I am asked this, and similar questions, frequently. What do people do in treatment? Who provides treatment? Why is DCCCA in the treatment business? The answers are not simple. Addiction treatment is part of a larger, lifelong process, facilitated by dedicated people who truly want to help those struggling to improve their lives. Improving Lives is the big picture “why” DCCCA is in the treatment business.
This is the first in a series of newsletter articles about our treatment services. Future articles will introduce you to the amazing people who give their skill, talent and heart every day in DCCCA’s programs; a glimpse into the lives of those entering treatment; and, finally, the role addiction treatment has in our communities and in health care.
But first, it is important to know the foundation of how DCCCA approaches treatment and recovery. Our philosophy is grounded in the thirteen, evidenced based Principles of Effective Treatment as defined by the National Institute on Drug Abuse.
Addiction is a complex, but treatable disease that affects brain function and behavior.
DCCCA treatment programs offer individuals the skills, information and resources necessary to effectively address the long term changes that substance use creates, even after the individual discontinues use. Addiction is a chronic illness, requiring ongoing support and, in some instances, periodic intervention to help individuals sustain long term recovery.
No single treatment is appropriate for everyone.
The flow of DCCCA treatment begins with effective screening and a comprehensive biopsychosocial assessment. Service type and intensity is determined by the individual’s unique needs, as identified during the assessment process, which includes the potential client, family members and established community supports. Strengths, assets, and resources identified build the frame work for an individualized treatment plan that outlines specific goals, objectives and strategies to address the client’s needs, as well as the participation of his or her family and social supports. Planning for ongoing support following treatment is initiated early, ensuring the client is connected to community support groups, professional services, safe housing, and the basic living resources necessary to continue the recovery process.
Treatment must be readily available.
Community outreach efforts are designed to offer individuals, families and professionals a place to turn when they or someone they care about needs addiction treatment. Responding quickly and remaining in contact when an individual is motivated increases the likelihood he or she will engage in treatment. DCCCA programs manage waiting lists and provide interim services based on established federal and state priority populations. Referrals are made to other treatment providers when access to a DCCCA program is not possible.
Effective treatment attends to multiple needs of the individual, not just his or her drug abuse.
Successful, long term recovery is contingent on an individual’s ability to effectively manage all aspects of his or her life, including mental health, physical health, financial self-sufficiency, family relationships, legal challenges, and social support. DCCCA programs, from assessment through aftercare planning, assist clients to identify their strengths, needs and resources in all areas of their life. Treatment interventions and community based referrals offer skills, information and strategies to address their unique needs.
Remaining in treatment for an adequate period of time is critical.
Each individual’s course of treatment is unique. We encourage clients to remain engaged in some type of treatment process for three or more months, moving among levels of intensity based on their need. Individuals are more likely to stay engaged when we are successful in developing an effective, trusting relationship with them. It is this trust in our commitment to them that will help them ask for help through the ups and downs of their recovery.
Counseling – individual and/or group – and other behavioral therapies are the most common forms of drug abuse treatment.
DCCCA programs incorporate evidenced based practices throughout the treatment modalities. Outpatient and residential modalities include individual counseling, educational groups, process group counseling, family counseling, peer support, crisis support, and case management interventions. Evidenced based curricula and therapeutic approaches are based in Cognitive Behavioral Therapy (CBT), Motivational Interviewing, and Trauma Informed Care.
Medications are an important element of treatment for many patients, especially when combined with counseling and other behavior therapies.
DCCCA encourages clients to pursue medication management as an adjunct to more traditional treatment strategies, when such use is clinically indicated and physician supervised. Clients may start or continue established Medication Assisted Treatment during their time with DCCCA.
An individual’s treatment plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs.
DCCCA’s full continuum of treatment modalities, and flexible service strategies, allow staff, clients, families, and community supports to modify a client’s recovery plan based on changing needs and newly acquired strengths. Treatment plans are evaluated on a regular basis to ensure they remain appropriate for the individual’s current needs.
Many drug-addicted individuals also have co-occurring mental health disorders.
Seeking substance abuse treatment or seeking mental health treatment is not a choice required of those requesting help from DCCCA. Our treatment programs effectively serve individuals with co-occurring substance use and mental health disorders through completion of a comprehensive assessment, monitoring a client’s self-administration of psychotropic, and quality service integration with internal and community based mental health professionals.
Medically assisted detoxification is only the first stage of addiction treatment and by itself offers little to change long-term drug abuse.
The social detoxification modality offered at each of DCCCA’s residential treatment facilities not only offers a supportive environment in which an individual can safely withdraw from alcohol and other drugs, it is designed as an initial point of engagement in which the individual can begin a more long term recovery project. Social detox clients are introduced to recovery concepts and community based support during their stay, with staff facilitating the transition into residential or outpatient treatment immediately upon detox completion.
Treatment does not need to be voluntary to be effective.
Sanctions or consequences from corrections officials, employers, child welfare providers and families are often powerful factors in encouraging individuals to enter treatment. While DCCCA treatment facilities are not locked or restricted in a manner that prevents a client from leaving whenever he or she chooses to do so, we are very successful in helping clients work through the potential consequences of leaving treatment, and understanding the opportunities available to them if they remain.
Drug use during treatment must be monitored continuously, as lapses during treatment do occur.
DCCCA programs use planned and random urine drug screens and breathalyzers to monitor client abstinence during treatment. Positive results may result in increased service intensity or a change in strategy to more effectively meet the client’s recovery needs. Family and social supports are encouraged to participate in ongoing relapse prevention activities.
Treatment programs should assess clients for the presence of HIV/AIDS, Hepatitis B, and Tuberculosis, and other infectious diseases as well as provide targeted risk-reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious disease.
All clients who complete an initial biopsychosocial assessment and/or begin treatment services with DCCCA are screened for risk factors related to HIV/AID, Tuberculosis and other infectious diseases. Information about testing, risk factors, prevention and service options are offered. All residential treatment clients are tested for Tuberculosis shortly following admission.