Discharge Planning & Placement Treatment

APEX Rehab

At APEX, our mission is to help every patient recover from addiction and live their best life. In doing so, we take care of patients in every step of their recovery process. For residential patients, this may mean continuing to work with our therapists through outpatient treatment, group counseling or our sober living programs, among others. We strive to provide our patients with the best ongoing care, realizing that sobriety is a lifelong challenge. 

Even though every rehabilitation program is specially adapted to the patient’s needs, one thing is in common for all programs – the hope and plan that the patient will be discharged. It may sound counter-intuitive, but plans for discharge are made at the beginning of the recovery.

We put a lot of effort into carefully designing and refining the discharge plans as the rehabilitation process advances, because that way we ensure the best possible support for the patient once they leave the safe environment of our alcohol and drug rehab in San Diego.

During rehabilitation, patients prepare for the life ahead of them, but when that stage comes readjusting can be challenging. The first few months are especially risky for relapse and that’s why well-envisioned discharge plans are crucial. Patients need something solid to hold on to after they leave the “safety zone” of our San Diego alcohol and drug rehab. They know what is waiting for them when they return to their normal life. 

Residential patients typically continue treatment through our outpatient programs, where they can get further counseling and psychotherapy. This aftercare, also called continued or extended care, takes place after the completion of the rehabilitation program. Patients enter it when they are generally able to function in the outside world, but they need ongoing support through adhering to the discharge plan and working with therapists.

The patient’s treatment coordinator and the team of professionals the patient has worked with work on building a plan that takes into account specific risks, as well as the strengths and needs of the individual, family and community. The plan also promotes the patient’s and the family’s resilience, commitment to recovery and inclusion in community life.

Discharge Planning & Placement Treatment

Case Management Treatment San Diego

APEX Rehab

Overcoming addiction is no easy task. At APEX, we understand your struggle. That’s why we want to make recovery as simple as possible for all of our patients. When patients work with APEX, they’re assigned a treatment coordinator who manages their case from inception through treatment and post-discharge. Your treatment coordinator will handle all paperwork, work with your insurance company and ensure you are getting the best possible treatment.

Treatment coordinators are experienced and qualified individuals who have the ability to relate to the patient, build trust and support them in their transformation. They are the patients’ unique assistants who help them navigate the recovery process until they can find their own way.

Having a treatment coordinator in alcohol or drug rehab in San Diego has multiple advantages. First of all, this person handles administration and coordinates all the various elements of care. They also manage the patients’ insurance providers and work for the best interest of the patient, who is typically not able to take on this responsibility.

Treatment coordinators are also a single point of contact for the patient to access all services available. These professionals provide a single, well-structured service that facilitates the rehabilitation and extended care for the client and adds a sense of continuity.  

Case managers, as they are also called, serve as a single point of contact for the family as well. They provide support to the family and friends by providing them relevant information regarding the process of rehabilitation and the specific services available. They can also mediate between the family and therapists and in that way, include the family more in the patient’s recovery.

Case manager responds to the patient’s needs and thus, engages the patient more in the recovery. They also work as additional support and a certain role model for the patient. Their pragmatic skills can implicitly teach the patient how to handle the practical things after rehabilitation.

Finally, treatment coordinators have an anticipatory role. Because they are well familiar with the recovery process and because they grow to know the patient well, they can anticipate which problems or issues are likely to emerge and then work with the patient and the staff to handle those issues effectively.

APEX Rehab is one of the leading addiction treatment centers in San Diego, seeking to provide an all-rounded addiction recovery care of unparalleled quality. We have developed programs and procedures that streamline the recovery process and allow the patient to access all the treatments they could benefit from quickly and effortlessly.

Case Management Treatment

EMDR Therapy San Diego

APEX Rehab

For patients who have been through some type of trauma, whether acute or long-term, APEX incorporates Eye Movement Desensitization and Reprocessing or EMDR therapy into their treatment. EMDR has been proven to decrease stress related to addictions, depression, anxiety, PTSD and other traumas. Deeply embedded memories can be challenging to bring to the surface and talk about. Our team of licensed therapists are trained to help patients address these past issues in a safe, comfortable environment so they can move forward in healing.

EMDR can help patients resolve the traumatic experience. Trauma is at the core of many conditions, so it follows that if trauma is relieved, so is the resulting condition.

