Don't Know What To Do?
- Article Summary
- Inpatient or Outpatient?
- Who needs inpatient treatment?
- What if the addicted person doesn't believe he or she has a problem?
- What if the addicted person has been in treatment before?
- What if the problem has significant psychiatric aspects?
- Should you focus on programs exclusively for a special population?
- Matching the program to the person
How To Choose The Right Program
Inpatient or Outpatient?
The goals of rehabilitation can often be accomplished without necessarily "going away" to an inpatient setting. Structured outpatient treatment programs include education, group bonding, work on more subtle forms of denial, and support in maintaining abstinence. However, since the decision to go to treatment must be made for each session over a period of weeks or months, there must be a greater degree of self-motivation.
Who needs inpatient treatment?
- The simplest criteria for making this decision are as follows:
- Outpatient treatment requires:
- Willingness and ability to attend sessions diligently and regularly.
- The ability to abstain from all mood altering substances for 48 hours at a time with support.
- Those who cannot meet these criteria will probably need to be referred to an inpatient rehabilitation program.
What if the addicted person doesn't believe he or she has a problem?
- External motivation is OK. Many people start recovery because of a push from someone else.
- All rehab programs are voluntary. (Historically, Rockefeller programs, which were involuntary, were not a success.) Therefore, the patient must still give his or her consent to treatment. This level of acceptance is good enough for the beginning of recovery.
- For adolescents, we feel that the basic training, even if the patient clearly wants to return to drug use as soon as possible following treatment, is still worth a great deal. The education and the experience of what recovery is like may not be utilized immediately, but are likely to be valuable in the future.
What if the addicted person has been in treatment before?
- It is good to get evaluation and advice about this from a professional familiar with recovery. Sometimes the individual is at a new stage of recovery, and the experience will be entirely different than before. At other times, it may be repetitious. Some programs have a specialized "relapse" track, which may be more relevant.
- When we evaluate patients who have relapsed, we look at three areas:
- Was there ever a full recovery program in place?
- Is there a source of enabling that is preventing recovery from working?
- Is there an internal "Stuck Point," that stops the recovery process at a certain spot?
What if the problem has significant psychiatric aspects?
- This is a hard question to address in general. Evaluation by a professional who specializes in substance abuse as well as mental health is particularly important. Many mental health specialists are well trained at recognizing symptoms of psychiatric problems, but may not be as knowledgeable about how emotional symptoms interact with addiction. Addiction specialists may not be as sensitive to emotional problems and diagnoses. Let's take anxiety for example:
- Anxiety can be a result of addiction.
- Anxiety can be an accompaniment of addiction.
- Anxiety can be a contributor to addiction.
- If you think the person you are concerned about could be "dual diagnosis," put your energy into getting the best possible initial evaluation and treatment recommendation.
- Where addiction and other psychiatric problems coexist, the options are either to focus on the addiction first, or both problems at once. It is almost never optimal to focus on emotional problems before focusing on an active addiction.
What kind of program
Local vs. Long Distance:
Should you focus on programs exclusively for a special population?
Matching the program to the person
Local vs. Long Distance:
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