ARCA's Outpatient ProgramOverview and Philosophy
Each day about 240 people die from alcoholism and about 74 die from opioid overdose. These are sobering numbers; and each death is someone’s parent, spouse, child, sibling, or friend. Addictive disorders impact every segment of society.
Drugs and alcohol exert their effects throughout the body but most powerfully on the brain. The brain is a complex organ involved in the basic biological survival, which among other systems involve pain and pleasure. Most human experiences broadly fall within the spectrum of pain and pleasure, and are intricately linked to survival and well-being. Drug and alcohol stimulate the pleasure system in an abnormal manner and the brain process these stimuli into the memory, emotion, and motivation circuits. The intense ‘high’ or abnormal pleasure overwhelms the finely balanced pleasure systems to a point that the patient’s motivation becomes focused on just one activity – the seeking and use of drugs to mitigate the pain and feel ‘normal’.
Over a period of time, the patient moves away from thriving to survival. The longer the drug or alcohol use goes on, the more profound changes to the physical and behavioral well-being of the patient. By the time the patient seeks help the devastation has progressed far beyond just the withdrawal and cravings. The patient often develops serious issues with employment, family, law, and health.
The ARCA Approach
The ARCA approach provides an environment to promote health and recovery at several levels. The medical detox and stabilization is the first critical step to break the vicious cycle of withdrawals and cravings. The detox is done under the care of a medical professional. The medications also help to reduce anxiety, normalize sleep and other symptoms associated with the use of drugs and alcohol.
This first step is followed by a comprehensive psycho-social assessment and allows the treatment team to address the behavioral issues closely linked to the addictive disorder. The ARCA approach emphasizes treatment in the patient’s natural home environment. This environment is filled with cues and triggers of past drug or alcohol use and ever-present to seduce the patient into relapse. If the environment is not likely to change, can the patient be trained not to be impacted by a plethora of cues and triggers? The ultimate test of any treatment program is how well a patient can cope with the cues and triggers that don’t go away.
To successfully eliminate or extinguish the conditioning that has sustained the disorder, the patient needs to be protected by anti-craving medications. These medications blunt the cravings triggered when the patients is exposed to various cues. These cues could range from sight of the drug or alcohol to anger and loneliness. The protective ‘bubble’ afforded by the anti-carving medications allows the patient to become immune to the cues of past drug or alcohol use. This process is called behavioral modification.
Behavioral modification is best achieved through psychiatric services, individual, group and family counseling. The healing and recovery takes time – 6-12 months! This may seem long and tedious and counter to the short 28-day stay in a residential treatment, but this time period is critical to achieve long-term recovery. The ‘home-based’ approach has several benefits. It allows the brain to heal; allow new behaviors to evolve; improve family relationships and finally move away from survival to thriving again.
Why 6-12 months, because it is enough time to…
Allow the brain to heal;
For new behaviors and routines to be learned, tried and implemented effectively;
Explore and change family dynamics;
Identify relapse triggers, new activities, friends and behaviors and implement positive change;
Educate families to understand the illness, their role and the impact to all involved;
Begin to appreciate life-long relapse prevention maintenance and care;
The bottom line is, because it is evidence based and supported by research. The National DATOS study of treatment programs found that individuals engaged in long term, structured treatment, greater than 3-6 months, performed significantly better and were 87% less likely to relapse. Our belief is six months is the opportune amount of time based on our client’s experience.
The Team of Professionals
Our team is highly educated, supervised, licensed and board-certified professionals who focus on staying current with research and treatment approaches to addiction, psycho-social issues and emotional health. ARCA treatment is provided by professionals that are educated and trained to explore, challenge and teach new skills, behaviors and understanding of the illness. They are also trained to identify co-occurring illnesses (medical/psychological) and develop solutions to treat in a timely and effective manner. This is different than support groups where an individual receives encouragement to maintain sobriety.
Our team’s approach to the psycho-social aspects of the illness is about challenging the thinking, behaviors, relationships and habits of the addicted individual. Additional time is spent focusing on developing new routines, medication compliance and relapse prevention. It allows for one to make substantial changes eliminating the previously used substances and behaviors that often involve manipulation, justification, misleading, lying, and deceit.
