Three intertwining perspectives are relevant to a meaningful and community-appropriate health promotion context in which the TriCounty Addiction Services delivers its services.

Determinants of Health Approach
Health is not defined simply as the absence of disease but as a state of well-being and a quality of life which is maintained and enhanced by equal access to affordable health care, employment, housing, income, good nutrition, meaningful relationships, the absence of violence, environmental health, and hope for the future -- both individually and collectively.

Transtheoretical Model of Stages of Change
Readiness of individuals, groups, communities, or society generally to make changes that will sustain health may vary in stages such as Precontemplation, Contemplation, Preparation, Action, and Maintenance. Efforts to change may be interrupted by Relapses (or Recycles). Matching of counselling or health promotion activities or interventions to the needs of persons or groups should be sensitive to the stages of readiness at which they find themselves.

(An overview of the Transtheoretical Model of Change can be found in James Prochaska, Carlo DiClemente and John Norcross, "In Search of How People Change: Applications to Addictive Behaviours," in American Psychologist, September 1992, Vol. 47, No. 9, 1102-1114.)

Feminist Practice
Recognizing that contemporary society remains without equitable distribution of determinants of health, that imbalance is characterized by inequities in access to health by persons of different gender, ethnic identity, sexual preference, physical and mental health status, etc., and that our communities are at only an early stage of contemplation in their readiness to change such inequities, the TriCounty Addiction Services is committed to having its services reflect a "political" perspective that will champion the cause of achieving healthy communities.

A "feminist approach" takes into account the context in which men, women, children, and families (of varied composition) live, and it attempts to address many ways in which the "power-over" nature of patriarchy hurts all persons and perpetuates many of the behaviours that cause people to abuse substances, become problem gamblers, or develop other addictive and mental health disorders; e.g., physical and sexual abuse.

Besides echoing a "determinants of health" approach in its naming of inequities that exist in the larger life context and dramatizing the intensity of struggle (e.g., social debate) that arises normally when change is under way, "feminist practice" clearly names imbalances in power as a root source of those inequities which is, unfortunately, regularly evident in counselling and health promotion work.

Its reflection of of such imbalance in contexts beyond that of individual and collective health reminds the Directors and staff of the TriCounty Addiction Services to remain ever vigilant of how the addictive potential of alcohol or other drugs, gambling, other risky behaviours, or mental health problems is promoted by complex socio-economic-political forces. Such recognition is an essential reminder to the agency’s day-to-day operations that its concrete interventions will not always be helpful, and that its flexible, client-centred, pragmatic and creative interventions must be enacted with sensitivity to "the larger picture."

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In this general context, an intention of all services at the TriCounty Addiction Services is to provide continuity of service through a variety of specific processes which include:

• Health promotion: promoting community awareness of contextual factors in which addiction and mental health are likely to develop (e.g., personal, structural/environmental, and those related to aspects of the addictive and/or mental health behaviour itself), educating communities about ways to manage the level of risk in such factors, and working with community groups to keep such risks absent or low.
• Assessment: determining a person's (couple’s or family’s) needs, strengths, and resources required to manage those needs.
• Planning: developing a specific service plan for a person/family to access resources in the most effective way.
• Linking or co-ordination: helping connect a person/family to required services.
• Advocacy: interceding on behalf of/with an individual/family to ensure access to needed resources.
• Counselling: working with a person/family to use available resources in a manner that resolves her or his or their problems.
• Monitoring: doing ongoing evaluation of progress, provision of support, and other interventions as needed.
• Follow-up: ensuring that continuation or re-engagement of service is flexibly responsive to a person’s/family's changing needs after formal counselling has ended.

Treatment of all persons and families who are engaged in these processes while seeking assistance at the TriCounty Addiction Services should be:

• Flexible and responsive, driven by the needs of the person/family being served, able to provide extensive and flexible services to a person/family with many problems or to provide minimal services when that is all that is needed.
• Pragmatic and taking a variety of forms, characterized by willingness to provide both unconventional services and conventional services in unconventional ways.
• Delivered in keeping with models of evidence-based practice which are available in counselling and health promotion.