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An interventionist's view of treatment centers

March 17, 2015
by Rickard Elmore
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Rickard Elmore

As an interventionist, my job is to solidly bridge the tumultuous river of denial, fear and emotional struggle that individuals with addiction and their families inevitably must cross in order to find a clear path into treatment. My focus is not only to help people navigate the challenging steps of committing to the treatment process, but also to connect clients to treatment that will create long-term success. Intervention is not simply about getting clients in the door to recovery—it’s about getting them through the right door.

Working both independently and as part of a clinical care team for more than two decades, I have found that for treatment to work, it is crucial for a client’s individual needs to be met. Beyond finding the ideal fit for each person, I think about one factor: quality at every level. At a treatment center, quality must be evident in everything from the management, facilities and clinical team to the support staff and maintenance team.

In this article I describe what I see as the most important characteristics of a high-quality treatment facility, starting with:

The organization has credentials, expertise and services that line up with advertised claims.

It’s easy to have a gorgeous website and advertising that attracts attention and drives calls to the admissions team. But shiny marketing does not equate to quality care. What is essential is for a treatment center to be run by qualified professionals, and for all the services represented by care providers to be as good as or better than what is presented online and by the admissions team.

Looking at the credentials of the clinical or medical director of a facility offers a good indicator of a facility’s qualifications, expertise and focus. It is helpful to ask the following questions about a center’s clinical and medical staff as well:

  • Do they have a doctorate degree or higher?

  • Are they a PhD or an MD? Have they gone to medical school and if so, are they newly practicing or do they have a history of working with patients?

  • Are they psychotherapists and/or do they specialize in mental health or addiction medicine?

An additional factor in determining if a facility is providing the care it advertises involves finding out if doctors spend one-on-one time with patients or if they only facilitate group work.

It also is important to look into the experience level of the support staff and uncover their background of working in treatment. Do they have higher education or training in addiction or behavioral science? Have they worked with a range of people and age groups or have they worked only with specific populations? Many people working in treatment are newly sober and/or do not come from the same social background as their clients. It is most productive for a client to be learning from a person whose experiences he/she can identify with.

Overall, one can be confident that a treatment facility practices what it preaches when it has an attitude of transparent access to its treatment model, facilities, admissions staff and clinical team. The treatment model should be based on well-documented practices that are proven to work. Accreditation through organizations such as CARF and the Joint Commission is also a clear indicator of high-quality care.

The organization is backed by involved leadership that supports and pays attention to staff.

Highly successful treatment centers that create impactful change in their clients’ lives have an administration that is present and truly supports its staff. Providing substance abuse and mental health treatment is both a rewarding and an emotionally and physically taxing job. In order for the most effective treatment to occur, qualified staff must be backed by skilled clinical leaders and an administration that listens to and highly values its staff members.

The best treatment centers know this, and maintain the number of staff and doctors needed to support clients, while taking measures to ensure that staff is not overwhelmed by the workload. They have support systems in place where their treatment teams can share concerns they may have about clients, and that allow for internal concerns to be addressed. The treatment centers that provide the highest standard of care for their clients also provide their own employees with emotional, behavioral and educational support to ensure the quality of health for clients and staff alike.

When members of a treatment team are excited and enthusiastic about their job, it creates a positive environment where clients’ needs and concerns can be heard and responded to effectively and efficiently. This provides a path for all clients to value themselves and their recovery, ultimately resulting in higher success rates.

It embraces both process-based and goal-oriented recovery.

It is extremely important for treatment providers to understand that recovery is an ongoing process and not an event. Any level of care for substance abuse or mental health treatment must take clients on a journey of increasing personal capability and independence. The goal of a treatment team involves teaching people how to achieve recovery in a process that allows them to meet short-term goals as well as succeed over the long haul.

The best treatment facilities provide a process that allows for clients’ ongoing growth and integration into independent daily lives. This approach can be offered via a single treatment center, or it can involve transitioning from an intensive level of care into a continuing care model featuring a strong team dedicated to longer-term treatment.

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Comments

With any due respect, this article seems to be written from a narrow perspective. For one thing, it assumes all good treatment is delivered through more individual processes over group processes and and secondly by doctors and doctorate level people over the entire village from CEOs to line staff. Simply not the case in my experience. The truth is that research shows that in addiction treatment group processes are much more effective than individual processes, and secondly, clinical teams make up for about 25% of the overall contact team effort producing good outcomes. I've surveyed clients for over a dozen years about their treatment experience, and the doctors and PhD's aren't who stand out to them.

Treatment centers vary on modality and methodology, all driven by different philosophies. Many of them are excellent, and they are all different. This is flowery perspective, and in my observation the more blue collar centers utilizing a myriad of talented people work best. Letters do not equate to quality. Eyes, ears and instincts for addiction and for recovery equates to quality.

There are a few things I agree with in this high-minded piece, among them making sure staff are not overwhelmed with workloads and that administration supports them as well as centers actually having what they advertise.

Curt Maddon, CIP

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