Treatment: Handle This Choice With Care : Selecting Rehabilitation Facility Is Matter of Meeting Individual Needs

Choosing a drug or alcohol rehabilitation facility for a child often is a decision guided more by emotion than reason.

But because of the number of programs from which to choose, state and local authorities who monitor the facilities say selecting the proper treatment center should be made with care. They say the parents must find the exact program for their child, and that each child must be judged as an individual case.

“You must proceed in a methodical fashion, because that is the only way to go,” said Chauncey L. Veatch III, director of the California Department of Alcohol and Drug Programs.

So where do you begin with a multitude of programs ranging from private, state-of-the-art facilities that charge several thousand dollars a week for treatment, to public-run centers that charge a minimal fee depending on a family’s income?

Veatch suggests that parents talk to friends, physicians and state and county agencies that deal with treatment centers before deciding which facility is best for their specific need.

For example, some teen-agers may need inpatient care in which they live at the facility. Others may need a strong outpatient program in which they spend part of the day in treatment but otherwise continue their daily routine.

Dr. Max Schneider, a Santa Ana physician who treats drug and alcohol patients, said there is no magic potion for recovery. An 18-day program may work for one person; another individual may need six months or more.

Schneider said the model facility should be located close to a person’s home so no one in the family has an excuse not to attend counseling sessions. He said it should have certified drug-alcohol abuse counselors, physicians who have shown expertise in the field of chemical dependency, and a psychologist, psychiatrist and recreational therapist available.

The treatment program also should have a strong family treatment plan so that all members of the family will be involved in the therapy.

“We will not take the kid without mom and dad, because we feel if we’re going to restructure the kid’s life, we have to do it with mom and dad there,” said Tim Allen, executive director of Break Through Clinic in Costa Mesa. “And in order to treat anybody, you’ve got to uncover all those family secrets.”

Schneider also said that after-care treatment programs are essential. He said patients must attend group meetings such as Alcoholics Anonymous or Cocaine Anonymous for a long time after they complete their recovery program.

“A 10-day, 21-day or 30-day program is just an artificial arrangement,” Schneider said. “You must go for a period of at least six months (including after-care treatment). Kids will require longer professional involvement than adults.

“It is most important of all once you are hooked on a mind-altering drug. The propensity to get rehooked to that drug or some other drug will be embedded for life.”

Treatment really is a re-education that emphasizes fighting temptations for the rest of their lives, Schneider said.

“I’ve been in the AA program for a few months,” said Deanna de St. Paer of Irvine’s University High School. “Through it, I’ve learned a lot about people’s problems, teen-age alcoholism in general and not to judge people too quickly. I don’t think it’s OK to drink or get stoned because drinking causes more problems than it’s worth.”

Typically, life at a recovery home or hospital is mundane and structured. Patients attend group therapy sessions, lectures on the effects of drugs and alcohol, meditation sessions and AA meetings at night. Those who must first go through detoxification are slowly weaned off the drugs through medication.

At Break Through, an outpatient clinic, therapists spend about 10 1/2 hours a week with the teen-agers and their parents for anywhere from 16 to 20 weeks. They usually attend meetings four times a week. They are given family therapy and group therapy and are tested for drugs. Then they are put into an after-care treatment program such as AA meetings to help assimilate them back into society.

Schneider’s model is one followed by most facilities, state officials said.

But one state official, who asked not to be identified, said about 10% of the private facilities are not up to industry standards. One of the reasons, he suggested, was that private facilities do not have the kind of stringent licensing laws that public-run programs have. The laws vary because government-funded programs often receive more scrutiny, he said.

Bill Edelman, division manager of drug programs for the Orange County Health Care Agency, said his office has heard complaints that as soon as insurance money runs out, patients have been dropped from programs. Other officials stated concerns that some doctors will convince parents that their children need hospitalization when the kids may not.

“Are they all legitimate?” Schneider asked. “I am not sure. Some are better than others. I think this a major national problem: How does a lay person know the criteria to pick a good treatment program?”

Schneider said the American Medical Society is preparing a consumer’s guide due to be released at the end of year.

Since 1982, there has been a 400% increase in drug and alcohol treatment facilities in California, said Veatch. Randall Huyser, a health care analyst from Montgomery Securities of San Francisco, estimated that the industry has had an annual growth rate of 25% for the past three years.

