When SECAD ’09 morning keynote speaker William White said traditional treatment generally sets up clients for failure, and much of a roomful of addiction professionals clapped in confirmation, it signaled that clinicians and managers want change in services. At the same time, these professionals wonder whether the timing of the innovative efforts they’d like to pursue could be any worse, given the bottom-line concerns they and their agencies now face.
An informal canvassing of addiction treatment organizations represented at the Feb. 9-11 SECAD meeting found that several have experienced a drop in census since last year’s fourth quarter. Meanwhile, others reported that their organizations are holding their own, but holding their breath at the same time. The overall message from presenters at the conference, however, urged professionals to think about comprehensive services first and worry about funding later.
Knowing full well that his call for longer-term treatment and support for persons in recovery would generate a chorus of “Where will the money come from?”, opening keynoter Carlton K. Erickson, PhD, said “show that it works, and the dollars will come.”
White, senior research consultant at Chestnut Health Systems and the leading chronicler of addiction treatment’s history, offered a 10-point presentation on why recovery-oriented systems of care should prove superior to the traditional acute-care model of treating persons with addiction problems. Looking at 10 dimensions of care, White found fault with many current treatment practices, reserving particularly stern criticism for the practice of terminating treatment for people who relapse (and who by that action simply confirm the presence of the very symptoms the program is trying to treat).
“History will treat us very, very harshly for that,” White said.
He also urged programs to nurture motivation in clients rather than berate them for lacking it when they arrive; to offer clients a menu of services rather than one approach for all; and to commit to long-term follow-up of clients, even those who aren’t able to graduate. “We discharge individuals back into an environment in which they don’t have a prayer,” White said.