What are the evidence based care essential components?

FACT: As of today there are no national standards for addiction treatment.

rock-off-shore-chi-recovery-evidence-based-care-essential-components What there is, however, is a vast body of research and reports indicating that our established methods for addressing addiction disorder have failed miserably. The good news is that, in recent years, there have been dramatic advances made in our understanding of substance abuse.  New healthcare therapies have arisen and are proving to be the most effective to date. Below, you will see how CHI Recovery embraces all of the evidence-based care essential components found in the CASAColumbia Report.

Unfortunately, too many programs cherry-pick the least expensive elements from evidence-based standards of care, wrongfully asserting compliance. In fact, there are fourteen (14) “essential” compliance standards for evidence-based care put forth by CASAColumbia and recommended by most national associations. These standards do not suggest that you can do two to three of these elements to be compliant—“evidence based,” under these recommendations, require that ALL essential features are addressed.

CHI Recovery is fulfilling all 14 of the evidence based care essential components addressed by the CASAColumbia’s Research Report to treat Substance Use Disorder.

  1. SCREENING FOR APPROPRIATE CARE

INTAKE SCREENING METHODS

  • conducted by licensed providers (MFTs, Psychologists)
  • behavioral healthcare providers have both 10-years treating addiction and complex co-occurring disorders
  • screeners have specific training in how to conduct screens
  1. BRIEF INTERVENTIONS
  • Intakes and Assessments administered by mental health professionals who are licensed (unencumbered) in field of psychology and are post-graduate-level— read well between the lines and are trained in Motivational Interviewing
  • All professional providers from Mental Health to Eastern Medicine are specifically trained in addiction
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    Photo: Olia Gozha/Upsplash

    COMPREHENSIVE ASSESSMENTS

  • Forms Utilized: Early Evaluation 1, (online, introductory), Early Evaluation 2 (live at Intake), WHODAS, Cross Cutting Inventories, Intake form and Brief Personal History (day after intake and every 3 months)
  • Medical Assessment includes full panel blood workup and comprehensive physical exam by general practitioner Medical Doctor
  • Individual’s needs evaluated and assisted: housing, transportation, nutrition, psych evaluation, relationships… and Integrative medical from Eastern and Western perspectives
  1. PATIENT STABILIZATION
  • Medically supervised outpatient detox
  • Case Management support during detox
  • Orenda Detox Center (County-run) for three-day on-site detox support
  • Nursing support as needed (Add-On)
  • Intensive acupuncture for pain management during detox and following for co-occurring conditions
  • Nutritional supplements for health restoration
  • Gym membership with FAR Infrared Sauna for detox

CHI’s evidence based care essential components are what makes effective treatment

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    Photo: Erol Ahmed

    TAILORED TREATMENT PLANS

  • Acute treatment via evidence-based psychosocial and/or pharmaceutical interventions
  • Chronic disease management
  1. TREATMENT & DISEASE MANAGEMENT
  • provided through a multi-disciplinary team of appropriately trained credentialed health professionals
  • Assessments given every three-months, on entrance and on exit from Program
  • managed by a physician
  • four follow-up medical appointments with physician or physician’s assistant
  1. PHYSICIAN MANAGED
  • comprehensive assessment and blood panel, AIDS and STD screening, nutritional and eating disorder review; other symptoms and complaints
  • diagnosis
  • stabilization and outpatient detox with medication
  • acute treatment
  • pharmaceutical support
  • disease management must be performed or managed by physicians
  • Suboxone (buprenorphine and naloxone) used rarely, but is available in extreme cases (used once to date)
  1. COLLABORATIVE CARE
  • integrated team—MD, acupuncturist, nutritionists, team of therapists and highly engaged care manager
  • licensed, graduate-level medical and mental health clinicians
  • all professional providers have specific training and/or certification in addiction care
  • on-going trainings provided
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    Photo: Miguel Ibanez/Upsplash

    PROFESSIONAL REFERRALS

  • to additional physicians trained in addiction medicine
  • addiction psychiatry for specialty care as needed—used regularly
  • also offer somatic release bodywork
  • health and nutritional consult included
  • intensive individual therapy
  • intensive group therapy
  • relational counseling
  • we do not use addiction counselors for therapy services
  1. CONNECTION
  • to support and auxiliary services legal, educational, employment
  • housing and family support nutrition and exercise counseling
  • mutual support programs
  1. CASE MANAGEMENT
  • the individual therapist drives the behavioral healthcare treatment plan while the MD drives the physical healthcare treatment plan
  • the acupuncturist contributes to the knowledge of the treatment team and manages most modest to mid-level pain management needs; nutritional support, and organ systems revitalization
  • The Program Manager (PM) collaborates with all involved providers and determines the treatment plan customizations for more complex, interacting conditions, (i.e. Bi-Polar)
  • Care Managers (CM) have a “transformational coaching” role and are on-site (in the field) managers of all conflicts, AWOLS, and Relapses and are first responders to most other outpatient issues and crisis that arise
  • The PM is the authority over all treatment and disciplinary adjustments and emergency responses
  1. AUXILIARY SERVICES
  • Provided by a range of professional and paraprofessional personnel
  • working within the treatment and disease management plan, PM and CM control all probation reports, volunteer implementations and educational and work opportunities
  1. PEER SUPPORT
  • require one home meeting a minimum of two sober support meetings per week (of any kind)
  • require a Sponsor or Sober Mentor
  • require 30 meetings in 30 days and 20 meets thereafter, however these may include yoga and Tai Chi or Chi Gung, meditation, Center for Spiritual Living classes, Arts and Ecology Center, and other spaces where self-awareness and personal responsibility grows. (Alternatives are approved by the PM).
  1. DURATION OF CARE
  • Treatment optimally lasts six months. We are adding a three-month and a one-month minimum plan, in order to serve more of those in need and financially strapped.
  • Treatments are active 6-12 months, on average.

Other Recommendations:

  • Holistic
  • Integrative
  • Community Reinforced
  • Sustained Support

To learn more about how to get started on the road to addiction recovery, please click here: I Am Ready.