Outpatient Addiction Treatment

Group therapy

Treatment works

So, what is outpatient addiction treatment? First of all, the lingo is changing in the addiction treatment field. Although most professionals in the field still refer to addiction as addiction, there are some organizations referring to addiction as Substance Use Disorder or Alcohol Use Disorder. These changes in terminology are for diagnostic reasons mostly, and I still prefer to distinguish between alcohol/substance abuse and alcohol or other drug addiction. With temporary alcohol/drug abuse, a person might be mishandling a divorce or a close death by drinking too much or using some other drug to deal with pain and lonliness. This is usually temporary, and the person might need short-term counseling to find better ways to cope — however, if signs and symptoms show that the person is in the early or middle stages of addiction, progressing toward late stage, full blown addiction, then this is a serious medical problem that requires some form of treatment.

When a potential client comes to NewDay Counseling for a free consultation, we gather enough information to determine if the person is temporarily abusing alcohol or some other drug, or whether the person appears to have a more serious problem and could be in the early or middle stages of alcoholism or some other drug addiction. We also determine if the person has insurance or the ability to pay for treatment. For some reason many people tend to think addiction treatment should be free, but we’re a private organization and receive no government funds. There are organizations that receive state and/or federal funds, and we refer to these treatment options if the person can not pay for treatment or doesn’t have insurance. When people receive other medical treatment, they expect to pay for it or have it covered by insurance — addiction treatment is no different. Addiction might be the most under-treated medical condition in the healthcare realm, costing society billions of dollars a year. Addiction also needlessly causes pre-mature death.

When the issue of money becomes a barrier to treatment, even for someone who can easily pay, we always do a calculation of how much the person is now spending/wasting on alcohol and other drugs and the consequences of drinking and doing drugs — like DUI costs or making bad financial decisions or days not working or loss of a job because of a drug screen or failure to get a promotion due to lack of motivation or trips to the emergency room because of an accident while drunk — and when the calculations are finished the cost of treatment looks like a very smart investment. For an amount equal to most payments for furniture, a big screen TV or a nice stereo, a person can make payments on something, treatment, that can turn the individual’s life around and enable the person to become prosperous and happy in the future — yes, it’s a good investment.

Once we’ve determined that a person has an alcohol or other drug problem that is serious enough to warrant treatment, we have to decide if the person needs to go inpatient or is appropriate for outpatient. Outpatient treatment is less expensive and, of course, less restrictive. In outpatient a person can continue to work and be with the family if there is a family. Our Medical Director makes the final decision between inpatient and outpatient. If a person is in danger of going into withdrawals, and it’s too risky to try detox medication on an outpatient basis, we’ll recommend the person go to an inpatient detox, then the inpatient facility will determine how long the person stays inpatient. It could be that the person stays inpatient for a week or so then is transferred back to us at NewDay Counseling to complete addiction treatment in outpatient.

If the person is going to receive addiction treatment with us in an outpatient program, we perform what’s called a Bio/Psycho/Social assessment which asks pertinent questions about the person’s drug use/drinking history, family history, medical history, emotional state, employment situation and history, etc. After gathering all this information, a treatment plan is developed. The treatment plan establishes treatment goals, objectives, and interventions to accomplish the objectives.

The person begins group therapy which is four evenings a week, Monday, Tuesday, Thursday and Friday, from 5:30pm to 8:30p. One hour of group is educational, regarding some topic pertinent to addiction or recovery from addiction, then the other two hours are process group therapy. Very real, powerful and therapeutic relationships are developed in group therapy if the person opens up and allows others to know him/her. When a group of people are working together toward common goals it’s a much more effective than going it alone or simply talking to a therapist once a week for an hour, especially when what you’re dealing with is something as powerful as addiction. The client receives at least one individual session a week, more if necessary, then family involvement as indicated.

The person in addiction treatment and their counselor work on treatment plan goals, and the counselors meet once a week, at least, with the Clinical Director and Medical Director to discuss clients’ progress and what adjustments are necessary. Referral sources, such as physicians, attorneys, employers, EAPs, if they are on the signed release of information form, receive updates regarding the clients’ treatment — the client has to agree to this update information, otherwise, the client’s treatment is confidential. Unless a client gives us permission to tell someone he/she is in treatment, we can’t tell anyone unless there’s a court order signed by a judge legally requesting the information, but even then it has to be a court order signed by the judge, not just a subpoena.

Near the end of treatment, the counselor and the client begin developing a discharge plan. I prefer to call this a Recovery Management Plan. This plan is very important and should address the long term goals of treatment. Addiction is a chronic brain disease and it takes a long time to clear up, gain insight, stabilize and develop the coping skills necessary to make changes. Then treatment becomes maintenance. We recommend that the client find a support group like Alcoholics Anonymous, Narcotics Anonymous, Rational Recovery, a recovery church group, or whatever, just support from others going through the same recovery from addiction and maintenance of recovery. After a period of time in a support group like AA, the person can begin helping newcomers coming into the group, and this is when recovery goes to a higher level.

Once an individual begins feeling good emotionally, mentally, physically and spiritually, making positive changes, developing purpose and meaning in life, and then helping others do the same, recovery becomes not a “staying away” from alcohol or other drugs, but a moving forward to a better life that improves as time goes on. Recovery can seem like something is pulling the person forward — this is recovery, and it has to be managed and maintained.

Outpatient Addiction Treatment

addiction treatment

Group Therapy

For those who are not familiar with the treatment of addiction, or substance use disorders, if you prefer, it helps to know the different levels of care. A person seeking treatment might be familiar only with inpatient treatment, because they’ve heard of The Betty Ford Center, or some other famous center that treats celebrities and gets into the news.

Celebrities can afford certain levels of treatment that most people with an alcohol or other drug problem can’t afford. For most people treatment must fit the need and the resources to pay for treatment. Even if treatment is provided by the state and costs the client very little, there’s still the problem of limited state resources.

If someone needs detox and can’t get into a program until first the withdrawal is medically managed, they might have to go into an inpatient facility for 24 care until they’re past the withdrawal phase, then they’d go to outpatient addiction treatment outside a 24 hour care facility.

Some people who’re dealing with an alcohol or other drug problem can go straight into outpatient, although they might require some type of medication management for the first week or so, but outside a 24 hour care facility. It depends on the severity of the addiction and the person’s ability to stay away from the alcohol or other drug without being locked away from the temptations.

Sometimes, a person might go to outpatient simply because they can’t afford inpatient and don’t meet the criteria for state assistance. In this case, the treatment professionals will do all they can to help the person maintain abstinence while receiving group therapy and individual counseling. It helps if the client also goes to an outside support group like AA or NA while attending outpatient. Between medical management of withdrawals, group therapy, individual counseling, family support, hopefully, and attendance at a support group, the client ought to have good chance of remaining abstinent long enough to develop a plan of recovery for the long term.

Intensive outpatient gives the client the best chance to remain abstinent and receive the education and counseling necessary to combat the cravings, negative thoughts, emotional confusion and peer pressure. Intensive outpatient usually entails about 12 hours of treatment a week, mostly in the form of group therapy. The client gains strength when others are also going through the same experience. When group members begin helping one another stay clean and sober, it’s a far more effective form of therapy than one on one counseling once or twice a week.

Too many people with an addiction problem think that any therapist can help them get better, but if the treatment is not provided by professionals trained in addictive disorders who understand the process of recovery, then lasting change is unlikely. Addiction is a specific brain disease with specific behaviors and experiences and should be treated by specialists just as cancer or specific mental health disorders are treated by specialists. Intensive outpatient is an effective form of treatment, either on its own or as a follow up to inpatient stabilization.