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The Haven at Pismo Has Availability in Several Of Our Addiction Programs.

 

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Principles of Treatment

 

Commitment to Integrity and Excellence

  • The Haven program strives for integrity: We strive to say what we do and do what we say.
  • We monitor the quality of care we deliver and make continuous efforts to improve patient satisfaction and outcomes.
  • Our residential environment has integrity. We teach patients a healthy lifestyle through modeling it in our program.

 

Accessible

  • We admit patients to treatment as fast as possible within a deliberate and thoughtful process. Some treatments can be initiated prior to completing a full assessment. Questions of motivation or the presence of co-occurring disorders, while important to assess, should not require prolonged evaluation prior to admission.

 

Safe, Compassionate and Respectful Care

  • We start with each patient from a position of trust and respect. We are non-punitive. In all that we say and do, we show reverence for each patient as a valuable, whole human being worthy of dignity and respect. We treat all patients with unconditional kindness, compassion, and respect.
  • We do not confront, accuse, or demean patients. We do not label people according to their illnesses. Rather than patients being “Addicts,” we see patients as human beings who happen to suffer from addiction.
  • We strive to create a positive climate of safety and trust so that patients can be open and honest. We recognize that patients cannot recover in a climate of fear. We do not discharge patients simply or automatically only because they stop taking their medications or continue to use substances.
  • We do not use drug testing in a punitive or shaming way. We understand that patients need continuous monitoring for drug use, as addiction flare-ups and acute exacerbations of signs and symptoms of addiction are common. We affirm the need for drug testing to help confirm for everyone the status of a patient’s recovery. We believe that drug testing should facilitate recovery by guiding more effective treatment.
  • We implement diversion-control procedures as a standard of care.
  • We are firm, yet flexible in promoting adherence to treatment guidelines. Our structure is designed to promote safe and effective care.
  • We recognize honesty as a key component of recovery. Other treatment requirements include: a genuine desire to improve one’s life, not harming others, including not jeopardizing the recovery of others, responsibly attending and engaging in treatment, advocating for one’s needs, taking responsibility for one’s treatment, obeying the law, and showing concern and respect for the rights and well-being of others.
  • We respect patient confidentiality in all aspects of treatment, including group therapy.

 

Patient-Centered, Patient-Responsive

  • We recognize that there is no one way to be in recovery. Everyone’s path is unique. We help patients to find their own way to the joy that recovery promises. We provide options and questions to think about. We meet patients where they are at and work on what they would like to work on.
  • We address patient requests and needs on a case-by-case basis while maintaining consistency and stability of the program therapeutic milieu and structures.
  • We listen to and respect how patients want to work their recovery. Each patient has a say in what happens in their treatment. We obtain informed consent for the treatment we provide.
  • We encourage patients to ask questions, and provide assistance with getting answers.
  • We allow family members to pursue treatment together if they wish, but will create a program where family might be in some groups and individual therapy together, and not be together in other groups and individual sessions.
  • Each patient has an individualized, formulation-driven treatment plan based on his or her unique strengths, vulnerabilities, goals, and preferences.
  • We match treatment to need. We offer patients choice and flexibility. We individualize the type and amount of individual and group therapy patients receive, mindful of the benefit plans of insurance payers. While we have generic groups pertinent to everyone, we also have specialty groups for specific patient needs.
  • Since mutual help groups enhance recovery, we encourage their use. We educate patients on options and help them choose the groups that they prefer.
  • We offer “Stagewise” treatment, recognizing that patients are at different points in their readiness to deal with their problems and that focusing on one problem over another is helpful at different stages of recovery.

 

Patient-Empowering

  • While the issue of “powerlessness” can be helpful to some by facilitating turning to outside resources for help, including a “Higher Power,” The Haven also recognizes that, particularly for women with trauma and abuse histories, a key goal of treatment is empowerment. The Haven strives to empower patients while recognizing the need for outside assistance in the self-empowerment process.
  • We empower patients to manage their own recoveries. We avoid authoritarian relationships and instead cultivate relationships of mutual respect and collaboration.
  • We strive to build patients’ confidence that they can succeed and make positive changes.

