How Do I Pick the Right Treatment Program?

by Rachel Gutow-Ellis, (CPC)  and Crystal Collier, PhD, LPC-S

Finding an appropriate treatment program for a loved one can feel like an overwhelming task, especially when in crisis. When feeling overloaded, a helpful strategy is to break your tasks into smaller, more manageable steps. The list that follows offers a path of action including elements to consider when seeking a treatment program for your child, adolescent, or young adult. 

1.) GET AN ACCURATE DIAGNOSIS.  The diagnosis informs and guides what the appropriate level of care will be for your child. Mood issues, such as depression or anxiety disorders, may co-occur with substance use problems. If this is the case, you will want to explore options that can treat both diagnoses. If your child’s primary diagnosis is either mood or substance-related, then you can narrow your focus on treatment facilities that specifically target that issue.

2.) DETERMINE APPROPRIATE LEVEL OF CARE. The graphic below depicts the many levels of care according to the level of use or symptom severity. As a general rule, start with the least restrictive environment when appropriate. For example, if you have tried one hour of therapy per week to no avail, increasing the level of care to Intensive Outpatient or Partial Hospitalization may be the next step. This will increase how much time they will be in care. If the level of substance use or mental distress requires a higher acuity of care, you may need to consider a detox program followed by a short-term stabilization period. See the types of treatment definitions below.

Many times insurance is the driving factor that determines treatment location and length of stay. Hiring an insurance advocate may be worth the effort to make sure your child is receiving the full care covered by your plan. It is helpful to start by contacting your insurance company for a list of approved treatment centers. Some facilities are private pay but will negotiate their fees in order to earn your business. As the consumer, you should absolutely request fee reductions!

3.) GET REFERRALS. Remember, websites are marketing tools where you will see general promises made regardless of your child’s needs. So, go to folks who know. Seek referrals from professionals who have relationships with programs and can speak to their outcomes based on experience. Likewise, reaching out to other parents who have been on this journey, may offer insights that steer you in a direction that might save time, cost, and heartache of not locating a good match sooner. 

That being said, remember…every child is different and what works for one family may not be what is best for yours. Consider hiring an independent educational consultant who has experience in therapeutic placements https://www.iecaonline.com/quick-links/parents-students/therapeutic-needs/, who will advocate for your family and make recommendations based on personal knowledge of the programs and their clinical and leadership teams. Ed consultants can also use their knowledge and experience to help you understand the continuum of care that takes place when seeking treatment for a loved one. 

4.) CRITICAL INQUIRY. With your list of programs in front of you, begin making the calls. The National Association of Therapeutic Schools and Programs offers an excellent tool to help with your inquiry: https://natsap.org/page/QuestionsToAsk Investigating the program’s accreditation, longevity and educational level of key staff, clinical and academic curricula, success rates, costs, family involvement, and aftercare planning should be included in your query.

5.) THINK LONG-TERM. Treatment is not a 30-day fix, it is a long-term commitment to keeping your child safe, sober, and healthy. Your child’s treatment plan should span a minimum of 18 months. So, an educational or therapeutic placement specialist can help you map out each phase of recovery and anticipate what to do in the event of relapse. Their professional relationships with insurance advocates, transport services, and in-home treatment professionals are invaluable connections.

6.) USE A TRANSPORT SERVICE, IF NECESSARY. If your child needs but is not willing to seek treatment, you may have to utilize the service of a transporter. Reputable, highly-trained transport services can assist when children refuse to go to a program willingly, may attempt to run away, or are in danger of escalating misguided behaviors. Request transport referrals from the program, other parents, your child’s therapist, or your educational/therapeutic consultant. Taking kids to treatment against their will may be distressing for you and them, but getting them there safe may save their lives.

7.) TAKE A BREATH, THEN KEEP GOING.  Once your child is safely in treatment, you will now have a window of opportunity to take a breath and a short respite, but continue family therapy and/or parent coaching while your child is away.  Keeping in mind that the first step is usually a short-term stabilization period, the next step is for long-term work. After stabilization, your child may need a long-term residential treatment center, a therapeutic boarding school, a transitional living facility, or wraparound services upon their return home. 

