Don’t Pay a Penny Until You Know The Following
Is This Rehab For Real?
Part 2 of 2
You Gotta Know What To Ask
Out of the 20,000+ rehabs and treatment facilities in our nation, there are unfortunately some who will answer, “Yes, we treat that as well” because whether they do or not (most likely not), they’ll say anything to get your credit card number. Think that families are the only ones they scam? How about the insurance companies they bill $3,000 per faux blood test 3-times per week and the weekly therapy sessions that never occurred. Yes, these cretins are equal opportunity porch climbers.
But, the lowest scam of all is “body brokering.” When calling a rehab that “looked good on Google,” often you are directed to a call center where a “treatment specialist” sympathetically pumps you for insurance, financial, and extremely personal information that they are entering into their database. With that “assessment,” they then steer you to one or more rehabs in return for a referral fee, but they don’t tell you about the kickback and since “your insurance is covering the treatment.” Their service is tempting at first since it is free of charge to you. However, you don’t know whether the company is recommending a specific rehab because it is the best treatment for you or your loved one or because it is the one paying the highest commission. This “body-brokering” approach is dishonest and unethical, and in some states, it’s illegal.
No matter how sympathetic the person may sound, remember to stick to the following script. Bottom line: be skeptical. Everything has to check out. One way to do that is by asking the following questions. If you want to drive crazy a 1–800 call representative pretending to be a healthcare professional, the following will do it.
Here’s What You Need To Know
The representative should ask if there’s a diagnosis for the individual who needs treatment. After you give the rep a brief description of the individual’s symptoms, the rep will likely respond, “Oh, we are the perfect place for that.” Of course, she would say that for any symptom you would give her. When you ask the representative if she is getting a referral fee. Don’t expect the truth, but at least the rep will realize you’re not like most of the other callers.
Licensure
Each facility has to be licensed by the state in which it does business. One of the first questions you need to ask is, “What is your licensure?” It has to be a) Substance Use Disorder (SUD), b) Mental Health (MH), c) Primary SUD, Secondary MH or d) Primary MH, Secondary SUD. Some facilities have two primary licensures, Primary Mental Health and also Primary Substance Use Disorder. If the rep says, “Well, we treat everything,” that’s not a good sign. The place that “treats everything” is the place that specializes in taking your money.
Additionally, is the facility accredited by The Joint Commission and/or CARF? Is it a member of the National Association of Addiction Treatment Professionals (NAATP)? If not, again, that’s another bad sign.
Demographics
Which demographics comprise the facility’s population? What is the population capacity and how many patients are there now? Male, Female, LGBTQIIA+, Transgender? What is the current gender ratio and age range? Children Age 7–11; Adolescents 12–17; Young adults 18–25; Adults 26–64; Seniors 65 and older?
Where are the residents on the socio-economic scale, race & ethnicity, vocations, legal problems? What’s the ratio of those who pay cash vs. using insurance resources? If using insurance, ask the rep approximately the percentage who are utilizing private insurance, Tricare (veterans), Medicaid, Medicare and state-funded care.
Does the facility have stand-alone programs or tracks for first responders, veterans, active military, police, fire fighters, EMTs/paramedics, physicians, attorneys, executives, pilots? Is there a faith-based track?
Stages of Treatment
Which stages of treatment does the facility treat? Detox, residential (RTC), partial hospitalization (PHP), intensive outpatient (IOP)? Are the programs 30, 60, 90-days or longer? What is the average length of stay (ALS)?
The Patient’s Treatment Team
When someone is a patient at a treatment facility, there should be a treatment team built around that patient. You need to know the following: is there a psychiatrist on staff or on call? How many private sessions per week does the patient see him or is it on an as needed basis?
Is the main therapist a Ph.D. or Masters-level? How many individual sessions per week does the patient have with him?
Which levels are the counselors, MS, MA, MSW, LCDC? What’s the number of private sessions per week?
Is there a case manager assigned to the patient and how many sessions per week do they meet?
Is there a nurse on site 24/7 or on call?
