Month: April 2020

Introduction

Trying to find substance abuse and mental health treatment that meets your needs can be overwhelming. Why? Well, one main reason is we often don’t know where to even begin and we have misconceptions about ‘rehab’ and recovery. When someone breaks a bone, most of us lay people have common knowledge about treatment protocol: See a doctor, get an X-ray, get a cast or sling to hold things in place to allow healing, go to follow-up appointments, and so on.

But what about when you find out a loved one has been injecting heroin? Or when you see signs in your child for something amiss—are those mood swings ‘normal’ or does their depression and anxiety need clinical attention? Is your teenager’s drug and alcohol use experimental and they’ll grow out of it or should you not wait to find out? 

Then, when you do decide to seek out treatment, you’ll find a world of options, approaches, and therapies. How do you know which one is right for you or the person you care about? Combine it with the fact that not all treatment centers are good. How can you tell which one offers quality care from the ones who are in it just for the money? You’ll also run into logistical hurdles, such as payment (whether being funded, using private insurance, or paying privately), and leave from work, and social hurdles like stigma.

You get the picture—it’s absolutely overwhelming and finding hope along the way to long-term recovery can seem near impossible. 

It should not have to be this way! So, we created this guide because we want to help you get help—in a genuine, no-strings-attached way.

Getting Started, Step-by-Step: Navigating Pre-Treatment

We identified 7 steps for navigating getting into treatment. We’ll take a closer, yet brief, look at each one. 

1. Recognize the need for help
2. Get an assessment/evaluation
3. Consider recommended options
4. Find a treatment center
5. Call (and ideally, schedule a tour)
6. Set a start date
7. Go!

The Simple Version

Since we just mentioned how overwhelming finding treatment can be, here’s the most concise version of the above 7 steps. If you’d like to dig deeper, you can keep scrolling.

1. Recognize the need for help.

If you’re reading this, you or your loved one need help. (Why? We often wait too long when it comes to mental health concerns to finally do some research about it.)

2. Get a professional assessment/evaluation.

Mental health and substance use assessments are best done in person. Ask your GP about psychiatrists they’d recommend or if they know of experienced licensed professional counselors in the area. You may be able to find a local treatment provider who offers stand alone assessments without having to commit to a program.
It’s important to get a clinical assessment before you decide which treatment program is best for you. Let an experienced clinician help you and ask them questions about any concerns you may have. 

3. Consider recommended options.

After the assessment, the clinician will recommend treatment options based on the severity of your condition (e.g. an inpatient or outpatient program). They may also recommend treatment providers (if not, ask them for provider recommendations).

Great, now you’re much more equipped to find a treatment provider!

4. Find a treatment provider.

Take a look at the recommended providers’ websites. You can search the internet for other providers too. For example, the FRANK site is another good resource for finding local and national services in England. 

Here are just a few things to pay attention to:

• If residential, what’s their CQC rating and inspection report?
• Do they have a team webpage showing licensed clinicians?
• Do they have pictures of their space? Does it look comfortable, safe, and clean?

5. Call (and ideally, schedule a tour)

Give the treatment provider a call. Ask them to describe what a day (or week) in their treatment program looks like. Discuss the costs or necessary referral steps. If possible, schedule a tour and see the center in person beforehand.

6. Set a start date

Once you have decided on which provider to partner with for your care, set a start date. This is easy—Start as soon as possible.
If you’re participating in a residential program, look on the provider’s website or ask for a packing list so you know what things to pack (or not to pack).

7. Go!

Yes, you’re here! Now you just need to stay and get the most out of your treatment program.

After the first week or so in treatment, you might be tempted to leave. One exercise you can do is write yourself a letter before going (or on the first day of treatment) about why you’re there and what your goals are for after treatment. Maybe take a selfie too. Read that letter and look at the photo; they may help support you to stay.

1. Recognize the Need for Help

Chances are that if you’re reading this guide you’ve already done this step. Lovely, that was easy! A few important notes before we move on though:

Be sure to be honest with yourself. Don’t choose treatment just because your _(mum, dad, husband, wife, partner, brother, sister, daughter, son)___ wants you to. Obviously, having loved ones in your corner is a good thing! But if you’re not in the ring, treatment may not be effective.

