Addiction Treatment Programming

Intensive "Landing Phase" of Treatment

During the initial "landing" phase we are getting to know you and create a treatment program that will give you the maximum long-term support that your schedule will allow. Our intake counselors will set up your initial "on site" assessment and ensure that our level of care is appropriate for your needs and your goals.

Week 1: In your first week, time commitment is 15-20 hours for treatment, medical and clinical admission assessments.

1. Meet with Clinical and administration for behavioral and psychological assessments
2. Meet with Medical staff for
   1. History and Physical
   2. Blood draws & labs
   3. (MAT) Medication Assisted Treatment Evaluation: assess appropriateness for MAT, educate, complete COWS for OUD, readiness form for vivitrol/naltrexone
3. Begin group participation (3 days/nights)
4. Family engagement: assess appropriateness involvement, provide ROI for identified loved ones
5. Receive assignment of Primary Clinician, treatment binder and schedule
6. Drug testing 2-3 times per week
7. At least 1 outside meeting (NA/AA/SMART/Life Ring/Refuge Recovery) and gather signature for verification

Week 2: Routine and Continued Stabilization

The work has begun as we have established your current progress toward achieving your goals and begun our recurring meetings. We will discuss with you how to design your treatment to integrate into your daily routine and also discuss the possibility of integrating family members into treatment.

1. First individual session: 90 minutes
   1. Assess for appropriate level of family involvement and contact
   2. Complete calendar containing medication times, Rx refill date, treatment dates, and outside meeting dates
2. Commit to Landing Phase primary goal is Stabilization
3. Establish trust, goals, therapeutic process
4. Continue to attend treatment groups (3 days/nights)
5. Attend at least 3 outside meeting (NA/AA/SMART/Life Ring/Refuge Recovery) and gather signature for verification
6. Continue to meet with Medical Doctor/Physician Assistant for check in, Rx Care, MAT protocol

Week 3: Making Progress and Adopting New Responses

After we have established positive routines and begun working on underlying issues, we will continue our progress with an emphasis on adopting new responses to life's stressors.

1. Attend 30 minutes family prep session with Primary Clinician. First Family Session Meeting (45 minutes) with family, client and clinician
2. Continue to attend treatment groups (3 days/nights)
3. Attend at least 3 outside meeting (NA/AA/SMART/Life Ring/Refuge Recovery) and gather signature for verification
4. Continue to meet with Medical Director or Physician Assistant for check in, Rx Care, MAT Detox/Maintenance protocol
   1. Establish routine with medication
   2. Primary Clinician will check in and assist with creating medication routine
   3. Establish regular refill date
5. Individual Session (45-55 minutes) with primary clinician
6. Drug testing 2-3 times per week

IOP Long Term Phase: Grounding Phase of Treatment; Upaya

Weeks 4-8: UPAYA: Skillful Means

In this phase of treatment, we are actively practicing skills learned in treatment groups (for impulse control, mindfulness, attunement, internal safety, delayed gratification, consistent schedule, safe behavior choices, self-soothing, emotional regulation, medication compliance and stabilization, distress tolerance etc.) as we navigate the moments of daily life. This intentional, conscious way of living can be summarized in the Buddhist concept of Skillful Means (upaya) : the action is applied with wisdom and compassion and that it is appropriate in its time and place.

1. Continue to attend treatment groups (3 days/nights)
2. Attend at least 3 outside meeting (NA/AA/SMART/Life Ring/Refuge Recovery) and gather signature for verification
   1. Establish community recovery support, meeting commitment? Sponsor, sober friends?
3. Continue to meet with Medical Doctor or Physician Assistant for maintenance and medical status updates and check-ups
   1. Maintain medication routine, and refill dates
4. Continue weekly Individual Sessions with primary clinician
5. Drug testing when requested by clinician
6. Commit to primary goal of this phase: “Skillful Means”
   1. Grounders commit to establish and practice consistent scheduling
   2. Grounders commit to apply and practice skills daily
   3. Grounders commit to safe choices in the moments and tasks of daily life
7. Week 7 the Clinical Team will evaluate the readiness/appropriateness for step down to OP level of care
8. Successful Grounders become well rooted in Skillful Means- safe routines, self- care
   1. Identify and regularly practice safe and effective behaviors supportive to their life worth living skills

Sustainable Recovery Phase

At this point, real progress should have been made toward complete abstinence. We would typically be achieving sobriety milestones (or at least progress toward them). We "step-down" the level of care to minimize the time commitment in order to shift focus back on pursuing career, family time and relationships, etc.

1. Outpatient (OP): Minimum of 6 weeks

   1. Group treatment participation steps down to just 1-3 nights a week (4-9 hours a week)
   2. Continued outside support meetings
   3. Increase recovery community support engagement
   4. Bi-Monthly Individual Session
   5. Random drug testing
   6. Continue to meet with Medical Doctor or Physician Assistant for maintenance and medical status updates and check-ups
      1. Maintain medication routine, and refill dates

2. Extended Care

   1. Attend group 1-3 hours a month
   2. Check in with support system
   3. Continue to attend outside support meeting
      1. Pick up a commitment in support groups
   4. Drug test when requested by the clinicians
   5. Follow up with Medical Director or Physician Assistant if further medication maintenance required

• Alumni

  1. Attend Monthly Alumni group
     1. Drop in to any additional Confidential Recovery groups if needed
     2. Share your experience, strength and hope
  2. Reach out to clinicians if further support is required
  3. Know that Confidential Recovery will always be here to support you in your process of recovery