Levels of Care
The fact is that addiction isn’t something that can be “fixed” or “cured”, and recovery demands a lifelong approach to treatment. This is the reason why 12-step groups like AA and NA emphasize that even when members have been sober for decades, continued adherence to their principals is important to maintain sobriety. And yet, within society, some in active addiction treat the disease as if it has a simple cure. Rehab is considered a pit stop to be used if one has hit ‘rock bottom,’ that will fix the issue so that life will continue.
Although addiction cannot be cured, it can be treated effectively with a comprehensive approach to the disease. This treatment requires more than a one-time treatment from a detox facility. At FHE Health, we provide a full continuum of care to our clients, giving them the best opportunities for a new, better life, free from their behavioral and mental health issues.
What Is the Continuum of Care?
Broadly, the continuum of care describes the process of treating addiction and behavioral health in the most complete and effective way. It summarizes the standards of treatment that are proven to be the most effective, namely, that care should take place over a significant period of time and eases clients back into independent life. The continuum of addiction care is the general name for a process that starts with a check-in to a residential rehab facility and tapers with outpatient treatment, it describes the levels of addiction care. While this may be the end of a facilities involvement in rehabilitation, effective addiction treatment continues after this, with community support.
Additionally, there is a medical definition of what the continuum of care really means, set out by the American Society of Addiction Medicine (ASAM).
The ASAM Levels of Care for Addiction
ASAM has established codes for each step of the continuum, as a way to standardize the way we look at addiction treatment. No two rehab facilities address clients in the exact same ways, so ASAM’s definitions make it easier to put services in two different facilities in the same context. This makes billing easier for insurers, but also provides guidance to the addiction treatment community on the most effective ways to assess and treat patients at each level. The scale ranges from 0-4, with 0 signifying no treatment at all, and 4 being the highest level of care in the industry.
Level 1: Outpatient Services
According to ASAM, outpatient services consist of treatments and therapies administered to patients who are not residents of a facility. For care to be considered outpatient at level 1, patients must spend less than 9 hours at the treatment facility during a given week.
Level 2: Intensive Outpatient (IOP) or Partial Hospitalization (PHP) Programs
Level 2 involves services where patients are not residents of a facility but still spend a significant amount of time in a location receiving therapies and treatment that support recovery.
Level 2.1 is IOP, which is more than 9 hours of intervention. According to ASAM, many of these are programs take place before or after work or school so that patients can receive treatment while integrating with society.
Level 2.5 is PHP, which involves 20 or more hours of care per week without the around-the-clock attention of residential care.
Level 3: Residential/Inpatient Services
Level 3 includes a scale of inpatient treatment that progresses from minimum engagement to fully-supervised, intensive care.
Levels 3.1, 3.3, and 3.5 describe different intensities of clinically-managed residential care, while level 3.7 and level 4 (the highest level of the ASAM scale) describe patients who need around the clock monitoring by medical professionals.
The National Institute on Drug Abuse (NIDA) describes the many options available to addicts when they seek care for addiction in the U.S:
- Long-term care: True long-term rehab takes place over the course of 6 to 12 months as part of a “therapeutic community”. This is an effective way to treat addiction, but it’s often not very feasible: most people can not afford to spend a year of their lives in treatment. 90-day programs are often the “long-term” care that patients receive.
- Short-term care: Residential stints of 30 days are considered to be short-term inpatient care. This is the most common model for residential facilities in the United States, where the inpatient portion of the continuum takes place over a period that lasts an average of a month.
- Outpatient care: Most inpatient facilities including FHE Health offer outpatient treatment, including dedicated rehab locations and outpatient clinical care. This may include IOP and PHP.
- Aftercare: This includes support groups and attendance at 12-step meetings like AA and NA. “Aftercare” refers to any services that patients receive that help them build healthy habits after treatment.
Choosing the Right Level of Care
ASAM’s continuum of addiction treatment doesn’t demand that facilities offer every level of care, or give patients a process that addresses care at each level. It’s tempting for addicts to choose a level that’s lower than what’s in their best interests. For example, it’s easy to say “all I need is a quick detox and then I’ll be ready to go to meetings”, but this mindset is often the reason why many addicts relapse multiple times before making the necessary commitment to choose a level of care that they truly need.
At FHE Health, we accept patients at all levels of care, but the most effective treatment takes place when you go through each level from start to finish.
FHE Health Levels of Care
At FHE Health (FHE), we offer a personalized continuum of care. This means that we assess the risk factors and unique needs of each client and build a schedule for their recovery, usually starting at ASAM level 4 and ending at 1. If and when relapse occurs — NIDA reports that the relapse rate for addiction is between 40 and 60 percent — we start the process back at level 4. Here are the services we offer at each level:
The continuum of care begins with the process of safely detoxing clients from drugs and alcohol. Successful therapy and rehabilitation can occur only when the body is free of its physical need for a substance. At FHE, we have a staff of medical specialists prepared to oversee the process and manage medications when necessary.
Upon arrival at our residential facility, each patient will be assigned to one of our specialty programs, as appropriate. This designation will depend on an in-depth assessment of the patient’s needs as well as quantifiable measurements using our Neuro Rehabilitation services. A personalized plan for each patient improves, not just the completion rates of our programs, but the long-term success for every patient.
We offer PHP and IOP for all patients, focused on clients who have completed our inpatient programs. In both of these programs, our clients are given the opportunity to utilize on our campus housing. Our outpatient residential facilities provide a structured living environment in close proximity to outpatient therapy. While attending PHP care, clients are given their first re-exposure to normal life. They frequently visit our facility for continued outpatient therapy, often seeing the same therapists and support groups. They begin utilizing the learned skills for managing emotions and processing external stressors as they take on responsibilities. In our gender separate housing, men and women focus on their recovery without the stressors of their home environment which may have, in some ways, contributed to the behavioral health issues. In IOP care, while less time is spent in therapy sessions, we facilitate job searches and encourage more responsibility to be taken on, if possible.
Sober Living is part of what we call “continuum-plus”, a category that covers services that aren’t part of the official continuum of addiction care but are still important for overall recovery. Our Sober Living communities give recently treated clients a place to share experiences and support without fully leaving the recovery campus. The structure provided through this program is critical for many patients as they are not fully confident in their independence.
Alumni and Aftercare
FHE offers a strong alumni support system and aftercare options that include continued group meetings like those in NA and AA, as well as therapy sessions that continue long after clients have completed our inpatient programs.
At FHE, we have many options for care available for your mental and behavioral health needs. We treat each and every client that comes to us as an individual case, meaning that you’ll get top-notch care tailored to your unique needs. For more information, contact us.