By: Alexandra Plante, M.A. and John Kelly, Ph.D. of the Recovery Research Institute
Substance use disorder treatment takes time and financial resources. With over 14,500 substance use disorder treatment facilities in the United States, it is challenging to assess which ones offer quality treatment to help people begin the process of recovery. Your loved one’s life can depend on a successful outcome, so how do you find an effective program?
In a blog post for Psychology Today, the Recovery Research Institute has detailed 11 indicators of a high-quality addiction treatment center. Here we share six important things families should look for.
1. Nationally recognized accreditation from a quality monitoring agency
Accreditation from external regulatory organizations such as the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), the Commission on Accreditation of Rehabilitation Facilities (CARF), and the Council on Accreditation (COA) requires that any program offering minimum levels of evidence-based care must be open to a random audit of its clinical care. The same is true of state-licensed programs. Ask the treatment center about its national accreditation, call the certifying group, or ask your health insurance company.
2. Personalized, evidence-informed practices
Programs that deliver services founded on scientific research and available best practices tend to have better outcomes. Evidence-based care includes taking an individualized, comprehensive assessment and history of a range of substance use disorders and related conditions, including any physical or mental health conditions. This is followed by an assessment of the many factors affecting the person struggling with addiction (family and social networks and available recovery resources, or “recovery capital”). High-quality treatment programs create treatment that addresses the specific needs of men and women, adolescents versus adults, and those from different minority communities (e.g., LGBTQ) or cultural backgrounds.
Evidence-based treatments involve psychological interventions and accessibility to FDA-approved medications for addiction (e.g., buprenorphine/naloxone, methadone, naltrexone/depot naltrexone, acamprosate), as well as medication for people who have other mental health diagnoses (depression, anxiety, etc.). Motivational incentives to encourage patients to stick with their treatment plan are also part of evidence-based treatment.
3. Measures of program performance, including during-treatment “outcomes”
A further indicator of quality treatment is having reliable, valid measurement systems in place to track patients’ response to treatment. Similar to regular assessment of blood pressure at each check-up in treating high blood pressure, addiction treatment programs should collect “addiction and mental health vital signs” in order to monitor the effectiveness or ineffectiveness of the individualized treatment plan, and adjust it accordingly when needed.
4. Qualified multidisciplinary staff
A high-quality center should have a multidisciplinary staff (e.g., addiction, medicine, psychiatry, spirituality). A diverse staff can help patients uncover and address a broad array of needs that can aid addiction recovery and improve functioning and psychological well-being. One indicator of a higher quality program is staff who have graduate degrees and adequate licensing or board certification in specialty areas. In addition, clinical supervision and team meetings should take place at least once or twice a week for outpatient programs, and three to five times a week for residential and inpatient programs.
5. Strategies to engage and retain patients in treatment
Dropout from addiction within the first month of care is around 50% nationally, and this leads to worse outcomes. It is vital to employ strategies to keep patients engaged and committed to sticking with treatment. Involving significant others and loved ones in treatment increases the likelihood that the patient will stay in treatment, and that progress will be sustained after treatment has ended. Approaches that help the family adapt to changes that occur during recovery include techniques to clarify family roles, reframe behavior, teach management skills, encourage monitoring and boundary setting, help people access community services, and formulate re-intervention plans. A respectful and dignified treatment environment is also important because those suffering from substance use disorders often feel as if they’ve lost their self-respect and dignity. A respectful environment helps them regain it.
6. A comprehensive approach from initial treatment through transition
Treating the whole person will improve the likelihood of substance use disorder recovery. Patients in treatment may have a range of health concerns, from psychiatric disorders (like depression and anxiety) to issues like hepatitis C, alcoholic liver disease, or sexually transmitted diseases, and programs should directly address these issues and link patients to needed services. Programs should connect patients to community resources, ongoing health care providers, peer support groups, and recovery residences. This “warm hand-off” or personalized introduction to potential peers and resources in the recovery community produces substantially better outcomes.