A few days after the inaugural session of the Outpatient Congressional Debate Club (OCDC), Patricia starts circulating a proposal she drafted. Which calls for implementing a protocol for screening for addiction patients' educational needs as well as expanding the OCDC to patients in inpatient care.

Her boss holds a meeting with not only the outpatient rehab medical staff (including but not limited to therapists, nurses, physicians and counselors) but also the inpatient rehab medical personnel.

"Welcome to this meeting. The agenda of today's meeting is twofold: first, the screening plan for educational needs, and later, the Outpatient Congressional Debate Club. Let's begin with an overview of the first item on the agenda, and, for this stage, I'll leave the floor to the assistant director of outpatient addiction services, Patricia Halpern!" the director of addiction services opens the meeting, before letting Patricia speak.

"Welcome everyone. I might have worked at this hospital for only a few months, but I already found a serious shortcoming my predecessors neglected. It appears the loved ones of several outpatient recovery patients, past and present, expressed concerns in one key area: the recovering addicts' education deficiencies" Patricia starts speaking, while Ainslee raises her hand to bring up a point. "Yes, Ainslee?"

"Patricia, what we found out during the first session of the Outpatient Congressional Debate Club, thereafter, the OCDC, is that several patients had language issues, as well as critical thinking issues. It happened irrespective of what patients were addicted to before checking in here for outpatient treatment. Since not every patient in outpatient rehab is in the OCDC, it's only the tip of the iceberg" Ainslee responds, with her face getting redder with every word.

"At the same time, as we all know, there is no one-size-fits-all approach that can work in addiction recovery. What I am proposing here is that we screen for educational deficiencies in our patients because we feel the lack of education of some of our patients may hold them back once they are released, and make them prone to relapsing, or otherwise unable to make the most out of their addiction-free lives. At the same time, not every patient who needs continuing education have the same issues. It may be that one patient might have trouble with language, another patient could mostly be lacking in critical thinking, and yet another patient could have mathematical weaknesses. Ideally, we need to make sure we can properly identify the patients who need continuing education the most: if certain conditions are met, the patient does not need to be subjected to testing. Beyond the rationale behind implementing the screening protocol, I am welcome to work out the details of its implementation with you here today" Patricia finishes her speech, before letting others speak.

"That screening should, ideally, be made at the intake stage, since I have the suspicion the issues you are raising do not discriminate between inpatient or outpatient" the intake specialist retorts, before another counselor eyes her, wanting to make another point about the logistics of implementing the protocol.

"I am not sure screening for educational gaps at intake is a good idea: at the intake stage, patients may not be ready to act upon the results. I believe that such screening should be conducted when preparing the patient for release instead" an inpatient counselor makes a counterpoint about when screening tests are made.

I am willing to acknowledge that I don't know much about continuing education and the diagnostic tests in use, so, if it comes to opening a bid process for these tests, I want someone who knows better with me on the selection committee. While the families of patients raised concerns about educational gaps in the patients, maybe some patients could themselves have objections to even getting the holes in their educations fixed, Patricia reflects while the other staffers realize they don't agree on whether they should even be screening addicts in recovery for educational issues.

"As much as I'm willing to acknowledge that patients come in with all sorts of personal issues, mental health conditions may prevent or impair some of them from being able to work on their educational gaps" Deepak, another inpatient drug addiction counselor shouts, furious about this plan he views as overstepping the role of rehab. "Plus several patients have squandered educational and career opportunities because of their addictions. What is not to say that they will squander them again?"

"Please excuse my lack of familiarity with the continuing education landscape, but can anyone here give me ballpark figures for tests we can administer for our patients?" Patricia asks the crowd, clueless about the specifics of continuing education beyond its existence.

I know some patients will harbor skepticism towards continuing education, because some of them see it as indoctrination. However, if an addict or two is functionally illiterate, I strongly believe the addicts gaining literacy is necessary before addressing any indoctrination concern, which tend to come up more often about civics and social studies, Ainslee thinks, while she regularly heard arguments about school choice.

The discussion seems to open several angles that might have been part of the hurdles Patricia considered, but one of these may well be problematic:

"Even if we assumed that whatever tests we could be administering for screening purposes were reliable enough to accurately detect the kinds of educational weaknesses we want to address, my main concern is about when they actually go back to school. If the continuing education coursework is heavy on homework and group projects, I'm not sold on whether we achieve what Patricia here seems to desire" the inpatient assistant director warns the other people in the assembly.

