How to Choose an Alcohol and Drug Rehab Treatment Program

Deciding which drug rehab program to use out of the more than 10,000 in the United States can feel daunting to say the least. Frequently, family members are attempting to select an alcohol or drug rehab program for a loved one. The generally increases feelings of responsibility but it can be a bit challenging since you have to use your best guess about the details of the person’s alcohol or drug use history. Each alcohol treatment center has certain unique aspects to how they help get someone clean and sober. There are also similarities in how many programs approach substance abuse recovery. This generally means there is a standard of care that most programs will attempt to offer, but a slightly unique style they will use or niche a treatment center will attempt to fill to keep up their market share.
 

Choosing a drug rehab center will be easier if you clarify your situation. If you start by asking yourself some questions that will give you a foundation to ask useful questions when you speak to the admissions or intake coordinators at each rehab program it will make thing a lot simpler for you.

Here are some important questions to ask as you prepare to start the process of choosing a rehab program for someone. Ideally, once you finish with these questions you will be able to begin an interview with a brief, very clear paragraph that provides an outline of your situation and needs.

  1. What is your relationship to the person you might be calling the treatment program about and what is his/her age?
  2. Where do you live and where does he or she live – That is to say, where is your son, daughter, wife, husband or friend living right now now?  Does the person you are calling about have any family he or she lives with and are they actively involved in his/her life?  This helps convey how stable their family life is or has been.
  3.  Are you calling at their request or without their knowledge? In other words, what led up to the current call? Possibly a family intervention…maybe he has asked for help.
  4.  To the best of your knowledge, what is his or her current drug of choice? If you have any knowledge about the history of their drug or alcohol use, what is the brief overview of how that looks: briefly describe duration, intensity, consequences that have included legal, financial, physical or other difficulties and what the current situation is to the best of your knowledge. 
  5. What is the current social situation for the person? Do they have family, friends, a job or other stable elements of their life? How much of an impact has the person’s drug use had on their relationships and possible support? Have they burned bridges in their life? A thumbnail sketch helps a lot.
  6. Do you have a sense of how treatment might fit into their employment? How stable and reliable is their job?  Do they have insurance that might help them seek treatment? You do not need to know all the answers, but having some general information about the type of position the person holds may make it easier to answer questions together.
  7. Does the person have any religious or spiritual inclinations in their life?  
  8. Although you may not be trained, do you suspect or are you aware of any other major mental health concerns or diagnoses the person may be dealing with in their life? Is there a family history of depression? Are other family members dealing with any psychological issues you know about? 
  9. Has he or she ever been in any drug or alcohol treatment before? If so, talk about the relapses that took place and what they looked like. Has he or she ever worked with a psychotherapist or counselor? Are you aware of any medications, drugs or others substances he or she is or has used? 
  10. What resources does the person have as they seek help? This might include insurance or other means such as family. Have they ever sought out help through self-help programs such as AA or NA and if so, what was the reaction they had?

 With the above in mind, your side of the conversation with an intake or assessmenr counselor at a treatment program might sound something like this:

“Hi, could I speak to someone who could talk with me about your program please?”

 “My name is Jane Doe and I am calling you today from Del Mar, California about my 28-year-old son, John Doe who lives in San Diego, California with his wife and 4-year-old son. I am calling because my son asked me to help him try to figure out what to do to start to sort out his life.”

“I think John has smoked pot or drank since he was maybe fifteen or so on a fairly regular basis. When he went to UC Berkeley I am sure he just continued getting high, but he somehow managed to keep up pretty good grades. He got a degree in economics and moved back here to San Diego with his girlfriend from up at school. I think she probably got high with him too until she got pregnant. They were already thinking about getting married and did when she first learned she was going to have a baby. For a while he seemed to quit smoking pot and kind of got serious about being a father. Then he slowly got back into it. He seemed like he was just sort of moody…kind of sad at times like his grandfather used to get. He says pot helps him from getting down on himself so much. My Dad always drank when he was down like that.”

“Now, his wife is getting more frustrated daily, as she doesn’t want him getting high around their son. He still has a job with an investment company in town that provides health insurance, but John is really reluctant to go into some program.  He is not a very religious guy and is kind of unsure how he could deal with 12 step programs and the God thing.”

“I am very worried for him and want him to get some help. I know he and his wife are really struggling with this, but she loves him a lot. I want to learn about your program and see if it would be a fit for him.”

 The person doing the assessment might be hearing something like this:

You have described a person who has a history of substance use that extends through his teenage years and into early adulthood and includes mostly alcohol and marijuana with occasional use of other drugs. You established that the person has a genetic history of alcoholism and possibly depression. The possibility was raised that he may be self medicating to cope with depressive symptoms.

 He has not had any major legal problems that result from his drug involvement however his condition is beginning to impact his marriage and general family life. The stressors connected to work, marriage and the responsibilities of growing-up may be weighing on him. His coping skills are in question. You have made it clear that your son has a support system in his wife, parents and son and is maintaining a job. However, time and repeated difficulties could undermine his support.

He lives locally in San Diego and has insurance. His religious tendencies might make it somewhat difficult for him to connect with AA. Being an economist, he has a strong mathematical background that has many of the same attributes as an engineer. Problem-solving and logic are probably strong suites for him.

Most important, it is clear that you care a great deal about him and it certainly sounds as if others do as well.

