by Chelsea Bringham
There are few circumstances that leave a family more vulnerable than enduring an ongoing crisis of mental health, addiction, trauma, and the like. When a loved one’s life is in danger, urgency for solutions becomes dire, leaving families – who, unfortunately, are often uneducated – vulnerable to some of the behavioral health treatment industry’s buzz words, unethical providers, or misrepresentation of services. In California alone, there are close to 2,000 treatment centers, with only 16 state inspectors to monitor the ethical and safety practices of licensed facilities. How, then can you ensure that your family will get the help that you so desperately need? Today we will discuss the why and how of treatment vetting and its crucial importance to successful care.
Learning how to vet programs with confidence.
Unethical Practices and Safety:
While there are numerous ethical and clinically sophisticated programs across the nation, it is no secret that the behavioral health industry has become a lucrative opportunity for private equity firms, business entrepreneurs, and newly sober individuals who take advantage of this vulnerable population seeking help. Unethical practices include billing and insurance fraud, marketing fraud and misrepresentation (more on this later), unlicensed homes or clinicians and even human trafficking.
“Buzz Words” are legitimate modalities for treatment, but are exhausted, and often misused and falsely or improperly represented, based on actual services being provided, and who is delivering the services. Some of the buzz word terms that families may hear include:
- Trauma Informed
- Dual Diagnosis
- Individualized Treatment
- Premier/World Class
- Life Skills
- Holistic Approach
While these terms may be valuable aspects of treatment when delivered appropriately, they are overused in the marketing and admissions process of treatment. Without the proper knowledge, families often check all the boxes and without asking the intricate follow-up questions about how these treatment functions are actually implemented.
Treating Symptoms Rather than the Underlying Issues
As treatment experts, our philosophy surrounding addiction, mental health, and behavioral challenges must always be that they are not the problem, but rather a symptom of unresolved trauma, undiagnosed mental health conditions, or both.
Given this knowledge, when interviewing addiction treatment centers, you will find a consistent theme of treating addiction as a disease. Most programs will introduce the Priority Family Member* to a 12-step program, or group work revolving trigger management, and of course, relapse prevention. While these are notably imperative aspects of treatment, many programs are missing the mark– they treat the prominent symptoms themselves (substance abuse and behaviors) rather than the underlying trauma that leads to the chronic manifestations of these symptoms consistently over time.
The “One Stop Shop” Phenomenon
Perhaps you are aware that the Priority Family Member has unresolved trauma; or perhaps in addition to their substance misuse, they also suffer from mental illness, disordered eating, or relationship issues. Your educated research leads you to a myriad of “Dual-Diagnosis” programs. DDCAT and DDCMHT, or Dual-Diagnosis Capability in Addiction Treatment and Dual-Diagnosis Capability in Mental Health Treatment, IS an imperative capability for a loved one struggling with more than one challenge. However, the concern lies with the actual abilities of programs who advertise the expertise and their level of treatment capability for these dual diagnoses. Programs with solely an addiction psychiatrist on staff may market themselves as a dual-diagnosis program since the psychiatrist can prescribe medications. Another program may portray themselves with dual-diagnosis capability because they treat clients with both substance abuse and mild depression or anxiety, and while this may be helpful and truthful, it bends the standards by which we adhere.
A vital part of the vetting process is to discuss the Priority Family’s Members history and presenting issues not only with an admissions counselor, but also with a clinical professional from a program, and to ask questions to further understand the scope of their treatment capability.
Based on these why’s, you may be feeling more hopeless than before. How do we find a program that is ethical, safe and will help my family rather than harm?
Stay tuned for our next blog later this week: Vetting with Confidence: Doyen’s Steps of Treatment Vetting.