"I would be lying if I said I had no reservations. However, the reservations I harbor are not for us to address directly. It's more for the loved ones and their choice of continuing education providers. Especially if a loved one acts as an enabler and covers for the educational shortcomings of the patient" Patricia speaks again, while her face becomes bright red. "We need to ensure the patients' concerns are heard before we start implementing a screening protocol for educational needs. Patients have a variety of educational backgrounds, and my colleague in inpatient care rightly raised the issue of patients having ruined educations and careers because of addiction"

So it appears that the staff does not seem to embrace this plan as much as Ainslee and Patricia would like, and all they agree upon is the reality of the issue that plan is supposed to address.

"Since we can't agree on the necessity of a screening protocol for educational issues, nor on issuing recommendations to patients for continuing education, I propose that we consult with the patients and their loved ones before we start implementing it" the director of addiction rehab then speaks again when the discussion starts getting counterproductive.

"We rarely discussed where to fit in continuing education courses with patients unless the patients explicitly expressed their needs or interests" Ainslee points out something she feels has been overlooked.

Both Patricia and I have identified some OCDC patients as having oral language and critical thinking skills issues, which we discussed with their respective counselors. However, the absence of oral language or critical thinking skills doesn't prevent a patient from having financial literacy issues, nor from having issues with the written word, Ainslee muses, while the director of addiction rehab is drafting a survey for counselors to administer anonymously to the patients and their families.

"Now that we have agreed that patients and their loved ones will have a say in what they need most out of screening, their educational issues and what they need out of continuing education, all we can do in the meantime is to offer activities that will help them address their problems. So we got the OCDC, which will have them debate issues in groups, and we would like to expand the scope to all addicts. Right now, we only have outpatients in the OCDC" Ainslee harangues the crowd, since the OCDC is her brainchild.

"So we may as well introduce civics through the OCDC as well. At this point, I am concerned about Patricia wanting too wide a scope for holistic care. As much as I acknowledge that the patients' needs don't end upon release, as she does, I am not convinced it's our role" the inpatient assistant director retorts to her.

"In fact I believe that inpatients in the OCDC will force us to rename it. And we may as well allow all patients to join the Congressional Debate Club, regardless of whether they have addictions or not" Patricia adds, with an additional limitation. "That said, I believe it would be ill-advised to allow patients to join club sessions if they pose a threat to other patients. But they'll benefit from what the club has to offer nonetheless. Yet, it shows that we don't need to wait until the patients are released to start fixing their knowledge gaps. If someone else has appropriate knowledge of financial literacy, I invite you to ask your patients, their loved ones, and your colleagues, whether it's something they would like to learn about"

"Such a thing already exists, but is currently unavailable to outpatients. Given the size of the needs in that area, Patricia has a point, however, we lack the resources to do so" an inpatient therapist tells the other people, and then shrugs.

One more thing I forgot to tell the patients in the OCDC: while the last session had a resolution and a bill that could reasonably be acted upon by the Feds, notwithstanding the partisanship, future dockets will no longer be limited to items of federal jurisdiction. Nor will it be limited to healthcare issues. Then we will be able to cover more ground in civics, Ainslee muses, while the other medical staff keeps discussing for whom Congressional debate is medically appropriate.

Yet, the facts are laid out plainly: an additional financial literacy section would require someone else working overtime, and the staff is already overworked.

"Maybe... maybe we could try to get volunteers at the local high schools or colleges for both getting financial literacy training to the outpatients and running additional Congressional debate chambers! That's if manpower is an issue. There always seemed to be those overachievers who always want to get involved in as many activities as possible, or simply needed community service hours to graduate" Patricia, after getting a flash of inspiration, makes an additional suggestion for both aspects.

However, she couldn't see the demand for these two activities among the patients not already served to require a large number of volunteers to run. And yet, as with education needs screening, the issue of these activities seems to be divisive enough among the medical staff for the final decision to be made with patient input. After all, better have the 3 points of the plan put forward simultaneously to the patients and families, so they know what they are getting out of it! They might not understand immediately, but if the patients and their loved ones nix the plan, at least I will have good conscience, Patricia muses, while the director of addiction rehab adds more questions to the survey to distribute. This time around, the questions seemed to be about Congressional debating as well as financial literacy.

This meeting seems to take forever! It's no longer about just educational screening or opening Congressional debating to the rehab inpatients! Never would I have imagined such disagreements over philosophy and ethics of rehab! Ainslee reflects, in turn, as these discussions seem to turn into rehash and she wishes she could ask for the prior question, feeling this meeting is wasting everyone's time.

