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Drug and Alcohol Treatment Stages

With the completion of each stage, the patient progresses to become a healthier, more productive member of society.The Caring Together program uses a four-stage treatment plan, based on the one developed by the National Institute on Drug Abuse for its "Principles of Drug Addiction Treatment: A Research Based Guide."

In order to graduate from the program, patients must complete the four stages, which help them identify issues that negatively impact their lives and develop the skills needed to overcome those challenges. With the completion of each stage, the patient progresses to become a healthier, more productive member of society.

While each stage has its own specific requirements (number of positive drug tests allowed, number of meetings that need to be attended, etc.), they all share a set of core components.

All patients must:

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  • Submit to regular drug testing
  • Attend all therapeutic groups
  • Attend one individual session a week (and complete exercises/homework as assigned)
  • Meet with program psychiatrist
  • Meet with program case manager
  • Meet with child development staff
  • Attend 2 AA/NA/CA meetings a week (one must be on a weekend)
  • Complete other short term goals

Below, you'll find each individual stage with its specific requirements.

STAGE IV (Early)

In order to successfully complete stage IV, the individual must meet all preliminary treatment plan goals within a 90-day period. These include:

  1. Submit six urine samples (minimum of two a month and as requested by treatment team), only two of which, in 90 days, can be positive for substance use. A client will also be considered positive by self-report.
  2. Attend all five therapeutic groups, which will include but not be limited to topics such as parenting skills/issues, addiction issues, dual diagnosis issues (including the role of past trauma in current addiction - TREM), life skills, and women's issues on a weekly basis with a minimum attendance rate of 90% (i.e., no more than two unexcused absences a month with a 5-day-a-week attendance requirement).
  3. Attend a minimum of one individual session a week and as scheduled.
    1. Complete any therapeutic exercises/homework as assigned.
    2. By the end of this stage, client will be able to identify:
      • Typical self-rationalizations (excuses/reasons) for use
      • Triggers and patterns (people, places, and things)
      • Obsessive thinking
      • List of negative consequences for use (reasons not to use)
      • List of support people and means of contact
  4. Meet with the program psychiatrist within the first 30 days of entering the program, attend all subsequently scheduled appointments with the psychiatrist, and take all medications as prescribed, if applicable.
  5. Meet with the program case manager within the first 30 days.
  6. Meet with the child development staff within the first 30 days.
  7. Attend minimum of one weekend (Friday/Saturday/Sunday) AA/NA/CA meeting a week and one additional meeting a week (client will be required to submit regular meeting confirmation slips signed by AA/NA/CA meeting leader).
    1. Obtain temporary sponsor and identify potential permanent sponsor.
  8. Achieve any other short-term goals (as agreed upon by client and treatment team) listed on preliminary treatment plan, and participate in the development of the comprehensive treatment plan.

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STAGE III (Middle)

In order to successfully complete stage III, the individual must have successfully completed stage IV and within a 90-day period must:

  1. Submit six urine samples (minimum of two a month and as requested by treatment team), only one of which in 90 days can be positive for substance use. A refusal, as well as a self-report, is considered a positive.
  2. Attend all therapeutic groups as required by current comprehensive treatment plan, which will include but not be limited to topics such as parenting skills/issues, addiction issues, dual diagnosis issues (including the role of past trauma in current addiction - TREM), life skills, and women's issues on a weekly basis, with a minimum attendance rate of 90% (i.e., no more than two unexcused absences a month with a 5-day-a-week attendance requirement).
  3. Attend a minimum of one individual session a week and as scheduled.
    1. Complete any therapeutic exercises/homework as assigned.
    2. By the end of this stage, client will be able to identify:
      • Alternatives to using
      • Losses associated with past use
      • Ongoing mental health issues/symptoms which may be present
      • Spiritual needs (if applicable)
  4. Attend all scheduled appointments with the psychiatrist (if applicable) and take all medications as prescribed (if applicable).
  5. Attend minimum of one weekend (Friday/Saturday/Sunday) AA/NA/CA meeting a week and one additional meeting a week (client will be required to submit regular meeting confirmation slips signed by AA/NA/CA meeting leader).
    1. Obtain permanent sponsor.
  6. Make an honest, positive contribution (as determined by treatment team and peers) in group sessions at least once a week.
  7. Complete initial short-term therapeutic goals from comprehensive treatment plan.
  8. Meet as needed with the program case manager re: assistance with housing, employment, referrals for medical treatment for self and children (if applicable).

