Searching Google for an addiction treatment center results in 1, 620,000 + listings. Most have fabulous websites, enticing advertisements and generally speaking strong marketing techniques. The real question is how one determines the appropriate treatment center for yourself and/or a loved one?
Let’s face the facts; most of us are not familiar with either addiction and/or treatment. We want the very best treatment outcomes we are able to achieve for ourselves and/or loved ones. This is an important, life and death situation. This may be the only chance for us to get the help that is needed. This means that we must become knowledgeable and be able to recognize the best place for us.
The following are a list of things that as an informed consumer you should be looking for:
1. Determine the specific needs of the person that is to receive treatment.
a) Does the person require detoxification?
i. Is the person using alcohol to excess?
ii. Is the person using Benzodiazepines?
iii. Is the person using an opiate?
If the answer to any of these questions is yes, a detoxification program is probably in order. This type of program will comfortably and safely help the person to withdraw (i.e. address the symptoms that come with stopping these drugs.)
b) Does the patient require in-patient treatment? This is the highest and most intensive level of care. Generally speaking, this level of care is required for those patients who either medical complications and/or are at high risk for flight. Some residential programs will take other types of patients… and should be considered.
c) Day/Night with Community Housing is often a very good alternative to inpatient care. Often significantly less expensive, this type of program is extremely useful for those who require greater supervision but do not have significant medical complications.
d) Intensive outpatient is appropriate for those who can live on their own and do not require the amount of treatment provided by the other three programs. It is often recommended for those who have completed the levels of treatment in order to provide continued support and guidance in the road to continued recovery.
e) Last but not least is outpatient treatment. This is most appropriate for those who have completed treatment and/or whose problems are relatively controllable.
It is important to understand that in addiction, breaking the cycle is important.
Day/Night with Community Housing as well as Residential Programs offer the patient the safety of 24/7 access to staff and peers to help support their recovery.
2. Having decided on an initial level of care, the next step is choosing a program. In my opinion the following are the things that should be considered.
a) Certification and Licensure: All programs in Florida must be licensed by the State of Florida. This means that they have passed minimum standards that the state believes are necessary for the treatment and safety of clients. The next level of a measurement of competency is Certification by a nationally recognized certification agency like Joint Commission. (This is the organization that certifies hospitals and behavioral health programs). In my opinion, this is an absolutely essential requirement for assuring that a program is of high quality.
b) Cost: As important as good treatment is, we must be realistic. Some programs are simply beyond our financial ability to pay. This means that affordability is an area that must be considered. It is important to remember that not necessarily is the most expensive program the best. The following are questions that should be asked when making a determination about where to go for treatment:
i. Does the program except my insurance?
1. If so, what will my responsibility be?
2. What will happen when the insurance runs out?
3. What will my responsibility be if the insurance company does not pay the full amount?
c) Does the program offer any financial assistance?
ii. Payment Plans
d) In the event that insurance is not available, one should ask?
i. What is the total price of the program?
ii. Are there any extra costs not covered by the program. (e.g. extra M.D. visits, special services like massage therapy etc.)
iii. What is the program’s refund policy?
iv. Are there any scholarships and/or payment plans available?
3. What are the qualifications of staff? Most programs will list the qualifications of their staff directly on their website. I suggest that you look for programs that have certified (CAP) or licensed staff (LMHC and/or LCSW). In addition one should ask:
a) Will the client be seeing the staff listed on the web site?
b) How often and for what duration will the client see them? Does the program have a Psychiatrist specializing in addictions? How often are clients seen?
c) What is the client to staff ratio?
d) Is the program prepared to treat, if needed:
i. Dually Diagnosed Clients
ii. Special Need Clients
iii. Forensically involved clients
iv. Clients with unusual addictions.
4. What are the living arrangements like?
a) How many people in the program.
b) How many people are housed in an apartment? Room? Etc.
c) What are the amenities? (Gym, alternative therapies …)
d) What is the supervision like? (Be sure to ask about who is supervising and if they are awake at night.)
e) Are the clients allowed to leave the program unescorted?
5. Other necessary questions:
a. Does the program provide aftercare?
b. Is the aftercare provided in house?
i. Can the program arrange for more convenient aftercare locations?
ii. Does the program have access to sober living?
iii. What are the requirements for aftercare?
iv. What is the cost of the aftercare?
c. Does the program provide family programs?
i. How often are these programs provided?
ii. Are there any additional costs for these programs?
iii. Does the program provide individual counseling?
iv. Is there a cost for individual family counseling?
d. Can I visit the program? Even if you can’t this is a good question to ask to make sure the program is what is represented in their advertising.
e. What are the hours for visitations? What are the requirements?
f. What are the rules regarding mail?
g. What are the rules regarding telephone use.
6. How long should I wait before I go or send my loved one to treatment? The answer to that question is “not at all”. Remember that an addicted person can change their mind very quickly. The very best advice is that when the person says that they are ready to go, put them in the car and/or airplane and send them.
Now let’s talk about you. As a prospective client, and/or family member, the operational word is going to be nervous, spelled S C A R E D. Understand that this is a natural reaction. It is a new experience, new people and above all you or your loved one are being asked to do this without the use of drugs, alcohol, gambling or whatever addiction they are experiencing. It is going to take resolve, support and above all the courage to change. Recognition that this is all for the good will come quickly after treatment begins.
Last but not least, I feel compelled to give warning about the dreaded “Pink Cloud”. This is the time in treatment when the client feels physically better, but still has their addictive thinking. I remind you that you or your loved one’s best thinking is what got them to where they are today. This is a disease of the thinking process, and as such the best advice that I can give is to follow the advice and recommendations of the treatment staff.
The only other advice that I can give is to have everyone remember, “Recovery is something we do for ourselves. No one can do it for you. If those who loved us could, there would be no more addicts.”