Substance Abuse and Co-occurring Mental Health Disorder

Comprehensive Biopsychosocial Assessment

A comprehensive assessment is completed at the time of admission.  All assessments are performed by clinicians who have at least a Master’s Degree and are credentialed through MCBAP. Therapists are proficient with distinguishing between mental health and substance abuse disorders and their influence on each other.

The assessment includes a significant mental status examination along with a comprehensive grid of alcohol/drug usage and trauma, family, social, legal and educational influences. Ancillary information is requested and made part of the assessment process.

Mother and daughter smiling and hugging

Treatment Plans

All clients are involved in the development and updating of their treatment plan. Clients develop their own goals in their own words with the assistance of the clinical staff.

The goals are measurable, achievable, relevant and time orientated. To maintain motivation and positive outcomes, treatment goals are designed accordingly to each of the client’s respective problems and modified over the course of treatment.

Case Management

Case management services are intended to support, promote recovery and prevent relapse through services that result in the knowledge and skills necessary to enhance an individual’s recovery.  Case management services are available throughout the course of  care which include, but are not limited to:

  • Transportation
  • Housing
  • Basic Needs
  • Health Issues
  • Legal Problems
  • Employment
  • Education
  • Community Support Groups

It is a basic expectation that clients will become aware of and instructed how to access a variety of services within their community.

Co-occurring Services

group conselling

All treatment modalities include the treatment of co-occurring issues utilizing a simultaneous treatment model.  Our therapists understand that co-occurring diagnosis is an expectation, not an exception with the population we serve. This expectation is included in every aspect of system planning, program design, clinical procedure and clinician competency.  It is incorporated in a welcoming manner into every clinical contact.

Our assessments, treatment planning and program staff are licensed through the State of Michigan and credentialed to provide substance use treatment through MCBAP. Staff have the skill sets to make reliable diagnostic judgments in the presence or absence of all clinical features.

We treat the mental illness and substance disorder simultaneously with each disorder considered primary.  We understand that treatment success with the co-occurring population is dependent upon empathic, hopeful treatment relationships.  Lastly, our co-occurring services incorporate strength based comprehensive case management services inclusive of family education, peer supports and alumni service to maintain a lasting therapeutic network of supports.

Trauma Informed Services

Trauma informed services will be reflected in all aspects of treatment care and interactions with the client; inclusive of welcoming and customer services and verbal and nonverbal language expressed with clients.

A critical component of our trauma informed treatment services revolves around “timing and pacing.”  Simply put, trauma is addressed when the client is ready to explore experiences of trauma.  Timing is directed by the client and client boundaries are respected.  Our staff are sensitive toward clients vulnerabilities and triggers and to not exacerbate or re-traumatize clients through poor timing and pacing principles.

Trauma informed trainings include the following principles:

  • Respecting clients boundaries
  • Attaining trust
  • Clear expectations
  • Consistent rules
  • Safe, stable & secure environment
  • Flexibility
  • Normalizing PTSD
  • Respecting privacy
caring hand for a military person

Outpatient Services

teacher and her student

The primary goal of outpatient treatment is to provide a continuity of care which addresses each client’s individual needs and goals.  Programming includes a wide array of services devoted to the individual needs of clients with co-occurring substance use and mental health disorders through simultaneous treatment models compatible with trauma informed care. Services are individualized and client directed.  Treatment services address, but are not limited to depression, anxiety, social concerns, trauma, disability, employment, relapse prevention and recidivism. Our programming emphasizes the empowerment and responsibility of the client and significant others.  Every client is entitled to experience the promise and hope of recovery and wellbeing.

Intensive Outpatient: Services consist of three – 3 hour groups and two – 1 hour individual sessions per week.

Enhanced Outpatient: Services consist of two – 3 hour groups and two – 1 hour individual sessions per week.

Residential Services

Admissions are based upon the American Society of Addiction Medicine (ASAM) and DSM-5 admissions criteria.  Service modalities are comprehensive; treating co-occurring substance use, mental health and physical health disorders through simultaneous treatment models compatible with Trauma Informed Care.

