Finding a good drug & alcohol treatment center is the first step to lasting sobriety. Substance Use Disorders cause severe distress, disability, and total disruption to the lives of individuals, families, and communities affecting health and quality of life. Substance use is far less stigmatized nowadays, as education and knowledge about why people use and abuse alcohol and drugs, despite the serious consequences to their wellbeing, are much better understood and accepted by society. This acceptance of the disease of addiction has led to more and more affected people seeking treatment and a much greater availability of drug and alcohol treatment centers.
The process of deciding among the various types of treatment interventions for substance use, types of therapies, and treatment providers can be overwhelming. Choosing the setting and therapeutic environment that’s right for you or your loved one is critical because you must make the most of the recovery process and set yourself up for success. The life of an alcoholic or addict depends on getting effective treatment that will help in maintaining sobriety and prevent relapse. For this reason, choosing a treatment center that’s a good fit for you or your loved one is paramount. Below I will discuss 5 important tips to keep in mind when finding a quality drug and alcohol treatment center.
Choosing a treatment center for yourself or your loved one can be far from straightforward. It’s common for this decision to be made when spouses, family members, and/or the patient are in a state of stress, anxiety, depression, guilt, and/or fear. This is also a time when the patient has also hit their most profound rock bottom, have lost all hope, and entering treatment is often the only option they have left. Due to the severity of the situation and the vulnerability of all those involved, making an impulsive decision when choosing a treatment center is a potential risk.
When making this important decision, most people will resort to researching on the Internet. This is a good option and an important step in making your final choice; however, make sure you dig a little deeper beyond the façade of the center’s website and any marketing or advertising that stands out to you. Although drug and alcohol treatment centers are in business to rehabilitate people and save lives, the reality is that these institutions are also businesses that must make money in order to remain open to the public. Websites and advertising are where treatment centers are going to showcase their best qualities with professional photos and wording aimed at ‘selling’ the center to you so that you can choose them over their competitors. In your decision-making, investigate how long the treatment center has been in business and if the center has changed names several times or has done business under another name (and if so, why have these events occurred). When reading through websites, it’s a good idea to consider the wording used or the claims made by treatment centers. Does the center present itself in a genuine, down-to-Earth, and ‘real’ manner? Be wary of any facilities that make “guarantees” when it comes to recovery. This could be a big red flag in terms of the ethics and values held by those who run the center.
Even if you or your loved one does not have a mental health diagnosis, the recovery process will elicit emotions and personal issues that substances often serve to mask. Substance use is often a coping skill that has been utilized to avoid or medicate other problems. Once the substance(s) is/are no longer present, many of these emotions and issues will surface. For these reasons, it is critical for a drug and alcohol treatment center to provide treatment for depression, anxiety, fears/phobias, anger, and trauma, among other emotional concerns. This is also known as Dual Diagnosis treatment. Contact the facilities you are considering and ask whether individual and group psychotherapy are offered for topics other than substance use and if so, how often during your stay will you receive these services.
Sometimes, recovery from alcohol and/or drugs will require medical detoxification or ‘detox.’ Detox is sometimes conducted on an outpatient basis under the care of a physician. In some cases, detox is part of inpatient treatment. The setting where detox will take place and the methods used by your provider will influence the treatment center you choose, so make sure that you or your loved one consult with a psychiatrist or other physician to decide the best and safest option. Detox methods differ from person to person. This decision is not made depending on the type or class of substance.
‘Level of care’ simply means how intensive the treatment will be. A ‘higher level of care’ indicates that treatment will take place in an inpatient facility or inpatient hospital. In this type of setting, the patient stays overnight for a predetermined amount of days. This type of treatment is also called ‘substance abuse rehabilitation’ or ‘rehab’ and traditionally lasts about 28 days. Nowadays, inpatient rehab for substance abuse can be shorter or even lengthier, depending on many factors, such as the patient’s progress in treatment and even financial factors. Higher levels of care are also chosen for patients who have been through rehab several times before and have relapsed or in cases where the person may need to detox from one or more substances and require inpatient care for the medical attention that is provided.
