How to Select a Drug and Alcohol Rehab Program

October 3, 2012 |
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Drug and Alcohol Rehab Programs That Work

Introduction
Selecting a drug and alcohol rehab program for substance abuse treatment can be a challenge. Decisions are often made with the best of intentions, but perhaps without considering the most important criteria. What are the right questions to ask when considering which program is best for you, or your loved one? What criteria are “musts” and which are “nice to have”? How do you rank criteria in order of importance? This article provides some insights to help you in the process.

What is most important?

Montana Lodge Recovery What is most important to one person is not always what’s most important to another. Experts agree that getting the right level of care should be the number one criteria. Alcoholism and drug addiction are killers and should be treated as seriously as cancer or any other serious and deadly disease. Everything else is secondary to finding the appropriate level of care. So how does one determine what the level of care should be? Levels of Care range from hospital emergency room to unstructured halfway houses.

Hospital Emergency Room

An emergency room should be used for a life or death situation. These include:

  1. An overdose that makes one unconscious, stop breathing or appear unresponsive.
  2. A related accident (auto, fall, etc.) that requires immediate emergency medical care.
  3. Severe intoxication that is life threatening.
  4. The role of the Emergency Room staff is to make the patient medically stable so that he/she may be transferred to an appropriate facility for treatment.

Medical Detox Center

  1. The alcoholic/addict (referred to as “client” from here forward) is not in a life or death situation, but is not necessarily medically stable due to alcohol or drug inebriation.
  2. Ask what the protocols are for alcohol and drug withdrawal.
  3. Ask what the medical and psychiatric staff-to-client ratios are.
  4. Ask if they have one or multiple “wards” for clients.
  5. Who pays?
  6. Is insurance accepted? How is insurance verified?
  7. Is payment in full required upon admittance?

Residential Primary Care

Once the client is medically stable and has detoxed, it is time to move to the next level of care, which is often a residential primary care program.

The first questions should be: “Are you a licensed facility? If so, what is your license number?”
What programs are offered and what are the lengths of stay for each?

Ask about the overall program philosophy. Is it:
1. Twelve-step based?
2. Faith based?
3. Based upon some other philosophy related to recovery?

Ask what services are offered.
1. Initial assessment? Who does this? What are their qualifications/license levels?
2. Case management? By whom?
3. Individual therapy? By whom? What are their credentials?
4. Group therapy? Who leads the groups? An intern, a “counselor”? What are their credentials? How long have they lead groups?
5. Is substance abuse education provided? By whom? What are their credentials? How long have they been doing this?
6. What provisions are made for medications?
7. Is there an MD on-site or on call?
8. Is there a clinical psychologist on-site, or on-call?
9. What are the qualifications/credentials of the clinical staff? (Those who provide psychotherapy.)
10. What are the qualifications/credentials of the program staff? (Those who provide education and/or experiential programs.)
11. Are clinicians in recovery? Are program staffs in recovery?
12. What is the client-to-staff ratio?

Is there an aftercare program?
1. Who does it?
2. What is it?
3. How? Phone, on-line, on-site?
4. Where?

Is there a family program?
1. What are the components?
2. When is the program offered? At which stage of the process?

Is the facility coed or gender specific?

Is staff bi-lingual, if required?

Is the facility equipped to handle handicapped clients?

What is the visitor policy?

How does staff ensure there are no illegal drugs at the facility?

What arrangements are there for transportation, if required?

What makes this program unique?

What are the expected outcomes?

Is there an alumni organization?

What are the costs?
1. What is included/excluded?
2. Does the client have access to personal funds?
3. When do the fees need to be paid?
—- a. Before admittance?
—- b. Upon arrival?
—- c. Within “x” days after admittance?

What are the grounds for discharge, other than completion of the program?

Extended Care/Transitional Living

Following Primary Treatment, the next level is longer term and is often referred to as “Extended Care” or “Transitional Living.” The purpose of this level of care is to help the client achieve long-term sobriety by offering additional substance abuse treatment and mental health services, such as Partial Hospitalization, Day Treatment, Intensive Outpatient (IOP), Relapse Prevention, therapy for co-occurring disorders and in depth substance abuse classes and/or intensive Twelve Step work. This level of care of “Treatment,” “Rehab” or “Recovery” programs is often more intensive and offers an increased opportunity for long-term sobriety. The questions here are similar as for Primary Treatment.

The first question should be: “Are you a licensed facility? If so, what is your license number?”

What programs are offered and what are the lengths of stay for each?

Ask about the overall program philosophy. Is it:
1. Twelve-step based?
2. Faith based?
3. Based upon some other philosophy related to recovery?

