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LCSW, CCS
Clinical Social Worker/Therapist

Most of us depend on our health insurance to pay the majority of the cost of treatment. Managed care is very stringent regarding justification for treatment. I often have to explain to folks that just because they believe that they need to go to rehab that doesn’t mean their insurance company will pay for it. Rehabs are expensive and your insurance company will likely insist that less expensive and less intrusive forms of treatment be tried first. The philosophy of utilizing the least intrusive form of treatment is also accepted throughout the healing and helping disciplines.

Managed care generally follows the American Society of Addictive Medicine (ASAM) criteria, which specify levels of care that correspond to a degree of objectively demonstrated need. The levels include:

  1. Early intervention
  2. Outpatient services
  3. Intensive outpatient programs (IOP) / Partial hospitalization programs
  4. Residential / inpatient services, and medically managed intensive inpatient services

Early Intervention

Early interventions are typically very brief educational efforts. They tend to be offered and not sought out. Perhaps your primary care physician advises that something is unhealthy and explains why. Public schools and colleges make varying attempts to educate regarding the potential dangers of substance abuse.

Outpatient

Outpatient services generally take place in community clinics or private offices. They include counseling and therapy services for individuals, couples, families, and group treatment. These services tend to be provided once weekly. They are brief in content (50 minutes counseling, 60-90 minutes for a group session) and brief in duration (eight weeks up to a year).

Intensive Outpatient (IOP)

IOPs usually occur in community clinics or hospital settings. They are most often 3 hours per day and between 3-5 days a week. They include a curriculum of sorts in which a person will receive a great deal of information/psycho education, attend group therapy and skills groups and likely get individual counseling concurrently. IOPs are time limited - most often 8-12 weeks.

Rehabs, Residential Medically Managed Inpatient

These addiction treatment options all involve living 24/7 in a facility that has the means to monitor, treat, and ensure the safety of its patients based on their holistic needs. There is a lot of variance amongst rehabs (faith based, medical detox, holistic, 12 step focused and others).

The focus is on ensuring that a person safely withdraws from their drug of choice and engages in intensive treatment amongst peers who are on similar journeys.

Paraprofessionals

Recovery coaches and life coaches have become accepted as legitimate and helpful supports for those making major life transitions. There is a great deal of diversity amongst these paraprofessionals – some are licensed and formally trained and educated, while others simply have a great deal of success in long term recovery, business, health, or other specialty areas.

The advantage of having a recovery or life coach is that there are no externally set boundaries. Because these are not (generally) licensed professions, the parties are free to establish whatever type of working relationship works for them. This may include meeting in each other’s homes, in public, or going to meetings together. It can include a lot of phone contact, web cam contact, texts, and email.

The only true downside of coaching is that insurance companies will not pay for it. Just as there exists a great deal of diversity amongst coaches, there is also a great deal of variance in rates charged. Shopping around can make this a vastly more affordable option.

Peer Support

My favorite word is “and.” Whenever people ask me whether they should pursue one treatment option or another, I’ll suggest they try both.

This is especially true of peer support. I’m heavily biased in favor of groups like Alcoholics Anonymous and Narcotics Anonymous because I’ve seen folks have enormous success. I understand that these groups are not for everyone and that there are indeed many pathways to recovery. Here’s something that we can all agree on – peer support is FREE and its availability is far more extensive than any professional efforts or programs.

My goal is always to put myself out of a job. In order for a successful transition to occur and for folks to move on, it’s vitally important that they have an holistic support system in place. Natural supports (friends, family, peer support in every form whether AA, church, or other organizations) are desirable and sustaining throughout our lifetime.

SMART Recovery has been growing in popularity of late. This is a form of peer support that seeks to incorporate elements of research and psychological treatment. It also supports the use of psychiatric and addiction medicine. Its 4 point system promotes:

  1. Building and Maintaining Motivation
  2. Coping with Urges
  3. Managing Thoughts Feelings and Behaviors
  4. Living a Balanced Life

I urge folks to experiment with different forms of peer support and find what seems to work best for them. I also advise that no two meetings of peer support are exactly the same. It’s actually very common that a client will tell me that they enjoyed the AA meeting they went to on Sunday but disliked the AA meeting they went to on Tuesday at a different location. Each peer support meeting has unique aspects and the more willing we are to investigate, the more likely we are to get our needs met.

Continue to the second part of this article to learn more about the benefits of working with an addiction counselor.

About the author Jim LaPierre:
My story is I'm forever a work in progress and I love connecting with REAL people who are doing great things. I'm blessed to be making a living doing something I love. I'm a proud dad and the luckiest husband ever. I'm an aspiring author - check out my recovery blog at: recoveryrocks.bangordailynews.com Thanks! Jim
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Page last updated Feb 27, 2015

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