A level of care that is one step lower than inpatient treatment is a partial hospitalization program or PHP program. This type of program requires participants to attend treatment at a facility on a full-time basis; however, the patient does not stay at the treatment center overnight. A PHP program schedule can often be Monday through Friday from 9:00am to 5:00pm, like a typical workday. And speaking of a typical workday, these higher levels of care will require patients to take leave time from work or other responsibilities since the patient must fully commit their time to the requirements of the program. At a PHP program, the patient receives many of the services that they would receive at an inpatient facility, such as individual and group psychotherapy, recreation/activities, individual study time, and psychiatric appointments.
The lower levels of care include participation in an intensive outpatient program, also known as an IOP program; outpatient individual therapy with a counselor or a psychologist specializing in substance use disorders; and/or outpatient substance use group psychotherapy. An IOP program is similar to a PHP program with the exceptions that participants attend only half days of treatment (e.g., from 9:00am to noon) and sometimes, treatment is only 3 days weekly rather than daily. This schedule doesn’t disrupt the participant’s typical daily activities as much as higher levels of care and participants are often able to still go to work, school, and/or tend to their personal lives with less modifications. However, it’s important to keep in mind that lower levels of care may not be appropriate for everyone. Depending on the severity of the substance use disorder, some participants may need to fully devote themselves to treatment full time.
Outpatient therapy, which can include individual and/or group therapy, is the lowest level of care in substance use treatment because this treatment typically only takes places approximately one to two times weekly for one-hour per session. The therapist or counselor serves as a treatment provider and guide, but the client is responsible for following through with things like homework assignments and other recovery interventions in between sessions. A type of group therapy is Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) meetings, which can be attended as often as the participant likes (e.g., one time weekly or even every day) and are often an adjunct to psychotherapy. AA and NA meetings are an excellent source of support for people in recovery but are still considered a lower level of care. The participant must be motivated enough to attend meetings and work on their recovery independently in between meetings.
If you’re in doubt about what treatment setting is right for you, consider getting a mental health or psychological evaluation by a licensed mental health counselor, a licensed psychologist, a psychiatrist, or a licensed social worker. These professionals often work in private practices while many also work in substance abuse rehab facilities. Your best bet is to be evaluated by a mental health professional who works in a private practice. Although the setting shouldn’t matter, as mental health professionals must never be biased when evaluating clients and are bound by legal and ethical guidelines, choosing someone who works in a setting outside of a treatment facility (or is not affiliated with the treatment facility) might make you feel more at ease that your seeking an ‘outside’ opinion.
During a mental health evaluation, the provider will ask questions about present and past substance use, the presence of any other mental health symptoms, stressors, or concerns, family history, medical issues (if any), etc. Family members of the person seeking treatment can also be present during the evaluation as long as the appropriate consent is provided. This evaluation will help the mental health professional determine the level of care and treatment that would be most beneficial for you or your loved one. A diagnosis (if applicable) is also provided following the evaluation.
If you have made the courageous decision to enter treatment or if you are the spouse, family member, or friend of a person in need of addiction treatment, you have already taken a major first step in the direction of a more promising and healthy future. It’s critical to make a knowledgeable and informed decision, but once you’ve done your research, make a final decision and take that leap of faith. You deserve the happiness that a life in recovery has in store for you.
Carolina Estevez, Psy.D.
Dr. Estevez is a clinical psychologist licensed in the State of Florida. She specializes in providing individual and group psychotherapy to diverse mental health populations in inpatient, outpatient, community mental health, and substance abuse rehabilitation settings. She has worked with individuals of all ages and with a variety of diagnoses including mood and anxiety disorders, personality disorders, behavioral and developmental disorders, psychotic disorders, and trauma-related disorders. Dr. Estevez has worked extensively in the administration and interpretation of a variety of psychological tests including personality evaluations, diagnostic assessments, academic and neuropsychological tests, and vocational and disability assessments.