"It sure has given you all a lot to think about, and these are questions I believe we waited far too long to ask. Then Patricia must come along and force all of us to ask them" the director of the addictions ward makes his closing statement. "But, regardless of what the patients and the loved ones can say about my colleague's plan to enhance care for the addicts, regardless of any disagreements on what the aims and scope of rehab are, we all agree on one crucial thing. Rehab and treatment for the underlying conditions, if any, does not end when the patients are released from this psychiatric hospital"

The medical staff return to their work, to their patients, with multiple questions in their minds, and the various opinions given ringing in their respective heads.

For the past hour or two, hey discussed not only the struggles a lack of education could cause in recovery, but also what indicators to use to determine who should need screening or not. And so many more related topics on top of that, such as the choice of activities, this, and that, and so on, so forth. They were used to question patients about the circumstances that led to them hitting the point of needing help. And, more often than not, their "rock bottoms" (what a rock bottom is, remains an area that has no concrete definition in the world of rehab, but is generally understood to involve the loss of resources, such as health, finances, loved ones, employment and housing).

In short, the medical staff was used to just doing their jobs without really questioning the effectiveness of whatever they were doing. Or what outcomes constituted "good rehab". Or what else could be done to help the addicts recover and stays out of addiction.

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Meanwhile, a memo is circulated so that the addiction counselors invite their patients to fill out a survey over what it calls simply the reform plan, with 3 sections devoted to each aspect. The financial literacy part arose as part of the discussions but ended up being a part of the plan in its own right in the anonymous survey the addiction ward director designed.

When comes lunch time, Patricia sits down with Ainslee and the latter has questions about why Patricia went to such lengths to try to get the staff to open their eyes to the grim post-rehab realities so many addicts face.

"I can see it in your eyes, Patricia. You seem to be burning with drive and devotion to these addicts even though you clearly had limited interactions with the patients. But why?" Ainslee asks her, burning with impatience.

"I came to this field to make a difference in people's lives. Here's my chance to improve the quality of life of those patients in recovery, provided the patients and their loved ones acknowledge the issues" Patricia answers with vehemence.

Getting these outpatients to participate in a Congressional debate was what led to the key eye-opening event of my short tenure here. At least the rest of the administrative team of the addiction ward understands by now that a lack of education can make recovery in general harder, both from addiction and the underlying mental health conditions, if any, Patricia muses shortly afterward. Upon realizing that, at this point, her plan is in the patients' hands, she tries to take her mind off from it. By thinking about the upcoming ChGK tournament instead. But I was so caught up in this experience and this plan to make the lives of future patients better that it got tiresome. Tonight, back to ChGK with the Kansas State Team, at Vira's home, away from these ambulatornyy (outpatients) and on to the final round of the International League!

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When Patricia arrives at Vira's home in Overland Park, for the final round of the International League, they review the standings of the league as of the end of round 3:

"There are lots of very strong teams, several of which are already qualified for the ChGK Worlds. While it's our first participation in the International League, we entered, believing Patricia would somehow vault us into ChGK Worlds contention" Vira tells the team with the standings on a tablet.

"However, it's too early to anoint Patricia as some sort of savior" Bohdan warns the other players." She only played at one tournament with us before the International League"

"We might have been able to defeat Hwasong and Al-Azhar, the North Korean and Syrian national ChGK teams respectively, but this is not going to cut it at Worlds. And we barely placed in the top one hundred. We have a better idea of what to expect at Worlds since these questions are the same difficulty as at the Worlds" Yakiv adds to this chorus of warnings.

"It's a very good ranking, given that Patricia and Sergei both have limited experience of tournaments, we were able to take about sixty percent of the questions" Bohdan points out, before getting seated in the dining room.

"Before this tournament begins, let's sing the national anthem!" Patricia suggests, before they start answering the final 36 questions of this year's International League.

North Korea and Syria, having eaten 2 of the 5 wildcard slots for the year, are widely considered the weakest countries at the ChGK Worlds. As for the United States, the Kansas State Team is the third best American team in the International League, behind Quantum Computers (California) and Saturday 13 (New York), both going into the final round and once said round ends, two and a half hours later.

The Kansas State Team finished the League with a total of 85 points across 4 tournaments, finishing only one point behind Saturday 13 and 5 points behind Quantum Computers, even with this round being their best round, with 23 points.

"Bravo everyone! This is our best tournament at the International League! And this gives us a glimmer of hope that we are on the right track! Next year, we're aiming for the ChGK Worlds!" Yakiv harangues the rest of the team.