Traumatic experiences can have a truly debilitating effect on an individual’s life and cause them to have negative psychological and physical responses. Sometimes, the effects can be so powerful that they result in anxiety, depression, insomnia and self-destructive behaviors such as addictions.

People automatically want to repress memories of traumatic experiences. However, this is impossible and even if they do succeed in burying the experience deep into the subconscious, the effects will not disappear.

EMDR is a standardized set of procedures that combine eye movement, attention focus and visual, auditory or tactile stimulation. The procedures activate the disturbing experiences and lower the negative response through reprogramming with positive associations.

In a typical session, the therapist will ask the patient to follow an object with their eyes only and simultaneously recall the traumatic experience. Next, the patient will be asked to focus on a positive memory and then they will switch between the traumatic and the positive memories. The object that is followed can be substituted with some light or some auditory or tactile cue. The process is not as simple as it sounds and must be conducted by a qualified professional.

EMDR has demonstrated an enormous success in reducing the adverse emotional, mental and physical responses in individuals who have suffered a trauma. What is important is that results are achieved rather quickly, sometimes even immediately.

It isn’t clear just how this therapy does what is does, but the results are unarguably remarkable. One possibility is that the eye movement involved mimics the one in REM (rapid eye movement) sleep cycle. During REM sleep, our brain processes information and this cycle is also known to reduce anxiety. It seems that the information processing during REM and EMDR allows the individual to put things in a different perspective.

Alcohol and substance use disorders are highly individualized conditions. The qualified therapists at APEX Rehab apply EMDR together with a wide range of other therapies – pharmacotherapy, counseling, psychotherapy, holistic healing, nutritional counseling, fitness and recreation and alternative experiential therapies. Only a varied approach that is specifically tailored to the individual’s needs can work for a successful alcohol and drug rehabilitation in San Diego.

EMDR Therapy

Trauma Therapy San Diego

APEX Rehab

We utilize both cognitive behavior therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR) to help patients remember, articulate and heal from past traumatic events. Whether the trauma originated in childhood, adolescence or adulthood, we employ proven psychological counseling methods that help patients recover from emotional wounds. Through this healing, they’re able to better tackle addictions and mental illnesses resulting from trauma.

Trauma is not necessarily easily identified. The National Comorbidity Study revealed that as many as 51% of women and 61% of men had had a traumatic experience of some sort. The type of trauma tends to vary by gender, but women experience a broader range of trauma.

It’s easy to recognize that exposure to or witnessing assaults, rapes, combats, violence, near-death experiences and accidents are traumatic, but trauma can also be neglect, rejection, abandonment and emotional abuse. Trauma can happen once or over a period of time, but it will make the individual feel afraid, less trusting and maybe guilty, ashamed or incomplete.

Negative symptoms of trauma are anxiety, fear, guilt, shame, self-blame, irritability, agitation, insomnia and difficulties with concentration. When individuals don’t deal with their trauma, it can have a crippling effect on their lives and it makes them more susceptible to developing addictions in an attempt to self-medicate.

There are numerous techniques and therapies that provide ways of approaching trauma in addicts and APEX Rehab uses a variety of them.

Cognitive behavioral therapy explores the negative and self-defeating thought patterns that prompt users into addictive behavior. It seeks to replace the negative thoughts with constructive alternatives.

Eye movement desensitization and reprocessing (EMDR) is a non-traditional psychotherapeutic approach. It has been mostly used with individuals suffering from a Post-Traumatic Stress Disorder (PTSD), associated with events such as combat, assault, rape and car accidents. Its goal is to weaken the effect of negative emotions and make disturbing memories less disabling.

Dialectical behavioral therapy aims to help the patient accept pain and past experiences, but also to encourage the patient to change thought patterns and emotional responses.

Experiential therapy that includes music and art  can also be beneficial in encouraging patients to get in touch with their suppressed emotions. These therapies can also enable the patient to learn how to express their emotions and deal with them in a less destructive manner. APEX Rehab is also one of the few addiction treatment centers in San Diego that include Rock to Recovery technique. This is a form of songwriting therapy that allows patients to learn new ways of expression and relaxation while enjoying and having fun. 

Trauma Therapy

Sexual Issues in Recovery Therapy San Diego

APEX Rehab

Sexual issues, including performance anxiety, low libido and sexual addiction, can accompany almost any mental illness or addiction. Additionally, treatment for substance abuse and other mental health issues can result in sexual side effects that interfere with intimacy and partner relationships. APEX’s licensed sex therapist helps patients resolve their sexual issues to rebuild intimacy with loved ones and to promote positive sexual relationships.

