Saturday February 25th 2017

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Is private luxury addiction treatment a new necessity?

Is private addiction treatment for you?

Private addiction clinics are taking a new approach to treating addiction. We know that the old “one-size-fits all” treatment model is not working because individual needs are just as diverse as people themselves. Currently, tailor-made programs can include the following:

  • Anonymity and privacy precautions
  • Alternative addiction treatments
  • Support group facilitation

How is the face of addiction treatment needs and services changing? What are dedicated teams at rehab facilities doing to do what’s best for the experts on addiction – their clients?

We asked Chief Counselor Bridget Curran, and Clinical and Health Psychologist Elisa Crespo Blanco from Alpine Horizon Luxury rehab center in Switzerland to answer these and many other questions. Continue reading to learn more. At the end, feel free to send us your questions and we will do our best to answer personally and promptly.

ADDICTION BLOG: Would you tell our readers what makes a good private addiction treatment clinic? Then, how is Alpine Horizon different than other treatment centers?

BRIDGET CURRAN: For me, it’s a multitude of different factors that make us special, different and unique.

First it’s the location. Without a doubt it’s the first thing that you hits you in the face when you drive here. It’s so beautiful! And, we absolutely use our external environment in our therapeutic program.

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Then, the holistic approach to treatment that we take. And, as we spoke earlier, we do not promise that we will wave a lovely Swiss magic wand and everyone will be cured of their addiction. Instead, we are committed to taking and working with people at whatever point in their addiction cycle that they are in, whatever their difficulty is, and wherever they are in their substance abuse.

Our tailor made program. The fact that we have a tailor-made program is key for increasing the chances for long term results. In other facilities you will have the “one-shoe-fits-all” kind of approach. But not everybody has an addiction, they might have a Substance Use Disorder (SUD), which are two very different things. So, if you put someone with an SUD into an addiction program, chances are it’s not going to work.

At Alpine Horizon we are tailor-making our programs. We do analysis, we cover every angle, the mini mental state examination is done when people arrive, they have a full medical examination, they are then interviewed by a Senior Clinical Member of the team where they complete a comprehensive initial assessment and fill in the gaps that we may be missing from the information that we received previously, or from the psychiatrist or psychoanalyst. And, THEN we tailor-make a program. We sit down as a multidisciplinary team, we feed back on the initial assessment, we agree what may work or what might not work.

Our clients have a say. We sit down with the client and we say “Look, we’ve come up with this program. What do you think?” It’s that collaborative approach: someone is in charge of their treatment program. People don’t come in here and lose control of what happens to them, and they are not just escorted into room B until they have therapy scheduled at 3 o’clock. Our clients ARE their program.

Clients are the addiction experts. Our team, we’ve realized that the addiction experts are the people coming through the door. And we have to learn from them. We have to build a relationship with each client, that they can trust us to share their expertise and can believe us to support them in trying to move on with life…I think that’s something incredible! But there is never any doubt that every person that comes in here is their own expert. Nobody is more qualified in knowing about their addiction that them.

This does not mean that sometimes when people come in they will not try to avoid the more difficult therapies, or that they won’t have to push themselves. And, that’s where I see the therapeutic relationship, trust, and what’s clinically best for the client come into play.

We use evidence based methodologies. The evidence based methodologies that we use have been proven in the field of addiction treatment.

Limited intake of clients. We take a maximum of 5 clients at the same time. Not taking more that 5 people gives us the opportunity to really work on an individual basis, while also providing a group aspect of therapy if they choose so.

ADDICTION BLOG: What type of substance use disorders can be treated at Alpine Horizon: opiates, alcohol, harder drugs?

BRIDGET CURRAN: Alcohol use disorder and any Class B-drug from substance use disorders. And, then for non-substance misuse we are looking at helping people deal with sex, gambling, phone, computer. But that’s just our starting point.

ADDICTION BLOG: If someone has money (or access to it…or a lot of money), how do you know when they hit bottom? How can someone hit bottom if others are bailing them out?

BRIDGET CURRAN: This is always going to be a challenge with a facility like this. Lots of people may hit their mother’s rock bottom, or their father’s rock bottom, or their spouse’s rock bottom…and never actually hit their own rock bottom. And, everybody’s rock bottom looks different.

But, we don’t want everybody coming in the door to be, necessarily, at their rock bottom. That’s not our prerequisite to be able to work with them. If they’ve hit their husband’s or wife’s rock bottom, and they are here because they have a sense that something is wrong, but still think they have it under control; that’s just picking them up at a different point of their addiction cycle.

Sometimes a person may feel that they are at their rock bottom on Monday, and by Tuesday they feel that everything is good. So, that’s where our skills need to come into play. That’s where we as addiction treatment professionals need to be fluid and adjust a program. That’s where our individual approach and our tailor-made programs come into play. And, it’s OK because that is the nature of addiction…but that’s also why professionals need to be really skilled be able to change with it.

