Substance Use Intensive Outpatient Program

The Addiction Treatment Program (DHMC-ATP) provides a comprehensive evaluation service and an Intensive Outpatient Program (IOP) for adults. We offer state-of-the-art evaluation and treatment, and referral services for people seeking help for substance use and related disorders.

Services:

DHMC-ATP is focused on developing new knowledge through research. We serve as an evidence-based resource for knowledge about treatment, about the basis of addictive disorders, and about optimal approaches toward treatment and prevention of substance use and co-occurring disorders. And we advocate, network, and link with other available community resources to ensure the continued health and growth of our patients, our community, and our field.

DHMC-ATP also seeks to become a recognized leader in addiction treatment training by educating students, post-doctoral trainees, and professionals of many disciplines about the nature of substance addictions and effective evidence-based approaches to treatment.

About the Program

When and where do the groups meet?
The DHMC-ATP is located at 85 Mechanic Street in Lebanon, NH - Suite B3-1. The program is open Monday through Friday. Most groups meet in the evening hours. Evaluations and individual sessions are available by scheduled appointment.

What is the evaluation service?
Our evaluation service is designed to assess an individual's needs and match the person to the appropriate level and type of treatment. The evaluation includes a clinical interview focused on substance use history, medical interview as needed, urine toxicology, and breath analysis. The person being evaluated and the referring physician receive timely feedback regarding treatment recommendations.

What is the treatment philosophy and model?
The DHMC-ATP philosophy is that everyone can get better. The Intensive Outpatient Program covers a period of time long enough that everyone can make significant progress if he or she attends as scheduled and participates in the group and individual sessions. The treatment model combines motivational, behavioral, relapse prevention, and 12-step facilitation.

The "Motivational Model" theorizes that everyone who enters the program will be at some degree of readiness to change their substance use behavior. The "stage of change" will be somewhat different for each participant. The model allows each person to move through his or her own "stages of change" at a pace that works for that person, while not compromising others in the group.

The Motivational Model is not an "cookie-cutter, one-size-fits-all" approach. Blended into the Motivational Model is help dealing with self-defeating beliefs, psycho-education, individual feedback, and encouragement to increase efforts toward change.

The program also involves Cognitive-Behavioral Therapy and Relapse Prevention. These parts of the program are designed to help patients restructure their thoughts, learn new coping skills, participate in replacement activities, and form new social support networks to motivate healthier lifestyles.

How is the treatment delivered?
The Addiction Treatment Program's Intensive Outpatient Program is delivered in three phases:

Interventions will be based on the models described, and can include psychiatric evaluation and pharmacotherapy if needed. The session format will combine individual, group and multifamily sessions, one to three times per week, dependent on the phase of treatment. Participants will be expected to join and increase participation in a self-help program of their choice over the course of treatment, and work with clinicians to create a continuing recovery plan after treatment.

What types of groups are offered in the Intensive Outpatient Program (IOP)?
The Addiction Treatment Program Intensive Outpatient Program (IOP) is a 12 week program consisting of the following groups:

GROUP COUPLES BEHAVIORAL THERAPY (GCBT)
The Family/Couples Group Therapy theorizes that significant others have the ability to help patients be more likely to succeed in treatment. With guidance from the treatment team the individual and family learn to move in the same direction toward recovery making change more possible. The goals of these sessions are to: build support for abstinence, increase relationship cohesion, teach communication skills and effective conflict resolution strategies. Components of the family/couples therapy involve: a recovery contract, setting up daily abstinence trust discussions, increasing awareness of positive behaviors, sharing rewarding activities, learning how to negotiate for requests, and teaching effective communication using "I" messages and reflective listening.

MINDFULNESS/INTERPERSONAL EFFECTIVENESS (MIE)
The Mindfulness skills training group utilizes Marsha Linehan's DBT material whereas the Interpersonal Effectiveness skills training utilizes a structured skills training guide specific to interpersonal issues for those who have substance dependence. The goals of these structured sessions are to learn mindfulness skills (e.g., Wise Mind and Clear Mind vs. Negative Emotion Mind and Addict Mind) as well as skills focused on dealing with interpersonal conflict situations effectively.

MOTIVATIONAL ENHANCEMENT THERAPY (MET)
The MET group is designed to help patients enhance motivation for change by setting goals, examining decisions and building self efficacy. Members are to complete a log assignment during the week. The expectation is for participants to bring their completed logs to the group in order to check in around specific skills taught in session (e.g., deep breathing, mastery/replacement activities, and tracking cravings/urges). During the evening's check-in, the group members will be asked to give feedback on the quality of the other group members' engagement, participation in their own recovery activities, and their efforts in their recovery in general. This is meant to be an opportunity for self-reflection and offering others vital support.

COGNITIVE BEHAVIOR THERAPY (CBT)/RELAPSE PREVENTION
CBT will help teach participants to restructure their thinking patterns, learn new coping skills, participate in replacement activities, and form new social support networks to motivate healthier lifestyles. Groups will contain a check-in on recovery efforts to date: including the use of avoidance, replacement, and coping skills. Members will be asked in group to fill out activity schedules of their weekly activities. Schedules will contain a review of the past week and record recovery "activities" (e.g. deep breathing, yoga, running, self help group, mastery hobbies etc.). Group members will be asked to present schedules to each other and receive constructive feedback.

RELAPSE PREVENTION GROUP
Groups will include a focus on continuing avoidance, replacement activities and coping skills. Weekly check-in around slips, urges, self help, the four pathways to recovery, living in balance, and high risk situations. The expectation will be that participants strengthen their commitment to recovery by beginning to initiate continued care planning: involving oneself in self help and or making a connection to counseling. Participants are also expected to actively engage in discussions and provide/receive feedback from others to help boost relapse prevention strategies.

Who should attend an Intensive Outpatient Program (IOP)?
The IOP is for adults ages 18 and older, who need treatment for alcohol or drug addiction more than once per week but are not in need of a residential or hospital program. The program is for people who have developed dependence to alcohol or some other type of substance, whose medical complications from this dependence can be managed in an outpatient setting, and who are able and willing to attend the three times per week sessions.

How much does it cost?
The cost of participating in the DHMC-ATP is much less than the cost of inpatient or residential treatment. Most major insurance carriers are accepted.