Again, ask trusted resources for referrals. Stay in regular contact with your child’s clinical team who will make recommendations as your child’s discharge date approaches. Having options planned in advance will be imperative. Many step-down programs have waiting lists. The continuity of their care should not be interrupted. Coming home after successfully completing treatment will necessitate a plan for an Alternative Peer Group, an appropriate educational environment (ie.Sober High School), or a Collegiate Campus Recovery Center depending upon need.  

A solid after-care plan will help you feel more confident in supporting your child’s return to a home or school environment. Utilizing a family therapist or parent coach can help you maintain appropriate boundaries to reduce over-functioning or policing your child. Remember,  regressing into old patterns of dysfunctional parenting when your child returns home is as common as children or teens regressing into old patterns of acting out or using. So, stick with it. You have scientific justification to be your child’s frontal lobe until they successfully grow one of their own! 

 

GLOSSARY OF TERMS

Alternative Peer Group: A comprehensive adolescent recovery support model that integrates recovering peers and prosocial activities into evidence-based clinical practice. 

Collegiate Campus Recovery Program: Universities or colleges that offer services and tools to support students recovering from substance use or co-occurring disorders. 

Frontal Lobe or Prefrontal Cortex: A part of the brain that governs executive functioning skills such as problem-solving, decision-making, impulse control, and emotion regulation that does not completely mature until about age 25.

Independent Educational Consultant (IEC): Professionals who possess extensive knowledge of schools, colleges, treatment programs to provide students and families with individual attention, assessment, placement, and referral options. Two professional organizations that vet their members are IECA (Independent Educational Consultants Association) https://www.iecaonline.com/ and TCA (Therapeutic Consulting Association) https://www.therapeuticconsulting.org/.  

Insurance Advocate: A consumer advocate who advises on insurance policy purchase, assists with negotiations between policyholders and insurance companies, and helps consumers get the most out of their policies.

Licensed Chemical Dependency Counselor (LCDC): A professional that provides counseling specifically for substance use disorders. Although licensed, these professionals are not qualified to treat a person with a mental health disorder.

Master’s Level Counselor: A professional trained to provide counseling and guidance on personal, social, or psychological problems who possesses a master’s level degree. 

Parent Coach: A professional who offers education and support regarding youth mental health, behavioral challenges, and substance use issues. They may or may not possess a professional license.

Psychiatrist: A medical practitioner specializing in diagnosis and treatment of mental illness, behavioral health problems, and substance use disorders. Psychiatrists are qualified to prescribe medication.

Psychologist: A doctoral level professional specializing in assessment, diagnosis, and treatment of mental illness, behavior health problems, and substance use disorders. Psychologists are not qualified to prescribe medication. 

Recovery Coach: A professional who provides strengths-based support for people with addictive behaviors including resource location, education, and aftercare accountability.

Residential Treatment Center (RTC): A live-in health care facility providing therapy for substance use disorders, mental illness, or other behavioral problems, sometimes referred to as ‘rehab’.

Sober High or Recovery School: Secondary school designed specifically for students in recovery from substance use or co-occurring disorders.

Social Worker: A professional who aims to enhance overall well-being and development. Depending upon their education and licensure, social workers may serve as case managers, clinical counselors, referral brokers, and advocates.

Therapeutic Boarding School: Residential schools that provide academic support, supervision, and counseling for youth who suffer with emotional, social, and/or behavioral issues.

Transitional Living: A temporary living situation to support people who suffer from mental health, behavioral challenges, substance use issues, or need support when transitioning from residential treatment, incarceration, or wilderness programs into long-term recovery.

Transport Service: A professional transportation service designed to provide safe transportation and a therapeutic transition to treatment programs. 

Wilderness Program: A mental health treatment strategy that combines experiential forms of therapy and outdoor experiences. 

Wraparound Services: A comprehensive, family-driven plan of care including a system of support for a youth who experiences mental health or behavioral challenges including case management, counseling, crisis care, educational services, self-help groups, family support, and/or vocational assistance pre- and post- treatment.