Understanding the Rise of Substance Abuse Treatment Centers
When seeking treatment for substance abuse, many believe that residential treatment – rehab inpatient – is the first step. What may be more helpful is outpatient counseling. It is helpful to review the options before placing yourself or a loved one in a specific level of care.
In today’s clinical world, in the midst of an opiate crisis plus the medical and recreational use of marijuana, it appears that substance abuse treatment centers are popping up all over. There are commercials on TV and the radio, many promising to be “unique, and individualized.” Those words are obviously attractive to those seeking this type of care. However, there has been a huge shift in this type of care and it is important to do research on your options. Not only for treatment centers but also the level of care you choose.
Choosing the Right Treatment Option: Outpatient vs. Inpatient Treatment
How do you decide whether to start with an assessment for outpatient counseling or inpatient substance abuse treatment? I have worked in all levels of substance abuse treatment. As a result I have been able to observe firsthand the benefit and individual appropriateness of each level of care.
Common Misconceptions: The First Step in Treatment
Often, loved ones of those seeking treatment for substance abuse, believe that residential treatment is the first stop. However, there are other options that may be appropriate and helpful before placing yourself or a loved one in that exact level of care. I will break down what each level of care means, and provide some details for the expectations of each.
Understanding Detoxification: The First Level of Care
Detoxification is identified as physical and mental assistance in the removal of substances from one’s life. This means that if you are drinking alcohol daily or using certain drugs you will require a specific level of care to safely allow your body to detox. Since this is not solely a physical process, it is important to have the emotional support while doing so, which is offered at residential treatment programs. If one is using opiates there are options for medication assisted therapy that can also be treated on an outpatient basis.
The Role of Residential Treatment: Stabilization and Support
The next highest level of care that follows detox, is often residential treatment. Residential treatment is effective in stabilizing the individual, but that is pretty much where it ends. Residential programs are often structured to keep clients busy through long days of groups, lectures, activities, etc. Most residential treatments are based on a 21-28 day model. With private insurance companies, the stays often are closer to 10-14 days. The greatest benefit aside from the education, is the time away from one’s natural environment.
Communication Challenges in Residential Treatment
With residential treatment there is generally limited access to the outside world. Which can make it difficult to communicate with loved ones throughout the course of treatment. Very little “deep” clinical work is able to be accomplished given the short stay. However, inpatient treatment can focus on firming up an aftercare plan which bolsters commitment to recovery, anticipates relapse triggers, involves family and loved ones and strengthens the scaffolding necessary to support healthy recovery. The good news is that this can also be done on an outpatient basis as well.
Exploring Partial Hospitalization and Outpatient Options
Types of therapy that you are able to attend while living at your home (or perhaps in a sober living home) include:
- Partial hospitalization (PHP), often 20 hours or less
- Intensive outpatient (IOP), often 9 hours or less
- Outpatient counseling
PHP and IOP occur in group settings and often contain general education on addiction, coping skills, understanding your mental health, etc. You will also probably be provided drug screens regularly to ensure this level of care remains appropriate for you based on your ability to sustain sobriety. It is important to also research the type of foundation your program is built upon. Examples include 12-step fellowship and SMART recovery. Outpatient counseling can include groups also, but less often. Outpatient counseling can simply be 1:1 therapy with the therapist of your choice.
Starting Treatment: The Importance of Outpatient Care
It is important to note that one can start their treatment process in an outpatient setting and that this is often the best place to start so that your therapist can help you decide if you would benefit from IOPO, PHP, Inpatient, or Detox. You do not have to begin at detox or residential unless you are using substances at a rate that would require you to do so, you can’t stop or danger is a high risk. If you feel that perhaps your substance use is concerning you or your loved ones, you can begin the process here. If you are continuously unsuccessful in remaining sober at this level of care, then a higher level of care is often recommended.
Seeking Professional Guidance: Consulting a Treatment Provider
Being that a large majority of my clinical experience has been in substance abuse treatment settings, I believe it can be important to consult with a trusted treatment provider. Contacting an individual therapist that specializes in addiction can be helpful as they are able to assess and assist in treatment placement. They often have previous experience either working in or working alongside treatment centers that they find to be trustworthy and reputable. They can often point you in a direction based on the information provided in the discussion and an objective assessment.
About the Author
Lauren Barrett, MA, LPC, LCADC is a Licensed Professional Counselor and Certified Alcohol and Drug Counselor. Her private practice is located in Audubon, NJ. She specializes in substance abuse treatment, trauma and other mental health issues.
