Introducing collaborative addiction treatment to the client

Practical Recovery aims to offer ideal addiction treatment for any substance or activity addiction. We describe our approach as “collaborative addiction care.” Because each client is unique, and we are fully collaborative, no two treatment plans are alike. Hence we do not offer a “program.” Our treatment intensity can be as high as alcohol and drug rehab or our treatment-in-residence program, and can range downward to brief outpatient services. The treatment-in-residence program is a combination of day-long intensive outpatient services, and residence either in our six-bed sober living facility or an adjacent hotel. Our services work best for local clients, who can begin with high intensity treatment (if needed), then transition to a gradually decreasing intensity over whatever time period is needed. However, because our fully collaborative approach is unique, clients come to us from around the world. Out-of-town clients are transitioned to hometown providers, and may also continue with us through extended phone coaching or follow-up visits. The following description assumes a client who begins treatment with a high level of intensity.

The first client choice is about whether to attend treatment.  Our initial presentation describes the range of choices the client will have upon arriving.  We believe this presentation immediately engages potential clients in a process of change and self-discovery. The following paragraph describes our treatment-in-residence program. Clients in our residential program have a somewhat reduced number of options because of the structure needed in residential program.

“The core of our approach is one-on-one sessions, with psychotherapists, counselors, holistic healers, and medical and health professionals.  These sessions are usually 60 to 90 minutes in length, but can be of any length.  Allowing for breaks during the day, you typically will have two to six sessions per day, but any number of sessions is acceptable.  We work with you in six broad areas: motivation, coping with craving, problem solving, relationship enhancement, lifestyle balance, and meaning and purpose in life. For most clients identifying and resolving underlying issues (the problem solving component) is the primary focus, often followed by relationship enhancement, but we will focus with you on whatever is needed to improve your life.   Perhaps the most important work we will do together is to help you connect to and understand better what is most important to you (whatever it may be). It is not our job to tell you which ultimate values or deepest beliefs to have.   They can be whatever they are. We simply want to help you live in accordance with them. That way you will be living a purposeful and meaningful live, which is the best protection against relapse.  Groups are available but not required (we offer four per week). You won’t need or want every type of service, so we’ll begin by talking about which ones you might start with, and how long you are intending to stay.”

We then review what we offer, provider by provider (over 20 providers in all) and possibly service by service (all providers offer multiple services).  We also inquire whether services we do not immediately have available are needed or desired.  For instance, if someone needs or wants a particular form of yoga instruction, physical therapy, type of psychotherapy, etc., we find a suitable provider and include these sessions in the client’s schedule. We also accommodate events or outside activities (a relative’s wedding during week three, Wednesday afternoons off for hiking, mornings off to conduct business back east, etc.). Detox if needed can be done at a San Diego hospital, or a hometown hospital first.

At no time do we suggest that treatment, with us or with anyone, is necessary for change.  Instead we state that “you will be the primary agent of change. Our job is to reinforce and support your decision, based on our training and our observations of others we have worked with.”

Our goal in the initial conversation is to help the client view treatment as an interesting, desirable, and possibly life-changing experience, an experience worth trying, and one which will not completely disrupt life as usual. We also emphasize that there is no set length of treatment, which could last days or months. Our only requirement is 48 hours notice of cancellation (residential clients pay a higher daily rate if they stay for less than 30 days). Outpatient clients pay only for the services they actually receive, and are free to leave at any time.