.
The loss and
confusion
in
moral
and
spiritual
values,
and
the
misdirection of family life are among the basic causes of
this problem.
For these reasons, in our movement we work
directly with the families, involving them in the treatment
process and assuring their cooperation in sharing the
responsibility for the re-education of their relatives.
The Crea Home is based on the extended traditional
family. We offer our residents a homelike atmosphere where
they find the counsel and support of fathers, mothers,
grandparents, uncles, aunts, and others, offered by the
members of the Community Support of each home.
The Crea
family provides the addict solid moral and spiritual
principles and a true home environment in which his
problematic character can be healed and strengthened. This
is why the community participation is vital for the proper
functioning
of
our
program.
The
community
is
the
cornerstone and base of the Hogar Crea movement, making it
unique as a treatment program for drug addiction.
The
community is an integral part of the Home and an essential
element of the therapeutic environment which evolves each
Home.
The letters C.R.E.A. of Hogar Crea come from the verb
"to create"— in Spanish "crear"— and is symbolic of the
transformation
which
occurs
in
the
degradated
and
demoralized addict who becomes a new person after receiving
treatment and obtaining his re-education.
The aim of our
movement is to create a new human being out of each addict
who enters our program and continues the re-education
process through his life.
Please note the use of the word re-education as opposed
to rehabilitation.
The addict has failed in learning the
basic skills to deal with himself and others that are
offered by the major social institutions of our society,
such as home, school, and church. So, it is essential that
he learns these skills and be educated.
Since education is
511
a process that continues through life, the ex-addict does
not end his capacitation when he adquires the re-education
certificate; he continues gaining knowledge and skills
throughout his lifetime. That is why in Crea we re-educate
the addict instead of rehabilitating him.
Another of Hogar Crea's particularities is that most of
the
treatment
is
offered
by
qualified,
well-trained
ex-addicts who serve as motivation and inspiration to the
active addict who comes for treatment to our agency.
The
addict sees them as peers who have gone through his own
experiences and they challenge him with the phrase, "If I
could do it, you can too." The ex-addict works hand-in-hand
with the professionals working in the program and the
volunteers from the community to engender an effective
treatment for our residents.
The basis of the treatment offered by Hogar Crea, Inc.
is the therapeutic community based on the existential,
vitalist principles of individual responsibility, mutual
help,
personal
effort,
and
community
support.
Our
philosophy
maintains
that
it
is
the
individual's
responsibility to make the best use of the treatment
available to him in spite of the obstacles of his own
emotional, social, economic, or physical condition.
The
therapeutic community provides the tools but no one can
accomplish for him his progress toward self respect,
personal dignity, faith, capacity to love, and usefulness as
a member of the society.
To regain all these elements
requires hard work.
The purpose of the program is to re-educate the addict
through the development or growth of his character.
Character, as opposed to temperament which is inborn, is
defined as that part of the personality of the addict which
is developed since birth through the daily experience of
living. Due to the already-mentioned social problems, many
of these experiences have been negative, therefore, his
character is underdeveloped.
To attain our objective of
developing and strenghthening the addict's character our
program has organized a series of therapeutic activities to
be carried out in each Crea Home as part of the daily
experiences he lives so that the resident can learn to trust
himself and others, to have control and initiative, to have
responsibility, to gain self identity and, above all, to
learn to deal with the problems and frustrations of daily
living.
Hogar Crea Program is also based on the fact that
addiction is the manifestation of an underlying disturbance
in the addict's personality.
Personality, as we have
512
defined it, is the form of being of a person: how he acts
and how he thinks as distinctive from others; part of it is
inborn and part is adquired through the daily living
experiences.
The inborn part is the temperament and the
talents or natural abilities; the part that is adquired is
the character which is an instrument to deal with reality
and to control the temperament.
It also helps in the
development of the talents or natural abilities of a person.
The character is composed of 8 capacities: confidence,
autonomy, initiative, industriosity, identity, compromise,
generativity, and transcendency.
All Crea Homes are
equipped with the necessary elements to form a therapeutic
environment
in which
these
character
capacities
are
developed and strengthened.
The Hogar Crea re-education program has 2 major
components: the Therapeutic Environment and the Community
Support.
The Community Support is an integral part of our
movement and contributes to the effectiveness of it.
