by Peter Lazar, LCSW

Peter Lazar, LCSW, is Freedom Institute’s Senior Director of Strategic Development.  As part of the leadership team at Freedom Institute, Peter is responsible for overseeing marketing, business development and customer relations, as well as contributing to strategy and organizational development.

In the shifting sands of the addictions treatment world, it has become increasingly difficult to find the right facility for your client, your loved one, or yourself. In the past 10 years, the number of residential treatment programs (RTP’s) has increased by approximately 300%, and more are slated to open. This is because we now exist in an era where, at least outside of the State of New York, obtaining a residential treatment license has become relatively easy, particularly in the states of California and Florida. As fast as facilities are opening, however, many are closing as well. Inexperienced new owners who don’t really know what they are doing are here and gone.

At the same time, the field is experiencing an onslaught of unethical marketing, advertising, and admissions practices in the form of kickbacks, insurance fraud, website and facility contact information pirating, and patient brokering. According to a recent report by National Public Radio, some sober homes received kickbacks from residential programs in the amount of $500 per week to steer clients in their direction. If someone has good insurance, the RTP knows that there will be a return on their investment — in some cases, patient insurance coverage has been paid for by the broker or RTP. Residential treatment has become a multi-billion dollar industry, and some facilities are little more than warehouses. As a direct result of unscrupulous practices, many clients have been “chewed up and spit out”, and people are dying.

As an outpatient facility, we assess clients and their recovery needs.  Often it is necessary for an individual to start with inpatient treatment. Freedom Institute has over 40 years of experience helping people get into the right inpatient treatment for their recovery needs. We continue to provide this service, as an independent non-profit that bases recommendations on what the client needs. When searching for a residential facility to recommend for a particular person. It is critical to have an understanding of what sets apart the wheat from the chaff. Here are the more salient criteria:

  1. What kind of licensing do they have? Are they licensed to treat what they say they treat? Is their license in good standing in the state in which they are located?
  2. Does their website provide adequate information regarding their services? Are there staff bios that detail experience and credentials?
  3. How many beds are in the facility and what is the average daily census? What is the staff-to-client ratio?
  4. Is the staff made up of licensed professionals, and are they in good standing with their issuing body? (Again, this can be confirmed on the issuing state government website.)
  5. Does the clinical staff have advanced degrees and specialty training in the clinical offerings that are advertised?
  6. Do they have an Addiction Psychiatrist on staff, or at least in a consulting capacity?
  7. When and how often are clients seen by psychiatrists?
  8. How much does the program cost and what does that include? Are there additional costs for certain types of services? What is the typical length of stay?
  9. Is the facility In-network for insurance? (Be specific about the name of the policy.) Many websites advertise “Insurances Accepted”. This does not mean that they are actually In-network. Verify in or out-of-network coverage with the insurance provider.
  10. Is the facility gender-specific or does it provide gender-separate programming?
  11. What is the average age range of clients?
  12. Is there age-specific programming (e.g. Adolescents, Young Adults, Adults, Seniors)?
  13. How often will a client have individual therapy?
  14. What is the average caseload for a therapist?
  15. What specific groups are offered and how often do they meet? (Ask for a copy of a sample schedule.)
  16. What is the average size of therapy groups?
  17. When clients are not participating directly in individual or group sessions, what else are they doing with their time?
  18. Does the program treat underlying trauma, and if so, how? (It is good to get specific on this, as trauma is the “Pandora’s Box” of mental health treatment, and requires special care and clinical expertise.)
  19. How are co-occurring mood disorders treated? Can the facility handle other co-occurring disorders?
  20. Do they have full-on programs for process addictions such as compulsive gambling, sexual addiction, food addiction and eating disorders?
  21. What is their policy on Medication Assisted Treatment?

Lastly, and very importantly: Ask around. Do research. Ask trusted colleagues. Ask the facility’s admissions department if you can speak with an alumni and/or alumni family. Often when you’re trying to get someone (or yourself) into treatment, there’s a sense of urgency. It is important not to let this push you into a poor choice. Making the right choice for residential care can mean the difference between life and death.