Recovery Services - VA Central Ohio Healthcare System
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VA Central Ohio Healthcare System

 

Recovery Services

ASSESSMENT/TREATMENT PLANNING

 

All Veterans seeking treatment regarding substance use are seen for a biopsychosocial assessment.  During this assessment, information is gathered about the Veteran’s life to determine what type of treatment would be most helpful to this Veteran.  The clinician will make a recommendation regarding type of treatment indicated based upon the assessment, however, the Veterans are always free to choose another type of treatment, provided they meet the requirements for that treatment.  Treatment planning is worked on collaboratively.    Clinician will make appropriate referrals (detox, inpatient, residential or outpatient treatment) and also help alleviate any barriers to accessing care.

 

Assessment and treatment planning sessions typically last 90 minutes.    Veterans can schedule an assessment by calling 614 257-5440 or can be seen as a ‘walk in’ Monday through Friday.

 




OPIATE SUBSTITUION THERAPY - SUBOXONE

Suboxone maintenance therapy provides a very valuable service to Veterans who are addicted to heroin or other opiates. In the first treatment phase, Veterans are offered induction (2-3 days) followed by weekly follow-up appointments for 12 weeks.  During this phase, the Veteran is monitored closely, providing UDS on weekly basis, and participates in evidence-based treatment modalities on a group or individual level.   Once a Veteran has completed the initial 12 weeks, providers can extend Suboxone dose to two weeks, which begins phase 2 of treatment. At this time, treatment would be provided two times per month, unless the Veteran specifically asks for continuation of one-week appointments.  After 6 months of stability while on Suboxone therapy, providers can offer one-month follow up appointments which is the foundation of phase 3. This phase is generally granted only if the Veteran has identified movement towards completing treatment goals and considers themselves to have a stable base for recovery. The stepped format of Suboxone care allows for fluidity, should a Veteran experience complication, in their recovery and dosing can be scaled back should a Veteran need more time in a group or individual setting. Therefore, the format, while theoretically structured is not practically fixed, but rather dynamic, based on Veteran’s need. Veterans are expected to provide urine drug screens (UDS) at every Suboxone appointment, regardless of which phase they are in.

             

 

OPIATE SUBStITUTION THERAPY - METHADONE

The Methadone program provides a valuable service to Veterans who need this type of treatment to gain stability in their lives despite heroin and/or other opiate addiction.  This program has been contracted out to CompDrug, the main provider of Opiate Substitution Therapy in Columbus, Ohio. 

Veterans dose at CompDrug on 11th Ave, and are seen for therapy services by our Social Worker at either the CompDrug location, or the VA.  Treatment is coordinated by our Social Worker and group services are available in addition to individual therapy, and a drop-in group is offered weekly on Wednesday afternoons. Clients receive counseling services twice monthly until they are stabilized and eligible for initial take-home doses, which is determined by CompDrug providers.  After receiving take-home doses, counseling is tapered to once per month unless the client would request additional sessions.

TOBACCO CESSATION THERAPY

The Tobacco Cessation program is doing well in engaging Veterans and employees in treatment for tobacco cessation.  Veterans can obtain Nicotine Replacement Therapy (NRT) at no charge.  It has been found that a combination of NRT and counseling seems to work best to help people quit tobacco and stay quit.  Motivational Interviewing as a part of the counseling is being used.  Evidenced based practice suggests the implementation of MI as a part of the counseling process.

A multidisciplinary group has been formed of professionals across the clinics who are interested in helping both Veterans and staff with Tobacco Cessation.  Flexible counseling cessations (daytime and evening hours), telephone and telehealth interventions are available.  An employee tobacco cessation program was re-launched to offer flexible counseling sessions, telephone interventions and nicotine replacement therapy at no cost to the employee.

DUAL DIAGNOSIS (PTSD/SUD) THERAPY

The PTSD/SUD specialist is a full-time provider under the Trauma Recovery Division (TRD) and also functions as a member of the Recovery Services (RS) and Integrated Dual Diagnosis Treatment (IDDT) teams. The PTSD/SUD specialist provides PTSD/SUD services to veterans with these diagnoses.  Veterans are referred to these services via the PTSD Consult.  Consults are managed by the TRD director.  The PTSD/SUD provider offers evidence-based individual and group treatments for PTSD/SUD, such as Prolonged Exposure (PE) or Seeking Safety, according to his/her training.  Veterans have access to the full range of treatments offered by Recovery Services and the Trauma Recovery Division.  Veterans can also be referred to residential programming for PTSD, SUD, or PTSD/SUD according to need.

