Online directories that list addiction treatment providers are surfacing everywhere, but the latest to become available departs from current trends in a couple of important ways. First, no money will change hands as providers become part of the new site from the Self-Empowering Addiction Treatment Association (SEATA). Second, as the association name suggests, the SEATA directory is designed to call attention to individual practitioners and treatment centers that embrace a self-empowerment approach with their patients, grounded in harm reduction principles.
Although the site and directory are being launched with no planned oversight of those who decide they want to be listed there, a reading of the provider practice guidelines section of the site suggests that many treatment organizations could not honestly say they embrace principles such as these:
“Providers accept the client's goals so long as harm is reduced. Even in a case where the client does not seek to abstain, the provider will work to promote client well-being.”
“Unless a 'success rate' or similar statistic can be supported by scientific research published in a peer-reviewed scientific journal, the provider will not cite one.”
“If the provider pays a referral fee (or “kickback”), the client is informed of the amount of the payment and to whom it is made.”
SEATA and the directory are the brainchild of mutual-help organization SMART Recovery president A. Thomas Horvath, PhD, who says treatment programs such as his San Diego-based Practical Recovery that take a self-empowerment approach have long needed a central resource for finding similarly oriented programs in other parts of the country for referral purposes. He believes that individuals and facilities that ignore the site's provider guidelines and simply list themselves so they can be in another place where prospective clients might land online could be risking their reputation, since the website also will include space for consumer reviews of providers. “If they list themselves, they could be trashed in a review,” Horvath says of these providers.
Horvath says the SEATA site also will include educational information about what self-empowering addiction treatment is. It is not, he says, a program without rules and lacking client accountability. In the case of residential settings, for example, patients in licensed facilities by definition must abstain from substances while they are in treatment, and in some cases that might include nicotine and even caffeine.
Self-empowerment also doesn't mean that program operators who espouse a harm reduction philosophy believe that all clients can safely use substances moderately. In fact, Horvath says, most of the clients in the California treatment program he runs under a non 12-Step model choose an abstinence goal. “The difference is that they elected it—we didn't demand it,” he says. He adds, “Abstinence is one place on the harm reduction spectrum.”
Providers, either individual or facility, will be able to list themselves on the directory according to the populations they serve (by demographic group, etc.) and the level of care or support they provide (from high-intensity residential treatment to sober living and recovery coaching). He says SEATA will mainly employ a search engine optimization (SEO) strategy for getting the word out about this new resource for providers and consumers.
How large a directory could this ultimately become? Using some widely circulated numbers for the ranks of private-practice therapists and addiction treatment facilities, Horvath estimates that possibly one-third of 60,000 therapists are friendly to harm reduction approaches, while perhaps only 10% of 14,000 addiction treatment facilities truly embrace that philosophy.
The SEATA practice guidelines emphasize client responsibility over a program- or therapist-directed approach. They state, “Provider presents treatment and support services as adjuncts to the natural process of recovery, a process for which the client is primarily responsible, working in collaboration with the provider.”
Other components of the guidelines stress client choice, as in the decision to involve family members in the treatment process and to choose the clinicians with whom they work where possible.
A listserv for SEATA has been in operation for months and was used to gather input over how the guidelines should read, Horvath says.
He says he sees much evidence that a growing number of consumers are looking for a more self-directed approach to treatment and recovery. This is evident to him from both the steady growth in SMART Recovery groups as alternatives to 12-Step groups and in the success of his Practical Recovery treatment facility. “We're not at this point a flash in the pan,” Horvath says.
The SEATA website states, in reference to 12-Step based programs and the alternatives, “Either approach can work. However, the self-empowering approach has been underrepresented in U.S. treatment.”
Horvath says that in his work he will refer a patient to a 12-Step based program when the approach he offers isn't achieiving results. He says it's possible that programs that don't take a harm reduction approach will eventually use the directory to do the same when their efforts aren't working. But he doesn't expect a reciprocal arrangement to evolve.
“A colleague [from traditional treatment] will call us occasionally, but it's usually someone saying, 'I don't want my boss to know I'm calling you,'” Horvath says.
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