 

Recovery and Discovery Oriented

  • We embrace the paradox of holding up to patients an ideal of recovery while honoring and insisting on their need to create their own personal ideals unique to them as to how to live a joyful and meaningful life.
  • We are also Discovery-Oriented, however, supporting patients’ desires to find a way to live with more happiness and less distress even if they are using addictive and consciousness-altering substances. We honor where people are while helping them to discover what is best for them. We provide treatment for patients with both abstinence and non-abstinence goals, while taking care to make sure those not committed to abstinence do not jeopardize the recovery of those who are committed to abstinence. We refrain from judging those in recovery from one substance who use other addictive substances, recognizing it is each patient’s task based on their values and beliefs to decide whether to alter their consciousness with addictive substances.
  • We ascribe to a harm-reduction philosophy. We do not terminate treatment for patients who continue to manifest addiction with recurrence of signs and symptoms, as long as they are working in treatment on their stated treatment goals.
  • While we help patients understand the costs of addiction, we place equal emphasis on understanding how patients’ use of substances or addictive behaviors makes sense to them. We then help patients see if anything else could make more sense.

 

Total Recovery Oriented

  • We are “Total Recovery” oriented, meaning that we encourage patients to not harm themselves in any way by continuing addicting substances or behaviors. We support and encourage the practice of learning to live a joyful life without using consciousness-altering substances.
  • As much as possible, we embed treatment in the patient’s life. We recognize the importance of helping clients to heal and develop a full life to compete with the pull of their substance use or other addictive behaviors. We address the “Six foundations of recovery”: Motivation, coping with cravings, managing emotions, nurturing relationships, lifestyle balance, finding purpose in life.
  • We teach a balance of work, love, and play. Patients receive a personal exercise training program, a personal recreation plan, education on healthy nutrition, and are encouraged to engage in a daily spiritual practice.

 

Comprehensive and Integrated Treatment

  • We conduct comprehensive, biopsychosocialspiritual assessments. We gather information from patients and their collaterals. When using structured assessment tools, we use valid and reliable assessment tools.
  • Medical assessment and screening includes screening for infectious diseases such as HIV/AIDS, hepatitis B and C, and tuberculosis.
  • We access patient’s strengths while addressing their vulnerabilities, including psychiatric illnesses, trauma, low self-esteem, anger issues, and stress intolerance.
  • We provide comprehensive, integrated psychiatric care for addiction and other psychiatric illnesses. We recognize that 50% or more of patients in substance use or addiction treatment have one or more other psychiatric illnesses. We recognize that rates of trauma can be upwards of 55%, and thus provide trauma-informed treatment. We do not consider one illness as “primary” and others as “secondary.” We consider all psychiatric illnesses, including addiction, as “Primary.”
  • We attend to the whole person, not just their problematic substance use or behaviors. We address all social and clinical problems, either directly or by referral.
  • We promote addiction psychopharmacology, but encourage the use of medications in the context of a larger recovery treatment plan. We encourage patients to stay on medication to minimize recurrence of signs and symptoms of addiction if that is their wish. Patients on buprenorphine are encouraged to transition to naltrexone if they choose to reduce their dose and terminate buprenorphine treatment.
  • We provide treatment of gender-specific issues.
  • We provide access to outside resources for treatment of specific issues as needed: e.g. eating disorders, behavioral addictions, neuropsychological testing and treatments.
  • We understand that treatment needs to address living skills. We provide a life skill-enhancement approach to addictions treatment. We provide habilitative and rehabilitative services for addressing problems of living, either directly or through referral. We work to enhance living skills such as cooking, shopping, cleaning, parenting, childcare, and financial management. We provide or arrange for recreational therapy, legal assistance, housing assistance, financial assistance, and vocational skills assistance.
  • We teach stress management skills. We help people learn to manage life’s challenges.

