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When today's conveniences pose a distraction

December 1, 2008
by Gary A. Enos, Editor
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At the same time that addiction treatment facilities are becoming more technologically sophisticated, many leaders of these centers remain hesitant to loosen rules that generally restrict clients' access to technology while they are receiving services. Particularly in residential programs, access to computers is often carefully granted or not allowed at all, largely over concerns that patients will become distracted from their recovery work through this connection to the outside world.

Still, managers of treatment programs also realize that this is not an issue for centers to dismiss out of hand, given that the work- and family-related details of clients' lives don't go away simply because they enter treatment.

“There's a difference between surfing the Net and dealing with something that may have come up in the client's business,” says Carl Kester, president of Washington-based Lakeside-Milam Recovery Centers.

It is generally thought that residential treatment centers look at client access to computers much in the same way they have historically treated personal phone calls. As National Association of Addiction Treatment Providers (NAATP) president and CEO Ronald J. Hunsicker succinctly puts it, “If it gets in the way of the treatment process, it is restricted.”

And indeed at Kester's facilities in the Pacific Northwest, access to technology is offered under rare and controlled circumstances. The issue doesn't normally arise in the organization's outpatient programs because of the time-limited nature of these client encounters. Yet in residential treatment, Kester says the facilities' restrictions on access to computers, wireless technology, even television and books to a great degree comes as a surprise to some people entering treatment—and sometimes is used as an excuse not to enter treatment or not to stay.

“We want the residents to be free of stimuli from the outside world,” Kester explains. “This is rarely an issue after the first three to seven days of a resident's stay.”

Kester adds that the questions or conflicts that might come up about access to technology at the start of treatment sometimes reflect clients' relative lack of knowledge about what to expect in treatment and what the process is about.

Exceptions to the rule

Kester explains that access to technology also would be rarely offered to adolescents in treatment and to adults in inpatient detox programs. In the latter situation, any authorized contact with the outside world would take place in the office of the patient's counselor, he says.

Adolescents probably never would have access to anything outside of a phone pass while in treatment, Kester says, while adults completing detox might receive some phone privileges during their post-detox adjustment period.

On the adult treatment side, Lakeside-Milam will be more flexible in situations in which it might be reasonable for patients to receive access to a computer. Kester says that for clients who own a business, for example, a work situation might necessitate occasional use of e-mail. An impending court date also might require that a client maintain contact with someone outside the facility. In all such situations, use of technology is still carefully monitored, Kester says.

The chief clinical officer at Caron Treatment Centers in eastern Pennsylvania says the policies of facilities around the country concerning access to technology run the gamut, from no restrictions to no access. “It truly should be agreed upon and individualized, by the patient, employer, and treatment staff,” says Caron's Michael Early.

At Caron, computer workstations and time are made available based on individual need, Early says. The patient and his/her employer are involved in any decision to make computers and cell phones available for work-related purposes, he says.

But Early emphasizes that in this decision-making process, all parties remain mindful of the importance of the patient maintaining a primary focus on the work involved in treatment.

Effect of emerging technology

Lakeside-Milam's Kester says that the company's recent acquisition of a new software system inspired some thinking about whether residents could be allowed more computer use sometime in the future. The knowledge that some hospitals now have systems that allow patients essentially to check in on a computer might lead some addiction professionals to wonder what kind of information could be captured if technology were integrated more into the treatment experience, he says.

While Lakeside-Milam's policies aren't changing, Kester believes the question of client access to technology constitutes a reasonable discussion item among treatment administrators. “At least you want to be comfortable explaining why you don't allow it,” he says.

Addiction Professional 2008 December;6(7):28-29