The Substance Abuse and Mental Health Services Administration (SAMHSA) is a branch of the U.S. Department of Health and Human Services. Established in 1992 by congress, SAMHSA’s mission is to reduce the impact of substance abuse and mental illness on American’s communities.
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Levels of Care:
Intensive Outpatient Programs (IOP) are for those who want or need a very structured treatment program but who also wish to live at home and continue with certain responsibilities (such as work or school). IOP substance abuse treatment programs vary in duration and intensity, and certain outpatient rehab centers will offer individualized treatment programs.
Outpatient Programs (OP) are for those seeking mental rehab or drug rehab, but who also stay at home every night. The main difference between outpatient treatment (OP) and intensive outpatient treatment (IOP) lies in the amount of hours the patient spends at the facility. Most of the time an outpatient program is designed for someone who has completed an inpatient stay and is looking to continue their growth in recovery. Outpatient is not meant to be the starting point, it is commonly referred to as aftercare.
Certain drug and alcohol rehabs have standard treatment regimes they expect all patients to follow. Others offer individualized treatment, meaning they tailor treatment to a person’s specific background and needs. For example, a rehab facility may adjust a treatment program to take into account the type of drug or addiction from which the person suffers, their age, medical condition(s), religious beliefs, or lifestyle.
12-step programs are addiction recovery models based on Alcoholics Anonymous (AA). A number of substance abuse programs (including some drug and alcohol rehab centers) use the 12 steps as a basis for treatment. Beginning steps involve admitting powerlessness over the addiction and creating a spiritual basis for recovery. Middle steps including making direct amends to those who’ve been hurt by the addiction, and the final step is to assist others in addiction recovery in the same way. 12-Step offshoots including Narcotics Anonymous (NA), Cocaine Anonymous (CA), Dual Recovery Anonymous (DRA), Sex and Love Addicts Anonymous (SLAA) and Gamblers Anonymous (GA).
Completing a drug or alcohol rehab program shouldn’t spell the end of substance abuse treatment. Aftercare involves making a sustainable plan for recovery, including ongoing support. This can include sober living arrangements like halfway houses, career counseling, and setting a patient up with community programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA).
Opioid rehabs specialize in supporting those recovering from opioid addiction. They treat those suffering from addiction to illegal opioids like heroin, as well as prescription drugs like oxycodone. These centers typically combine both physical as well as mental and emotional support to help stop addiction. Physical support often includes medical detox and subsequent medical support (including medication), and mental support includes in-depth therapy to address the underlying causes of addiction.
The goal of treatment for alcoholism is abstinence. Those with poor social support, poor motivation, or psychiatric disorders tend to relapse within a few years of treatment. For these people, success is measured by longer periods of abstinence, reduced use of alcohol, better health, and improved social functioning. Recovery and Maintenance are usually based on 12 step programs and AA meetings.
Mental Health and Substance Abuse:
A combined mental health and substance abuse rehab has the staff and resources available to handle individuals with both mental health and substance abuse issues. It can be challenging to determine where a specific symptom stems from (a mental health issue or an issue related to substance abuse), so mental health and substance abuse professionals are helpful in detangling symptoms and keeping treatment on track.
Many of those suffering from addiction also suffer from mental or emotional illnesses like schizophrenia, bipolar disorder, depression, or anxiety disorders. Rehab and other substance abuse facilities treating those with a dual diagnosis or co-occurring disorder administer psychiatric treatment to address the person’s mental health issue in addition to drug and alcohol rehabilitation.
Rational Behavior Therapy:
Rational Behavior Therapy (RBT) is a form of cognitive behavioral therapy meant to be short-term and comprehensive. It was intended to help clients become more self-sufficent and move forward without the need for expensive, ongoing therapy. It includes an emotional self-help method called “rational self-counseling,” the purpose of which is to give clients all the skills needed to handle future emotional issues by themselves, or with significantly less professional help.
Research clearly demonstrates that recovery is far more successful and sustainable when loved ones like family members participate in rehab and substance abuse treatment. Genetic factors may be at play when it comes to drug and alcohol addiction, as well as mental health issues. Family dynamics often play a critical role in addiction triggers, and if properly educated, family members can be a strong source of support when it comes to rehabilitation.
Cognitive Behavioral Therapy:
Cognitive Behavioral Therapy (CBT) is a therapy modality that focuses on the relationship between one’s thoughts, feelings, and behaviors. It is used to establish and allow for healthy responses to thoughts and feelings (instead of unhealthy responses, like using drugs or alcohol). CBT has been proven effective for recovering addicts of all kinds, and is used to strengthen a patient’s own self-awareness and ability to self-regulate. CBT allows individuals to monitor their own emotional state, become more adept at communicating with others, and manage stress without needing to engage in substance abuse.
Dialectical Behavior Therapy:
Dialectical Behavior Therapy (DBT) is a modified form of Cognitive Behavioral Therapy (CBT), a treatment designed to help people understand and ultimately affect the relationship between their thoughts, feelings, and behaviors. DBT is often used for individuals who struggle with self-harm behaviors, such as self-mutilation (cutting) and suicidal thoughts, urges, or attempts. It has been proven clinically effective for those who struggle with out-of-control emotions and mental health illnesses like Borderline Personality Disorder.
In individual therapy, a patient meets one-on-one with a trained psychologist or counselor. Therapy is a pivotal part of effective substance abuse treatment, as it often covers root causes of addiction, including challenges faced by the patient in their social, family, and work/school life.
Trauma therapy addresses traumatic incidents from a client’s past that are likely affecting their present-day experience. Trauma is often one of the primary triggers and potential causes of addiction, and can stem from child sexual abuse, domestic violence, having a parent with a mental illness, losing one or both parents at a young age, teenage or adult sexual assault, or any number of other factors. The purpose of trauma therapy is to allow a patient to process trauma and move through and past it, with the help of trained and compassionate mental health professionals.
Group therapy is any therapeutic work that happens in a group (not one-on-one). There are a number of different group therapy modalities, including support groups, experiential therapy, psycho-education, and more. Group therapy involves treatment as well as processing interaction between group members.
Whether a marriage or other committed relationship, an intimate partnership is one of the most important aspects of a person’s life. Drug and alcohol addiction affects both members of a couple in deep and meaningful ways, as does rehab and recovery. Couples therapy and other couples-focused treatment programs are significant parts of exploring triggers of addiction, as well as learning how to build healthy patterns to support ongoing sobriety.
Motivational Interviewing (MI) is a clinical approach to helping people with substance abuse issues and other conditions shift behavior in positive ways. It is more goal-oriented than traditional psychotherapy, as MI counselors directly attempt to get clients to consider making behavioral change (rather than wait for them to come to conclusions themselves). Its primary purpose is to resolve ambivalence and help clients become able to make healthy choices freely.
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