Hard Work / Dedication / Commitment
Treatment is long term and may very well result in relapse. Approximately 60% of individuals will experience relapse after their initial recovery. Other chronic illnesses (diabetes, hypertension, etc.) experience the same relapse rate. However, that does not mean you did not make progress or you failed, it indicates this is an insidious, life long illness that can kill if one does not remain committed to treatment, remain focused and trust in the professionals that are involved.
ARCA’s Outpatient Program:
- Allows for flexibility to maintain work, school, and family schedules
- Provides monitoring several times a week in a supportive group and individual setting.
- Groups are held in the morning, afternoon and early evenings Monday through Saturday. Patients can attend groups in a variety of locations and at different times. We recommend a minimum attendance in groups each week based on one’s treatment plan with one group assigned as their “home group” which they are required to attend consistently.
- Assigns an individual counselor/therapist for once a week one on one session. Patients may be seen more frequently if it is deemed therapeutically beneficial by their therapist.
- Evaluates and monitors the patient by a physician and/or psychiatrist throughout the course of treatment. More frequently early on or as their condition warrants.
- Length of treatment is between 6-12 months and individually created
As stated previously, addiction is a brain disease that is life long, each person’s treatment is unique; however, it is found that most individual’s find more success with what we consider is required over a six (6) month period of time.
Physician / Psychiatrist / Psychiatric NP – Regular visits: (8 visits)
- Initial H&P
- 2 week follow up
- 4 week follow up and repeated until the end of treatment
Nursing Consultation – Every 4 weeks (8 visits)
- Initial Nursing Assessment
- 1 week follow up
- 4 weeks follow up and repeated until the end of treatment
Urine Drug Screens – A UDS is done for every Physician, Nursing, and Therapist visit (approximately 41)
Therapist – weekly (25 visits)
Group Therapy and Education – minimum of 3 times per week (no less than 72 visits)
Family Therapy – as needed, depending on support system
Family Education / Support Group – Weekly (25 visits)
Medical evaluation / follow up with an Advanced Practice Nurse – quarterly (2 visits)
Access to 24/7 crisis support
6 Month Addiction Treatment Program
3 Month Addiction Treatment Program
1 Month Medication Management Program
What ARCA expects of its patients:
I, the patient, am responsible for managing my care along with the treatment team I acknowledge and agree to stay engaged, schedule my appointments regularly, call if I will be late to an appointment or if I need to cancel an appointment. I will check in with my primary therapist as needed throughout treatment. I will take medication as prescribed, not share my medication, submit to requested Urine Drug Screens (UDS) and attend appointments with the physician as scheduled. I will be responsible to verbally approve the Vivitrol shipment when requested by the pharmacy to ensure delivery and medication compliance.
I am responsible to reschedule missed or cancelled appointments, attend the agreed upon groups, identify my “home group” time and location and attend weekly. A variety of appointment times are available, however, there are multiple individuals requesting dates and times, so best efforts to meet those requests will be made.
My emotional and physical health is my responsibility; the treatment team will support, encourage and challenge me throughout the course of treatment, if at any time I want to revise my treatment plan I will contact my primary therapist. The primary therapist will suggest and highly encourage me to challenge previous behaviors, relationships and use. I will do my best to openly accept these challenges and incorporate them into my treatment plan.
I acknowledge that part of my treatment plan is to be drug-free; slips, relapses and using is part of treatment, I will discuss these situations openly and honestly with the treatment team. I acknowledge without doing so my treatment may be hampered. I will openly discuss UDS results and the application of anti-craving medications.
I acknowledge I am responsible for my behavior, ARCA or any of its affiliated companies will not tolerate any abusive, threatening or demeaning language or actions. If at any time I demonstrate poor conduct, I acknowledge I may be terminated from the program and all fees paid will not be reimbursed and I will remain responsible for any and all outstanding fees.
I acknowledge my family, friends or significant others may request to be involved in my treatment, it is my responsibility to include them by signing the appropriate Releases of Information (ROI) and having them attend family meetings and or family education as scheduled and requested. The treatment team will not disclose or provide information to those requesting without being on my ROI, unless it is deemed necessary to protect me in accordance with HIPPA and Federal State laws.