ADDICTION BLOG: Is privacy an issue for program attendees? How can you protect individual’s confidentiality when it comes to anonymity?

BRIDGET CURRAN: The fact that we have a small number of people admitted at Alpine Horizon at any time, which is a maximum five (5), it creates a level of privacy. Now, if a client wants an absolute privacy we also offer them to rent their own private living arrangement (chalet), and still receive the exact same service that they’d receive at the center, except they would be living in their own private space. Of course, for clients who require absolute privacy we can omit the group therapy aspect.

Then, I’d add that the location is pretty private as it is. The environment here, the fact that it’s juts a little village, and that it’s such a quiet, small, community – it all adds up the the privacy factor.

Also, the entrance to our center is very private, you go in through your private garage, you go up through a private stairway…we’ve thought about that as well.

ADDICTION BLOG: What evidence based treatment modalities are currently in use?

BRIDGET CURRAN: There is a range. My background is Cognitive Behavioral Therapy, which is proven to be very successful in the treatment of addiction. CBT is useful for changing the way you think about something, which can in turn change the way you feel about it and how you behave as a result.

We have 12 Step facilitation, and that is optional as well. This treatment modality focuses on acknowledging the addiction and embracing the 12 Step program.

Addiction Counseling sessions we provide are looking at addressing emotional issues, at the addictive behaviors, but are also really working to heal some of the damage that addiction has caused.

ELISA CRESPO BLANCO: We also have the Alpha Stim which is a non-invasive Cranial Electrotherapy Stimulation. It’s a device that uses low level micro current and is used to treat depression, anxiety, pain, insomnia which can accompany substance use and addiction problems. This is also a proven method and works by influencing the brain chemistry to improve your emotional and psychological state…it’s also a safe alternative for medications.

EMDR or Eye Movement Desensitization and Reprocessing, which is also a proven integrative psychotherapy approach. EMDR helps accelerate the process of emotional healing and can reduce psychological stress coming from past traumatic life experiences. During a session, the therapist uses bilateral stimulation, using eye movements, and tapping sounds or different tones. It’s purpose is to allow the brain to process those stressful and traumatic events, so the person can integrate those traumatic experiences in a calm and more relaxed state.

We also use Motivational Interviewing, which is a client-centered psychotherapy approach. It is used to promotes, enhance and elicit the patient’s intrinsic motivation. Which is sometimes the key point for starting and facilitating change.

Another treatment method that we use is Mindfulness. This is the process of bringing attention to a person’s internal and external experiences without judging them. So, it’s basically learning to be aware of your thoughts, feelings, emotions, and not feeling any pressure to change them or act upon them. The point is to be aware of the present moment and relax.

SMART Recovery is also a treatment modality that we use, which is an addiction recovery support group kind-of-approach that is based on self- empowerment.

BRIDGET CURRAN: Also, a Family Therapy program is available to look at codependency and at the family dynamics. And, we’d also use Psycho-Educational Workshops in terms of looking at the idea that the first point to successful long term recovery is knowledge and understanding.

So, we’ve tried to develop a program in which each individual aspect complements the other aspects. The individual therapy, for example, will complement the psycho-educational so there is a well planned out flow of integrated therapeutic modalities. If sometimes people aren’t comfortable with group therapy, we develop individual programs.

ADDICTION BLOG: What alternative treatments are currently in use? How do you integrate alternative therapies with addiction treatment modalities?

BRIDGET CURRAN: We create a weekly schedule. Within the schedule what we are looking for is providing 1 to 2 individual therapies a day, a group therapy per day, a psycho-educational session 3-4 times a week. That would make for the clinical basis of the program. And then, in between that we’d incorporate the alternative therapies. A typical day might look like this, for example:

8:00 – Wake up & Meditation
9:00 – Breakfast
9:45 – An individual session
12:00 – Lunch
13:00 – Hiking, biking, yoga, meditation, Pilates, acupuncture, reflexology, swimming, golf, tennis…
18:00 – Dinner

For us, motivation is an important part of the recovery process. So if someone has an interest in hiking or golfing or tennis, we’d be happy to provide that and incorporate time for these interests into their alternative program. But, the clinical part of the program and the alternative activities compliment each other.

ADDICTION BLOG: Do you provide service(s) to meet the treatment gap between detox and long-term sobriety? If so, what are they?

BRIDGET and ELISA: I think we are it!

BRIDGET CURRAN: But, I think long term sobriety isn’t really about what you do in rehabilitation…it’s the aftercare. People can do really really good in rehab, and then if they don’t have a solid aftercare program, it’s almost setting them up to fail.