* Loved ones, this does not necessarily mean treatment will not work if your loved one does not want it. Many recovery stories start with family basically forcing their loved one into treatment.

We often convince ourselves that we do not need treatment for drug and alcohol use, addiction, and mental health disorders. A variety of reasons sway us against treatment:

• Denial
• Stigma associated with mental health and its treatment
• Fear of the unknown
• Difficulty of getting into treatment
• Recovery is challenging … or change is extremely hard

Denial

Denial is a very powerful part of mental health issues, especially drug and alcohol addiction. This is worthy of its own article. Read more about denial here.

Intervention 

This is another topic worthy of many articles, but we’ll try to describe it briefly. Intervention is basically when you recognize your loved one needs help, but they do not (or at least, are not coming forth to admit it), and you encourage, or in some cases force, them to get help. “Intervention” is often used to describe a professional intervention by an interventionist.

Ways to Intervene

• Informal, small personal question. Yes, intervention can be as simple as asking your loved one if they would like to get help. They often know they need it, but are too afraid to stop or ask or take the first steps toward getting it. Be opportunistic when you ask; that is, don’t ask when they’re high or drunk. You could lead with stating a behavior you have observed or your concern for their health. Tone and coming from a place of love, support, and willingness to help (not judgment, anger, or shaming) is very important.

If they say no, then might be time to consider a bigger intervention.

• Formal, 2+ person intervention. A variety of intervention styles exist with different levels of effectiveness. Confrontational, ARISE, systemic family, Johnson, and love-first models to name a few. Do-it-yourself intervention literature is available too, if you are hoping to save money by not hiring a professional. However, hiring a professional interventionist is generally going to have higher chances of convincing your loved one to go to treatment. Most interventionists are in recovery themselves, which helps them understand your loved one (they’ve been in those shoes before), they have a lot of experience compared to you doing it on your own, and they are a third-party who may see and help with issues you might not have noticed since you’re deeply involved in the situation.

Questionnaires

Be Cautious About the Results

A quick word on questionnaires and quizzes that gauge if someone has a drinking, depression, or other problem. They can be a helpful tool, but keep in mind its accuracy varies per person and per the organization behind the quiz (or the validity in the way they designed it).

Another thing to be cautious about is these quizzes and questionnaires can be a form of denial or procrastination. In other words, don’t wait for a questionnaire result to tell you that you’ve reached the threshold for needing treatment. If you know that something is not right, or that alcohol and drug use is having negative consequences in your life, then stick with your gut. You do not have to be a full-blown ‘addict’ or have deep depression to seek out treatment. The earlier you receive treatment for mental health conditions, the higher the likelihood for your long-term recovery. On the flip side, if the questionnaire result says you likely have a problem, then you likely have a problem and probably don’t need to fill out 5 more quizzes to confirm it.

You do not have to be a full-blown ‘addict’ or have deep depression to seek out treatment. The earlier you receive treatment for mental health conditions, the higher the likelihood for your long-term recovery. 

2. Get an Assessment (Evaluation) From a Professional 

Just like you would go to the GP to assess a broken bone or a suspicious lump, you should go to your GP, who will likely refer you to a mental health professional to assess behavioral patterns that are interfering with your life. 

What Is an Assessment?

A clinical assessment, or often called evaluation, takes an hour or so where the clinician gets to know you, your story, and ask questions about your medical history, substance use, and mental health. Based on the assessment, the clinician will then go over recommended treatment options with you. With their recommendations and your own personal preferences, then you are able to decide which treatment option is right for you and what type of provider to start searching for.

Where Do I Get an Assessment?

Find a mental health professional who will conduct your assessment, ideally in person. To find one, perhaps start by asking your GP about psychiatrists they’d recommend or if they know of experienced licensed professional counselors in the area. You may be able to find a local treatment provider who offers stand alone assessments—conducted by one of their licensed professional counsellors—without having to commit to a program.  