Disorders treated
If the facility treats substance use disorder, does it specialize in a particular drug of choice? Does its addiction treatment protocol include alcohol, illicit drugs, stimulants & methamphetamine, over-the-counter drugs and related substances or inhalants?
If the facility treats mental disorders, which ones does it include?
- Depression
- anxiety / panic attacks
- bipolar disorder
- schizophrenia
- schizoaffective disorder
- PTSD — experiential, emotional, physical, or sexual trauma
- borderline personality disorder
- dissociative identity disorder (formerly known as multiple personality disorder)
- eating disorders
- obsessive/compulsive behavior
- impulse control
- anger issues
- ADHD (attention-deficit hyperactivity disorder)
- autism
- Self-harming — burning, cutting, hair-pulling
- reactive Attachment Disorder (RAD)
Does the facility treat process addictions including gambling; sex and intimacy; love; pornography; work; compulsive buying / shopping; internet; codependency; gaming?
Evidence-Based Treatment
Evidence-based therapies are termed evidence-based for a good reason — the voluminous metrics and evidence that they do actually work. Which ones do this particular facility incorporate? The two most common are DBT (dialectical behavioral therapy) and CBT (cognitive behavioral therapy). Others include FBT (family behavioral therapy); BCT (behavioral couples therapy); EMDR (eye movement desensitization and reprocessing for treating trauma); brainspotting (trauma); psychodrama; exposure therapy; relapse prevention; equine therapy; gender-specific group sessions; mixed gender sessions.
When it comes to addiction, approximately one-half of facilities in the country practice medication-assisted therapy (MAT). The most common medication used to even-out the highs and lows of addiction’s cravings is Buprenorphine which “is a process for treating addiction by using a substance to substitute for a stronger full agonist opioid (such as heroin).”¹ The Surgeon General’s Report on Alcohol, Drugs and Health of November 2016² recommends a minimum of one-year of MAT, three years as ideal. You need to know this facility’s policy on using MAT.
Other
Is the facility for-profit or non-profit? Is the ownership private; a foundation; public company; or an equity fund
What is the setting of the facility? Urban; Rural; Suburban; Residential? What is the size of campus
Are the living Accommodations dormitory style; cottage; bunk house; apartments? How many residents per room? Are single rooms available for additional charge?
Are meals prepared by a chef, catered or prepared by residents on their own? Do residents do any housekeeping, make their own beds, bring their own towels & linen? Do they do their own laundry or is that provided by a service?
What is the facility’s policy on smoking, cell phone and computer use, visitations and drug testing? Does the facility provide a list of clothing and personal items that are allowed and prohibited?
These are just a few of the items you should know prior to determining if a particular rehab or program is a good fit for the patient. Although unlikely that you will get answers to all or some of these questions from a 1–800 sales rep, hopefully, you’ll see that when considering a facility, you need to know a lot more than, “Well, it looked good on Google.”
Walter Wolf is the pen name of a 30-year veteran of the movie and television industry who produced studio and independent films and television throughout the United States, Australia, and South Africa. That all changed in 2010 with one 3 A.M. call that a family member was in crisis due to addiction. Today, he is an interventionist who matches adults and adolescents with the optimum treatment program and facility for their particular diagnosis, demographics, financial and personal needs. In order to demystify and explain in layman terms what treatment is and how to get it, Wolf wrote The Right Rehab which became the only step-by-step guide for vulnerable families navigating the confusing world of addiction and mental disorder treatment, health insurance and recovery.
Footnotes
¹ STATPearls; Buprenorphine; Rachna Kumar, Omar Viswanath, Abdolreza Saadabadi; April 2023; https://www.ncbi.nlm.nih.gov/books/NBK459126 /#:~:text=Buprenorphine%20is%20FDA%2Dapproved%20for,opioid%20(such%20as%20heroin).
²U.S. Department of Health and Human Services (HHS), Office of the Surgeon General, Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. Washington, DC: HHS, November 2016; https://store.samhsa.gov/product/Facing-Addiction-in-America-The-Surgeon-General-s-Report-on-Alcohol-Drugs-and-Health-Full-Report/SMA16-4991
