How to choose a quality treatment program
Finding an effective addiction treatment center or program can be a confusing and frustrating process, but if you’re armed with the right questions, it doesn’t have to be. Here’s some help.
—What type of accreditation or licensing does the program have?
Failure to obtain accreditation may mean nothing, but it could indicate fringe status or, in the worst case, a quasi-cult or an abusive form of “care.” Look for accreditation from national programs — such as the Joint Commission on Accreditation of Health Organizations, the Rehabilitation Accreditation Commission and the National Committee for Quality Assurances — that look for effective elements of treatment. Accreditors also require a well-documented patient complaint process. Remember that “state licensing” is not the same as accreditation, since states vary widely in their requirements.
—Have there been studies to measure the effectiveness of the program's treatment methods?
Treatment effectiveness is a new field of study, so it is too early to expect all providers to have done the full research necessary to credibly evaluate their methods. Still, it’s not too early for them to be planning these studies. Keep in mind that the most objective evaluations usually come from outside agencies rather than “in-house” evaluators.
—What medications does the program support or prescribe to treat other medical problems?
Many medical symptoms may be complications of addiction, and clear up after a period of sobriety, but that’s not always the case. Clinical depression or anxiety can undermine chances for recovery. The best programs evaluate patients shortly after admission and offer appropriate care, including medication. Methadone, naltrexone, and disulfiram (Antabuse) can be effective in helping some addicts. Staff should discuss them with patients.
—What sort of “aftercare” does the program offer?
Short-term treatment by itself is not enough to sustain recovery in most patients. Aftercare is crucial, preferably at least a year of weekly or biweekly outpatient counseling, plus participation in 12-Step programs such as Alcoholics Anonymous or other addiction self-help groups, like Smart Recovery or Women for Sobriety. A good treatment program will actively help the patient integrate into a self-help group, although patients sometimes have to shop around to find a comfortable fit.
—What does the program do about relapse?
Unfortunately, relapse is a common occurrence in substance abuse treatment, just as it is in treatment for other chronic illnesses. A good program includes prevention classes that teach patients to recognize and avoid or deal with situations and emotional states that could trigger relapse. It should also have a plan for the patients reentering treatment or support groups to prevent a one-time lapse from becoming a full-blown return to active addiction. Relapse, though demoralizing, can be an important learning experience –with the necessary coping skills.
Other key considerations:
—Does the program accept your insurance? If not, will they work with you on a payment plan or find other means of support?
—Is the facility clean, organized and well run? What is the ratio of clinical staff to patients?
—What is the average length of treatment?
—What is the treatment philosophy?
—Are services or referrals offered to family members to ensure they understand addiction and the recovery process?
—What happens in a typical day or session?
—Does the program encompass the full range of needs, including help in finding a job and child care; dealing with legal problems; parenting?
—Is a mental health evaluation done? Does the program offer inpidual or group counseling and other behavioral therapies?
—Does the program address sexual orientation and physical disabilities as well as provide age-, gender- and culturally appropriate services?
—Is there ongoing assessment of the treatment plan to meet changing needs?
—Does the program have ways to engage and keep people in longer-term treatment?
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(STORIES CAN BE REPRINTED WITH THE FOLLOWING CREDIT LINE: From the Robert Wood Johnson Foundation's "Silent Treatment: Addiction in America" project, produced by Public Access Journalism LLC.)