The increase of facilities reflects both the growing problem and the growing market for clinics now that an increasing number of insurance programs are willing to reimburse policy holders for drug detoxification.

Irma Strantz, director of the Los Angeles County Drug Abuse Program, said the rise of private programs such as those run by the Comprehensive Care Corp. has occurred because the cocaine epidemic moved into the upper and middle classes. The addicts were people who could pay for comprehensive treatment with or without insurance. Also, she said a state law change in 1984 allowed hospitals to add treatment programs without losing licenses for areas that they cut back to give attention to drugs and alcohol units.

Hospitals, searching for new sources of revenue because of Medicare funding limits, started delegating beds for substance abusers.

Huyser, the health care analyst, said the publicity of popular athletes committed to rehabilitation programs also has contributed to the industry’s growth.

Despite this increase, the state-subsidized programs in Los Angeles County have waiting lists as long as six months, Strantz said. She said there is not enough funding to accommodate the needs of teen-agers. Orange County, however, usually does not have long waiting lists, said a county social worker.

One solution to the high cost of operating recovery homes would be stronger intervention programs at the schools, Strantz said.

Tom Anthony, principal of Mission Viejo’s Capistrano Valley High School, has set up a system that will involve 30 families this school year and is expected to double next school year.

Anthony, who developed a similar program at Los Alamitos High School five years ago, said he educates teachers to identify students’ behavioral changes. The teachers then alert a core drug committee as to which students may need help.

He said the program at Los Alamitos has been a success, and initially, it is working at Capistrano Valley.

“We’ve met with about 20 families and every one of the teachers has been right on (about identifying problems),” Anthony said.

REHABILITATION CENTERS AVAILABLE TO ADOLESCENTS IN ORANGE COUNTY

AGAPE COUNSELING AND THERAPY SERVICES (Outpatient Services)

Address: 520 N. Brookhurst 104, Anaheim 92801

Fees: Scale begins at $30 an hour

Length of Program: Varies

Phone: 999-1161

POSITIVE ALTERNATIVES TO DRUGS-ALCOHOL, ANAHEIM MEMORIAL HOSPITAL (Inpatient)

Address: 1111 West La Palma Ave., Anaheim 92803

Fees: About $345 a day

Length of Program: 8-12 weeks

Phone: 774-1450

BACK IN CONTROL TRAINING CENTER (Outpatient)

Address: 1234 W. Chapman, Orange

Fees: $295

Length of Program: 6 weeks plus follow-up

Phone: 538-2563

BREAK THROUGH (Outpatient)

Address: 151 Kalmus Suite J-2, Costa Mesa 92626

Fees: Maximum $40 an hour, family

Length of Program: Average 10 weeks

Phone: 957-8229

Address: 1661 N. Raymond, 112/114, Anaheim 92801

Fees: Maximum $40 an hour, family

Length of Program: Average 10 weeks

Phone: 870-0337

CAPISTRANO BY THE SEA HOSPITAL AND CLINIC (Psychiatric Inpatient)

Address: 33915 Del Obispo, Dana Point 92629

Fees: About $400 a day

Length of Program: Up to 12 months

Phone: 496-5702

CAREUNIT HOSPITAL OF ORANGE (Inpatient)

Address: 401 S. Tustin Ave., Orange 92666

Fees: About $394 a day

Length of Program: 30-120 days

Phone: 633-9582

CENTER FOR CREATIVE ALTERNATIVES (Outpatient)

Address: 132 E. 18th St. Costa Mesa 92627

Fees: In-school no fee, outpatient scale

Length of Program: Varies

Phone: 642-0377

Address: 28261 Marguerite Pkwy, Mission Viejo 92692

Fees: In-school no fee, outpatient scale

Length of Program: Varies

Phone: 364-1066

Address: 16541 Gothard, Hunt. Beach (administration)

Fees: NA

Length of Program: NA

Phone: 841-8770

CHARTER GROVE HOSPITAL (Psychiatric Inpatient)

Address: 2005 Kellogg Ave., Corona 91720

Fees: About $600 a day

Length of Program: About 6 weeks

Phone: 735-2910

CONCEPT 7 FAMILY SERVICES (Residential Treatment, Group Home)

Address: 17772 Irvine Blvd. Suite 211, Tustin 92680

Fees: $2,150 a month for Social Services

Length of Program: 9-12 months

Phone: 669-9119

COUNTY OF ORANGE, HEALTH CARE AGENCY/DRUG ABUSE SERVICES (Outpatient)