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STAGE II (Late)

In order to successfully complete stage II, the individual must have successfully completed stage III and within a 90-day period must:

  1. Submit a minimum of six urine samples (minimum of two a month and as requested by treatment team) for 90 consecutive days, none (0) of which are positive for substance use. A refusal, as well as a self-report, is considered a positive.
  2. Attend all therapeutic groups as required by current comprehensive treatment plan, which will include but not be limited to topics such as parenting skills/issues, addiction issues, dual diagnosis issues (including the role of past trauma in current addiction - TREM), life skills, and women's issues on a weekly basis with a minimum attendance rate of 90% (i.e., no more than two unexcused absences a month with a 5-day-a-week attendance requirement).
  3. Attend minimum of one individual session a week and as scheduled.
    1. Complete any therapeutic exercises/homework as assigned.
    2. By the end of this stage, client will be able to:
      • Identify and implement successful anger management/reduction strategies.
      • Identify and implement successful coping strategies for depression, emptiness, and anxiety.
      • Successfully integrate/use all of the 12 steps in daily life.
  4. Attend all scheduled appointments with the psychiatrist (if applicable) and take all medications as prescribed (if applicable).
  5. Attend minimum of one weekend (Friday/Saturday/Sunday) AA/NA/CA meeting a week and one additional meeting a week (client will be required to submit regular meeting confirmation slips signed by AA/NA/CA meeting leader).
    1. Maintain regular contact with permanent sponsor.
  6. Make an honest, positive contribution (as determined by treatment team and peers) in group sessions at least once a week, and provide truthful accounting of any relapses and plans for relapse prevention in future.
  7. Complete subsequent short-term therapeutic goals from comprehensive treatment plan, especially as they relate to obtaining needed services for children (if applicable).

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STAGE I (Maintenance/Graduation)

In order to successfully complete stage I, the individual must have successfully completed stage II and within a 90-day period must:

  1. Submit a minimum of six urine samples (minimum of two a month and as requested by treatment team) for 90 days, none (0) of which are positive for substance use. A refusal, as well as a self-report, is considered a positive.
  2. Attend all therapeutic groups as required by current comprehensive treatment plan, which will include but not be limited to topics such as parenting skills/issues, addiction issues, dual diagnosis issues (including the role of past trauma in current addiction - TREM), life skills, and women's issues on a weekly basis with a minimum attendance rate of 90% (i.e., no more than two unexcused absences a month with a 5-day-a-week attendance requirement).
  3. Attend a minimum of one individual session a week and as scheduled.
    1. Collaborate with treatment team regarding aftercare planning and preparation, which includes:
      • Identifying therapeutic support group for maintenance.
      • Identifying plans for adequate food, shelter, income, and employment training (if needed).
      • Identifying provider for psychiatric and medication monitoring (if applicable) and making first appointment.
      • Identifying provider for continuing outpatient mental health therapy (if applicable).
      • Identifying emergency/crisis plan in case of significant change in biological, psychological, or social status or potential relapse.
      • Identify social support network of persons that will promote recovery.
      • Identify transportation resources to all needed aftercare services.
    2. Complete any therapeutic exercises/homework as assigned.
  4. Attend all scheduled appointments with the psychiatrist (if applicable) and take all medications as prescribed (if applicable).
  5. Attend a minimum of one weekend (Friday/Saturday/Sunday) AA/NA/CA meeting a week and one additional meeting a week (client will be required to submit regular meeting confirmation slips signed by AA/NA/CA meeting leader).
    1. Maintain regular contact with permanent sponsor.
  6. Make an honest, positive contribution (as determined by treatment team and peers) in group sessions at least once a week, provide truthful accounting of any relapses and plans for relapse prevention in future, and begin to take on a mentoring role with early stage group members if approved by counselor.
  7. Complete long-term goals from comprehensive treatment plan.

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Note: At any stage, the treatment team can decide to place a client in a different stage, supported by corresponding clinical evidence.

The information on these pages is provided for general information only and should not be used for diagnosis or treatment, or as a substitute for consultation with a physician or health care professional. If you have specific questions or concerns about your health, you should consult your health care professional.

The images being used are for illustrative purposes only; any person depicted is a model.

 

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