How to Start Looking for Treatment Center Information

The new year often prompts people to evaluate their alcohol and drug use. Those who resolve to seek treatment face daunting tasks, the first of which is identifying where to start looking for information. The internet is the wild west of information. There are few impartial sources of information; the sites that most often appear at the top of searches are for-profit treatment centers. Those websites are polished and compelling. Many of them have chat boxes that instantly pop up to answer any questions you may have.

Most people don’t know what to ask, so they end up following the lead of an organization that has a very real interest in convincing people to commit to their center. People looking for treatment—for themselves or for families or friends—are particularly vulnerable. In the face of great suffering and desperation for a cure, they may suspend their due diligence and be lured by promises of success.

To help prepare people about to embark on finding a treatment program, I offer some observations about the state of treatment in the United States. This is by no means exhaustive but may help to clarify what a person may need or want in a treatment setting.

• Abstinence requires complete cessation of the use of alcohol, other drugs, or behaviors such as gambling. Harm reduction takes a variety of forms, which may include a substitution of Suboxone or Methadone for heroin or opioids. Some abstinence-based programs are suspicious of medication-assisted therapies, falsely believing that one drug is being substituted for another so that one isn’t truly sober. Harm reduction may include moderation management, where one works on skills to curtail or cut down on problematic use.

• In-patient treatment provides intensity and singular focus, which may give a person the opportunity to focus solely on their sobriety. Many in-patient programs are 28 days or longer. In-patient may but does not always include detoxing facilities where a patient can go through withdrawal with medical supervision. However, not all in-patient treatments have regular physicians on staff. One worry with in-patient treatment is how well people adjust to the re-entry into their regular lives.
• Out-patient keeps a person in their regular life, which may help people build the skills to balance competing demands. Some worry outpatient treatment lacks intensity because it is one activity among the many of daily living.
• There are too few treatment modalities. The 12 Step model is used in about 75 percent of in- and out-patient treatment, whether as the primary model or as one among several. Other treatment modalities include cognitive behavioral therapy, community reinforcement and family training (CRAFT), individual counseling, motivational interviewing, and contingency management. Medication-assisted therapies are often paired with some of these modalities.
• There are no national standards or accreditation of treatment centers. The term “treatment professional” is overly broad and may include physicians, psychologists, social workers, licensed alcohol and drug counselors, and the person who drives the van to pick up clients. The ratio of staff to patients may be misleading.
• There is no benchmark of success; each center can decide for itself what counts as success. Few longitudinal studies provide evidence of success.
• Not all treatment programs are well-qualified to address co-occurring disorders such as depression, anxiety, and ADHD, for example. Some treatment centers that are abstinence-based may view any psychiatric medications with suspicion. With co-occurring conditions, there should be regular appointments with physicians/psychiatrists and psychologists.
• Insurance coverage may be insufficient. Expense is a major barrier to treatment. Coverage through the Affordable Care Act should be available. Identifying the correct forms, getting a referral/approval, and filing the correct claim forms can be barriers. A person who has insurance through work or a spouse’s work should consult with the human resources department. This may be a challenge if an employee is wary about “outing” him-, her-, or themselves. Losing a job by going to treatment—even outpatient—is a serious worry. Some may use their savings, sell some assets, or ask family or friends for money. Some treatment centers may offer loans or financing, but a person must be very careful of the terms and conditions. Lease to own sobriety may be a very risky approach.
• Many people in the United States live in a treatment desert. There are few options available in rural and poor areas. One’s choices may be sharply limited by proximity and convenience.
• Membership in particular demographic groups may matter enormously. Members of the LGBT community may want a program that is specifically tailored to them. The same may be true for people from religious faiths, especially faiths where drug and alcohol use are prohibited. Certain professionals, such as physicians, might want specialized programs as well.

As I noted above, this is not an exhaustive list of considerations about seeking treatment. It is intended to help people begin their search, acquire more information, and be better positioned to make a momentous decision. Below are three helpful resources that are more objective and straightforward than many other resources on the internet. Each provides more suggestions and information as well as a tool to search for treatment.

Substance Abuse and Mental Health Services Administration

National Institute on Alcohol Abuse and Alcoholism

National Association of Addiction Treatment Providers

Psychology Today offers an extensive listing of treatment options and information.

My final recommendation is to ask directly for very specific information about the qualifications of the staff, the treatment models used, duration, medical supervision, the types of individual or group counseling, and follow-up care. If any treatment center balks at providing this information, that is a red flag.

To find a therapist near you, visit the Psychology Today Therapy Directory.