Why an Assessment Is Important

An assessment helps you and treatment professionals know where you’re at and offers insight for possible care plans that fit your situation. 

Currently, it is more common for people to make treatment decisions themselves, either after researching endlessly or going with what an admissions coordinator helps them decide. We believe people should find treatment that’s right for them, but also believe appropriate experts should be involved to help support and guide you toward treatment options that best fit your needs and preferences.

3. Consider the Recommended Options

Now you should have some treatment options recommended by a professional based on your assessment. Let’s take a look at the main ones. 

Detox

Detoxification, or detox, is the period of time where an individual is withdrawing from drugs and alcohol. A doctor will prescribe medications, usually on a titration or taper (gradually less and less) to help keep symptoms as comfortable and safe as possible.

Who needs detox? 

Anyone who has been drinking or using drugs up to the start of their treatment program (which is very common) needs detox. Residential centers often set a standard amount of days someone needs to be substance-free before coming. 

Although detox can be done at home, it should not be done alone. It is safest to detox under medical supervision and with others to support you, whether at home or elsewhere. Some providers offer detox and residential care under the same roof, while other providers may help arrange detox at a nearby hospital or detox center.

How long? 5–7 days

Detox length depends on various factors, such as substance and level of use. For example, opiates and benzodiazepines can take 14 days, whereas alcohol detox is generally 5 days. Most centers allot a week for detox.

Who’s involved? A physician, nurses, support staff.

Detoxing on your own can be risky. Although most drugs are not life-threatening to detox from (beware, alcohol is!), detox is painful and unpleasant. So without support and medicine to help, most individuals will use again to relieve withdrawal symptoms.

What’s before detox?

Detox is the first step of treatment. Assessments often happen at the same time as well.

What’s after detox? 

A program, usually residential or a higher level of outpatient care, follows detox. It’s essential to long-term recovery to continue with a treatment program after detox. Detox only helps rid your body of substances, a program helps treat the underlying issues that cause you to use and/or drink in the first place.

Inpatient, also called Residential

Inpatient ‘hospitalisation’, or residential treatment, is what many know as and call ‘rehab’. An individual resides and receives treatment at the provider’s facilities. Some providers have all the buildings on a single ‘campus’, while others may have houses nearby and provide transportation to the clinical portion of treatment during the week. Therapies and approaches vary per center.

Who needs inpatient?

Residential is generally for those who have moderate to severe addiction (diagnosed as substance use disorder (SUD)), as well as those with co-occurring mental health and substance use disorders—for example, alcohol use disorder and bipolar disorder.

How long? 30, 60, 90+ days

Some centers will offer shorter stays, but the most common stay is 30 days. Other options tend to include 60 and 90 days, while some even offer 180 days.  

Who’s involved? A team full of people: psychiatrist +/or psychologist, therapists, case managers . . .

Each center varies. Some will boast a ‘multi-disciplinary team’ and have specialized therapists, such as an art therapist, trauma therapist, massage therapist and so on. In addition to a clinical team, some centers also staff housekeeping, groundskeepers, chefs, ‘guest’ services, and more. These people may not be involved in your therapy, but will certainly have an impact on your experience.

What’s before inpatient?

Detox. A number of residential centers have detox on-site, which is really convenient for making a smooth transition into treatment. Some do not though and you’ll have to either go to a detox center or detox at hospital.

What’s after inpatient?

It’s ideal to ‘step-down’ into another program afterward, whether it be a day treatment, intensive outpatient or simple outpatient program. This helps an individual still have support during early recovery. Most residential providers include discharge planning in the program, where your therapist and case manager will help guide you to the next best treatment step. Some individuals also arrange for sober living after inpatient treatment.

Day Treatment, also called PHP

Day treatment, or sometimes called PHP (which stands for partial hospitalisation program), is just that, treatment during the day full-time, but living is separate. Sometimes living could be in an individual’s own house, a sober living house, or a ‘structured’ living environment (often owned by the same provider). 

Who needs day treatment?

