National leaders frequently fault addiction treatment centers for forcing patients to accommodate to their usually rigid program structure, rather than taking steps to adjust their own programming to meet patients’ needs. At Castlewood Treatment Centers, a Missouri-based eating disorders treatment organization, leaders are testing a more flexible approach to scheduling at their newly opened facility in Birmingham, Ala.
The Highlands offers partial hospitalization and intensive outpatient program (IOP) levels of care, and at the IOP level it is allowing patients to establish a schedule that best coordinates with the other obligations they are trying to meet in their lives.
“The IOP goal for clients is to get them to start living the life they want,” says Nicole Siegfried, clinical director at The Highlands. “We want them to be able to balance our services with the life they’re creating.”
In order to achieve this, The Highlands offers programming hours every day of the week rather than having all IOP patients come in at the same time under a limited schedule. Patients come in for four hours a day, but in some cases may arrive at different times of the day over the course of a typical week (they generally will visit the facility two to five times per week depending on where they are situated in their recovery).
There are occasions, of course, when a treatment schedule may have to become more structured if a patient begins to struggle to achieve the proper balance and runs a greater risk of relapse. “It’s really important to be able to offer the flexibility but to balance that with the structure and support that’s necessary,” Siegfried says. “At times, some patients need for treatment to be more of a priority than their other life responsibilities.”
The Highlands has found other advantages to the more flexible scheduling. Patients can come in at more staggered hours if they need to participate in a variety of topic-based groups (such as relapse prevention or gender and sexuality groups) that are scheduled at different hours over the course of the week.
The Highlands opened for business last August. At the IOP level it serves both individuals who are stepping down from residential eating disorders treatment and those who need a more intensive program than the traditional outpatient care they have been receiving. Siegfried says early results of the scheduling experiment in Birmingham have been promising, and other Castlewood facilities are now considering enacting a similar policy.