Address: 1133 Homer St., Anaheim 92801

Fees: Sliding scale

Length of Program: Varies

Phone: 991-2334

COUNTY OF ORANGE HEALTH CARE AGENCY/ALCOHOLISM SERVICES (Outpatient)

Address: 3115 Redhill Ave., Costa Mesa 92626

Fees: Sliding scale

Length of Program: Varies

Phone: 834-8323

COUNTY OF ORANGE HEALTH CARE AGENCY/ALCOHOLISM SERVICES (Outpatient)

Address: 211 W. Commonwealth, Fullerton

Fees: Sliding scale

Length of Program: Average 9-12 months

Phone: 441-0740

COUNTY OF ORANGE HEALTH CARE AGENCY/DRUG ABUSE SERVICES (Outpatient)

Address: 1725 W. 17th St. Suite 232, Santa Ana

Fees: Sliding scale

Length of Program: Varies

Phone: 834-5041

COUNTY OF ORANGE HEALTH CARE AGENCY/ALCOHOLISM SERVICES (Outpatient)

Address: 14120 Beach Blvd. Suite 203, Westminster

Fees: Sliding scale

Length of Program: Varies

Phone: 896-7574

DAYBREAK (Aftercare)

Address: 1515 W. North St., Anaheim 92801

Fees: $110/week

Length of Program: Varies

Phone: 635-9622

POSITIVE ACTION CENTER, HEALTHCARE MEDICAL CENTER OF TUSTIN (Inpatient)

Address: 14662 Newport Ave., Tustin 92680

Fees: About $393 a day

Length of Program: About 3 months

Phone: 838-9600

JOINED FIRMLY TOGETHER (Assessment)

Address: P.O. Box 4379, Irvine 92716-4379

Fees: $40 an hour

Length of Program: Varies

Phone: 786-2730

HOTLINE HELP CENTER (Crisis Services, Youth counseling)

Address: P.O. Box 999, Anaheim 92805

Fees: Donations accepted

Length of Program: Short-term

Phone: 778-1000

MEMORIAL COASTVIEW (Inpatient)

Address: 455 Columbia, Long Beach 90801

Fees: $310 a day

Length of Program: 45-90 days

Phone: 213-426-6619

NEW BEGINNINGS, PLACENTIA-LINDA COMMUNITY HOSPITAL (Inpatient)

Address: 1301 Rose Dr., Placentia 92670

Fees: $330 a day

Length of Program: Average 60 days

Phone: 524-4894

ORANGE COUNTY COMMISSION ON ALCOHOLISM FOR SPANISH SPEAKING (Inpatient)

Address: 9842 W. 13th St., Garden Grove 92644

Fees: Sliding scale adults, no fee children

Length of Program: 90 days

Phone: 531-4624

PALMER DRUG ABUSE PROGRAM (Outpatient)

Address: 9812 Hamilton, Huntington Beach 92646

Fees: Donations accepted

Length of Program: Varies

Phone: 968-2714

PHOENIX HOUSE (Residential program)

Address: 1207 E. Fruit St., Santa Ana

Fees: Sliding scale

Length of Program: 12-18 months

Phone: 953-9373

STRAIGHT AHEAD (Residential program)

Address: 34185 Coast Hwy., Dana Point 92629

Fees: $800 a month or sliding scale

Length of Program: About 6 months

Phone: 831-0360

STRAIGHT TALK CLINIC (Outpatient)

Address: 5712 Camp St., Cypress 90630

Fees: Sliding scale

Length of Program: 6 months

Phone: 828-2000

TEENS LIVING CLEAN, PACIFICA COMMUNITY HOSPITAL (Inpatient)

Address: 18792 Delaware St., Huntington Beach 92648

Fees: $465 a day

Length of Program: 8-10 weeks

Phone: 842-0611

TURNING POINT FAMILY SERVICES PROGRAM (Outpatient)

Address: 12912 Brookhurst Suite 150, Garden Grove 92640

Fees: Sliding scale

Length of Program: 10-12 weekly sessions

Phone: 636-3823

WEST COUNTY COUNSELING CENTER (Outpatient)

Address: 17612 Beach Blvd., Huntington Beach 92647

Fees: Sliding scale

Length of Program: Minimum 3 months

Phone: 847-3356

Source: National Council on Alcoholism