Long Term Treatment That Works

A Step Down Program for Success

When people think of addiction rehab or treatment, especially people who have never experienced it or have little knowledge about it, habitually, they think treatment is a 30-day program in an addiction treatment facility or hospital. Or often it means 30 days in a locked-down facility. This notion is reinforced time and again by movies and television.

Here is the truth, The traditional 28-day residential care program of treatment is a program that was popular in the 80s, and for no clinically proven reason. Every patient has unique needs when it comes to addiction treatment. As such, when the patient joins a rehab facility, it is crucial that he or she is assigned the appropriate level of care.

This approach to addiction treatment is called the continuum of care, and it was designed to ensure that patients get sufficient and appropriate care upon joining a rehabilitation program, and to transition them smoothly to lower or higher levels of treatment based on the severity of their condition.

Video: Levels Of Care For Addiction Treatment

Benefits of enrolling in an addiction treatment program that offers all levels of care for addiction

What Is A Continuum of Care Facility?

The term Continuum of Care Facility might mean a physical rehab hospital, a substance abuse treatment organization, or any other facility such as assisted living and nursing homes. In the context of addiction treatment, Continuum of Care Facility means a substance abuse rehabilitation / treatment center that offers different levels of care as a step down process to treat addiction.

What Exactly Is The Continuum of Care?

“Continuum of Care” or CoC is a treatment system in which an individual or client enters treatment at a level/stage appropriate to his/her needs and then steps down to a lower or higher level of treatment based on his or her progress towards recovery. A helpful CoC involves the successful transfer of the patient, patients’ records, and treatment principle across the seven levels of care. Different people and organizations have listed varying levels in a CoC for drugs and alcohol treatment but the main ones are:

The ASAM Continuum of Care for Addiction Treatment

Learn more about the ASAM levels of care (Continuum of Care).

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In most resources on CoC, intervention is split into two phases: early intervention and initial intervention. Early Intervention is the first step in the CoC and is usually a precursor to treatment. Early intervention services are designed to help adolescents or adults at risk of addiction but are yet to display symptoms that can warrant admission to a rehabilitation center. In most cases, early intervention involves eradicating the risk factors that incline the patient towards substance abuse and educating him or her about the adverse effects of substance abuse.

The length of early intervention phase is determined by the patients understanding of dangers of drug abuse and whether the specific patient shows behavioral patterns that gears him/her away from substance abuse. During the early intervention phase, the patient is closely observed to determine whether a higher level of care is required.

Initial Intervention is the process of identifying the addiction and putting in place measures to enroll the patient in a treatment facility. In case of emergency intervention, enrollment might not occur until after the patient has gone through the second stage detox and withdrawal. Normally, the detox center and the treatment facility are connected or have a relationship that facilitates a complete CoC.

If this initial intervention occurs before a full drug or alcohol abuse disorder arises, it might be possible, via preventive measures, to control substance abuse; eradicating the need for a complete 7 stage CoC. Otherwise, the patient moves to the next level in the Continuum of Care.

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If the patient is already addicted to drugs, detox and withdrawal must be done as the second phase of the CoC. Medical Detox is a process that helps an addict to separate from the substance in a medically supervised and safe environment.

Often, many individuals attempt to detox on their own, without professional assistance. This isn’t right. Research has shown that patients who seek help are more likely to attain the objective and enjoy long-term benefits.

The duration a patient stays in detox varies according to the degree of addiction and the substance of abuse. Certain substances, including benzodiazepines (prescription anti-anxiety drugs) and alcohol, can lead to severe withdrawal symptoms during detox. Other substances might lead to symptoms that are quite uncomfortable but not fatal. All of these vary depending on the person undergoing the treatment and so does the duration of detox.

Getting detox assistance from a professional care facility makes the process more comfortable and safer, and makes it possible to initiate the next level in Continuum of Care smoothly.

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Residential Treatment

Residential Treatment, also called Inpatient Treatment, is a program where the patient remains in the treatment facility 24 hours a day, gets intensive treatment at least 4 hours a day, and eats and sleeps in the center. Depending on the individual and the result of the initial assessment, the patient may receive treatment for a period of 30 days, 60 days, or 90 days.

Some residential treatment facilities include detox as part of the program while others don’t offer this service. If a person enrolls in a facility that offers detox, he/she will be transferred straight from detox to residential care. However, people attending standalone detox facilities are recommended to attend a residential facility upon discharge.

Residential treatment is highly structured, and it includes group and individual therapy as well as alcohol and drug educational sessions. Some centers provide medication management while others offer medication-free treatment or a combination of both.

The various aspects of the inpatient treatment might include:

  • Individual and group counseling.
  • Nutritional counseling.
  • Structured physical activities.
  • Holistic approaches such as acupuncture, neurofeedback, and yoga.
  • Stress reduction.
  • Vocational training.
  • Social skill training.
  • Relapse prevention support.
  • 12-step recovery programs.
  • Educational services.

Residential treatment facilities offer a multidisciplinary approach to addiction recovery and prepare the patient for the next level in the Continuum of Care.

