Outpatient settings may have limited therapeutic contact per client, but have the opportunity to do impactful clinical work. The absence of a traditional milieu setting may seem like a challenge for implementing a model that basis so much of its belief on the healing power of community. Fortunately, the opportunity to create safety and shared practice among clinicians abounds. When Sanctuary is used to create relationships among the staff at a clinic and is used as a way of addressing organizational issues, client services improve. The experience that a client has at the front desk and with the billing office can be as important as their clinical experiences.
As clients are not necessarily exposed to multiple workers nor are they necessarily interacting with others who are receiving services, outpatient staff are more likely to use psycho-education materials, safety plans, S.E.L.F. treatment planning and the other individualized tools of Sanctuary with clients. Workers may need to adapt the community based tools (ie: community meetings, red flag reviews) to include others in the client’s life as appropriate and introduce these tools to clients for use at home.