We don’t want to do that! That’s why we have the rehabilitation program that we do, and there is our aftercare program which is equally as important.

ADDICTION BLOG: What do you do to address enabling family members, especially wealthy parents? For example, do you teach family members to provide “tough love”…?

BRIDGET CURRAN: We have a family program that family members and loved ones can participate in if they want to. Again, that’s a choice and we don’t drag family members and sit them down for therapy. If the client feel it’s beneficial that the family is a part of the recovery program, and if the family also wants to participate, we take a systems approach and family therapy approach. It’s based on improving trust and improving communication, because usually at that point effective communication is gone.

But at the same time, the family program would look into what individual issues the codependent family member is bringing to the table. We would offer individual sessions with the family member, because sometimes codependency issues have nothing to do with the recovering client. The tricky part is that sometimes codependent people get defensive and say “Well, I am not the addicted one or the one with the problem”.

Family therapy programs teach how to not point fingers, but have to do with building a therapeutic alliance with somebody. This is the point where our psycho-educational sessions come into the program. We work with family members on understanding the addiction, understanding their role in it, and then looking at how if that individual changes – other parts of the family system will also change for the better.

In addition to the family program we offer during the rehabilitation process, we would also offer an aftercare program for family members.

ELISA CRESPO BLANCO: We consider the role of family to be very important. Family and friends of someone who’s recovering from addiction can have a very positive, and also a very negative influence on the person. So, having their cooperation is absolutely necessary.

Also, we don’t only look at the ways a family unit can help an addicted individual, but we also work to remind them not to forget about themselves. It’s important for everyone who are impacted by a loved one’s addiction to care about themselves, stay healthy physically and mentally…because after all, that will also influence the person in recovery and the rest of the family members.

When there is an addiction problem in a family, chances are that people have been hurt. So you potentially have a room full of people who are hurting in different ways. We always try to stay mindful of that, and to remember the role of family and friends in addiction recovery.

ADDICTION BLOG: How do you keep up with clients after treatment? What kind of aftercare or continuum of care do you recommend or suggest? What kind of contact do you have with those who complete the program?

BRIDGET CURRAN: After a person finishes our program, we’d be offering Skype sessions once or twice weekly, or how many times weekly there is a need. Telephone sessions in between are also required. And, that will ease off as time goes by. It’s all based on the client’s needs.

Then, we’d be looking at supporting them with access to local services from their living country and city. So, we do a lot of ground work in terms of where they are from, what services are available, what would be helpful, and link them to those services.

We also have clients come back for a “top-up”. When people who live on the other side of the planet hit a “speed bump” – as I call it, and experience a massive wobble; we’d take them back in for a week long top-up program. It serves to maintain the link with the center and with the therapist, and to refresh all that they’ve done in rehab. So, they wouldn’t be coming back into the same program, they would have a completely different program for one week. Top-ups are designed to look at how a person has progressed, what has gone well, what are the areas that they want to continue progressing, and how can we move it forward even more.

For me, this continuum of keeping the link and refreshing is very important for long term results and sustained sobriety.

ADDICTION BLOG: Are you looking to track/research/analyze program results? Why or why not?

BRIDGET CURRAN: It’s absolutely important that we do this. We track results from the minute people walk through the door. What we’ve developed is a kind of a weekly care plan, and along with clients and their assigned key worker we develop goals that they want to achieve. At our clinical multidisciplinary meeting, which will happen weekly, a client’s key worker would say “These were the goals from last week, this is what this person did well, this is what s/he didn’t achieve, and this is what we need to work on or change.”

This tracking happens throughout a client’s stay at the clinic and continues after they leave the program. Tracking the clients’ changes and results is also a part of their aftercare program, and I would view it as a “long term care plan”. So, on each Skype session, you’d have your set of questions:

  • How did you do this week in terms of your set goals?
  • What did/didn’t you achieve?
  • What did you feel you need to work on next week?

If things aren’t going well, we’d be able to see it through this long term care plan system, then re-assess the program and see what could be done, how it could be prevented, what intervention could we offer to prevent relapse. It’s a very clear way for us to be able to analyze progress.

We are also constantly reviewing previous goals, while at the same time looking for new goals that need to be set. Of course, the best way we can track our program’s success is through our clients, their progress, as well as the feedback we’d be getting from them.

ADDICTION BLOG: One last question! What would clients do if at night they have cravings or a need to speak with a therapist? As we know, nighttime can be a difficult time…

BRIDGET CURRAN: A clinical member of staff will be with clients 24/7. Clients would never be on their own. Of course, during the day they would be in a program and busy with things to do. But, the nighttime staff is really important and we are all available on call if there is any immediate need at any time.

Photo credit: Alpine Horizon

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