It
consists of 3 major divisions: The Steering Committee; The
Family
Members
Committee;
and
The
Voluntary
Members
Committee or Resources Bank.
Besides being part of Crea's
family, as we have mentioned before, the Community Support
participates actively in the treatment offered at the homes
by
sharing
therapeutic
dialogues
with
residents,
participating in and coordinating activities in cooperation
with them, serving as guides and guardianship to residents,
sponsoring athletic and ecumenical religious activities, and
giving moral and spiritual support to them.
Besides this,
the community support has administrative and evaluation
functions and gives technical assessment to the staff.
The Therapeutic Internal Environment includes the
residents to whom the different therapies are offered to
develop their character, a well-trained therapeutic work
crew to offer the treatment, and the physical structure with
all those facilities and equipment necessary to facilitate
the growth of the character of the residents to obtain their
re-education. The therapies offered at the Home to develop
each one of the character capacities mentioned above are the
following: individual therapy; group therapy; occupational,
educational, representational, and sales therapy; courtesy,
sports,
and
recreational
therapy;
confrontation
or
existential
encounter;
family
and
spiritual
therapy;
meditation;
and mobilization through carefully studied
passes to home and community.
Also, the therapeutic internal environment consists of
the necessary physical aspects to provide the privacy and a
sense of being at home.
This is the structure and the
513
necessary furnishings for the whole Home: rooms for therapy
sessions, a well-equipped library, workshops with materials
to work, a receiving office which serves also as sales shop,
vegetable gardens, directories, signs, playing fields, and a
room for religious services.
The
Therapeutic
Environment
comprises
also
a
well-trained staff to administer the Home and to assure that
the daily therapeutic activities are carried out and a
healthy atmosphere is maintained so that the most effective
treatment is offered.
Besides the 3 major components of the Therapeutic
Environment mentioned before, there is another one without
which our program could not
function:
the group of
re-educated ex-addicts.
They offer their services, working
together with both the Internal Environment and the Comunity
Support so that the treatment offered in the Home is the
most favorable for the re-education of the residents.
As an additional reinforcement to prepare and to give
technical assistance and assessment to other components of
the Therapeutic Environment our program has structured a
"Training Workshop for the Re-education of the Character"
involving the 9 Crea treatment districts with focal sites at
San Juan, Mayaguez, and Cayey.
The treatment offered by the Hogar Crea movement for
the reconstruction and growth of the addict's character is
structured in phases and steps in ascending order beginning
with the active addict in the contact office located in the
community and ending in the follow-up and rehabilitation
phase whereby the re-educated ex-addict re-enters the
community as a socialized, productive citizen.
The addict
in our program is an active participant in the treatment
given: he has to gain— earn— each step and each phase in his
road up to obtain the rectification of his character
disorder and the clarification of values leading to his
re-education. He receives careful and periodic evaluations
by the therapeutic work crew and the Evaluation Board of
each Home where he is promoted or demoted, depending on his
progress in treatment.
Hogar Crea, Inc. gives services to minors and adults of
both
sexes,
who are addicted
to drugs
in all
its
manifestations.
Recipients can be admitted on a voluntary
basis or referred from courts on bail and from penal
institutions on parole or probation or transferred to the
Homes in the community to continue treatment. They can also
be referred from the T.A.S.K. Program.
514
To give treatment to the above mentioned persons, Hogar
Crea, Inc. has established 56 Homes for male adults located
throughout the island; 6 Homes for minors located at
Arecibo, Isabela, Ponce, San Juan, Bayam6n, and Guaynabo;
and 2 Homes for women, one at Hatillo and the other one at
Trujillo Alto.
Hogar Crea offers the following services to the
residents: food; housing; clinical treatment; active and
passive recreational services; transportation; specialized
medical services;
and formal education with voluntary
teachers leading to the primary, intermediate, and high
school diplomas through the extension courses of the
Department of Instruction of the Government of Puerto Rico.
Instruction is also given to minors (aged 6 to 14 years) at
Crea Educational Center.
The
residents
also
receive
pre-vocational and vocational training in workshops at some
of the Homes where they learn carpentry, car-painting and
upholstery,
baking,
agriculture,
poultry
raising,
pig
raising,
wrought
iron working,
furniture making,
and
ceramics
and
other
artisan
crafts.