Day treatment is great for those either jumping into treatment and don’t quite need the full-time support and structure residential provides or for those stepping down from residential. 

How long? 4 weeks, 30-40 hours per week

It depends. It could be as short as a week or up to 6 to 8 weeks. Most stay in PHP for 2 to 4 weeks.

Who’s involved? A team full of people: psychiatrist +/or psychologist, therapists, case managers . . .

The team is very similar to that of a residential center, but this time it’s mostly just the clinical team. Again, some providers will boast a ‘multi-disciplinary team’ and have specialized therapists, such as an art therapist, trauma therapist, and so on.

What’s before day treatment?

Individuals can start with day treatment or they can transition into day treatment after a residential stay.

What’s after day treatment?

Intensive outpatient or outpatient often follows day treatment.

Intensive Outpatient (IOP) 

Intensive outpatient treatment, or IOP for short, can be thought of as part-time treatment. Some IOP programs run cohorts, that is, an individual will be with the same group of people throughout the program. Other IOP programs will have the opposite, sometimes called rolling enrolment, where people can jump into the program at any point.

Who needs intensive outpatient treatment?

Some individuals can certainly start their recovery journey at the IOP level of care, while others may attend IOP as a step-down option. IOP may be a great fit in the following situations: 

• Mild to moderate substance use
• Safe, supportive home environment
• Functioning in other responsibilities (work, school, etc.)
• Stepping down from residential or day treatment

How long? 8 weeks, 10 hours per week

IOP is usually from 9 to 15 hours a week for 4 to 10 weeks, depending on the program.

Who’s involved? Clinical director, psychiatrist +/or psychologist, therapists, possibly case managers . . .

Each provider varies, but in IOP level, it’s mostly just a general clinical team.

What’s before IOP?

IOP can be the beginning of someone’s path to recovery or it can follow residential or day treatment programs. 

What’s after IOP?

Typically, an outpatient program follows IOP.

Outpatient (OP)

Although outpatient treatment is a general term that can mean varying levels of care in which you’re not living on premises, it’s also used to describe the lightest level of outpatient care. Other names for this level are ‘continuing care’ or ‘aftercare’—both can be confusing since that sometimes describes any care after initial treatment.

Who needs outpatient treatment?

Any individual who has completed a more intense level of care (i.e. residential, PHP, or IOP), is a fit for outpatient. Even when you may think you do not need more treatment, outpatient provides support that’s vital in early recovery.

How long? 2 hours per week, 3 months

Outpatient can be 1 to 5 hours per week and last from 3 to 6 months or more.

Who’s involved? Therapist(s)

Therapists are involved in the outpatient level, facilitating group therapy and conducting individual sessions.

What’s before outpatient treatment?

Most outpatient programs require that an individual is stepping down from residential, PHP or IOP. Providers do not typically ‘admit’ individuals into an outpatient program.

What’s after outpatient treatment?

Outpatient treatment may overlap with individual sessions with a personal therapist and/or sober living, as well as support group meetings (e.g. 12-Step meetings). 

Sober Living

Sober living is just like it sounds, a drug and alcohol free place where an individual can live. It goes by other names (some have nuanced differences): 

• Sober living environment (SLE)
• Sober living home / house (SLH)
• Structured living
• Transitional living
• Halfway house

Who needs sober living?

Sober living helps those who are looking for a safe, drug and alcohol free environment to live. It’s ideal for individuals who have completed a treatment program and returning to the place they were is not a healthy option for their recovery. 

How long? 1–12 months

Each house varies. Some homes are tied to a treatment provider’s outpatient programs, so they have short-term leases. That is, you can stay while you’re in their outpatient program, but are expected to transition to the next living arrangement near or upon program completion.

Other homes are free-standing and you can rent a room for as long as you like (and are following the house rules). 

Who’s involved? Roommates

Some houses will have a ‘live-in’ manager or support staff who check in regularly, while other sober living places will just be you and a few other people who also share the goal of recovery.

What’s before sober living?

Usually a treatment program occurs before or during sober living.

What’s after sober living?

