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October 23, 2019
Have you ever thought about seeking treatment for post-traumatic stress, depression or alcohol use? Maybe a well-intentioned crewmember or spouse has said, “You really need to get help.”
But what does it actually mean to get help? For someone in distress, navigating the world of behavioral healthcare can be challenging. You know there are resources out there, but you may be confused or overwhelmed by the numerous options.
Let’s break down some of the most common forms of help:
Although they are the least intensive and most affordable option (often free), support groups offer an invaluable resource for those in recovery, often with no commitment or obligation to attend.
A support group is typically peer-facilitated by individuals who are in recovery themselves versus a licensed healthcare provider. Support groups operate on the premise that uniting individuals around a common, shared struggle can facilitate healing through empathetic support and promote behavior change through peer accountability. Some examples of support groups include Alcoholics Anonymous, Al-Anon, SMART Recovery or Co-Dependents Anonymous (CoDA).
Counseling or psychotherapy is provided by a master’s or doctorate-level licensed mental healthcare provider (psychotherapist) and can be in an individual or group format. While treatment approaches and methods vary widely, the psychotherapist’s aim is to work with you to establish treatment goals, gain insight into dysfunctional patterns of thinking and behavior, and develop coping skills to more effectively manage symptoms and problems. An average course of counseling could be once weekly for eight to 12 weeks, though sometimes individuals benefit from ongoing care.
Offered alone or in conjunction with counseling, the goal of medication management is to treat symptoms of a mental health problem with psychotropic medication. After starting a medication regimen prescribed by a psychiatrist, physician’s assistant (PA) or nurse practitioner (NP), you attend brief follow-up appointments to evaluate medication efficacy in treating problematic symptoms. In contrast to counseling, the practitioner’s primary focus is to treat and alleviate symptoms through medication, not talk therapy. The timeframe to remain on psychotropic medication is highly individualized.
Intensive outpatient treatment (IOP) — sometimes referred to as an intensive outpatient program — typically consists of nine hours of treatment per week, spread over three days. IOP can have a mental health, substance abuse or (combined) dual-diagnosis treatment focus. IOP is designed for individuals who need a more intensive level of support than the once-weekly outpatient counseling or medication monitoring options. IOP can occur during the day or evening and typically combines group psychotherapy and psychoeducational sessions, provided by master’s degree-level clinicians. The length of treatment can vary widely based on an individual’s clinical needs, but an average timeframe for IOP is four to six weeks.
One step up from IOP, partial hospitalization programs (PHPs) offer the most intensive level of outpatient care. PHPs are designed for individuals who are coping with moderate to severe symptoms or significant daily functional impairment but do not require overnight care. Sessions typically run five to six days per week, for six hours a day, for one to three weeks, though the length of stay varies based on need. PHPs can focus on mental health, substance abuse or both.
Inpatient behavioral healthcare typically consists of three to five days of treatment in a hospital or other acute care setting. Inpatient care is intended for individuals coping with severe symptoms, presenting imminent danger to themselves or others or who are temporarily unable to care for themselves. The goal of inpatient care is to ensure a patient’s safety, provide 24-hour monitoring of behavior and vitals, assess a patient’s need for medication and establish a discharge treatment plan for continued outpatient care. Patients are often discharged to PHP or IOP levels of care.
Residential treatment is designed for individuals whose symptoms warrant a PHP level of care, but may also benefit from living in a supportive therapeutic community while receiving care. Sometimes referred to as rehab, residential treatment is intended for individuals who have not benefited from lower levels of outpatient care. Treatment can focus on substance abuse, mental health or other specialized clinical populations. Length of stay is typically 30 to 90 days.
Commonly mistaken for rehab, a medically monitored inpatient detox is the process of removing toxic substances from the body while monitoring and treating any life-threatening withdrawal symptoms. The primary goal of detox is medical stabilization, not recovery. Once medically stable after a detox period of two-five days, the patient can transition to psychotherapeutic treatment (residential, PHP, IOP, etc.) to address addiction and any co-occurring mental health issues.
If you are struggling, start by talking to your spouse, a trusted friend, your captain, your chaplain or your EAP to get pointed in the right direction. The only way to identify the appropriate level of care for your needs is to have a comprehensive diagnostic assessment with a qualified mental healthcare provider. Remember, unless you display imminent danger to yourself or others, treatment is always voluntary and your decision.
The IAFF Center of Excellence for Behavioral Health Treatment and Recovery is a comprehensive treatment center designed exclusively for IAFF members struggling with behavioral health problems. Call today for a free and confidential mental health screening.
Lauren Kosc, M.A., LCPC is a behavioral health specialist, clinician and writer for the International Association of Fire Fighters. If you are an IAFF member in recovery and want to share your story, contact [email protected]
Medical Disclaimer: The IAFF Center of Excellence aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.