Alcohol and drugs all contribute to sexual dysfunctions in addicts, but in different ways. Some drugs initially enhance sexual pleasure like cocaine, methamphetamines and alcohol. However, long-term abuse of these substances inescapably has a negative impact on the user’s sexual experiences because the chemicals in the brain change and the substance becomes the main source of pleasure.

On the other hand, it also happens that sexual issues are at the root of dependence and they existed in the person’s life before they started abusing alcohol or drugs. Sexual dysfunctions of any kind (problems with sexual desire, arousal, orgasm or pain) can very easily make people feel frustrated, embarrassed and inadequate. They could also be consequences of a sexual trauma which hasn’t been processed. These feelings and states make it easy for people prone to addictions to seek escape from unwanted feelings in alcohol and drugs.

Promiscuity and orgies are wide-spread in substance abusers because when people are high or drunk, their inhibitions are low. Former addicts often report waking up next to strangers with no recollection of the intercourse. This type of behavior compounds the problem, because it further closes the users off from intimacy.

Intimacy is crucial for patients in addiction recovery. Intimacy means there is trust between two people and they feel they do not have to face life alone. Being close to another human also means getting in touch with who you really are and reaching spiritual experiences that make us feel complete.

Feeling whole is the best cure for addiction. That’s why APEX Rehab includes dealing with sexual issues in addiction recovery as part of an integrative approach. Resolving sexual issues that are consequences or partial causes for the addiction means making the patient able to reconnect with their partners or to start positive, fulfilling sexual relationships after rehabilitation. It also contributes to preventing the patient from feeling depressed and possibly relapsing into old patterns.

Sexual Issues in Recovery Therapy

Coping Skills Therapy San Diego

APEX Rehab

Patients who suffer from addiction are often overburdened and stressed beyond their limits from the normal problems of life. While we all face some degree of adversity, certain individuals have a harder time coping than others. With this in mind, APEX’s approach involves behavioral modification and additional integrative therapies to help patients learn how to deal with the everyday demands of life. We’ve found that by developing better coping mechanisms, patients are much more likely to break the chains of addiction and stay sober for the long haul.

Everyone develops coping mechanisms to deal with the challenges in life, no matter how big or small those challenges are or seem to be. There is a variety of coping mechanisms, and some of them are more functional than others. For example, talking it out with someone you trust is a more constructive way of releasing tension than being passive-aggressive.

Alcohol and substance abuse is a form of coping mechanism that people use to deal with life stressors and problems. A great number of addictions start as a way of de-stressing after a long day or after a big trauma or loss. In the inception of the problem, alcohol or drugs help people avoid unwanted feelings and sometimes maybe induce heightened pleasure. With time, alcohol and drugs are abused every time the person feels something they don’t want to be experiencing and that’s the beginning of addiction.

Why are coping skills necessary for a successful alcohol or drug recovery? It’s important to understand that recovery doesn’t mean not using. People recover when they live a life in which it is easier to live without using. That inevitably means developing skills to cope with the unwanted feelings that brought the person into addiction.

It is a common saying in Alcoholics Anonymous: Nothing changes if nothing changes. A recovering addict cannot live the life they did before rehab and hope for success. This is not to say one has to change their whole life to recover, but some behaviors must. The more the former addict sticks to their old ways, the less chance they have of staying sober.

At APEX Rehab, patients work closely with therapists to recognize the harmful patterns of thoughts and behaviors and develop constructive coping skills to deal with stressors. This is done through a variety of counseling and therapy techniques – cognitive behavior therapy, dialectical behavior therapy, relapse prevention therapy, family therapy and so on.

Patients at APEX Rehab also work hard to prepare for the phase that comes after rehab. Together with the therapists they build plans and practice skills that will support them in avoiding relapse. First of all, they must identify high-risk situations and triggers for craving (people, places and things connected to their addiction). Then, they must work on the strategies for avoiding the situations and triggers and for enduring craving.

Coping Skills Therapy

Medication Management Treatment San Diego

APEX Rehab

While many patients come to us to break free from drug addiction, they often have been prescribed necessary medications as well. APEX therapists integrate medication management into their treatment protocols. The approach is two-pronged: we monitor medications that a patient takes to confirm he or she is complying with the dosage and regimen, while we also ensure the patient avoids dangerous drug interactions and other complications.