It
also
offers
psychological and vocational rehabilitation services.
Our movement has implemented a series of programs to
extend, fortify, and complement the services offered to the
residents and to all the community.
One of these is the
Crea Educational Center.
The purpose of this center is to
integrate the intellectual development of the adolescents
who come to Crea for treatment with their process of
psychological
reconstruction
and
re-education.
The
education given there is specialized according to the
individual needs of the student.
Crea
also has
the Unit
for
Services
to Penal
Institutions and Courts which works in coordination with the
correctional institutions and courts of the island.
It
offers services to addicts, both adults and adolescents, who
have had problems with the law such as inmates at penal
institutions, probationers, parolees, and those pending
sentence in the courts.
For the federal prisoner who is sent to the United
States for imprisonment, Crea offers a halfway house for his
readjustment to the island community.
They are transferred
to our halfway house when they are near completion of their
sentence or near receiving parole.
515
Very important to Crea and its interaction with the
community are the prevention services.
They are divided
into 3 phases and are carried out, mostly, by the individual
Homes.
Thefirst phase is Induction: the process of making
the community aware of its responsibility in the problem of
addiction and of its implications and treatment, and of
gaining its cooperation toward the solution of the addiction
problem. This is done through conferences, meetings, radio
and television programs, press conferences, articles in the
newspapers, and so on. The second phase is the preparation
and training of the volunteers who responded in the first
phase.
The third phase consists of the identification of
persons who have been prepared and have become change agents
in their own respective communities and helpers in their
local Crea community.
These persons assist in the first
phase of prevention so that the cycle may continue.
They
become part of the Community Support of the Homes.
The
training
Workshop
for
Emotional
Growth
and
Character Re-education was established to equip Crea's
personnel with knowledge, skills, and experiences that
prepare
them
to
perform
their
responsibilities
more
effectively.
The workshop is also given to community
volunteer personnel, such as the steering committees and
other, community supporting agencies, clubs, churches, and
schools.
HOGAR CREA INTERNATIONAL
Hogar
Crea
International
was
incorporated
as
a
non-profit organization on June 21, 1983 with the State
Department of Puerto Rico. Seeing the effectiveness and low
cost of the services offered by our movement, others have
became interested in utilizing Crea's treatment program in
their respective countries.
In 1975, the first Crea Homes
were established in the Dominican Republic, which was the
first country to recognize the work done by our movement and
saw the necessity of establishing it there to solve their
own addiction problem.
At present there are 7 Homes
functioning in different parts of their country.
The second country that became interested in our
program was the United States.
In 1979 some Puerto Ricans
living in Bethlehem, Pennsylvania visited our facilities and
learned about the functioning of our movement.
Upon their
return to Bethlehem, they formed a Steering Committee and
began plans for the Home which was inaugurated in 1981. At
present, there are Steering Committees formed and plans to
516
establish homes at Allentown, Lancaster, and Reading in
Pennsylvania, Hartford in Connecticut, Jersey City in New
Jersey, and in the County of Bronx in New York.
Other countries in South America that have problems of
addiction became interested also in establishing Crea's
Treatment Program.
At present there
are Crea Homes
functioning
at Barranquilla
in Colombia,
Valencia
in
Venezuela, and Cartago in Costa Rica.
Hogar Crea began in 1968 in a little shack in Saint
Just, Puerto Rico, with 4 residents.
In 2 years there were
10 Homes scattered over the Island.
Five years later, the
program increased to 35 Homes. When we celebrated our tenth
anniversary, the total reached 57 Homes. At the present we
have 65 Homes serving 3,125 clients.
"EL ADICTO TIENE CURA: CREA LO ASEGURA."
"THE ADDICT CAN BE CURED: CREA ASSURES IT."
ACKNOWLEDGEMENT
Thanks are due to the many people who in one way or
another made possible that our participation in the Ninth
International Conference on Alcohol, Drugs, and Traffic
Safety had the expected results.
We are also most grateful to the residents, the
Community Support (Steering Committee, Family Committee, and
Cooperating
Members),
the
Treatment
Directors
and
Supervisors, and the Crea personnel who worked so hard in
their different activities sponsored by Crea resulted in a
success.
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the
The