DUAL DIAGNOSIS (smi/sud) THERAPY

Veterans are assessed at intake and those meeting criteria (presence of substance use diagnosis and co-morbid SMI diagnosis) can be referred to dual diagnosis therapy. The aim of this approach is to specifically “meet the veteran where they are at” in terms of their recovery goals and needs. The group content is designed to reflect the goals/needs of this population and have activities aimed at facilitating conversations amongst group members that highlight discrepancies between substance use choices and larger life goals and hopefully help veterans resolve any ambivalence with regards to their substance use in the favor of making changes. This includes discussions of the pros and cons of use, pros and cons of change, values exploration, importance/confidence/desire for change, etc. The length of treatment typically ranges from 3 to 6 months; however, timeframe is determined on an individual basis.

Reinforcing the understanding of the importance of treating both diagnosis’ to assure a successful outcome is part of the weekly discussion. Veterans are discharged/graduated from the group upon completion of program and/or upon being determined to have reached maximum treatment benefit based on clinical judgment

 

AMBULATORY DETOX

The Ambulatory Detoxification Treatment (ADT) will provide eligible veterans with uncomplicated detoxification treatment from alcohol or other substances. Such treatment will allow veterans to begin a period of abstinence from their dysfunctional substance use, thereby permitting them to participate in the other facets of RS programming.  ADT is only done on days of the week when the Veteran can return for follow up on at least two more days in the same week, e.g. a Veteran can only begin ADT on Monday, Tuesday or Wednesday.  A Veteran cannot be started in ADT on Thursday or Friday because sufficient monitoring time is not available as the clinic is closed on the weekends.

 

Criteria for a Veteran to be a candidate for ADT are:  evaluation of withdrawal symptoms and history; absence of co-morbid conditions, treatment acceptance; meets ASAM criteria for ambulatory detox; has housing and support in the community.  Veterans are ineligible for ADT if they meet the following criteria:  moderate to severe alcohol or sedative/hypnotic withdrawal; inability to tolerate oral medication; imminent risk of harm to self/others; recurrent unsuccessful attempts at ADT; reasonable likelihood that Veteran will not complete ADT; acute psychosis or severe cognitive impairment; or verbally or physically abusive towards staff or other Veterans.


Staff of RS work closely with the referral sources to coordinate care.  Veterans who are ineligible for ADT are referred to inpatient detoxification at Chillicothe or one of the other inpatient facilities in the VISN. 

 

ADT is considered the beginning of treatment, and every effort is made to engage the Veteran in ongoing care based upon current need and treatment history.  Staff are available during the detox process to begin the SUD counseling as well as develop realistic plans for ongoing care.

 

INTENSIVE OUTPATIENT TREATMENT (IOT)

IOT meets three times weekly to provide those in early recovery with the structure and support they need to develop the coping skills to achieve their substance use goals.  IOT is a structured program which includes home assignments received in group. IOT is recommended for those just starting their recovery journey or those who have recently completed residential programming and need a high level of support and structure on an outpatient basis. All treatment in IOT utilizes evidenced based practices which have demonstrated success at helping individuals make successful change to their substance use.

 

IOT drug screens (including alcohol) twice weekly and completes breathalyzers once weekly. IOT may include may include screening randomly as well. Abstinence from substances is not required for participation in IOT. We encourage group members to openly discuss all aspects of their substance use in group to receive support for their individualized goals.

 

Successful completion of IOT is based on personal progress. We measure successful completion based on accomplishing measurable objectives like having a strong support network, being able to identify personal coping skills and strategies utilized to cope with urges/cravings, and having a solid relapse prevention plan. We also factor in how confident participants are feeling about their recovery progress if they have any unmet goals. On average, most Veterans stay in IOT for 2-3 months. 

AFTERCARE/REHAB GROUP THERAPY

The Aftercare/Rehab group is one of the most frequently attended groups in Recovery Services.  This group is offered four times per week – twice on Mondays mornings, twice on Wednesday mornings, once on Wednesday evenings and once on Thursday evenings.  “Living in Balance”, the evidenced based curriculum from Hazelden, supplemented by videos, is used in this therapy group.

The group is designed for those Veterans who have completed inpatient treatment and need ongoing care and support as well as for those Veterans who need Substance Use Disorder treatment, but don’t need or have the ability to attend our intensive level of care.  The groups are ninety minutes in length and a number of recovery topics are addressed over a six-month period.

Coordination is done with the courts and other referral sources to insure legal or other issues are addressed.  Veterans are seen individually for initial treatment planning and for individual therapy and treatment plan updates.

CLINCAL VIDEO TELECONFERENCING

 

Clinical Video Teleconferencing (CVT) is an innovative tool which allows providers to reach Veterans who live great distances from the Columbus VA. This treatment delivery system affords Veterans the opportunity to receive treatment for SUD’s at their nearest Community Based Outpatient Clinic in lieu of making long commutes to the Columbus VA. Treatment is delivered through a tele-monitoring system which provides face-to-face contact between Veterans and providers throughout CBOC’s in Marion, Zanesville, and Newark. This group meets weekly on Wednesday’s from 1PM- 3PM.

