What Questions Should You Ask a Rehab?
Editor's note: Dr. Jeff Reynolds is the President and Chief Executive Officer of Family and Children’s Association (FCA), in Mineola, NY. This article was written based on Dr. Jeff Reynolds' presentation at THRIVE's Addictions Conference.
Where you go to rehab matters! Whether it's a for-profit or non-profit, the important thing to know before you go is how do they do what they're doing? That is, what kind of treatment are they providing?
Here's a list of questions you can ask to get the info you need.
1. What type of accreditation or licensing does the program have?
There are a lot of organizations that provide accreditation so it can be difficult to know what they did to acquire it or maintain it. Also, anyone can put a gold seal on their site but that doesn't mean they earned the accreditation, since many accrediting bodies don't necessarily police the use of their seals!
Just because a rehab has a seal on their website, doesn't mean they actually are worthy of being accredited. It's better to check the accrediting organization's site - look to see if the rehab you're considering is listed there. In New York, you need an OASAS license to do treatment. So if the rehab you're considering has accreditation from OASAS, you can be reasonably assured that they've been there and checked it out in the past year.
2. What credentials and licenses does the program's clinical staff hold?
Some websites don't list the clinical staff and credentials. There should be a medical director, facility director, and you can ask about who provides the services on a daily basis. Peer-to-peer is good, but there should be a clinical component also.
3. What is the patient-to-counselor ratio?
he number is important, but more critical is whether staff are actually qualified and whether they are engaging the people there in services, or is the staff just "watching" them?
4. Does the program offer an individualized addiction treatment program?
You can say to them straight out: "Tell me about your evidence-based practices," then look for clinical depth and the rebuilding of skills or competencies the person may have lost in their addiction.
Assessment practices are really important too - do they provide a psychological evaluation? A "psych eval" is the most basic screening they should be providing and is very important in this scenario since mental health issues are often driving the train. Another clue is to find out if they accept everybody. If so, that's a problem, because it's not feasible that one treatment place would be able to accommodate all different types of people. So find one that cares about meeting the individual's needs and not about accepting anyone and everyone.
5. Does the program offer a full range of needs to help the individual including medical, psychological, spiritual, social, and health and wellness issues?
Exercise is critical. Substance use beats the crap out of your body, so it's important to rebuild your body and replenish what you've lost. It's also great if a 12-step component is involved, but exercise and 12-step programs are not treatment. Those aspects should be there, but they shouldn't be the only things. The medical piece is important. For example, you're at higher risk of certain diseases if you've been injecting drugs. So ask what the facility does to address and talk about the fullest range of needs.
6. What type of help is available for families?
It's a deal-breaker if a treatment facility doesn't have help for the family and it doesn't count if they say they're "thinking of getting one" or "working on one." (Also of note: an alumni program is NOT a family program!) In many cases, family dynamics are part of what drove the use. Not only that, but families adapt to substance use disorder in ways they never thought possible; meaning, a mom, dad, and siblings have all adapted to the chaos in order to survive. We need to reprogram that. The family needs treatment via a family program - it produces a better outcome for everyone.
7. What type of continuing care is available?
A follow-up phone call at 30, 60, and 90 days is NOT continuing care!
There should be a process where you learn how to live again. So when someone completes treatment, then what? What's the plan for transitioning that person back to life? How do we get them back to their everyday routine without drugs or alcohol involved?
Part of the reason relapse rates are so high is a lack of continuing care. Everyone leaving treatment should be given Narcan in Dr. Reynolds' opinion. When someone leaves treatment, they're at the highest risk of overdose fatality. So ask the rehab program what plans they put in place for a safe transition after treatment.
8. What type of insurance do you accept and what's the overall cost?
This shouldn't be the first question out of the gate. First, you need to find out if this rehab is an appropriate fit. Tell them: this is my insurance, these are my benefits, what will the out-of-pocket cost be? What happens if insurance covers 14 days but you determine they need 28 days? What's the extra 14 days going to cost?
Make sure you have as much info as possible to make a decision that works for you. (Even if money is not an issue, the best treatment place may not be the most expensive one.)
9. What's the admission process like?
The admissions process should be thorough and include a comprehensive substance use assessment using a standardized tool, a psychiatric evaluation, family history, medical exam and social/vocational assessment.
Thanks to Dr. Reynolds for this crucial and informative post! If you're looking for a rehab or treatment program and don't know where to turn, feel free to contact us so we can connect you to a professional who can help.