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Entering addiction treatment is a powerful and beneficial decision for those looking to make significant progress on substance use disorders they are struggling with. The term treatment encompasses quite a few different concepts and ideas, which are often seen in many different lights depending on what professional you are speaking with. One of the most important things to understand before entering addiction treatment is how it works. This guide was designed to provide a basic understanding and example of how each element of a treatment program’s service is meant to help those seeking care.
The first thing to understand is the basic order of events in which a brand-new patient may see services provided to them, as well as some of the types of services to expect. This guide will review the common service types, their timeframes, and the reasoning for each service. Because some addiction treatment centers do things differently than others, there may be some variation depending on what program is attended.
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The process of admissions is typically quite standard at any reputable treatment center. Usually, a professional nurse or a therapist will complete a thorough assessment of the reasons for entering treatment. The assessment will review your overall medical history, psychiatric concerns, social history with friends and family, employment, as well as any current legal issues.
This process often includes completing basic health checks such as measuring vitals, completing drug screens, and testing for any health-related needs. Feel free to use this time to ask questions about the facility and general staff roles. Click here to learn more about the admissions process.
After you complete the admissions process and enroll in the program, you will likely be asked to see the treatment center’s medical provider. This could be a physician or an advanced nurse practitioner who does a review of all medical systems, including detox symptoms. This action is designed to be completed within the first 24 hours of admission and often occurs on the day of admission.
The main goal is to make sure all medical needs are met via a provider’s medical order for prescription medications or to identify the need for a medical specialist if indicated. Feel free to use this time to ask questions and learn more about the medical side of addiction medicine.
In most cases, the therapist, also called a counselor, assigned to help throughout the treatment process will want to meet with you within the first 48 hours of admission. This may be done on the same day that the H&P was completed or potentially afterward depending on schedules and the time of admission.
This meeting will include an opportunity to get to know each other as well as allow the therapist to complete an assessment called a biopsychosocial. It systematically reviews different areas more in-depth than the admissions assessment and helps the therapist work with the clinical team (all the medical staff working with a client) to formulate a diagnosis and plan for care.
This is a prime opportunity to share any concerns or fears that you may have, and is also a great time to ask any other questions. The therapist will work hard to build a positive relationship to help encourage open dialogue and provide guidance on identified needs.
One of the more focused services many treatment programs provide is care from a psychiatrist or psychiatric advanced nurse practitioner that will help address behavioral health conditions with appropriate medication management.
The provider will complete an assessment that focuses on psychiatric health and history of medication usage. They may provide focused services on addiction medicine, including the possible inclusion of medication-assisted therapy services to help manage cravings as well as other symptoms in long-term recovery. These professionals have a great deal of knowledge and encourage asking questions as well.
Case management services are commonplace in many programs to help facilitate any external issues that need to be managed for treatment to be successful. Although the time frame to see the case manager may differ from location to location, it is common for the case manager to see someone within their first 72 hours of treatment and generally weekly after that.
Case management will inquire about employment needs such as submitting leave requests, completing short-term disability forms, and other factors such as legal or probation officer concerns.
The job of the case manager is to deal with these issues so you can stay focused on treatment without added stress. They will also work throughout the treatment process to help you develop a full aftercare plan that sets you up for success when treatment is completed. For some programs, the therapist may take on the role of case manager.
Individual therapy is generally going to occur weekly to help process experiences learned in group therapy as well as to help with intimate issues that require a more focused strategy. The therapist will help guide treatment plan goals with encouragement and support.
Family and friends will often be included in these meetings. The therapist may even suggest family therapy if decided to be appropriate by all. The therapist may also have special training to perform advanced therapies for various conditions, so it can benefit to ask the therapist what specializations they have that may be a great fit for your needs.
The important thing to be aware of is your therapy time is there for you to make the most of, so asking questions, sharing concerns, and being as open as you can will bring more results than not doing so. It is also common to see the therapist throughout the week as they also provide group therapy.
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Group therapy has long been held as one of the most effective forms of care in substance abuse settings as it allows peers to dive deep into their struggle with substance use in a safe environment free of judgment and stigma. Group therapy is the basis of addiction treatment for many programs and is covered under most insurance platforms. Most programs will require at least 4-6 hours per day to provide effective care as well as to ensure they are meeting the standards of care set by insurance program guidelines. Patients are encouraged to start attending groups as soon as they feel well enough to engage.
Group services will focus on a variety of topics including triggers, cravings, mental health symptoms, family and relationship issues, relapse prevention skills, addiction education, life skills development, and other specialized groups depending on the program. These services are usually offered in groups of varying sizes depending on the topic or issue being addressed. Some may be larger and more lecture-based for education purposes and others can be smaller to be more process-oriented as deeper emotions arise.
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Like group therapy, most programs will offer access to 12-step programs such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) that allows for the peer-support side of recovery to be experienced. There is an old phrase that says, “you will get things at AA that you won’t find in therapy, and you will get things in therapy that you won’t find at AA.” This highlights the importance of including both in the early recovery stages.
Many addiction treatment centers will include this either within their facility or through transporting patients to local meetings in the area if they are in a residential program. It is highly encouraged to attend these meetings to gain insight and understanding into the disease process of addiction.
One of the most important elements of attending treatment is learning to manage life without the use of substances. This is not an easy task; however, treatment focuses on helping patients find ways to experience joy in sobriety.
One way treatment helps you achieve this is by having many different activities that allow fun and joy to occur. Some examples of these activities are a crafts night, karaoke night, talent show, spa day, sports days, movie night with snacks, boardgames night, as well as many other activities treatment professionals often encourage patients to explore with others.
These moments can be some of the most powerful in developing strong bonds and relationships with peers in recovery. Many treatment centers have these types of activities nightly for residential patients and weekly for those in outpatient settings.
There are many other aspects involved in the addiction treatment process, many of which haven’t been mentioned here. However, they all still matter in your overall experience during recovery. Some important moments that patients often identify are having meals 3+ times a day created to help with rebuilding their physical health, having a gym to exercise in, life skill services like resume building, luxury services such as equine therapy, engaging in spiritual activities (bible study, meditations, Buddhist recovery, etc.), special weeks where family members are invited to attend treatment with their loved ones, as well as many other aspects that programs include to help engage patients even more.
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No matter what program you engage in or what services you complete, completing an aftercare plan throughout your treatment stay is paramount. This plan continues to be updated as you learn more about your own needs. It will include feedback from everyone on the treatment team, as well as your loved ones, and will ultimately help you decide what you need to complete after treatment.
This plan will include your next steps once addiction treatment is completed, as recovery is a lifelong commitment and an aftercare plan is the path on how to maintain it. Make sure to have this conversation often with your treatment team and family so everyone can feel prepared for the next steps.
This guide is not meant to be an exact representation for what treatment will look like, but rather an overview of the common requirements and expectations seen within most reputable treatment programs. Armed with this knowledge, you can feel more confident stepping forward into the treatment environment knowing that it will have people who care and are looking out for your future.
If you’re ready to find treatment for yourself, contact a treatment provider today.
Travis Pantiel, LMHC, MCAP
Travis Pantiel is a Licensed Mental Health Counselor and a National Board-Certified Counselor with specialized expertise in the co-occurring disorder treatment field.
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