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.