Who Works At An Addiction Treatment Center?
When you think of addiction treatment, you probably think of an inpatient rehab facility staffed by various counselors, medical professionals, and other administrative personnel. While these types of individuals do work in these settings, this only scratches the surface of the types of people you’ll find in an addiction treatment facility.
Understanding who exactly you can expect to see during treatment can be confusing at times, especially given that there are many different types of specialists with various titles and areas of focus. Trying to figure out who does what can be difficult to understand even for experienced healthcare providers, let alone patients going to treatment for the first time.
It’s important to note that not every treatment center has every type of specialist, and some centers may not include certain services. Additionally, certain centers may have a staff member who wears multiple hats to perform multiple services. Below are the various types of staff and specialists that are often seen at treatment centers.
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A medical provider is an essential member of the team at any treatment center and is likely the person most people will be most familiar with if they have ever been to a medical facility before. A medical provider is often a licensed medical physician (MD/DO) or an advanced nurse practitioner (APRN/ANP) who is licensed to treat patients under a physician’s supervision.
The main focus of a medical provider, particularly in an addiction treatment center, is to make sure that all of a patient’s medical needs are met during their stay. Most patients will meet their medical provider on their first day of treatment. During this first contact, a medical provider will complete a full medical history and physical examination to understand what, if any, medical conditions may be present upon arrival. This exam reviews any current medical conditions, detox symptoms, or currently prescribed medications to ensure the patient is medically safe to engage in treatment.
This provider may also be involved with any addiction medicine treatments, including anti-craving medications or other drugs designed to assist in the recovery process.
A psychiatric provider is another essential member of the team at any treatment center that works with people who struggle with both substance use disorders and mental health disorders at the same time, also known as co-occurring disorders. This provider is often a medical physician (MD/DO) with additional years of training to become a licensed psychiatrist or is an advanced psychiatric nurse practitioner (PMHNP) who is licensed to treat patients under a psychiatrist’s supervision.
A psychiatric provider will usually meet with a patient within the first 72 hours of entering treatment to perform a psychiatric assessment. This assessment reviews many different elements of how mental health disorders develop alongside substance abuse. Once an assessment has been completed, a psychiatric provider can help a patient explore the underlying causes of these conditions and explain how they can be managed through psychiatric care.
The goal of a psychiatric provider is to help provide appropriate medication recommendations to assist with mental health symptoms, as well as reduce the difficulty of entering sobriety and navigating withdrawal. Often, mental health symptoms become a driving factor for many to use a substance in the first place. By working with the patient to find solutions to these issues, a psychiatric provider can help improve motivation to continue sobriety.
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Nursing staff are one of the most important members of the medical team at any addiction treatment center, and will likely be the staff you interact with the most. Nursing teams are often made of Registered Nurses (RN) and Licensed Practical Nurses (LPN), and they spend years in education and training to become experts in providing sophisticated medical care.
Nursing staff have a wide array of responsibilities in a treatment center. They often complete the admission assessment for many new intakes and help take care of them daily by taking their vitals, completing lab work, communicating any concerns with the medical team, as well as dispensing any medications provided during the treatment stay. Nurses will be there to help should anything go wrong, and ensure that the right provider will help if needed.
Most treatment centers will utilize nursing staff to triage medical concerns, resolve any crisis events that might be happening, and even help to ensure everyone has a snack if needed. Nursing teams are problem solvers by profession, so feel free to utilize them for help when needed.
A therapist can play many different roles in a treatment center due to the many different types of therapies that exist. One of the main goals a therapist has is to be a safe resource for the patient on their journey through recovery. They will help create and foster a safe environment where they will open dialogue through relationship building. This may include individual therapy, group therapy, assessments, brief encounters throughout the week, family calls, family therapy, and many other options.
A therapist is there to be a support system to help when things get tough and uncomfortable, which often means that treatment has begun to work. The process takes time, and ultimately, a therapist will be the one to help you along the way when the going gets tough.
Most therapists have gone through many years of schooling (at least 6-8 years) and many are either working towards their licensure or have achieved independent licensure through years of training with supervision during their post-graduate education. Most states require therapists to have completed a minimum of a master’s degree with some requiring them to have their doctorate as well. The license title can alter state by state, however, common licenses a therapist may hold are licensed clinical social worker (LCSW), licensed mental health counselor (LMHC), licensed professional counselor (LPC), licensed marriage and family therapist (LMFT), and a licensed psychologist (LP).
Case management helps with all the external things happening outside of treatment. A case manager will help you with managing employment documents for leave such as short-term disability, Family and Medical Leave Act (FMLA) paperwork, legal needs for probation officers or court systems, as well as helping identify potential needs before discharge. Your case manager works closely with the rest of the clinical team to help ensure appointments will be made for future services after completion of the program as well as making sure all of the details are finalized for traveling home, having family involvement, or returning to work is settled.