Individuals can continue their recovery via self-help groups (or some form of support system) and individual counselling with a personal therapist.

Medication-Assisted Treatment (MAT)

Medication-assisted treatment or therapy can be used for individuals struggling with specific substances, such as opioids. It’s been a controversial issue in abstinence-only approaches (who believe it substitutes one substance for another), while studies show it is effective and saves lives.

Support Groups

The most common support groups are 12-Step meetings, so AA, NA, Al-Anon, and so forth. There are other alternatives too: SMART Recovery, Women for Sobriety, Celebrate Recovery, and LifeRing. 

Who needs support groups?

Support groups can benefit anyone really. Each group has certain requirements and goals though. For instance, AA is for those who desire to stop drinking (and has open meetings, open to anyone who wants to come). Al-Anon is for friends and family of a person with a drinking problem.

How long?

Attend support groups for long as you need. Some attend support groups more frequently during early recovery (‘90 meetings in 90 days’), then may attend as a weekly rhythm. Some attend for decades, while others may fluctuate in attendance or find another support system.

Who’s involved? Attendees

The group may have some structure for who is ‘chair’ of meetings and rotate responsibilities (like making coffee) among group members. Some people in a meeting will have more experience than others. The diversity of experiences and perspectives can really make a group beautiful and effective for helping individuals reach the common goal. 

What’s before support groups?

Some individuals decide to attend meetings as their path to recovery (no formal, professional treatment). Otherwise, support groups often overlap with treatment programs. 

What’s after support groups?

If you decide to stop attending support groups, be sure to fill it in with another healthy, supportive, and community system.

4. Find a Treatment Provider

This step is very important. You’ll likely be able to receive some treatment provider recommendations from your assessment with a professional, your GP or therapist. You may need to be ready to put on a detective hat and do some research though.

First and foremost, you’ll want to make sure the treatment providers you’re choosing from have the following characteristics: 

• Reputable
• Trustworthy
• Quality
• Licensed professionals

Then, you can weigh differences in approach, amenities, location and cost.

We’ll go over all of the above before we suggest some ‘where to start’ research strategies.

Reputable

Does the treatment center have a good reputation? What do others think of it? How can you find that out? Here are some strategies: read reviews and ask others.

• Read online reviews. The big three sources for reviews currently are Google, Facebook and Yelp. At the same time, take the reviews for what they’re worth. That is, take extra time discerning really bad and really good reviews:
  • Some providers encourage their employees, family members, and friends to leave reviews. These reviews may still follow the guidelines of the review platform, but obviously, the raving review is biased. A quick comparison of the team page and names attached to reviews may uncover employee reviews. It actually adds more credibility if the reviewer discloses they’re an employee in the review.
  • Sometimes ex-employees will rant about the provider when there were legitimate reasons for the provider firing them—also biased.
  • Providers could be delivering the best treatment in the world and still have an upset customer who leaves a scathing review. If there are multiple bad reviews of similar issues though, then there is most likely truth to the issues they raise.
• Ask around. You might be wondering who to ask. 
  • Ask your GP.
  • Ask your primary therapist (if you’re seeing one).
  • This may seem odd, but if you’re on the phone with a treatment center who appears to be trustworthy, ask them if they’ve heard of the other provider you’re curious about and what they think of them. Of course, they will be biased, but their answer will likely have some truth to it. 

Attend an open AA meeting and in side, individual conversations, ask the person if they’ve ever heard of the particular treatment provider. (AA doesn’t allow ‘endorsements’, thus the emphasis on side, personal conversations.)

Trustworthy

Trustworthiness is very similar to good reputation, yet slightly different. Is the center reliable, honest, and ethical? Here are some characteristics to consider: length of operation, CQC report (for residential treatment in England).

Length of Operation

This may not always indicate trustworthiness, but generally speaking, if a provider has been around for a long time, they likely provide good services. Sometimes newer providers offer great services too, so do not necessarily avoid a provider simply because they are newer, but do look for other signs to make sure they’re legitimate.

