Day treatment for substance abuse
Outpatient (or day) treatment for addiction can vary in the intensity of services offered as well as types of therapies. Outpatient models, such as intensive day treatment, can be comparable to residential programs in services and effectiveness, depending on the individual patient’s characteristics and needs. And in many outpatient programs, group counseling can be a major component. As a main benefit, outpatient day treatment can cost much less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social supports.
But what does day treatment for substance abuse really look like? What are some of the best practices in day treatment? And how is attendance related to successful patient outcomes?
Experts in day treatment: A Q&A
Today, we are joined by experts to answer these questions. Jeffrey A. Henigan, LAADC, CADCII is the Clinical Director for Fountain Recovery and has worked in the field of addiction treatment since 1981. Fountain Recovery is a residential substance abuse treatment facility located in Livermore, California. Here, we take a look at some of the main advantages of day treatment for substance abuse, who and what this type of treatment best suits.
We hope that you will find this interview helpful. If you have additional questions or you want to share your experience after reading, please leave us a comment in the section below.
ADDICTION BLOG: What are some of the best practices in day treatment for substance abuse?
FOUNTAIN RECOVERY: To begin with, our program is intentionally small. This keeps the counselor-to-client ratio small and ensures that each client gets plenty of individual time with their counselor.
Next, our treatment process depends on the successful working out of an individualized treatment plan, worked out between the counselor and the client. Then, we arrange for the client’s length-of-stay to be commensurate to the severity of the problem and the successful completion of the treatment plan. For example, leaving treatment early can provoke relapse. In addition, we use Cognitive Behavioral Therapy (CBT) approaches in our life skills groups. We also have a free Aftercare Group which meets twice a month for clients who have successfully completed the program.
ADDICTION BLOG: Is day treatment different than intensive outpatient programs? How?
FOUNTAIN RECOVERY: Well, yes and no.
Yes, in that day treatment usually lasts an entire treatment day (from 9am to 4pm in our case). Intensive outpatient treatment lasts for only about 3 hours a day, a half day session.
No, in that both day treatment and intensive outpatient treatment are “intensive”. For example, our clients remain engaged in recovery in the evenings too: they are attending 12-step meetings in the community.
ADDICTION BLOG: How is attendance related to program success? For example, can clients miss a day?
FOUNTAIN RECOVERY: There is a close correspondence between regular attendance at the program and success in the program. However, there are good reasons a client might miss a treatment day here and there: illness, important medical, legal or family appointments or issues.
ADDICTION BLOG: Who is day treatment best suited for?
FOUNTAIN RECOVERY: The day treatment program is best suited for individuals whose addictive illness is not so severe or acute that it prevents them from staying sober when they leave treatment and go home at the end of the treatment day. If either they or their home environment or both are so disordered as to prevent abstinence at the day treatment level-of-care, then residential treatment in combination with day treatment is required.
ADDICTION BLOG: What types of requirements should be met clinically before someone starts day treatment?
FOUNTAIN RECOVERY: First of all, that they not be so ill with alcohol or drug withdrawal or other medical problems as to prevent them from benefiting from day treatment. If they are that ill then they need to get proper medical treatment and medical clearance before beginning day treatment.
Secondly, a client needs to have the cognitive abilities to benefit from the treatment process. However, we can work with language, speech, hearing or cultural challenges.
ADDICTION BLOG: What are the limitations of day treatment programs?
FOUNTAIN RECOVERY: There are few limiting factors. As I mentioned above, health problems or problems created in a toxic home environment may limit participation in day treatment. Financial considerations regarding health insurance coverage or ability to pay for treatment have to be taken into account as well.
ADDICTION BLOG: Do you think that day treatment programs across the U.S. will increase in size/number in the next decade, or not? Why?
FOUNTAIN RECOVERY: Day treatment programs have been increasing in size and number for some time and I think that trend will only continue. It is cost effective and very helpful to clients. If a client can benefit from day treatment, that is “to get well and stay well” and avoid residential treatment, this is a good outcome for them and for the payer.
ADDICTION BLOG: Does insurance typically cover day treatment? Why or why not?
FOUNTAIN RECOVERY: Yes, health insurance usually, covers day treatment for substance use problems, but not always. Some less expensive plans will cover only in a minimal way detoxification and outpatient counseling.
ADDICTION BLOG: On your website, you’ve stated that, “Addiction and alcoholism are not curable, but they can be treated.” What is your experience in patients’ behavior after becoming sober? What kind of help do you offer if they start using alcohol or drugs again?
FOUNTAIN RECOVERY: Though there is no cure for addiction (i.e. a treatment that allows and addicted individual to return to safe or casual use of intoxicants), there definitely is treatment and recovery.
Individuals with addiction “get better and stay better” all the time. We see it on a daily basis in our program. If the 2 elements of recovery are adhered to: 1. abstinence, and 2. working a program of recovery, recovery from addiction will occur.
With inattention, complacency or negative circumstances, relapse can happen. Sometimes it is a springboard to a stronger recovery. If our clients relapse they can return to treatment if they need to or can work out their relapse in our Aftercare group.
Recovery from addiction is a joyful experience; this is our work.
ADDICTION BLOG: Do you have anything else that you would like to add for our readers?
FOUNTAIN RECOVERY: The purpose of Fountain Recovery’s programs is to help our clients “get well and stay well”. We have been doing this for 8 years.
Fountain Recovery’s unique approach to treatment offers real help, real encouragement and real hope for recovery to those seeking help for their drug & alcohol problem. We believe recovery from addiction requires more than the cessation of substance use. The program is an abstinence-based, 12 step-oriented, evidence-based program. The foundation on which our program is build is encouragement, love, practical guidance and personal attention.
At Fountain Recovery we recognize that one size does not fit all in addiction treatment. With our small, focused groups and smaller client-to-staff ratio we are able to offer individualized attention to meet each client’s specific needs. Our client-centered approach to treatment provides a foundation for each client to achieve and maintain long-term recovery as the basis for a healthy and productive life. Treatment planning is individualized for each client by recognizing each client’s unique issues and challenges.