What is the “Right” Substance Abuse Treatment?


What is the "Right" Substance Abuse Treatment?

The substance abuse industry is a very difficult and cumbersome field to navigate, even for those of us within the profession. As Director of Admissions at Project Courage, I have had countless conversations with families, clients, and loved ones about how confusing and daunting this process can be. Daunting not only in regard to finding the right substance abuse treatment center, but sometimes how difficult it can be simply receiving a call back. When adolescents and young adults are in need of substance abuse treatment the initial contact usually comes from a concerned family member.

I often think about what this process is like for this individual. The process of corning to the realization that this next step is warranted for their child, but not knowing what that next step is or what it should be. I envision a mother, stressed and anxious, not knowing her next move, ultimately turning to Google and searching “substance abuse treatment for my son” or “addiction treatment near me.” But then what? She finds a number, gives it a call, learns about the process, but still her question remains:

“How do know if this is the right fit, especially when I don’t know what it is that my child needs?”

I encounter mothers like this daily, lost in the process and feeling hopeless. The first thing to consider when researching substance abuse treatment options is level of care. The substance abuse field operates along a continuum of care (see graphic below), which differs in the level of severity. Once the appropriate level of care is established, the best treatment option can then be explored.

For example, one way to establish level of care is to start with an evaluation. These evaluations, also known as biopsychosocial evaluations, and examine the factors of an individual’s life to determine where his or her needs are not being met, or where he or she is most adversely affected. Sometimes, the level of care is clear. For instance, if your loved one is actively using a substance such as opiates, alcohol, or benzocliazepines, which would cause physiological withdrawal if use was to be discontinued, then a medically monitored detox would be the most appropriate level of care.

However, it is not always so clear. One way for professionals to determine level of care is to utilize instruments such as the Level of Care Utilization System for Psychiatric and Addiction Services (LOCUS) or the American Society of Addiction Medicine ASAM patient placement criteria (ASAM). These instruments utilize the information gathered front the biopsychosocial evaluation and indicate the most appropriate care based off the client’s needs.

Project Courage’s Substance Abuse Treatment Continuum of Care

Project Courage's Substance Abuse Treatment Continuum of Care

  • Individual, Group, or Family Therapy

This usually entails a once-a-week therapy session lasting one hour, however it can be up to 3 hours a week and include several appointments. For example, often our clients will have an individual therapy session in the same week as a group and/or family therapy session.

  • Intensive Outpatient

Intensive Outpatient therapy usually involves 10-15 hours of therapy per week. Typically, the therapy is made up of individual, group, and family therapy. The therapy is usually offered three to five days a week for three to four hours each day.

  • Partial Hospitalization*

This level of care usually involves 15-30 hours of treatment each week, again consisting of individual, family and group therapy. It usually takes place five days a week for three to five hours each day.

* Partial Hospitalization (PHP) is not offered by Project Courage, but we utilize a large network of referral partners to ensure the best option for a client that may need this service.

After the level of care has been determined, appropriate treatment options can be explored. For residential services, families and clients usually have more options available to them as they can seek services outside of their state or geographic region. If your loved one needs an intensive outpatient program (IOP), or outpatient program (OP), you can begin researching programs in your area. Ideally, the information gathered from the biopsychosocial evaluation would be used in order to find the most appropriate provider.

When deciding on a treatment provider, it is advised to inquire about the following information:

  • The type of accreditation or licensing the program maintains
  • Provider specialty (Age, Diagnosis Type, Models of Treatment utilized)
  • Therapeutic modalities employed (if your loved one has a certain diagnosis, you want to make sure that the model being utilized has been proven effective for that disorder)
  • Service delivery options (type, duration, and frequency)
  • If it is a residential program or intensive outpatient agency consider the following:
    • How many clients are served in the groups?
    • What are the demographics and diagnosis types of other clients?
    • What is the client to clinician ratio?
    • Is treatment gender specific?
  • The credentials of the staff providing clinical services (Licensed Alcohol and Drug Counselor (LADC), Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor (LPC), Licensed Marriage and Family Services (LMFT)
  • What services/support is available to families?
  • Do they offer aftercare planning or programs for clients to engage in?
  • How long do clients typically enroll in services?
  • Is there any outcome data to demonstrate the providers efficacy?
  • What is the philosophy (Abstinence vs Harm Reduction? Mind, body, and spirit?)

Project Courage understands the stress that choosing a substance abuse treatment provider can cause. We make it as seamless and simple as possible, contacting your insurance for you to get your benefits, conducting preliminary assessments over the phone, meeting with parents to plan out a treatment strategy before the client is even admitted, and so on. We will always do everything in our power to ensure the best experience (before, during and after) working with Project Courage and utilizing our services. Feel free to reach out for more information.

By: Eric M. Vingo, LADC, LMSW