In the past, the treatment of addictions tended to be quite inflexible. Arrive at this time, follow this schedule, perform these tasks, and if it wasn’t compatible with your everyday life—sorry! All within the context of changing one’s entire life to fit into a treatment program even if it meant, for example, losing your job, leaving your family, or dramatically changing your life routine or because it was no longer suitable for your schedule.
This rigidity excluded many people from treatment. For example, a single parent can’t leave their children for months or a working professional may risk losing their job by going to treatment or a residential program; they can’t just disappear for a few months.
Many families simply could not financially afford a program like this; specialized treatment programs are generally very expensive and only certain families have insurance to cover costs, or have disposable income that could even consider a plan like this.
The new addiction treatment model flips this inquiry. Instead of expecting people to reshape their lives to treatment schedules, good programs design treatment plans that work within the realities of their met circumstances.
When Life Interferes with Getting Better
In the past, the treatment model essentially said that if you could not undergo a total program in residential treatment, you were not fully committed to your own recovery.
The model itself disregarded the fact that many individuals carry responsibilities that they simply cannot walk away from and abandon for a life span of several months to “get better.” For instance, a single mother cannot simply leave her children for three or more months, someone caring for their elderly parents can not just walk away from their profession and expected duties without jeopardizing the financial well being of their family.
So many families were left with impossible decisions: get help and lose everything else, or continue to struggle through for the years without having proper supports or indications of progress. It was a false dilemma to keep an individual from connecting to effective drug treatment options because the treatment options available did not fit their life contexts.
How Treatment is Modernized for Real Life
Modern treatment programs understand that the likelihood of recovery is higher when treatment is engaged in ways that do not disrupt the pre-existing life structure of the person being treated, and this is not the same as watering down the treatment method being delivered, it is simply using the treatment context in a smarter way necessarily given to the life circumstances of that person.
Intensive outpatient programs provide treatment services in varying hours per week, nightly discharging the person receiving treatment home to their family home, job site, and continued living in their established living situation as recovery happens.
Professionals who seek effective care have options designed around the roles associated with career and family life, providing options to review their work schedule, family schedule, and then spatially integrate one meeting or even intensive thinking that the week or weekend would help. These options may include evening options or thinking through a weekend schedule that intersects with their other routine commitments.
Partial hospitalization programs provide intensive hours during the day, treating persons who again would be returning home each evening.
These persons differ from outpatient persons primarily by advising Medicaid/Medicare boards that the outpatient yearly allotment will not meet some needs as the living situation might be stable yet again require more than what could possibly be provided by in-home clinical services financed by Medicare/Medicaid.
The Skill of Matching the Intensity to the Need
The intensity of treatment needed for a given person may not correlate with whether a person participating appears to be functioning and attending work. Someone who is attending and functioning well at work may well define someone that is progressing to intensive residential treatment as their addiction has progressed beyond what anyone is paying attention to.
Alternatively, someone who looks more like they are struggling might do better in outpatient treatment because their supports are strong compensations in their overall goal development of successful recovery.
The important part of treatment matching intensity action to need is dealing honestly with the severity of the addiction and their living situation. Is there a supportive network of family and friends in place? Has the patient had experience with a lower level of care? Are there mental health challenges that add to the complexity?
Good treatment facilities will spend the time necessary to determine the appropriate level of care for each individual rather than simply treating the patient like everyone else.
When Flexibility Is Helpful In Recovery
There is something powerful about a treatment option in which you don’t have to disrupt your entire life. If a person can still have some stability with work, relationships with supportive family members, and care of their children, they are often more optimistic about recovery.
The flexibility of treatment also offers the benefit of practice in recovery skills immediately. Individual patients are not simply learning coping strategies and working on applying them later; they are learning to handle work stress, family conflict, and routine issues of daily living patterns in real time with professional support.
Many transition experiences from various levels of care go more smoothly.
What About The Financial Realities
Let’s talk about something that affects us all: cost. It is costly to enter residential treatment. Few people have the financial resources to cover the cost of residential treatment without insurance, and even with good insurance, taking a leave of absence from work creates financial stress that makes recovery more difficult.
Outpatient treatment is less expensive and allows individuals to continue working. For a lot of families, it makes the difference between getting treatment, and struggling along without support.
This is not to say that outpatient treatment is simply the cheapest option. When outpatient treatment is the best fit for someone’s situation and need, it can be incredibly effective, sometimes even more effective than residential treatment.
Building Support in Your Actual Environment
One huge benefit of getting treatment that fits into your existing live, is that you are able to build recovery support into your actual living environment. Rather than creating an entirely new life in treatment and then trying to uphold that life when you return home, you are learning to create recovery supportive change in the context of your actual life.
This might mean having a challenging conversation with a family member about some enabling behavior. It might mean you are learning how to manage your job stress while being able to use your job as recovery support. It might mean that you begin slowly changing your social activities to support a recovery goal.
When More Intensive Help is Still Required
This is not to say that everybody can do it with solely outpatient treatment. Some people really need 24-hour support, and to have things changed entirely within their environment in the context of a residential treatment program. People with severe medical complications, people who live in unsafe living situations, or people who have been in outpatient treatment before, many times and that treatment was unsuccessful need more treatment.
The difference now is that there are more options. The goal is to find treatment that is appropriate binding resolution to the individuals’ specific ordeal intensity.
Making Treatment Work to Your Timetable
Another way that modern treatment attunes to real life, is with regard to the timeline involved with each treatment episode. Treatment traditionally was often based on some kind of timeline pre-established that may or may not have had anything to do with the individual’s treatment or progress in the parental or treatment program. There is more acceptance now of the fact that some people need longer treatment support while others could be able to step down before 6 weeks.
Many programs offer a step down model. Some one starts outpatient treatment at intensive level and episodically steps back care as they begin to build confidence. The step down model is thoughtful treatment planning, acknowledging changing levels of ambition, any willingness to work, that the patient can work toward make necessary changes in their real life.
The most critical element to recover is finding a level of treatment the individual can realistically engage in for a period of time.
A less or no intensive treatment episode that I can to involve is more meaningful than a 28 day treatment to where they are considered ‘success’ or ‘not success’ when they do not make any changes after 28 days. and they may not have changed, when the treatment episode it does not day care support their success as well not set of barriers to obtain necessary help.