Adult and adolescent residential programs provide five hours of clinical services seven days a week 365 days a year. Residential services encompass gender specific groups, individual, family and case management and recovery service. We incorporate Recovery Orientated Systems of Care (ROSC) principles and trauma informed services through all treatment modalities.  Programming is directed toward treating the entire person and how they perceive their concerns. The value of each day during residential services is promoted to advance and secure clients recovery.

The length of residential services is dependent upon the client’s progression towards meeting treatment goals and objectives; usually three to four weeks and up to 90 days depending upon specific contracts, insurance benefits and/or clients progress toward treatment goals. It is expected that clients will continue with step-down services once discharged from residential services.  A Continued Care Plan outlining recommended steps following residential services will be completed prior to discharge.

kids playing with bubbles

Therapeutic Activities Provided:

  • Intensive Group Therapy- Three hours daily – 7 days a week
  • Focus Group-  Two hours daily – 7 days a week
  • Education- Five hours- Weekdays
  • Family Therapy-Weekly
  • Individual Therapy Weekly
  • Recreation Activities- Daily
  • Didactic Group PRN
  • Big Book / 12 Step group Weekly/PRN
  • Access to medical care PRN
  • Consults with referrals /service agencies PRN
  • Discharge planning/Continued Care Services Over the Course of Care

Therapeutic Activities Focus:

  • Internal and External Developmental Assets
  • Trauma
  • Crisis Stabilization
  • Healthy Boundaries – physical, emotional, sexual and mental
  • Family Systems / Improved Family Roles and Relationships
  • Improved Behaviors / Decision Making
  • Abstinence / Harm reduction from illicit substances
  • Triggers – awareness and resolution
  • Defense Mechanisms – awareness and adaptive strategies
  • Peer Pressure – awareness and adaptive strategies
  • Resiliency – ecological approach toward risk and protective factors
  • Powerlessness – loss of control
  • Unmanageability
  • Big Book / AA, NA
  • Wellness
  • Effective communication
  • Anger Management & Impulse Control

Women’s Specialty Residential Programs

group of women reading books

Our women specialty residential program is a State of Michigan women specialty designated program. Women specialty services will focus primarily on pregnant women, women with dependent children and for women whose children have been removed from the home or are at risk of being removed.  The program is designed so that women may bring their non-school aged children into treatment with them.  Services are available for children while their mother is in therapy each day. Our women’s program incorporates a variety of health, parenting, child care, case management, medical care and education services substance abuse treatment combined.

Our women specialty programming adheres to the five federal requirements for women’s specialty services:

  1. Primary medical care for women who are receiving substance abuse treatment.
  2. Primary pediatric care for their children including immunizations.
  3. Gender specific substance abuse treatment and other therapeutic interventions for women that may address issues of relationships, sexual and physical abuse and parenting.
  4. Child care while the women are receiving these services, therapeutic interventions for children in custody of women in treatment which may, among other things, address their.
  5. Case management and transportation services to ensure that women and children have access to the services provided in the first four requirements.

Evidence-Based Practice and Treatment Interventions

We are committed to utilizing “Evidence-Based Practices” to provide the philosophy and treatment models which provide effective treatment.  “Best Practices” and “Promising Program Practices” are also utilized; interventions which are often based on the collective experience and wisdom of the field.

Prominent Evidence-Based Programs currently utilized are:

  • Motivational Enhancement Therapy
  • Motivational Interviewing
  • Cognitive Behavioral Therapy
  • Seeking Safety

The above models are viewed as mutually supportive of each other.  We have found these models to be remarkably versatile.

We utilize “Stage-Wise” interventions that identify the consumers’ level of motivation and “change resources.”  This allows staff to develop meaningful interventions that specifically address where the consumer lies along the continuum of change. Our interventions adapt to the consumer in contrast to requiring consumers to adapt to a predetermined program. We encourage honesty rather than compliance. We accept the consumers’ beliefs, values and input regarding their course of treatment. We understand that clients entering treatment either voluntary or involuntary are likely to have beneficial outcomes with motivational enhancement strategies adapted to meet the clients goals and needs.

We believe that gender specific groups are beneficial for both genders. Our gender specific groups focus on the different needs and treatment processes preferred by men and women. We are familiar with and utilize the Seeking Safety Model and have a credentialed Seeking Safety Trainer on our staff.