Today, we are joined by an expert to answer questions about outpatient treatment for substance abuse. Jeffrey A. Henigan, LAADC, CADCII is the Clinical Director for Fountain Recovery and has worked in the field of addiction treatment since 1981. Fountain Recovery is a residential substance abuse treatment facility located in Livermore, California.
Here, we take a look at some of the main advantages of day treatment for substance abuse, who and what this type of treatment best suits.
ADDICTION BLOG: What are some of the best practices in outpatient and residential treatment for substance abuse?
FOUNTAIN RECOVERY: To begin with, our program is intentionally small. This keeps the counselor-to-client ratio small and ensures that each client gets plenty of individual time with their counselor and plenty of fellowship time between peers.
Next, our treatment process depends on the successful working out of an individualized treatment plan, worked out between the counselor and the client. Then, we arrange for the client’s length-of-stay to be commensurate to the severity of the problem and the successful completion of the treatment plan.
For example, leaving treatment early can provoke relapse, that is not staying long enough in a program may decrease an individuals chances for sobriety. In addition, since we know that addiction is an emotional and spiritual illness as well as a physiological one, we employ a spirituality and 12-step emphasis to address the attachment deficit implicit in the illness and use Cognitive Behavioral Therapy (CBT) roaches in our life skills groups. We also have a free Aftercare Group which meets twice a month for clients who have successfully completed the program.
ADDICTION BLOG: Is day treatment different than intensive outpatient programs? How?
FOUNTAIN RECOVERY: Well, yes and no.
Yes, in that day treatment usually lasts an entire treatment day (from 9am to 4pm in our case). Intensive outpatient treatment lasts for only about 3 hours a day, a half day session.
No, in that both day treatment and intensive outpatient treatment are “intensive”. For example, our clients remain engaged in recovery in the evenings too: they are attending 12-step meetings in the community, talking with their sponsors, etc.
ADDICTION BLOG: How is attendance related to program success? For example, can clients miss a day?
FOUNTAIN RECOVERY: There is a close correspondence between regular attendance at the program and success in the program. However, there are good reasons a client might miss a treatment day here and there: illness, important medical, legal or family appointments or issues.
ADDICTION BLOG: Who is day treatment best suited for?
FOUNTAIN RECOVERY: The day treatment program is best suited for individuals whose addictive illness is not so severe or acute that it prevents them from staying sober when they leave treatment and go home at the end of the treatment day. If either they or their home environment or both are so disordered as to prevent abstinence at the day treatment level-of-care, then residential treatment in combination with day treatment is required.
ADDICTION BLOG: What types of requirements should be met clinically before someone starts day treatment?
FOUNTAIN RECOVERY: First of all, that they not be so ill with alcohol or drug withdrawal or other medical problems as to prevent them from benefiting from day treatment. If they are that ill then they need to get proper medical treatment and medical clearance before beginning day treatment.
Secondly, a client needs to have the cognitive abilities to benefit from the treatment process. However, we can work with language, speech, hearing or cultural challenges.
ADDICTION BLOG: What are the limitations of day treatment programs?
FOUNTAIN RECOVERY: There are few limiting factors. As I mentioned above, health problems or problems created in a toxic home environment may limit participation in day treatment. Financial considerations regarding health insurance coverage or ability to pay for treatment have to be taken into account as well.
ADDICTION BLOG: Do you think that day treatment programs across the U.S. will increase in size/number in the next decade, or not? Why?
FOUNTAIN RECOVERY: Day treatment programs have been increasing in size and number for some time and I think that trend will only continue. It is cost effective and very helpful to clients. If a client can benefit from day treatment, that is “to get well and stay well” and avoid residential treatment, this is a good outcome for them and for the payer.
ADDICTION BLOG: Does insurance typically cover day treatment? Why or why not?
FOUNTAIN RECOVERY: Yes, health insurance usually covers day treatment for substance use problems, but not always. Some less expensive plans will cover only in a minimal way detoxification and outpatient counseling.
ADDICTION BLOG: On your website, you’ve stated that, “Addiction and alcoholism are not curable, but they can be treated.” What is your experience in patients’ behavior after becoming sober? What kind of help do you offer if they start using alcohol or drugs again?
FOUNTAIN RECOVERY: Though there is no cure for addiction (i.e. a treatment that allows and addicted individual to return to safe or casual use of intoxicants), there definitely is treatment and recovery.
Individuals with addiction “get better and stay better” all the time. We see it on a daily basis in our program. If the 2 elements of recovery are adhered to: 1. abstinence, and 2. working a program of recovery, recovery from addiction will occur.
With inattention, complacency or negative circumstances, relapse can happen. Sometimes though relapse is a springboard to a stronger recovery. If our clients relapse they can return to treatment if they need to or can work out their relapse in our Aftercare group.