While no one would argue that a surplus of services exists at any level of adolescent substance use treatment, intensive outpatient services for youths who do not need or are leaving residential care appear particularly difficult to identify. A New York nonprofit organization that has been in operation for about a year is finding success in offering intensive outpatient services at a welcoming site and with some creative financial planning.
The Center for Living over the past eight months has offered intensive outpatient treatment on a self-pay basis from a three-level condominium in Midtown Manhattan. President and CEO Peter B. Rockholz explains that private foundation money and individual donations help pick up some of the costs of treatment, which range from $1,500 to $4,000 per month.
“If we charged families what it costs to run the program, I don’t think we’d have anyone coming in,” Rockholz says. He adds, “I don’t know what the third-party insurance market is like for this, because we don’t deal with third-party pay.”
Clients come in from various entry points, he says. Some have significant needs but fall short of requiring a residential stay, while others are stepping down from residential treatment and need a program that facilitates a smooth transition back to the community. Although most of the services occur during after-school hours, Rockholz recently was struck by a comment from one youth who entered the building at noon and said, “Can I hang out here? All the kids in school are getting high.”
“I thought, `This is what we want to be,’” Rockholz says.
The program features a variety of structured activities and a treatment philosophy that embraces a blending of approaches, from cognitive-behavioral therapy (CBT) to 12-Step facilitation. Rockholz says Dialectical Behavioral Therapy (DBT) is proving popular at many of the residential programs that refer clients to the Center for Living, so it is being applied in the outpatient program as well.
Other features of the intensive outpatient program include an on-site learning laboratory, a fully equipped instructional kitchen and a “sober café where youths congregate in the evenings in a terrace/solarium area. “They form a sense of community here,” Rockholz says of the adolescents. “We’re establishing a positive peer culture, and filling a void in the continuum of care.”