What Does ‘Continuum of Care’ Mean in Addiction Treatment?

To fully understand what continuum of care means in addiction treatment, one must first understand what is meant by continuum.

A continuum is a collection, a whole set, that has a progressive sequence. Each point in the progression varies only slightly from the prior point. For example, we provide a continuum of care to a baby when we first teach her to roll over, then push up, then crawl, and finally walk.

What Does Continuum of Care Mean?

Continuum is used widely in other areas of the medical community. Patients with severe illnesses don’t receive a single course of treatment; rather, they have a team of doctors with varying specialties who treat the whole person.

This is because any health issue – be it mental or physical – is itself a spectrum of severity. For someone who is battling addiction, the same is true. Each phase of recovery is a step in the continuum of care.

Partial Treatment Can Be Harmful

In the United States, we don’t often think of healing as a process – you are either suffering from addiction or you are healthy – but that is far from the truth. If you or someone you know has struggled with dependency, you’re likely already aware that there’s no magic cure.

There are partial treatment programs available, but we should think of them as a piece of the recovery process. Generally, these types of programs provide referrals for additional support, but they don’t provide that support themselves.

This leaves people on their own during a time that they are particularly fragile and vulnerable. It’s like explaining to someone why they are in critical need of surgery and then leaving them alone with a phone and a list of surgeons to call.

Partial treatment can do more harm than good, particularly if the person relapses and loses hope and respect for themselves. Their support system may lose patience and blame the person for the relapse. A vicious cycle of treatment and relapse can occur until, ultimately, a person may give up entirely, with devastating consequences.

Continuum of care programs see that addiction recovery is a process, and success in each stage is crucial to the success of the next one.

Do Bridge Programs Help?

A bridge program is one that collaborates with different treatment programs to try to create something closer to a continuum of care program. With this model of care, the patient starts with one program and then transitions to a different, loosely affiliated program.

This is certainly better than partial treatment; however, it lacks the continuity of a single full continuum of care program approach and increases the probability that a person will fall through the cracks.

Single Continuum of Care Program Approach

The definition of continuum care as it relates to addiction is “a single integrated care program with an individualized service plan developed so the client can move seamlessly through the program from before treatment starts and throughout the lifecycle of recovery.”

The timeline for treatment is based on the client, not the calendar. Rather than being referred to various external resources, the tools needed are provided and a single team of professionals is there to teach, guide and support the recovery work – before, during and after.

What Are the Different Levels of Care Within the Full Continuum?

The American Society of Addiction Medicine (ASAM) has outlined the various levels of care that make up the full continuum of addiction treatment. From the highest intensity of care to the lowest, those levels are as follows:

Detox and Inpatient Services

Within the realm of inpatient addiction treatment, there are actually various levels of intensity, according to ASAM. The most intensive level is “medically managed intensive inpatient services.” In other words, this means detox treatment that involves medication. Detox services almost always require an inpatient stay, usually anywhere from three to 14 days.

On the lowest level of intensity in residential/inpatient treatment is “clinically managed low-intensity residential services.” This basically means the client is still staying overnight in the rehab facility but is past the detox phase – and that the main form of treatment is clinical therapy, predominantly in the form of individual and group counseling.

Partial Hospitalization and Intensive Outpatient Services

Partial hospitalization programs (PHPs) and intensive outpatient services both allow the patient to live at home or a temporary offsite residence in between receiving treatment at an outpatient facility. Some people with less-severe addictions may start at one of two these levels of care, rather than inpatient.

PHPs usually require the patient to spend 20 or more hours each week in treatment, while intensive outpatient programs (IOPs) generally consist of nine or more hours of therapy per week.

Outpatient Services

Outpatient programs usually follow a patient’s time in an inpatient and/or partial hospitalization program. Standard outpatient programs feature fewer than nine hours of therapy each week. They usually serve as bridge between an inpatient stay and the return to everyday life (aka aftercare). An outpatient program is a good choice for someone who wants to maintain a job or their school studies while in treatment.

Early Intervention

Although interventions are lowest on ASAM’s scale of intensity, they actually tend to be the very first step in the treatment process for many individuals. An intervention is low on the ASAM scale because it doesn’t really involve any formal treatment; instead, the intervention’s objective is to get the individual into treatment.

Not every individual needs an intervention to be coaxed into entering rehab, but it is an important and readily available first step for many families. If a family is considering an intervention on behalf of a loved one, it’s important to reach out to a professional to facilitate the process – and to not attempt to do any intervention on one’s own.

Also Worth Mentioning: Aftercare

Although not featured on the ASAM-identified continuum of care, aftercare services are a very important consideration, too. Aftercare programs generally provide access to a counselor as needed, as well as alumni activities and other resources to help prevent relapse. Make sure the rehab facility you choose offers robust aftercare services for the post-treatment phase of your recovery.

Taking It a Step Further

Harmony Place in Los Angeles, California offers a full continuum of care when it comes to addiction treatment. By bringing together all of the components necessary for a true continuum of care program and complementing it with a integrated, whole-person approach, Harmony Place takes it a step further.

Our inpatient residential program provides evidence-based, integrated methods of treatment. The program has a concurrent focus on physical wellness, psychological, spiritual and emotional needs. Our top-notch treatment continues through the following services:

• Outpatient
• Transitional Living
• Discharge Planning
• Aftercare and Alumni Services

At Harmony Place, we, you and your family share the same goal: full recovery that lasts a lifetime.