Struggling with Addiction: What treatment looks like

Continuing the conversation of my previous blog “How to Spot Addictive Behaviors in Yourself and Others” posted on February 7th, 2024, I wanted to give you an idea of different treatment settings in a brief format. After sorting out that you or someone close to you may be struggling with addiction through the signs in the last blog post, it might be confusing/worrisome as to what treatment might look like going forward. Counselors are trained to offer each individual the specific care they need, which is why it is important to reach out if you are struggling.

Below are the main treatment settings and how they operate based on highest to lowest severity of addiction treatment.

- Medical Detoxification and Stabilization – During the withdrawal process, there can be complications that arise. Depending on the substance(s) that an individual has been using, safely withdrawing from the substance(s) might require the care and attention of medical professionals. This is usually in a hospital type of setting where there are nurses and doctors offering up to 24/7 supervision. This is for clients with the most severe use of substances such as alcohol, barbiturates, opiates, or cocaine (Lewis, 2014). Suddenly stopping chronic use of a substance can be life-threatening and should not be done without professional supervision.

- Hospital Inpatient – These settings are similar to the medical detoxification and stabilization settings in that they are hospital settings that help to withdraw safely from chronic use of a substance. However, these settings have additional staff that focus on one or more psychiatric or psychological conditions that may arise or currently exist in the patient/client. In combination, physicians and mental health practitioners help clients safely withdraw from substances, stabilize emotionally, and identify and treat concomitant disorders (Perez, 2005).  Both settings are restrictive in nature with locked units, limited access to family, daily group counseling sessions, and 24/7 care. Please do not let the restrictive nature of these settings sway you from seeking care!

- Therapeutic Communities and Residential Programs – These are highly structured environments where the major goal is for residents to let go of their connection to past drug abuse and learn what living with and in a community looks and feels like. Peer influence, mediated through a variety of group processes, is used to help individuals learn and assimilate social norms and develop social skills (The National Institute on Drug Abuse, 2002). Many times, individuals with chronic substance use and dependence have relied on this coping skill to get them through life. These communities aim to help individuals learn a new way of living, a new way to find joy without the use of drugs.

- Partial Hospitalization and Day Treatment – The previous settings require that you stay on campus until you have successfully completed treatment. This setting is less restrictive, and clients normally go back home in the evenings. You will learn helpful tools during the day and have the chance to reflect on what you have learned/ practice in the evenings. Then during group/individual sessions with counselors you can process how each evening went and continue to learn more.

- Temporary Recovery or Halfway Homes – Usually a community-based home near a residential facility where clients transition from a most restrictive setting to least (Lewis, 2014). Clients come and go as they are reintroduced to employment, and home settings. These settings also allow clients to live independently and benefit from a safe, stable, and supportive group of people going through similar struggles.

- Intensive Outpatient and Outpatient (IOP) – Often offered through community mental health centers and sometimes even private practices. IOP usually includes group and or individual counseling three or four evenings a week for 2-4 hours (Fisher & Harrison, 2009). Many IOP’s include family involvement which is crucial to support the individual in recovery to have a safe environment when treatment is over.

As you can tell, treatment settings go from most restrictive to least. However, just because a setting is restrictive does not mean that it is not the most appropriate type of care. Counselors are trained to ask questions and assess your needs and will recommend the least restrictive environment that will have the most benefits in treatment. It can be difficult to think about what type of treatment your loved one needs so please don’t hesitate to reach out to professional help! I hope this cleared up some of the confusions around the different types of treatment settings and create compassion for those who have been in and out of these services. Treating addiction can look like a lifelong commitment or change in perspective all together. Support from every angle is highly encouraged!

References

Fisher, G. L., & Harrison, T. C. (2009). Substance abuse: Information for school counselors, social workers, therapists, and counselors (4th ed.). New York: Allyn & Bacon.

Lewis, T. F. (2014). Substance abuse and addiction treatment: practical application of counseling theory. Pearson.

National Institutes of Drug Abuse (2002). Research reports series: Therapeutic community. NIH publication No. 02-4877.

Perez, P. J. (2005). Treatment setting and treatment planning. In P. Stevens & R. L. Smith (Eds.). Substance Abuse Counseling: Theory and Practice (2nd ed.). Upper Saddle River, NJ: Prentice Hall.

Martin Dolan, Counseling Student

University of Houston-Clear Lake

Taking the time to choose the right counselor is a great step towards your personal journey to mental health. I hope that by giving a little information about myself, you will have a better understanding of my beliefs and see if they align with yours.

I am a student counselor currently attending classes at the University of Houston – Clear Lake to become a licensed professional counselor (LPC). My wife and I have been happily together for 12 years and are parents to two young girls. Because of this, I understand the challenges involved in keeping and growing a committed relationship while understanding the intricacies of a complex family dynamic. I have always had an innate curiosity towards myself and others, what drives them, and how their experiences shape their perspective of the world. I believe that we are all simply trying our best to exist and thrive amongst each other and that relationships in our lives can help us progress towards our personal goals.

Personally, I have experienced the healing effects of group, individual, and couples counseling with difficulties regarding anxiety, depression, burnout, co-dependent relationships, grief/loss, and addiction. Having navigated these challenges, I have developed a greater understanding of the subtleties that come with each of them. I also believe that confronting generational trauma is a powerful way to gain awareness in one’s life and continue onward without passing it to future generations. Throughout my life, family, friends, and strangers alike have felt comfortable sharing their personal challenges with me. I believe that I can offer a calm and attentive space for you to do the same.

Together, we will uncover what is holding you back, what challenges are inhibiting you, and achieve your goals.