Speakers - 2026

Title: Reading the Person: A Clinical Framework for Accurate Assessment, Classification and Placement in Addiction Treatment

Abstract

The single most costly mistake in addiction treatment is applying the same response to people who are at different stages of addiction and at different levels of readiness for change. The result is predictable: resources are misallocated, rehabilitation environments are contaminated, and failure gets attributed to the individual rather than the placement decision. This session presents three clinical frameworks that solve this problem.

The A–E Progression Model maps addiction across five distinct stages — from functional use (Stage A) through increasing reliance, consequence accumulation, narrowing capacity, to survival state (Stage E). Each stage has different characteristics, different leverage points, and requires a fundamentally different response from clinicians, family, and the system. Applying a Stage B response to a Stage D person is not neutral — it actively makes things worse. The framework is not a diagnostic label. It is an operational tool that tells a clinician, case manager, or family professional what a person actually needs at the stage they are at, not what the available service happens to provide.

The E1–E2–E3 Classification answers a completely different question. The A–E progression tells you where a person has been. The E1–E2–E3 tells you what they can engage with today. E1 describes genuine readiness for change — demonstrated through sustained behaviour, not words. E2 describes relief-seeking: the person wants the pain to stop but is not yet committed to the internal change required. E3 describes no current capacity for meaningful engagement. Classification is based on observed behaviour over a minimum 72-hour period, not on self-report or intake interview. Most people presenting for treatment are E2. Systems that cannot distinguish E1 from E2 place unready individuals into rehabilitation environments designed for readiness and watch them fail — that is almost always a sorting error, not a programme failure.

The Ten Fingers Framework maps the enabling architecture around every person with addiction. Each finger represents an option available when they need help, money, a place to stay, or a way out of trouble — five relational (family) and five institutional (hospital, mental health, prison, rehabilitation, morgue). Addicts work through the relational fingers before facing the institutional ones. As long as one finger stays open, they never face the genuine choice. The framework makes this architecture visible for families and professionals, replacing isolated decisions with a systemic understanding of how enabling operates.

These three frameworks have been developed, tested, and refined across thousands of residents over 15 years of operational practice at Shalom House, Perth, Western Australia — a fully accredited residential rehabilitation organisation housing 150 residents across 13 facilities, 100% self-funded with no government operational funding. This session is practical and applicable. Attendees will leave with tools they can use immediately.