CQC Report

The Care Quality Commission (CQC) is an independent regulator of health and social care in England. Residential providers are inspected and rated by the CQC in the following categories: safe, effective, caring, responsive, well-led. You can read the inspection summary, download the inspection report, see who runs the service, and more. 

Quality

After looking for independent regulators to ensure quality care of a treatment provider, you may also want to look at the types of therapies offered and the experience of the clinicians.

What does quality care look like?

Quality care, of course, is always up for improvement, yet most can agree on certain standards of quality. After all, behavioural healthcare has come a long way from methods of the past (such as lobotomies, confinement (although some countries still approach treatment this way), straightjackets and the like). 

Standards of Quality

• Evidence-based practices (EBP)
  • Evidence-based practices sound complicated, but its meaning is literal. Practices are based on evidence. The evidence comes from best available evidence (from academic research), as well as the clinician’s own expertise, and with regard to patient values and preferences. 
  • If you do decide to research this deeper, keep in mind that academic research uses the word ‘intervention’ to generally describe a therapy or treatment. University of Washington Alcohol and Drug Abuse Institute put together an EBP database that anyone can access here.

• Integrated care
  • Integrated care most often refers to general (physical) healthcare and behavioural (mental) healthcare working together. 
• Licensed and skilled professionals
  • This should be a given, but licensed and skilled mental health professionals should be providing treatment services. (Of course, people need to start a career somewhere, so some clinicians may have less experience than others or may be working toward a specific certification, but they should only make up part of the clinical team.)

The World Health Organization (WHO) put together a QualityRights Tool Kit which has guidelines for quality services. Some of these guidelines we may take for granted, but they are worth noting since they have been neglected before:

• Services respect human rights (e.g. dignity, privacy, liberty).
• Services provide an adequate standard of living. 
  • (For example, the building is in good condition. Sleeping conditions are comfortable and have sufficient privacy.)

What to look for on websites, brochures . . .

Many providers will include phrases like ‘evidence-based’ and a ‘multidisciplinary team’ on their materials. Many will claim to treat ‘dual diagnosis’ or ‘co-occurring disorders’ as well. These are all good, but it’s challenging to tell if the descriptions are true.

Current industry ‘buzzwords’

• Evidence-based
• Multidisciplinary
• Holistic
• Individualised
• Personalised
• Dual diagnosis
• Co-occurring disorders

So rather than just look for the keywords many treatment providers are using, also take a look at the following:

• Sample Schedule
  • A sample schedule (by day or week) helps you visualise what the program may be like and how ‘holistic’ or ‘individualised’ it actually is. For example, you may see that a residential program who boasts individualised care only provides 1 individual counselling session per week.

• Photos of the Space
  • Often stock photos make up the photos on websites and brochures because they’re the easiest to get. However, you want to see photos, or video, of the real space, both inside and outside. Do the spaces look comfortable and clean?

• Staff Bios
  • If a program claims to be holistic, are some of the clinicians trained in alternative therapies? If a provider claims a multidisciplinary team, does the clinical team have varying disciplines? More importantly, do they work together? To tell if the staff actually collaborate to provide a multidisciplinary approach, you may have to ask the admissions person when you call (‘Can you tell me more about what multidisciplinary looks like? Does the entire clinical team meet and discuss client cases?’). 
• Treatment approach and therapies
  • Reading through the approach and therapies will also help you see if a program has evidence-based and/or holistic therapies. 

Licensed Professionals

The clinical team is such a big part of a provider’s ‘product’ so it’s very important to look at who will be providing the care you would be receiving, their licenses, qualifications, and experience. 

Differences to Consider

Treatment Approach

A variety of treatment approaches exist. Many centers will combine multiple approaches and some will adjust the approach and therapies to meet your needs. Look for or ask about a provider’s treatment philosophy to see if it resonates with your preferences and values. Here are the most common treatment approaches:

• 12-Step or a modified 12-Step
• Non 12-Step
• Holistic (alternative)
• Evidence-based
• Systemic 
• Faith-based (or spiritual)
• Therapeutic community

Family Involvement

Many addiction professionals agree that substance use disorders affect the entire family, so most providers will offer a form of therapy for the family. Each provider varies. Some have a family day every week that includes time for the family to meet with the loved one’s therapist and families to meet together (sometimes called multifamily group). Others may have a family week with various therapy sessions. 