 
COGNITIVE BEHAVIORAL THERAPY

Cognitive Behavioral Therapy (CBT) is a well-researched, efficacious, and time-limited psychotherapeutic approach that has been used to treat a number of mental and behavioral health conditions. CBT involves a structured approach that focuses on the relationships among cognitions (or thoughts), emotions (or feelings), and behavior. As the name suggests, CBT is guided by an integration of cognitive and behavioral therapies. Cognitive behavioral theory has informed treatment for a variety of different mental health conditions. Treatments based on cognitive behavioral theory have been successfully applied to problematic substance use. CBT for substance use disorders (CBT-SUD) is offered through Recovery Services on an individual basis and typically lasts between 10-15 sessions. Veterans will be referred to this form of treatment following completion of core assessment and documented properly in treatment plan which can be updated throughout

the duration of treatment.


MOTIVATIONAL INTERVIEWING/ENHANCEMENT THERAPY

Motivational Interviewing (MI) is an evidenced based practice used to help Veterans make changes.  All clinicians in Recovery Services are trained in this intervention.  MI has been proven to help a Veteran evaluate any issues or concerns regarding substance use and decide if any changes are needed.  MI is based upon the idea that the Veteran is in charge of treatment goals.

Motivational Enhancement Therapy (MET) is the use of MI in an assessment and feedback format. MET is a four-session process, each of which is designed to help the Veteran explore any use of alcohol or substances and then decide if any changes need to be made.  The Veteran is always in charge of change during this process.   Veterans who are being prescribed pain medications and have a positive Urine Drug Screen for substances are often referred for this process.  MET is also a useful process for those who are not sure there is a problem with alcohol or other substances, and want to take some time to explore this issue in a safe and supportive environment. 


GAMBLING TREATMENT

Recovery Services offers a specialized treatment for veterans needing help with a gambling problem. It is designed to help with the effects of a gambling problem on their lives. Services include consultation; psychosocial assessment; individual and family counseling; financial planning and budgeting; and relapse prevention.

 

SELF-HELP GROUPS

Women’s Peer Support Group

A peer lead group for any Veteran identifying as female for the purpose of empowering a gender specific population. Women are encouraged to become self-advocates in their healthcare by preparing and asking important and appropriate questions. Supportive feedback and resource navigation are shared among participants to include but not limited to; substance use disorder, basic needs, emotional health and women’s health. This group is catered by VCS funded by Central Ohio VA Health Center. This group gives participation incentives and outings based on availability of funding.           Friday 10:30-noon in 1A201

SMART RECOVERY

The SMART group is a self-help program facilitated by a certified facilitator and is open to Veterans and the public. The four-point program teaches individuals with any addictive behavior to build and maintain motivation, cope with urges, manage thoughts feelings and behaviors to live a balanced life. The program utilizes REBT (originally known as Rational Emotive Behavioral Therapy). Sponsorship and spirituality are not a part of this program. No scheduling or advanced notice is necessary for attendance.   Thursday 3:00-4:00 in 1A203

 

ALCOHOLICS ANONYMOUS (AA)

AA is the original 12-step program founded by a Veteran with PTSD and a physician established in 1935. This group is independently operated by members of the program with sobriety. AA is a spiritual program that practices 12 steps and 12 traditions that have helped millions of members obtain and maintain long term sobriety. Sponsorship, building supportive networks and self-inventory are key concepts. This group is open to Veterans and the community on a walk-in basis.

Tuesday noon-1:00 in 1A201


Narcotics Anonymous (NA)

NA is a 12-step program with an emphasis on the addiction to drugs. This group is independently operated by members of the program with substantial recovery. NA is a program the practices the usage of sponsorship and supportive networks. Frank and candid conversations are based on given topics by participants and/or the literature called the Basic Text. This group is open to Veterans and the community.     Friday noon-1:00 in 1A207

ASSESSMENT/TREATMENT PLANNING

 

All Veterans seeking treatment regarding substance use are seen for a biopsychosocial assessment. During this assessment, information is gathered about the Veteran’s life to determine what type of treatment would be most helpful to this Veteran.  The clinician will make a recommendation regarding type of treatment indicated based upon the assessment, however, the Veterans are always free to choose another type of treatment, provided they meet the requirements for that treatment.  Treatment planning is worked on collaboratively.    Clinician will make appropriate referrals (detox, inpatient, residential or outpatient treatment) and also help alleviate any barriers to accessing care.

 

Assessment and treatment planning sessions typically last 90 minutes.   Veterans can schedule an assessment by calling 614 257-5440 or can be seen as a ‘walk in’ Monday through Friday.

Contact Info

Location

  • 420 North James Road
    Columbus, OH 43219
    1st Floor

Contact Number(s)

  • 614-257-4285

Hours of Operation

  • Monday through Thursday, 10:30-3PM
    Walk in referrals accepted 8:30am to 3:00pm