The year-end holidays require careful management for residential treatment centers. Current clients might be addressing emotional issues the holidays raise, meanwhile, the season often spurs a wave of new arrivals seeking treatment. Staff in recovery also need additional support as they meet their own self-care needs separately from the treatment for their clients.
Beyond the clinical scope, treatment center operators must manage everyday matters such as staffing levels, meals, visitation schedules and policies.
As the 2016 holidays approach, executives have some key questions to consider— challenges that depend on treatment philosophy, patient needs and the populations they serve.
Family involvement is a key asset to recovery, even during the holidays. Some patients might want to go home to spend time with their loved ones, especially if they have children. Others might have such strained ties that family visits are out of the question. Likewise, family members themselves may or may not be willing to visit those in treatment at the facility.
The question of whether to allow patients to leave the facility during the holidays to spend time at home is rooted in each facility’s clinical approach.
“We work to help our clients understand that they’re battling a potentially fatal disease,” says Brad Masters, director of outreach for Serenity Acres Treatment Center in Crownsville, Md. “Recovery should always come first, and leaving our facility in the middle of treatment could mean losing sight of this goal and falling into relapse.”
Other facilities take a similar approach.
Steve Langley, executive director of Mountainside Treatment Center in Canaan, Conn., says programs must ensure consistency in treatment and the safety and well being of the patients.
“Clients do not leave our property,” he says.
Indeed, the psychological issues that could arise during the holidays often demand that patients be close to necessary therapeutic help.
“If someone is having a difficult time with drugs and alcohol, and they need residential care, they need to be there detoxing,” says Deni Carise, chief clinical officer at Recovery Centers of America in King of Prussia, Pa. “We do not want people to leave treatment prematurely during the holidays.”
Other facilities evaluate whether to allow patients to spend time off site during the holidays on a case-by-case basis.
“Some clients are granted a pass for the day if they have healthy and supportive family members near the treatment program,” says Ryan Potter, director of clinical development at Ambrosia Treatment Centers with facilities in Florida, California and New Jersey.
Staff evaluate the family based on how active and supportive they have been in the patient’s recovery and whether they can ensure that the any home celebration will be a sober environment.
“Although immediate family members might be very supportive, there can be alcohol or drugs being used by other family members attending,” says Potter.
Even then, the decision of whether to allow patients to do so depends on logistics. Not everyone is able to choose a residential treatment facility based on proximity to family members. Moreover, family relationships might be strained by the patient’s substance use disorder and those families might not be ready to support or welcome the patient home.
Celebrating on site
Even if patients are not in a position to travel home for the holidays, facilities do their best to make the season festive while also incorporating holiday-related issues into treatment. On-site celebrations can include family members on Christmas, Hanukkah or on a special visitation day for the holidays.
“Because Christmas falls on a Sunday this year, we will have our visitation day on the holiday,” says Langley. “We have a reception for approved visitors, including immediate family,” with music and refreshments. However, all visitors must spend the first part of the visit in the facility’s family wellness orientation. “The program pays particular attention to ways families can be supportive, including what to say and what not to say,” he adds.
Treatment center executives emphasize maintaining the program routine during the holidays.
“We don’t allow any special treatment in terms of visitation with family or friends,” says Masters. “Given the stigma that often surrounds addiction, a handful of our clients don’t have the benefit of full support of family members.”
In these cases, any extra family visits could be damaging to individuals who lack close family or could cause a setback for those who need to focus on themselves and their recovery without distraction from people outside the program.
Supporting staff during the holidays is crucial. Given that at least some staff members may be in recovery themselves, “we want to make sure that they are having a good holiday and that they remain committed to their recovery,” says Carise. “We support them so that that they, in turn, can support the patient.”
In general, treatment centers keep staffing levels as consistent as possible during the holidays. The non-essential staff might be a bit lighter on holidays, but key clinical staff must always be on-site, says Masters.
Adequate staffing is necessary to help patients deal with any issues that emerge during a time when past memories might arise or feelings of disappointment or loneliness. These situations require just as much if not more attention as they do during non-holiday periods.
“We plan well in advance to make sure that there is holiday coverage and of the programmatic element of the day gets the attention it deserves,” says Langley. “There is clinical staff here to meet any of the needs of the clients to help support those clients of that struggle with the holiday.”
To compensation staff, many treatment centers pay overtime for non-exempt staff working on holidays and provide extra time off for exempt staff who are not eligible for overtime.
Addiction issues can become acute during holiday celebrations, and the approach of a new year often spurs people to seek treatment. Sometimes, those in need seek treatment on Christmas or New Year’s Day.
Treatment facilities have different policies when it comes to accepting new patients on holidays. Some treatment centers consider Christmas to be business as usual and accept new patients who arrive for intake on that day.
“I have worked every Christmas for the last 10 years, and we have had intakes every time,” says Langley.
Other treatment centers do not accept new patients for intake on major holidays.
“If someone calls our hotline seeking help, we will provide counsel over the phone, walk them through the easy application process and work on placing them in treatment the following day,” says Masters.
If a patient is in immediate crisis, Serenity Acres will either refer that patient to an area hospital depending on the severity of the case or provide the individual with a list of other treatment centers that do offer intake.
Joanne Sammer is a freelance writer based in New Jersey.