Here's an excerpt from a good article in CNN about addiction treatment:
[QUOTE]Every year, state and federal governments spend more than $15 billion, and insurers $5 billion more, on substance-abuse treatment services for some four million people. That amount may soon increase sharply: last year, Congress passed the mental health parity law, which for the first time includes addiction treatment under a federal law requiring that insurers cover mental and physical ailments at equal levels.
Many clinics across the county have waiting lists, and researchers estimate that some 20 million Americans who could benefit from treatment do not get it.
Yet very few rehabilitation programs have the evidence to show that they are effective. The resort-and-spa private clinics generally do not allow outside researchers to verify their published success rates. The publicly supported programs spend their scarce resources on patient care, not costly studies.
And the field has no standard guidelines. Each program has its own philosophy; so, for that matter, do individual counselors. No one knows which approach is best for which patient, because these programs rarely if ever track clients closely after they graduate. Even Alcoholics Anonymous, the best known of all the substance-abuse programs, does not publish data on its participants? success rate...
Thomas McClellan, chief executive of the nonprofit Treatment Research Institute, said: ?It doesn?t really matter if you?re a movie star going to some resort by the sea or a homeless person: The system doesn?t work well for what for many people is a chronic, recurring problem.? ...
In 2003 the Oregon Legislature mandated that rehabilitation programs receiving state funds use evidence-based practices ? techniques that have proved effective in studies. The law, phased in over several years, was aimed at improving services so that addicts like Angella would not be doomed to a lifetime of rehab, repeating the same kinds of counseling that had failed them in the past ? or landing in worse trouble.
?You can get through a lot of programs just by faking it,? said Jennifer Hatton, 25, of Myrtle Creek, Ore., a longtime drinker and drug user who quit two years ago, but only after going to jail and facing the prospect of losing her children. ?That?s what did it for me ? my kids ? and I wish it didn?t have to come to that.?
When practiced faithfully, evidence-based therapies give users their best chance to break a habit. Among the therapies are prescription drugs like naltrexone, for alcohol dependence, and buprenorphine, for addiction to narcotics, which studies find can help people kick their habits.
Another is called the motivational interview, a method intended to harden clients? commitment upon entering treatment. In M.I., as it is known, the counselor, through skilled questioning, has the addict explain why he or she has a problem, and why it is important to quit, and set goals. Studies find that when clients mark their path in this way ? instead of hearing the lecture from a counselor, as in many traditional programs ? they stay in treatment longer.
Psychotherapy techniques in which people learn to expect and tolerate restless or low moods are also on the list. So is cognitive behavior therapy, in which addicts learn to question assumptions that reinforce their habits (like ?I?ll never make friends who don?t do drugs?) and to engage their nondrug activities and creative interests.
For Angella, this kind of counseling made a difference. She spent several months in a program run by Adapt, an addiction treatment center here in Roseburg, a small city about 175 miles south of Portland.
In treatment, she said, she learned how to ?just be with, and feel? bad moods without turning to drink or drugs; and to throw herself into creative projects like collage and painting. The program has helped her reconnect with her father and to enroll in college beginning in January.
?I want to be a teacher, and someone at the program is advising me on that,? she said in an interview. ?That?s the plan, to just move out and away from my old life.?
A friend of hers in the program, Alex, a 16-year-old from Roseburg, said that the therapy that helped him monitor his own emotional ups and downs, without being swept away by them. The counselors ?are always asking about our stress level, our anger, so you become more aware and have a better idea what to do with it,? he said./QUOTE]
It's encouraging that someone (governmental agencies and insurance companies, God bless their little hearts) is beginning to insist that "treatment" programs start using scientific methods and data to guide their work... it's an uphill battle in many treatment centers, however, which are staffed mostly by 12-step recovering addicts, with minimal academic training. In most states, there is actually separate track for licensing providers in the field of addiction treatment, with standards much lower than those for other counselors.
[QUOTE]Every year, state and federal governments spend more than $15 billion, and insurers $5 billion more, on substance-abuse treatment services for some four million people. That amount may soon increase sharply: last year, Congress passed the mental health parity law, which for the first time includes addiction treatment under a federal law requiring that insurers cover mental and physical ailments at equal levels.
Many clinics across the county have waiting lists, and researchers estimate that some 20 million Americans who could benefit from treatment do not get it.
Yet very few rehabilitation programs have the evidence to show that they are effective. The resort-and-spa private clinics generally do not allow outside researchers to verify their published success rates. The publicly supported programs spend their scarce resources on patient care, not costly studies.
And the field has no standard guidelines. Each program has its own philosophy; so, for that matter, do individual counselors. No one knows which approach is best for which patient, because these programs rarely if ever track clients closely after they graduate. Even Alcoholics Anonymous, the best known of all the substance-abuse programs, does not publish data on its participants? success rate...
Thomas McClellan, chief executive of the nonprofit Treatment Research Institute, said: ?It doesn?t really matter if you?re a movie star going to some resort by the sea or a homeless person: The system doesn?t work well for what for many people is a chronic, recurring problem.? ...
In 2003 the Oregon Legislature mandated that rehabilitation programs receiving state funds use evidence-based practices ? techniques that have proved effective in studies. The law, phased in over several years, was aimed at improving services so that addicts like Angella would not be doomed to a lifetime of rehab, repeating the same kinds of counseling that had failed them in the past ? or landing in worse trouble.
?You can get through a lot of programs just by faking it,? said Jennifer Hatton, 25, of Myrtle Creek, Ore., a longtime drinker and drug user who quit two years ago, but only after going to jail and facing the prospect of losing her children. ?That?s what did it for me ? my kids ? and I wish it didn?t have to come to that.?
When practiced faithfully, evidence-based therapies give users their best chance to break a habit. Among the therapies are prescription drugs like naltrexone, for alcohol dependence, and buprenorphine, for addiction to narcotics, which studies find can help people kick their habits.
Another is called the motivational interview, a method intended to harden clients? commitment upon entering treatment. In M.I., as it is known, the counselor, through skilled questioning, has the addict explain why he or she has a problem, and why it is important to quit, and set goals. Studies find that when clients mark their path in this way ? instead of hearing the lecture from a counselor, as in many traditional programs ? they stay in treatment longer.
Psychotherapy techniques in which people learn to expect and tolerate restless or low moods are also on the list. So is cognitive behavior therapy, in which addicts learn to question assumptions that reinforce their habits (like ?I?ll never make friends who don?t do drugs?) and to engage their nondrug activities and creative interests.
For Angella, this kind of counseling made a difference. She spent several months in a program run by Adapt, an addiction treatment center here in Roseburg, a small city about 175 miles south of Portland.
In treatment, she said, she learned how to ?just be with, and feel? bad moods without turning to drink or drugs; and to throw herself into creative projects like collage and painting. The program has helped her reconnect with her father and to enroll in college beginning in January.
?I want to be a teacher, and someone at the program is advising me on that,? she said in an interview. ?That?s the plan, to just move out and away from my old life.?
A friend of hers in the program, Alex, a 16-year-old from Roseburg, said that the therapy that helped him monitor his own emotional ups and downs, without being swept away by them. The counselors ?are always asking about our stress level, our anger, so you become more aware and have a better idea what to do with it,? he said./QUOTE]
It's encouraging that someone (governmental agencies and insurance companies, God bless their little hearts) is beginning to insist that "treatment" programs start using scientific methods and data to guide their work... it's an uphill battle in many treatment centers, however, which are staffed mostly by 12-step recovering addicts, with minimal academic training. In most states, there is actually separate track for licensing providers in the field of addiction treatment, with standards much lower than those for other counselors.
Comment