Step 3: Intake
New patients are asked to arrive 20 minutes before the session to complete paperwork and sign necessary releases of medical information from other providers and institutions. The first questions asked are: “How did you feel about the orientation? What are your concerns? Can you imagine succeeding in this program? Where do you see yourself regarding willingness to change?” We always ask: “What is the lowest dose of Suboxone you can function at?”
Almost 100% of our patient population has been taking Suboxone on the street and are familiar with personal dosing. It is not uncommon for some individuals to share honestly: “I can be fine on 4 mg a day.” or “I can get by on 4 mg but I would rather have 8.” This important information is recorded and shared so the medical provider will be prepared to engage in an honest discussion at their first appointment.
The history is taken with a special emphasis on an individual’s substance abuse history and is standardized with the hope of creating an area-wide data base set from which outcome research can grow. We are most interested in understanding previous experiences with treatment and what has “worked” or “not worked” in the past. We are aware that many individuals enter treatment for substance abuse multiple times and may succeed after multiple attempts. Program members are reminded that there is a mandatory initial 10 week “Skill Building Group” and 10 Week Individual counseling requirement followed by the assignment to a long term, weekly “home” recovery group.
Every new program member is given a copy of the signed treatment contract as well as the specific information regarding the start date of the Skill Building Group (usually an evening group, 5:00-6:30pm) and the phone number of the individual substance abuse-trained counselor (preferably LCSW/LADC) who is in partnership or on staff with the program. This counselor will be providing the individual counseling for 10 weeks at a minimum and be in close communication with (or a member of) program staff.
We STRONGLY encourage program members to remain in individual counseling and stress the importance of healing from the “inside out” to truly recover from addiction. Many program members have high (above 4) ACE (Adverse Childhood Event) scores. We speak directly about the need to address trauma and the improved outcome with comprehensive treatment. If a person is already in counseling, we ask to be able to speak to their therapist to share our program model and assess if our concerns can be incorporated in their work together. We also support involvement in 12 step groups. We cannot require attendance in 12 step groups but speak often of the benefit of developing ongoing, relationships with others in recovery following the 12 step model.