If you’re a family member or friend of an addict, you can play a vital role in guiding your loved one on how to choose (and stick with) treatment. Unfortunately, there’s a large gap between those who need treatment and those who actually get it. In 2013, nearly 23 million Americans could have benefited from treatment for substance abuse, but only 2.5 million people actually got the help they needed. Of the 20.2 million people who went without the treatment they needed at a specialized facility, only 4.5% even realized they needed to get help, according to SAMHSA’s 2013 National Survey on Drug Use and Health (NSDUH). That’s where loved ones come in: By recognizing when your child, partner, friend or spouse needs help with an addiction, you can do the research needed to help him/her figure out how to choose treatment. Depending on the severity of the addiction, the person you care about just might not be capable of doing this research for him/herself.
How do you start the process of finding a treatment center? A good resource is the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Behavioral Health Treatment Services Locator, which allows you to search by state, insurance status and program type (inpatient, outpatient, day treatment). You can also ask people you know for referrals from a trusted health care professional, interventionist or counselor.
Once you have a list of treatment program options, answering these questions will help narrow your choices:
- Is the facility licensed and accredited?
Ask if the facility is licensed by the state in which the center is located and accredited by national organizations like the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Commission on Accreditation of Rehabilitation Facilities (CARF). These accrediting bodies require programs to meet high standards of patient care. Also inquire if the center has experience treating your loved one’s type(s) of addiction and any other mental disorder(s). Consider centers that offer group-specific settings, such as ones for professionals/executives, Spanish speakers, teens/young adults, Christians or LGBTQ programs if your loved one would benefit from one of these. A setting tailored to your loved one’s specific needs means he/she will be doing group therapy and possibly 12-step work alongside other people who share similar struggles or are from a similar background who can help each other to reach a sustainable recovery.
- Does the program work with your loved one’s insurance plan?
Ask the facility to do a benefits check – this is a free service to determine if your loved one’s insurance would be accepted in he/she decides to go there. You can also go to SAMHSA’s Behavioral Health Treatment Services Locator and search for a facility both by the types of payment/insurance accepted and whether the facility offers payment assistance (such as a sliding-fee scale). For more information, read the Paying for Treatment for Your Loved One section.
- What credentials do staff members have?
The therapists and staff will be the ones working closely with your loved one, offering guidance and professional care. While their own life experience — including their personal recovery stories — can make staff inspirational, the people who treat your relative or friend must, of course, also possess high-level qualifications. When you ask about staff credentials, find out if the center has certified alcohol and drug counselors (CADCs) or licensed addiction and drug counselors (LADCs) — these individuals may go by a variety of titles — as well as master’s-level therapists and social workers, among other specialists such as consulting psychiatrists and dedicated nursing staff. In a residential center, the nursing staff should be available 24 hours a day. Ask what the staff-to-patient ratio is; usually, the higher the ratio of staff to patients, the more one-on-one and specialized attention your loved one will receive.
- Does the treatment center address co-occurring mental health issues?
If your loved one is also dealing with co-occurring mental health disorders such as depression, anxiety or a personality disorder, he/she will need simultaneous treatment for those issues along with care for an addiction(s). Integrated treatment (meaning help for both addiction and mental disorders) is most effective.
- What is the center’s environment like?
Look online at pictures, or, if you can, visit and tour the property. Some addiction treatment centers offer resort-like amenities, such as swimming pools, private rooms and beautiful views in desirable locales. Others have a more home-like atmosphere that can be equally comforting. Your loved one should be in a place where he/she feels safe and comfortable.
- What types of therapies and activities are offered?
Most programs offer the mainstays: medical detox and individual, group and family therapy. Others might also have art therapy, equine therapy, Eye Movement Desensitization and Reprocessing (EMDR) for trauma and other supplementary therapies. Some offer healthful activities where your loved one can learn about how to practice mindfulness and ways to relieve stress and cope with life’s challenges: These include yoga, acupuncture, biofeedback massage and other holistic therapies. Think about what kinds of hobbies and activities your loved one once loved before his/her life was overshadowed by addiction. Some facilities have outdoor recreation such as hiking and horseback riding, while others incorporate entertainment like moves, theater and museums. All of these activities are geared to help addicts relearn how to have sober fun and to find pleasure in activities other than using.
- Will family and friends be involved in treatment?
At a minimum you may be asked to attend a family weekend while your relative or friend is in treatment, or be invited to take part in couples or family therapy sessions. In some programs there is more partner or family involvement than others. So if it’s important to not only you but your loved one that family is involved, be sure to mention this to the center.
- What happens after treatment?
Any center you’re considering for your loved one should tell you that they will create an after-treatment plan to assist him/her in making the transition to sober life. The facility should teach skills related to relapse prevention and offer continuing care planning, as well as suggest long-term treatment options. This may include referring your loved one to live in a sober living or therapeutic community for a period of time – usually from six months to a year to help maintain recovery. Sometimes there will be a support team, alumni weekends and transportation to 12-step meetings or visiting nurses to keep an eye out for signs of relapse.Getting straight answers to these questions will give you clear options, helping you and your other family members make the right treatment choice for your loved one with confidence.
Sources: Commission on Accreditation of Rehabilitation Facilities; Joint Commission on Accreditation of Healthcare Organizations; Substance Abuse and Mental Health Services Administration.