Location

Perhaps the biggest question for location is does one partner with a local provider for treatment or go to a ‘destination’ treatment center. Each has its advantages and disadvantages.

Distance	Local
Some find the total break from environment beneficial to their recovery.	The closer location makes it easier for family to be involved.
Going out of the country likely adds privacy and confidentiality.	The transition into a recovery community after completing a program will be smoother.

Amenities

Accommodations, activities, and food certainly impact a treatment experience (for better or for worse). Naturally, some conditions must be met (like cleanliness and catering to dietary needs), but for the most part, amenities are ‘nice-to-have’ not must-have. 

It’s challenging to make a decision without being swayed by a provider’s amenities because they are so visual. You see a beautiful location, delicious food, a glistening pool, fun activities, and so on. The treatment itself is much harder to capture visually. Be sure to read and ask about the treatment though. Once you know a provider has a quality treatment program, then let amenities factor into your decision. 

To some degree, a treatment environment should be comfortable and conducive to recovery. Consider how much your comfort level will be impacted by accommodations. If you are not comfortable, then it may dampen your treatment. (Note: the first few weeks of treatment, you may feel miserable regardless of accommodations and amenities.) 

A few ‘gray’ areas:

• A treatment provider who has a really good program, but looks like an awful place to stay—Ask yourself a few questions: 
  • Why does it look like an awful place to stay? 
  • Did they simply take bad pictures and it may look better in person?
  • Is there something I care about too much that is not a big deal compared to the treatment I’d receive?
  • Is there another treatment provider who has a good program and looks like a better place to stay?
• A treatment provider who has amazing amenities, but a semi-quality treatment program—Ask yourself a few questions:
  • Is there something I care about too much that is not a big deal compared to the treatment I’d receive?
  • Are the amenities worth possibly needing more treatment in the future?
  • Is there another treatment provider who has a better quality program and still looks like a comfortable place to stay?

5. Call (and Schedule a Tour)

Call the Treatment Provider

This step can happen simultaneously with the previous step of finding a treatment center. Calling a treatment center is the fastest way to find out more information that perhaps is not listed on their website. Although the call will be based on one interaction with one employee, that interaction can go a long way for informing your gut if you’d like services from that treatment provider. 

Rather not talk on the phone? Some centers have live chat on their website or online forms that you can use to ask questions or even request that they call you. Some are also responsive over Facebook Messenger. (Eventually, you will have to talk on the phone.)

Schedule a Tour

The surest way to figure out if a treatment provider is right for you is to visit the center. Understandably, this may not work if you live very far away. However, if you’re able, definitely schedule a tour, go and see the place in person and meet some of the staff and clinical team before you agree to admit.

6. Set a Start Date

Start as soon as possible.

If you’re needing residential treatment, the thought of taking 4 weeks or more off often holds people back from treatment they need. Definitely ask the treatment professional at the end of your assessment how soon they recommend you starting treatment. At the same time, do not underestimate the urgency to get into treatment. If you are struggling with severe substance use and/or mental health conditions, start as soon as possible—your life is at risk. If you are struggling moderately, it’s still an urgent matter. Each time you abuse substances, you continue to damage your health, jeopardize your job and possibly legal record, and harm your relationships.

7. Go!

Now, it’s just a matter of the logistics getting to the provider. If it’s a residential stay, look on the website or ask for a packing list. Some providers list ‘What to Bring’ and ‘What NOT to Bring’ on their website, while some may email expectations, rules, and so on. 
Once there, stay and get the most out of your treatment program.

After the first week or so in treatment, you might be tempted to leave. One exercise you can do is write yourself a letter before going (or on the first day of treatment) about why you’re there and what your goals are for after treatment. Maybe take a selfie too. Read that letter and look at the photo; they may help support you to stay.