hOW TO cHOOSE a pROGRAM

The single most important element in the selection of a program at any level of care is the program’s philosophy. Programs that focus only on the discontinuation of use of the substance generally base their on the first three steps of AA. These programs are generally short -term programs, thirty days or less.

The disease of Addiction or Substance Use Disorder is less about the substances abused and more about what has prevented the individual from growing emotionally and spiritually prior to their use. In the very young with this disorder, substance use started before normal growth could occur. When substance abuse became problematic after some career and family goals have been realized, these early successes may be substitutes for growth. Long -term sobriety can only be achieved by identifying those barriers to growth, setting a plan, and beginning that journey while in a program.

Once it becomes obvious that professional help is necessary to treat the Chemical Use Disorder, the next task is sorting through multiple program options. An evaluation by a certified addiction physician will help determine the severity of the condition and thereby the level of care required. The levels of care are:

1. Hospital/Inpatient, short term for stabilization
2. Partial Hospital Phase with residential/community living
3. Outpatient Partial Hospital, no residential component
4. Intensive Outpatient, no residential component

     5.   Supportive living, with out patient care
 
In this blog, I have outlined the elements required for level one and two above. Level 3 through five, less intense levels, consist of variations of these elements. Chemical Use Disorder/Addiction is a disease of the body, mind and spirit and therefore requires a team of professionals each with training in these specific areas.
 
In choosing the hospital for detoxification, it is best to select one that allows for continuity of care from a more restrictive to a less intense level of care as the patient’s condition improves.
 
Clinical staff for both 1 and 2 above would include:

• On site Licensed Physicians, Board Certified Addiction Specialist as Medical Director, Additional on-site physicians including: Board Certified Psychiatrist/Addiction Specialist and Internal Medicine practitioner.
• Licensed Physician Assistant, PA, Licensed Nurse, RN
• Psychologist specialized in psychological and neuropsychological testing.

 
Warning:
There are many programs that claim to have the above staff when in fact they have physicians and nurses who consult when needed but are not an integrated part of the program.
 
Non-Medical Staff:

• Clinical Director, minimum of master’s level with years of demonstrated success in multiple levels of chemical dependency .
• Therapists/Case Managers, an adequate number to insure no more than a one to ten patient to staff ratio. Therapist should be a minimum of Masters Level and licensed or license eligible.
• Family Therapists, Masters Level, Licensed Marriage and Family Therapist, LMFT.
• Counselors, minimum of Bachelors Degree and at least 5 years of recovery.
• Activity Therapist, master’s education.

 
Community living, requires a support staff, adequate numbers for security for 24 hour monitoring and to assist patients in their interaction with outside community, i.e. food shopping, pharmacy, exercise/gym, and religious services,
 
Program Description:
A partial hospitalization program typically has seven days with minimum of 5 hours of daily facilitated group, and individual therapy, psycho-educational lectures and workshops to assist in completing assigned tasks.
 
The patient population can be varied but must also include individualized groups dependent on gender, age, career, and level of progress. Separate men’s and women’s, on campus living quarters, monitored 24 hours daily.
 
Multiple-day family program on campus should be provided monthly as well as weekly couples and family sessions, on site or by telephone.
Community living provides an environment where patients can practice communication and conflict resolution skills, and form healthy relationships with their peers.
 
ASSISTANCE IN THIS CHOICE
If you require objective, confidential information/help in the selection of a program specific to your needs, I will reply to an email or phone request for additional guidance.
 
Disclosures: I am a consultant to several programs that monitor and treat addicted health professional.