Learn more about how dual diagnosis treatment can help you.

Partial Hospitalization Program (PHP)

A PHP provides a balance between the 24/7 care offered in Residential Treatment centers and the semi-independence of Intensive Outpatient Program. A PHP schedule offers patients with a safe haven to recover from addiction who may relapse during the day, a chance to recover in the supportive living environment at night. Partial Hospitalization Programs provide a patient the medical assistance he/she requires to gradually develop a sense of autonomy by promoting critical skills required for one to lead a drug-free life.

But who needs PHP?

The right candidate for Partial Hospitalization Program should have:

  • Completed medical detoxification or/and residential care.
  • Reasonable expectations for improvement.
  • The capacity to participate in therapy.
  • A solid support system in the community or at home.

For people struggling with alcohol and drug addiction, a PHP is recommended for medical detox and intensive inpatient care. This program provides on-site housing as well as access to staff around the clock. For the majority of patients, a PHP is a vital step toward getting back to normal life and independent living.

From the moment the patient steps foot into a recovery center, he/she will be welcomed by a team of professionals who understand what he/she is going through and want to help him/her change his/her life. Every day, the patient will work on recovery in clinical-like intensive therapy sitting, and during the night, he/she heads to a supportive living environment (such as a sober living residence) to continue recovering.

Usually, patients in a Partial Hospitalization Program will complete at least 18 hours of treatment every week, 4-7 days a week. The PHP might include:

  • Access to doctors, psychiatrist, and nurses around the clock.
  • Nutrition and fitness oversight.
  • Sober living accommodations.
  • Medication management plans.
  • 12-step principles.
  • Daily group therapy, such as peer and specialty groups.
  • Individual counseling settings with a professional.
  • Aftercare planning and relapse prevention.

As the recovery process progresses, the patient will acquire new coping techniques and assume more responsibilities. Upon successful compression of PHP, the patient should be ready for the next level in Continuum of Care.

Intensive Outpatient Program (IOP)

Intensive Outpatient Program (also known as Intensive Outpatient Treatment or IOP) is major treatment program in CoC and is recommended in some situations after medical and clinical assessment. IOP is recommended for patients who don’t require medically-supervised detox sessions. It is designed to help a patient continue with the recovery therapy following a successful detox, on an intensive but part-time schedule, while still allowing him/her to live a family life and work.

IOP helps the patients to begin rebuilding their private lives and mend their important families’ ties but continue with the treatment program. IOP patients live at home and take part in the program. Intensive outpatient program allows the patient to start the foundation for long-term drug-free living from the beginning of the treatment, as opposed to waiting until they get from rehab centers.

Although IOP isn’t a live-in treatment plan, it still calls for the serious time commitment. Sessions are often scheduled at least three days per week and last about 3 hours a day. The main focus of this program is relapse deterrence, but there are other objectives, including:

  • Achieving and maintaining soberness.
  • Helping patients to develop a support network.
  • Addressing the issues that lead to drug or alcohol abuse.
  • Identifying psychological problems.
  • Implementing positive behavior as well as lifestyle changes.
  • Improving coping strategies.

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    Outpatient Treatment

    Outpatient Treatment is a type of drug and alcohol addiction treatment program that doesn’t require the patient to live at the center. This program varies from partial hospitalization to 12-step meetings. It allows the client to continue staying at home while attending the rehab sessions. Outpatient treatment tends to be more affordable compared to residential programs, and it is suitable for people who cannot take leave from personal duties or work.

    Normally, after a patient has been in inpatient or intensive outpatient program, a step down to outpatient program is recommended to train him/her about effective use of some of the acquired relapse avoidance skills and how to maintain sobriety without support. Here, the patient stays at home, and does his/her daily activity, with scheduled contact with a treatment center.

    During outpatient treatment, the patient may continue skill-building and therapy programs and even take part in self-help support groups such as the 12-step meetings. Research shows that individuals who receive this program as part of CoC are highly likely to recover and remain sober for over 2 years after the program is completed. Individuals who benefit from this program may step down to the Aftercare Programs with ease.

    Aftercare Programs

    Once the treatment part of the program is done, the individual can return to his/her daily life; however, this does not mean that the CoC is complete. Physical challenges and stress might occasionally arise and increase the risk of a relapse. Addiction requires a continual management; after all, it is a chronic condition. This is where this program comes in handy. An Aftercare Program is a post-treatment support system designed to promote proper management of situations that might lead to relapse and commitment to recovery.

    Generally, programs that offer aftercare programs are committed to the full CoC. They not only aim to help the patient recover but to help him maintain lifetime drug-free life. Aftercare programs often include:

    • Continued involvement in 12 steps or other similar programs.
    • Programs that reward continued abstinence or contingency management.
    • Telephone follow-up meeting or other motivational interviewing.
    • Self-monitoring programs.

    Conclusion – How to Start?

    Continuum of Care involves maintaining continuity of patient’s record, especially when transferring from one facility to another. This is important to patients and caregivers alike, and it results in an improvement of the recovery level, improves health, and reduces costs. It is important to enroll in addiction treatment programs that offer a complete CoC.

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