The ideal setting initially sounds like a locally based intensive outpatient program that emphasizes cognitive-behavioral therapy and uses a SMART recovery self-help program. Psychoeducational components will benefit him and the family a great deal. A psychiatric evaluation will help to determine if he is depressed . Building on his family support and connections will likely help him engage in a recovery process. Couples/family counseling will be important for John and his wife. A strong therapist for aftercare will increase his chance of recovery, so insure that the program is local or has a clear path for local aftercare service .

As you begin to discuss the various programs available, you will now be in a stronger position. You have created a personalized profile that clarifies that type of program your family needs. Now you can begin to ask some focused questions about the program itself. Here are ten questions to help you in your search for the right drug or alcohol rehab facility.

  1. What is their success rate and how do they define success? There are many variables to consider in outcome evaluations. Each program may use a slightly different set of criteria and will likely report somewhat different outcomes at the one year mark. However, the most important issue will be that they are performing outcome research on their clinical work. 
  2. What are the staff’s credentials and how long have they been in the field of drug rehab? The least credential you should expect for the line staff is a Certified Addictions Counselors (CAC) or Certified Alcohol and Drug Counselors (CADC). Supervisory staff should have higher a credential, such as a Licensed Clinical Social Worker (LCSW), Marriage and Family Therapist (MFT) or Licensed Psychologist (Ph.D.). Having extensive experience working with addiction treatment is a must. 
  3. Is the facility accredited as a drug rehab center and if so, with what organization? Since there are only a few creditable national level accreditation organizations, this is important. In order to receive accreditation, a facility will undergo a site review and all rules reviewed to have met up to national level standards. Two well-known accreditation organizations are the Joint Commission on Accreditation of Healthcare Organizations (JACHO) and the Commission on Accreditation of Rehabilitation Facilities (CARF). 
  4. Will they accept your insurance plan or is there any flexibility in rates? Financial planning for treatment is an essential part of developing a plan for working with a treatment program. The finances of treatment, like all business, are fluid and tend to reflect the current national economic picture more than you might expect.  As such, there is often some room for negotiation of rates, scholarships that cover extended stays and other flexible approaches to finances.  
  5. Do they offer medically supervised withdrawal? Some treatment centers do not have detox programs and use the facilities of hospitals or other centers. Withdrawal management is an extremely important part of early recovery and if not handled correctly, is very dangerous.  
  6. What is their ability to help with aftercare? Time spent in treatment is directly related to success in recovery. Regardless of whether you are in an inpatient or outpatient program, the use of an effective aftercare program can extend the length of treatment and increase the likelihood that treatment will be effective. Most programs will say that they offer this service.  It is OK to ask for specifics if you are considering going to a treatment program out of your area e.g. what are the names of the therapists they refer to? Can you speak with them before initiating treatment about their experience working with patients from the program? 
  7. What is the normal schedule for a day in their rehab? Treatment is serious business and how well it is implemented can mean the difference between life and death. Group therapy, individual counseling, education and family treatment are all important elements of effective treatment. 
  8. What is the program’s level of privacy and how well does it fit the needs for the intended patient? As mentioned at the beginning of the article, there are some 10,000 drug and alcohol rehab programs in the United States. In recent years, there has developed an increasing awareness that some might wish to seek help without drawing any attention to themselves in any way. Small, extremely private treatment setting have shown up throughout the country to fill this niche. While generally quite expensive, the patients who use these programs have the resources and need for such services. Take the time to reflect on each aspect of your needs as you consider what program might fit your situation best.
  9. What basic their treatment modality or philosophy and do they support others? Find out if they are 12-step oriented, provide options for “smart recovery”, use motivational, cognitive or behavioral therapies, and then ask them to explain any terms you might not understand. 
  10. Are their therapists diverse in their skills and training and how is the decision made about your matching patients with their primary therapist? Developing a strong bond with your primary therapist can dramatically improve your chances of success.  How does the program decide the therapist who will work with each client? 

The decision to seek treatment in a rehab program for drug addiction, alcoholism or some combination of the two can generate anxiety and a wide range of emotions. More often than not, families have seen this coming for some time, but faced with the decision where to get them help, may become somewhat overwhelmed with the number of choices.  You may find it helpful to speak with a trusted therapist who does not work for the treatment programs and can help you in sorting out your specific situation. Be patient and kind with yourself and take your time.  You will find a program that provides a great setting for you or your loved one once you put your mind to the task.

David L. Christopher, MS is one of San Diego County's premier counseling & marriage and family therapy providers. W/ over 30 yrs experience, his comprehensive approach to individual psychotherapy and couples counseling has helped thousands become effective communicators & develop stronger relationships. Specialties: self-esteem, relationships, ADD, depression, addiction, stepfamilies. His website is www.SanDiegoTherapist.com
David Christopher, M.S., LMFT

Comments (2)

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  1. Carol Maciula says:

    I am looking for a rehab center that takes couples. My husband suffers from alcohol abuse, but is currently sober. I suffer from depression, anxiety disorder and bipolar disorder. We want to find a place that can deal with us as a couple. We need a fresh start in our marriage. Any suggestions?

  2. This is very interesting, You are a very skilled blogger. I have joined your rss feed and look ahead to seeking extra of your excellent post. Additionally, I’ve shared your website in my social networks

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