Ask what services are offered.
1. Initial assessment? Who does this? What are their qualifications/license levels?
2. Case management? By whom?
3. Individual therapy? By whom? What are their credentials?
4. Group therapy? Who leads the groups? An intern, a “counselor”? What are their credentials? How long have they lead groups?
5. Is substance abuse education provided? By whom? What are their credentials? How long have they been doing this?
6. What provisions are made for medications?
7. Is there a physician who is board certified in addiction medicine on staff? (This is critical.)
8. Is there a clinical psychologist on staff?
9. What are the qualifications/credentials of the clinical staff? (Those who provide medical and psychological care.)
10. What are the qualifications/credentials of the program staff? (Those who provide substance abuse counseling, education and/or experiential programs.)
11. Are clinicians in recovery?
12. Are program staffs in recovery?
13. What is the client-to-staff ratio?

Is there an aftercare program?
1. Who does it?
2. What is it?
3. How? Phone, on-line, on-site?
4. Where?

Is there a family program?
1. What are the components?
2. When is the program offered? At which stage of the process?

Is the facility coed or gender specific?

Is staff bi-lingual, if required?

Is the facility equipped to handle handicapped clients?

What is the visitor policy?

How does staff ensure there are no illegal drugs at the facility?

What arrangements are there for transportation, if required?

What makes this program unique?

What are the expected outcomes?

Is there an alumni organization?

What are the costs?
1. What is included/excluded?
2. Does the client have access to personal funds?
3. When do the fees need to be paid?
—- a. Before admittance?
—- b. Upon arrival?
—- c. Within “x” days after admittance?

What are the grounds for discharge, other than completion of the program?

Who conducts group therapy?
1. Clinical psychologist?
2. Master’s level and licensed therapist?
3. Licensed substance abuse counselor?
4. Behavioral health technician?
5. Intern?

What does your partial hospitalization program include?

What does your IOP program include?
1. How often?
2. How long is each session?
3. Who does it? What are their credentials?
4. Who supervises IOP?

Individual therapy?
1. How often?
2. By whom?
3. What are their credentials?
4. Is the clinician in recovery?

Group therapy?
1. How often?
2. By whom?
3. What are their credentials?
4. Are they in recovery?

Halfway houses

At this level there may not be licensing requirements as each state is different. For substance abuse treatment, halfway houses are intended for those who require little to no supervision. Generally speaking there are no “program” components to a halfway house. It is simply a safe place for someone to live in as they work or attend school in the community.

Since there may be no governance in your state for halfway houses, be careful. Without licensing there may be no standards for the owner of the halfway house to adhere to. Hence, the quality of management and oversight vary from excellent to poor. So call around and see what their reputation is before you commit to one.

Other considerations:
1. Seek advice from a qualified and licensed therapist who specializes in addiction.
2. Has the client accepted his/her situation and therefore willing to seek treatment?
3. Is the client motivated to do “whatever it takes?”
4. Is alcohol/drug addiction the only problem?
5. Are there co-occurring disorders such as:
—- a. Clinical Depression?
—- b. Bipolar Disorder?
—- c. ADHD?
—- d. Anxiety Disorder?
6. Ask if they treat co-occurring disorders and what the qualifications of the staff are who do so.
7. Is there family trauma such as death, divorce or other major family trauma that may require significant counseling in addition to treatment?
8. What is the client’s condition?
—- a. Is the client so intoxicated that a medical detox is required?
—- b. Is the client incarcerated, or have serious legal issues?
—- c. Is the client medically/mentally stable?
—- d. Is the client motivated and willing to accept substance abuse treatment?
9. What is the ability to pay for services?
—- a. Does the client have insurance to cover medical and behavioral health problems?
—- b. Is the family able to pay?
—- c. Is the employer able to assist?

Summary
There are many other things to discuss as each situation is different; however, the above is a great start to help you understand where to look and what questions to ask. What you want is to find the right level of care for yourself or your loved one. At the end of the day, everyone needs to feel that the provider and client is a good match. Without that, the probability of recovery is lower.

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Category: Addiction Recovery, Arizona Alcohol Rehab, Arizona Drug Rehab, Arizona Substance Abuse Treatment, Arrowhead Lodge Recovery

About the Author ()

Dr. Kenneth Chance, D.Div., is the creator of the MONTANA Model for Recovery and CEO and President of Arrowhead Lodge Recovery,a residential substance abuse treatment program in Prescott, Arizona.Arrowhead Lodge Recovery is an Arizona licensed drug and alcohol rehab program and uses the Biopsychosocial (BPS) Model, the “Mind-Body Connection”, to treat the disease of addiction and any related co-occurring disorder(s).  Based upon the Twelve-Step programs of Alcoholics Anonymous and Narcotics Anonymous. For more information please call 1 (888) 654-2800 or Contact Us.

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