The case manager is often the one who knows what is going on during every stage of treatment and is a great resource to depend on for help with any external needs. The role of a case manager is quite important, yet can frequently be regulated to other positions such as therapists or nurses. Most case managers have at least a bachelor’s degree and many often have credentials in substance use treatment.
A technician is an extremely important staff member of the treatment program, as they are often the front-line worker who is actively involved with all the foundational elements of a program. They ensure appointments are being met and schedules are being followed; as well as handle the orientation of new clients, overall safety, drug screens, and many other tasks as they come.
This staff member often knows the ins and outs of the program and is an excellent resource to ask questions regarding program guidelines, how to do certain tasks, which staff member could help with different situations and anything else that involved basic functions of the program. A technician will generally have completed a bachelor’s degree and may be actively working on their education to be involved in the treatment field. In some instances, the technician may potentially be someone in active recovery themselves and has found a calling to help others.
Many patients report finding these staff members an extremely useful part of their recovery process. This staff member could go by many names, behavioral health technician (BHT), mental health technician (MHT), or recovery advocate (RA) amongst others.
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The medical director of an addiction treatment center manages all medical components of the treatment program. They usually oversee protocols and procedures designed to keep people safe. There is a high likelihood that the medical director is also a medical doctor of some form (MD/DO/Psychiatrist) who also provides services at the facility. Patients are allowed to speak with the medical director if there are grievances or concerns regarding the medical care they are receiving. The medical director is the final decision maker for medical and/or patient enrollment concerns.
The nursing director manages all the nursing components of the treatment center. They usually oversee protocols and procedures related to nursing and medication administration. They will also be active with patient safety and staff safety measures. They are normally an (RN) but potentially may have advanced education, in which they would be titled an advanced practice registered nurse (APRN). The nursing director is usually available for patients for any issues related to medical safety of the environment, nursing complaints, or medication administration concerns.
A treatment center’s clinical director oversees all the clinical components of care, from what the group service schedule looks like each week to ensure all care is provided ethically and clinically appropriate. They will generally oversee the therapists, case managers, and potentially the technicians as well.
This position most often handles any complaints regarding the treatment program outside of specific medical concerns. The clinical director generally makes final decisions for client concerns or safety issues that may require some patients to be left administratively. If there is an issue with the therapist, case manager, or service, the clinical director will be the resource to connect with for resolution.
The cooking staff, also known as dietary aides, are responsible for ensuring nutritious, often dietician-designed, meals are ready every day. They are usually made up of a small team of culinary professionals or chefs of various levels of experience. Most facilities can accommodate diets of all types, especially medically-required diets for those with certain medical conditions. It is highly encouraged to inform the chef and medical provider of any dietary needs so you can comfortably eat during your treatment stay.
The maintenance team is often the unsung hero of most facilities. They help ensure the center is safe both medically and clinically. They work with the other team members to follow all guidelines required by various governmental agencies to help make it a comfortable location. They also ensure it is sanitized frequently to reduce the risk of contaminants impacting patients’ stay. If there are any plumbing, electrical, HVAC, or other operational issues, they will be the ones to ensure they are corrected to minimize the impact they could have on a patient’s treatment stay.
Transportation may have its own department with dedicated drivers to both pick people up at the start of treatment and drop them off at their designations at the end of treatment. They tend to be warm and comforting, which helps to make new patients excited for their stay as well as provide insight for those leaving treatment. They work closely with case management and medical providers to coordinate transportation to appointments throughout a stay, such as possible medical appointments.
The business office is most likely one of the first departments you meet after admission. They oversee all your documents to enter treatment and ensure you are knowledgeable about the financial elements of your treatment stay. That may include reviewing insurance benefits, answering questions, and signing documents. They may also help with collecting funds or potentially putting funds on spending accounts within the treatment center if applicable.
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This includes most of the different types of staff members you may see in a treatment center. There may be different names for these positions, or perhaps multiple positions done by a single department, however, the duties are all relatively the same throughout the treatment industry. Knowing who is involved in what process and how they can be of help when needed can take a lot of stress out of many events while in treatment.
For additional information on what to expect in treatment, please contact a treatment provider today.
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Ashish Bhatt, MD, MRO
Doctor of Addiction Medicine
Learn about Dr. Ashish Bhatt
Dr. Bhatt has been Addiction Center's Medical Content Director for more than three years, providing his expertise to ensure quality and accuracy.
Doctor of Addiction Medicine
Expert in adult and child psychiatry
Over 20 years of professional experience