What treatment programme would you choose?

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What makes a treatment programme better than the rest? What characteristics would mark it out as special, outstanding in the field or different from the rest of the pack? Jason Schwarz at Addiction and Recovery News picks up on a Bill White interview where the subject is tackled. But first, what does White think the markers of poor treatment are?

The problems

  • Limited treatment attraction/access
  • weak engagement
  • narrow service menus
  • ever-briefer service durations
  • weak linkages to indigenous recovery support services
  • marked absence of sustained post-treatment recovery checkups
  • resulting high rate of post-treatment addiction recurrence and treatment readmission.

What programme would he choose for a loved one?

I receive calls every day from people asking variations of these questions. There isn’t a universally “best program.” What we are looking for is the best match between the characteristics of a particular person at a particular point in time and the characteristics of a treatment setting at that same point in time. What could be the best choice for one person would not necessarily be a good choice for another, and a good match today might not be so a year from now—because both individual/family needs and organizational capabilities evolve dynamically.

So what are the characteristics that ought to be considered? White lists them:

The solutions

  • accessibility
  • affordability
  • organisational and workforce stability
  • individualised care
  • evidence-based care
  • family-focused care
  • recovery-infused service milieu
  • effective linkage to recovery community resources
  • sustained support for the individual
  • sustained support for the family

But it’s not enough to tick all the boxes, because the quality of the relationship between the client and the professional is a major determinant of outcomes.

What also matters as much as the treatment approach and the treatment institution is the primary clinician who will be providing that treatment. Recovery outcomes vary widely from counselor to counselor.

It helps to use a lot of tools in individually tailored blends and it helps if the people delivering the service have got the right credentials and experience:

The programs with the best long-term recovery rates offer a wide menu of “active ingredients” that can be combined, sequenced, and supplemented to address the needs of individually and culturally diverse patterns of alcohol and other drug problems. And they provide clinicians with track records of achieving such nuanced treatment.

Jason Schwarz is able to say that treatment provider Dawn Farm fits the description, but how many other treatment services meet these criteria?

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