“Inside Rehab” is a new book by Anne Fletcher which sums up her four year investigation of the treatment industry in the U.S.
It’s a book worth reading if you want to know what actually happens in most “programs” and how we compare.
A useful Appendix is her “Consumer Checklist For Checking Out Rehabs” and we’ll spend this issue of the Newsletter reviewing some of the questions she thinks you should be asking – and giving our answers.
How soon do you accept people?
That can vary depending on space available since we only accept one new client or couple per week. Usually the wait is anywhere from a few days to 2 weeks.
Are you inpatient, outpatient, or both?
We are intensive outpatient only.
What is your overall program philosophy?
We reject the long debunked “disease” model and work from the research based model that alcohol abuse is a choice that can be “un-chosen” and that a variety of outcomes are possible.
Are clients required to attend 12 Step meetings?
We suggest that clients avoid 12 Step and AA meetings. If they want an alcohol focused support group we recommend Smart Recovery, Women for Sobriety, and other non-exploitive groups.
How are alcohol problems evaluated?
We use self-reports and, frequently spouse or family reports. We use Dr. Jane Loevinger’s Washington University Sentence Completion Test as an additional guide to design individualized treatment.
Do you offer detox?
Generally no, but clients who are having difficulty in this area are evaluated medically and referred appropriately.
Are clients searched and items confiscated upon arrival?
No. We are not the alcohol police and you are not a child. You are an adult and we treat you as such.
How long is your program?
5 Days of intensive individual work and 12 or more weeks of follow-up. The 5 day intensive is on-site, the follow-up by phone or Skype and in person as possible and as the client chooses.
What approaches does your program use?
As appropriate, we use a mosaic of CBT, motivational enhancement, assertiveness training, couples and family counseling, and other components as needed or desired.
What is the staff to client ratio?
Two staff (Dr. Barnes and myself) to each client. Plus Dr. Norcross’ medical evaluation for withdrawal issues and Naltrexone support.
How much client time is spent in group counseling?
None. We do not waste your time or money on irrelevant and ineffectual “filler” or destroy your confidentiality.
How much in individual counseling?
Each client receives approximately 15 – 20 hours of each of our time during the intensive portion and a minimum of an hour a week during the months of follow-up.
What are the primary counselors qualifications?
We each hold Ph.D.s as well as multiple state and national certifications in all areas of alcohol counseling.
Is any counseling done by students or interns?
We do not employ students or interns. We do not expose you to incompetent para-professionals, nor do we risk your confidentiality.
Evaluating Rehab (continued):
Do you provide medical evaluation?
All clients are evaluated by Dr. Norcross upon admission for any withdrawal symptoms and also for the use of Naltrexone.
What percentage of the staff consists of recovered people?
50% – I fully recovered from roughly 5 years of episodic alcohol abuse in 1982-87.
Describe your use of medications.
We recommend, and Dr. Norcross usually prescribes, Naltrexone, the only effective anti-craving med currently available.
Are men and women treated separately?
Since we treat individuals, that can be seen as treating them separately. We also treat couples. All treatment is client specific in every case.
What happens when clients “slip,” “lapse,” or “relapse”?
We assume that some regressions are a part of the process and are learning opportunities. As with the words alcoholic and alcoholism, “relapse” is a destructive, traditional concept that should be avoided.
Do you have a program for people who’ve been through rehab before?
We see many clients who have been through inappropriate and ineffectual 12 Step rehabs before finding us. They enjoy the same benefits and success as our first time clients and frequently do even better, having shed many of the destructive myths traditional rehabs promulgate.
What proportion of clients complete your program?
98% of our clients complete the program.
What about aftercare?
Our clients participate in 12 or more weeks of scheduled and guided aftercare as a part of the program package and this is included in the $8,750 program cost.
How do you monitor success?
Because we only see a small number of clients, 40-50 annually – and we are not punitive – we are able to do individual follow-up with accurate self-reporting.
How many of your clients are court ordered?
We do not accept clients who are third party ordered, nor do we accept third party payments. This comes from both motivational and confidentiality concerns.
What is your policy on drug testing?
We do no testing of any sort. Again, we are not the alcohol police – that’s your job.
One piece of informatuion she omits is the importance of what the program’s based on – as noted in Dr. Miller’s review of the research, cited in our Ending Alcohol Abuse: What Works . It is good to remember that the so called Minnesota Model, 12 Step Facilitation, and AA rank at numbers 36, 37, and 38 in terms of effectiveness.
Do you have more questions of your own? Remember, we answer the phone ourselves from 8:00 a.m. – 8:00 p.m. Pacific Time every day of the year.