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    Choosing outpatient substance abuse treatment

    Posted on June 4, 2017 by


    Congratulations! You have decided to seek counseling or education for alcohol or drug use. It is a big decision and commitment, no matter the reason you reach out for assistance. Below is a description of how to choose a substance abuse provider and make substance use treatment a success for you. Successful alcohol and drug abuse treatment is an experience that should have a long term positive impact. Proper diagnoses, proper placement and adherence to the treatment and continuing care plan through to completion are key components to your success.

    For early intervention counseling or education successful completion of the treatment plan can be as simple as completing a few group sessions. For moderate to severe substance use, longer more intensive counseling with aftercare groups and community support programs are beneficial to achieve lasting change.  Substance use disorder and mental health treatment are healthcare services, even if mandated by a third party.

    Whether you chose substance use disorder (SUD) treatment for yourself, to satisfy family, employers, school, or a legal charge or situation, your opportunity for long term benefits are equally as good. Extensive research proves that clients who are required to attend have outcomes as good as those of “voluntary” clients. (Search Google for “research voluntary treatment vs. mandated treatment” for more information.) Whether you chose treatment to improve your health or because you got a DWI or other legal charge, the process is largely the same.  If the treatment plan is followed through to the end, the outcome is significant improvement in your life. Don’t quit before the miracle happens!

    The benefits of treatment might not be experienced until after several sessions or, sometimes, after completion of the process. The key to obtaining a lasting positive outcome is to follow the treatment plan all the way through to the end. Tweaking the plan might be necessary along the way. The longer one remains in treatment is often more important than intensity. (Search Google for “how long do I need substance abuse treatment?”) Diabetics don’t stop insulin because their blood sugar is stable. Heart disease and cancer patients don’t quit treatment because they don’t like going to see the doctor.  When treatment seems uncomfortable, it is not time to quit. It is time to dig in and have discussions with your counselor. Treatment will work for most everyone when properly diagnosed and placed in the correct level of care. For those who believe substance use disorders are not as dangerous as heart disease, cancer or diabetes just read or watch the news. Substance use kills no less than 4 people daily in NC.

    Where to start, what to look for in an agency or facility:

    • When initially searching for a program or facility on the internet, steer clear of toll free numbers. Toll free phone numbers often route you to a national call center for a program that has hijacked the phone number of a reputable provider. First Step Services, LLC and other quality programs do not have national call centers or advertise toll free numbers. Search the service you are looking for online to get a  list of licensed and accredited programs, then find the actual websites of the program. Check the NC Department of Health and Human Services website for the company.  Check the NCDHHS licensing for the division you are considering attending.
    • If you are calling for First Step Services, LLC and the caller doesn’t answer “Thank you for calling First Step Services this is “Henry”, or the like, you possibly dialed a company with a national call center hundreds of miles away. Hijacking phone numbers and email addresses is a serious problem in healthcare.
    • Choose a program that is NC DHHS licensed for the level of care you are seeking, accredited by Commission for Accreditation of Rehabilitation Facilities (CARF) or by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). All properly licensed agencies will have DHHS (Department of Health and Human Services) licenses and their accreditation openly displayed in the lobby.  If you do not see a current, verifiable license and CARF Accreditation, ask to see one. If the license and accreditation are not available find a different agency. The best providers are proud of our licenses and accreditations.
    • How long has the treatment program been in business? How long has it been in the Triangle area? Has its, or any clinician’s, license ever been suspended?
    • Quality courthouse programs and other agencies who assist legally mandated clients will have DHHS licenses and CARF Accreditation prominently displayed at all offices and locations. Being sanctioned by, or located in, a courthouse does not guarantee the program has quality services. Ask to see licenses, accreditation and counselor credentials. If you have a DWI, it is illegal in NC for anyone to require you to attend a specific program, even at the court house. Report unlicensed agencies and counselors to the NC DHHS and/or NC DWI Services.
    •  When you meet with the counselor or therapist, look for degrees, licenses and/or certifications on the wall. If you do not see them prominently displayed, ask to see them or to see verification of licensure, certification and’/or degrees, If they have none to display find a different program whose credentials are prominently displayed.
    • Do not trust online public reviews. People who are asked to stop using alcohol and/or drugs are, understandably, often resentful and angry. An comprehensive assessment that reveals a health condition that is, or can become serious, frequently causes anger, denial or other adverse reactions. When upset by learning a diagnosis and recommendation, people sometimes write negative reviews online. When that occurs, it is usually more about the upset person than the treatment provider itself. Use the above listed information to choose a program, not online reviews.

    When you arrive, what to look for, what to expect: 

    • Ensure the facility is private, clean and neatly organized.
    • Front desk and administrative staff should be friendly, welcoming and knowledgable.
    • You should be welcomed immediately. If this is the first visit, the intake process should begin at your scheduled arrival time. For all appointments, your counselor should be ready to meet with you at your appointed time.
    • Ensure that parking is plentiful and well lit. You should feel safe outside the building as well as inside.  A safety office or staff member should be available to oversee safety in parking lots after dark.

    The intake process during your first visit:

    • You should be welcomed into an intake area with a staff member to assist with paperwork.
    • Intake takes about 25-30 minutes to complete paperwork. Intake includes gathering basic information such as address, contact information, a standardized substance use questionaire, health insurance, financial information guarantee of confidentiality statement, authorizations to release information, etc.
    • Bring your health insurance card. If you are on someone else’s plan, it is necessary to know the full name, date of birth, insurance ID and address of the insured.

    Your assessment:

    • Like any health evaluation, a substance use evaluation or assessment should be thorough, comprehensive and conducted by well trained credentialed professionals. Assessments should be conducted in licensed, accredited facilities that use ASAM (American Society of Addictive Medicine) criteria and Department of Health and Human Services guidelines.
    • A comprehensive assessment will also help sort out severity, causes, triggers, related to the condition and help to develop treatment, discharge and continuing care plans.
    • Non CARF Accredited, non DHHS licensed NC DWI, NC DUI assessors screen for a disorder, but do not typically conduct a comprehensive assessment that provides sufficient information to create a holistic treatment plan.


    • All counselors should be credentialed as MSW, BSW, MA, LCAS, CSAC, LPC and/or LCSW.
    • Family services should be included or available at all levels of care.
    • A discharge and continuing care plan should be in place prior to completion of treatment.
    • Post treatment services should be available and easy to access. First Step allows group graduates to continue attending their primary group for $5 per day as long as they are still abstinent and don’t need primary treatment.
    • Choose a program whose goal is to assist you in never having another problem with substance use.

    Take the first step to a life freed of problems from substance use! 

    “The counselors and group made me feel extremely welcome and comfortable throughout the program. My experience in group opened my eyes, taught me a lot, and reminded me of all the blessings I enjoy in life. I will certainly be more aware of my own struggles, risk factors and triggers, and will also be more aware and open to helping others who may benefit from what I’ve learned through this experience. I’m grateful to the counselors and group for their guidance, and for allowing me opportunities to “talk out” my own challenges, questions and thought processes.” Anonymous First Step Services group member

    Henry Tarkington, MSW, LCSW, LCAS, CCS

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