Case Management

Case Management

The best treatment experience is only as good as what patients do when they return home.   Inpatient/outpatient treatment is Phase One, designed solely to stabilize and prepare the patient for Phase Two.  Phase Two is about building upon the foundation and maintaining changes.  Think of Phase One as “surgery” and Phase Two as “post-op;” surgery is when you get saved, post-op is when you heal.  The first year of recovery generally sees a lot of relapse; in fact, the average number of inpatient treatments per patient is five.  This is unnecessarily invasive, costly and draining on the whole family and can be avoided with rapt attention to the right aftercare plan.  We know that there are only a handful of components necessary for success:

  • A support system with an active plan (the most accepted and successful venue is a 12-step program such as AA or NA); this will include working the steps with a sponsor
  • Regular meetings with an addiction specialist (i.e. case manager) who knows how to assess recovery and respond effectively to any signs of relapse.  This case manager will have communication with the therapist, the family, and access to the drug tests.
  • Regular (but more infrequent) team meetings where the whole family reports on what is going well and what the concerns are.  The treatment plan is then modified accordingly.
  • Regular or random drug testing
  • Group therapy facilitated by an addiction professional, weekly or bi-monthly for the first year
  • Any additional therapies recommended by the professional treatment team (e.g. couples or family counseling; psychotherapy for concomitant disorders and problems).
  • “Non-therapeutic” ingredients:  fun, recreation, purposeful work, service

Although the first year claims the lion’s share of relapses, addictive disease is chronic, ever-vigilant about structure weaknesses, never missing an opportunity to make in-roads. The three little pigs taught us everything we need to know about Phase Two.  A straw house is fine for low-stress days, a stick house is fine for medium stress but when the Big Bad Wolf shows up at your door, the ones left standing are surrounded by bricks.  Dr. Blair will help you navigate a tailor-made Year One plan, brick by brick.

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