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CARE AND TREATMENT

The ASAM 3.1 residential program provides cost-effective treatment support allowing for extended protection from the toxic influence of substance exposure, problematic or substance-filled environments or the cultures of substance-involved or anti-social behaviors. Tailored for individuals with DSM-5 diagnoses including primary substance use and co-occurring psychiatric disorders that require 24-hour exposure to low-intensity treatment, peer support, supervision, and monitoring and support not suitable for outpatient treatment settings, this program facilitates the practice of basic independent living skills and mastery of coping and recovery skills. The goal is to stabilize substance use disorder symptoms while developing and utilizing recovery skills for optimum psychosocial functioning.  
 
Through Residential staff, formal contracts, and referral arrangements with collaborative community partnerships, we provide a clinically directed program of activities utilizing evidenced-based, person-centered, and strengths-based approaches including but not limited to psychoeducation, motivational interviewing / enhancement, cognitive-behavioral therapy, reality therapy, mindfulness skills training, relapse prevention, exploring relational dynamics, recreational and wellness activities, medication assisted treatment, etc.  RCRS employs an LCSW / CSAC for clinical oversight of an LMHP-R / CSAC primary clinician assisted by Registered Peer Recovery Specialists (RPRS) and/or RPRS-applicants  to deliver a minimum of five hours direct treatment weekly designed to stabilize and maintain substance use disorder (SUD) symptoms, while reinforcing the development and application of recovery skills.
 
Our structured program of care includes, but is not limited to the following programmatic services: 

1. ASAM Multidimensional assessment: Provided by a credentialed addiction                treatment professional (CATP) acting within their respective scope of practice to        determine a diagnosis and formulate an individualized treatment plan. This                assessment may utilize standardized clinical tools such as the Addiction Severity      Index in combination with presumptive urine drug screen, breathalyzer, or mouth      swab tests to support clinical decision-making and may include an on-site and/or      follow-up physical examination as medically indicated along with laboratory              testing necessary for SUD treatment in accordance with ASAM Level of Care            guidelines. We also evaluate co-occurring psychiatric disorders and integrate the      course of treatment and care coordination into the ISP. ASAM multidimensional        assessments may be completed by CSAC and/or LMHP-R/RP staff pending              consultative approval of Clinical and/or Medical Director within 24-hours.
 
2. Individualized Service Plan: We develop the initial Individualized Service Plan (ISP)      within 24 hours and a comprehensive ISP within 14-days of admission based on      the identified needs in relation all six ASAM dimensions. The ISP will include              regular updates (every 30-days) of the patient’s needs, concerns, and                      preferences. Patients and/or family members (if desired) will be strongly                    encouraged to participate in developing their ISP’s and will receive a copy that          will describe collaboratively defined elements to include in the daily routine. This      service will be provided by an LMHP-R/RP or CSAC under direct supervision.

3. Treatment Team Meeting: Integrated substance abuse and co-occurring MH            treatment planning necessitates a multi-leveled collaborative process.  Each              patient will meet with the direct service team LMHP-R or supervised CSAC and        Peer Recovery Specialist weekly to review and discuss progress towards                  treatment goals and objectives, discharge planning, and any “high-risk” concerns      documented on treatment report.  The direct service team will collaboratively            consult with the Clinical and/or Medical Director during indirect weekly                      Treatment Team meetings and make necessary treatment planning adjustments        of any “high Risk” patients at these times.
 
4. Crisis Intervention/Stabilization: The nature of Clinically Managed Low Intensity          Residential Treatment Services is to 1st stabilize each patient SUD and/or                  psychiatric condition. If a patient experiences cravings that may lead to a relapse      and/or experiences a SUD and/or psychiatric relapse that places them or others        in imminent threat, our professional staff with LMHP oversight will work to                stabilize the patient to restore them to the level where they can continue to              benefit from our program. Peer Recovery Specialists by scope of practice are            uniquely equipped for crisis interventions with proper training and in accordance      with appropriately defined clinical protocols.
 
5. Physician Services: Our Medical Director or his ORP designee (NP/PA) will be            available to all Staff for consultation and emergency service (24/7/365) when            needed or requested.  Patient’s will be scheduled for an initial evaluation                  following intake to address any bio-medical or psychiatric medication mgmt.            issues and monitored according to physician recommendations throughout the        program. Additionally, if our Physician/ORP designee prescribes any medication,      they will routinely evaluate the effectiveness of medication therapy.  All patient’s      will be assessed for compatibility and provided psychoeducation (if relevant) for        Addiction-Medication Assisted Treatment
    (MAT) prescription and monitoring (as necessary), which includes medications          assist in reducing cravings for and/or blocking euphoric effects of opioid, alcohol,      and cocaine.

 
6. Professional Counseling and Therapy: The goal is to the address thinking errors        and triggers that lead to relapse and clinical monitoring to promote recovery            thinking and prosocial behaviors. Therapy also includes monitoring daily                    compliance and collaborating with the Medical Director regarding any prescribed      medications. Our clinically directed treatment strategies facilitate recovery skills,        relapse prevention, and promote independent living.  They include, but are not          limited to: Motivational Enhancement Therapy, Cognitive Behavior Therapy,              Dialectical Behavioral Therapy, Mindfulness and Reality Therapy interventions.          This service will be offered in individual, group and family formats conducted by      qualified CATP’s, Certified Peer Recovery Specialists (CPRS) monitored and              supervised by LMHP Director or their designee.
 
7. Family Counseling and Therapy: Psychoeducational and therapeutic interventions      collaboratively integrating willing family members supportively into the patient's        treatment can begin healing the family system.  This service will be offered in            multi-family groups, family sessions, and couple’s sessions as desired provided        by LMHP-R/RP and/or CSAC CATP’s in collaboration with CPRS.
 
8. Psycho-educational activities collaboratively directed by a CATP and CPRS’s will        include but are not limited to:

a.    Substance Use Disorder (SUD) education and training;
b.    Relapse Prevention;
c.    Anxiety, Stress, and Trauma;
d.    Independent living skills;
e.    Activities of daily living;
f.    Medication education, that includes monitoring;
g.    Vocational assessment, training and placement;
h.    Family reunification;
i.    Anger management;
j.    Recreational and leisure activities;
k.    Promotion of personal responsibility;
l.    Reintegration of the individual into the network systems of work, education,        and family life
 
9. Recovery Support Services: Peer support workers are people who have been            successful in their personal recovery process who come alongside guiding                others encountering similar situations. Their unparalleled insight acquired through      lived experience empowers them as patient advocates within the                              multidisciplinary treatment team. Our Peer Recovery Support Specialists are              certified by the Virginia Department of Behavioral Health and Developmental            Services (DBHDS). They are ambassadors of the “Recovery Lifestyle” capable of      creating a special rapport dynamic that can be leveraged when necessary to            overcome challenging resistance barriers encountered by clinical treatment              providers. Under professional oversight and direction in accordance with a                collaboratively developed Recovery, Resiliency, and Wellness Plan, CPRS’s will          guide patients in accessing community resources, building coping skills,                    participating in social/recreational activities, and implementing a solid program of      recovery to improve their overall quality of life.
 
10. Care coordination/Discharge Planning: The goal is to prepare each patient for            referral into another level of care and promote independence. This includes, but        is not limited to connecting patients to step-down treatment providers, service          coordination with case managers and facilitating warm linkages to community          resources, protective housing, courts and treatment centers when necessary,          etc. This service will be provided by RPRS, CSAC-A’s and directed by the                  LMHP and/or Medical Director.