 

Recovery Support Oriented

  • We are a “Recovery Support” organization. We focus less on acute treatment, though that is important, and more on sustaining recovery over the long term.
  • We recognize that medically-assisted withdrawal management is only the first stage of addiction treatment and by itself does little to change long-term addictive drug use. Withdrawal management needs to be followed by long-term recovery support treatment.
  • We avoid the term “relapse” because we recognize that acute exacerbations of addiction is not an all-or-nothing phenomenon. We do not believe that people must “start over” if they reengage in addictive substance use or addictive behaviors. We consider episodes of flare-ups of addiction as opportunities for learning and growth. If treatment is not working, we do not blame the patient. Rather, we look with the patient at how they might want to change their treatment based on an assessment of what is not working for recovery. We provide shame reduction. We normalize reoccurrence of signs and symptoms of addiction. We provide encouragement and teach the value of patience, persistence, faith, and hope. We use flare-ups of addiction as an opportunity to assess the reasons for a poor treatment outcome. We help people to handle setbacks. We proactively teach patients what to do if they slip. Patients leave with a slip management plan.
  • We provide alumni support services, including weekly groups, monthly individual therapy, recovery support outreach, and plan to create an online recovery community.

 

Community, Family, and Network Oriented

  • We involve families and other collaterals in the treatment. We provide family education and support, including for co-occurring disorders. We provide family and couples treatment before, during, and after a patient’s treatment with us.
  • We actively collaborate with patients’ outside providers. We will even facilitate transportation to appointments during treatment.
  • We work to create a network of social and clinical supports and resources to help patients’ recovery both during and after acute intensive treatment.
  • We provide case management services to link patients to needed social and clinical resources.

 

Evidence-Based, Cutting Edge, Effective Treatment

  • As much as possible, we endorse and utilized evidence-based treatments (e.g. SAMHSA’s National Registry of Evidence-based Programs and Practices—NREPP. https://nrepp.samhsa.gov/AllPrograms.aspx):
    • CRAFT (Community Reinforcement and Family therapy). Both for families of existing and former patients but also as a community service to families in distress who’s loved one are not (yet) in treatment with us.
    • CBT (Cognitive Behavioral Therapy)
      • Craving management
      • Trigger management
      • Management of readdiction
      • Drug-Drink refusal skills.
    • Contingent Reinforcement
    • Family/couples therapy
    • Individual therapy.
    • Neurofeedback
    • Addiction psychopharmacology
    • Individual and group psychotherapy
    • Trauma therapy
    • DBT (Dialectical Behavioral Therapy)
    • While we recognize that there is no evidence base for experiential therapies, we incorporate these activities together with a licensed therapist or AOD counselor to help teach patients how to have a balanced life that includes the capacity to play.
    • Since mutual recovery support groups enhance abstinence, we provide mutual recovery support group facilitation. We expose patients to the available options and educate them about these options. This includes providing support for attendance at Dual Recovery Anonymous, Double Trouble in Recovery groups, if available, and alumni groups. We encourage patients to develop a schedule of mutual help meetings according to their preferences.
  • We provide active learning. We minimize passive learning, such as lectures.
  • We provide treatment sensitive to the presence of cognitive impairment when this is an issue.
  • We understand that the therapist matters. We recognize the quality of the treatment relationship as being of utmost importance. If a patient is struggling in their therapy, we intervene to heal the treatment alliance or we offer patients a choice of another therapist.
  • We embrace and use technology-enhanced treatment.

 

Commitment to Long Term Care and Recovery

  • We recognize that recovery is a life-long process that goes far beyond abstinence to healing and skill building to ultimately developing a fulfilling, meaningful, and joyful life; we are here for our patients for the long run. We see the need for treatment sometimes for years or even decades to help patients achieve their goals, with treatment changing over time as patients heal and grow. We understand that persistence and consistency matter. Since retention in treatment is the strongest predictor of long-term recovery, our primary goal is helping patients stay in effective treatment for as long as they need it.
  • We develop long-term partnerships with patients, their families and their community support systems.