Some addiction treatment centers in San Diego are against treating recovering addicts with medication, but the general industry stance is that this attitude is behind the times. Pharmacy and medicine have come a long way in recent years and properly prescribed drugs can both alleviate the withdrawal process and reduce the cravings during rehabilitation. This is hugely important, because relapse is a high risk for addicts. The less the patient craves the drug, the less likely they are to relapse.

It is crucial, however, that the withdrawal and maintenance medication are administered under the strict supervision of a specialized addiction physician consultant. Addiction can be seen as a chronic disease which makes it extremely difficult for the sufferer to follow the rules regarding the medication without a physician’s constant monitoring. If an individual undergoes rehabilitation and relapses relatively soon by abusing maintenance meds, it is usually the case that they didn’t have anyone to manage their medication throughout the process.

Medication cannot make for a successful treatment on its own. However, it has shown excellent results in conjunction with counseling, psychotherapy and other complementary practices. When the patient isn’t burdened with the physical side of their addiction, they are able to focus better on the mental and emotional side of recovery treatment.

Medications in addiction recovery programs are used to handle withdrawal, maintain abstinence and treat co-occurring mental disorders.

Before they decide to enter a treatment program, addicts are typically afraid of the withdrawal process. A qualified addiction physician consultant will know which medications to use to make this recovery stage safe, controlled and as bearable as possible.

Medication used to prevent relapse is known as maintenance drugs. Sometimes, it is the same medication that was used in the detoxification process, but with the dosage adjusted. Such is the case with Suboxone which is used for treating opioid addiction, like heroin and prescription drugs. Maintenance drugs are vital in many cases because of the brain’s substance-altered chemistry. The recovering addict will find it difficult to function without these meds, because the brain has been rewired through their addictive behavior.

Addicts who are diagnosed with a comorbid mental disorder must take medications for that disorder. The relationship between their mental illness and their addiction is complex, but one thing is for sure – without controlling the disorder, it is quite impossible to stay away from alcohol or drugs.

Medication Management Treatment

Individual Treatment Planning

APEX Rehab

APEX follows best practices in developing individual treatment plans for all of our patients. Treatment plans are as unique as the individuals themselves, and our therapists have decades of experience in designing programs that cater to each patient’s specific needs. Our individual treatment plans are used for initial and end-of-treatment assessments and clearly outline the goals, anticipated timeframe and risks to effective treatment and recovery.

For recovering addicts, reclaiming their life and embracing sobriety as a way of life cannot be accomplished quickly or easily. It takes strong commitment for a long time to come, if not their whole life. To help them on their way to reaching health and balance, only personalized treatment plans can help.

Millions of individuals across the nation enter rehabilitation every year. Even though all addictions have a lack of control in common, there are differences in how they affect the user. Those who abuse alcohol have different health issues from those who abuse cocaine or meth, for example.

No two users are the same. Even though they can have some similar reasons or factors that brought them to addiction, the combination of those reasons, factors and their life conditions is unique. Some people suffer from comorbid mental illnesses, some have a family history of addiction, while others slowly slipped into addiction after a prolonged use of alcohol or a drug. There are many more emotional, mental and social factors at play, but there’s generally a mix of mutually interactive factors involved.

In any case, acknowledging that every patient is specific is a precondition for maximizing the success of the rehabilitation process. APEX Rehab assigns every patient a treatment coordinator and the individual treatment plans are designed through collaboration of staff professionals. The plans are intended to systematize the process, direct it and bring into clear focus what is important.

Our treatments make use of supervised medication therapy, counseling, psychotherapy, nutrition programs, recreation plans and outings, holistic healing, alternative treatments such as acupressure and alternative therapies like art and music. Each of these approaches brings its own benefits to the recovery process and the positive effects of one approach improve the results of others.

There are some principles on which we base our treatment plans. These principles have been widely accepted as a norm for contemporary addiction treatment centers in San Diego:

·        Addiction is a complex condition that has a profound impact on our brains and perceptions.

·        Recovery should make use of multiple complementary approaches to ensure the best results.

·        The treatment must address all aspects of the individual – the mind, the body and spirit. In other words, it must cater to the patient’s mental, emotional and physical needs.

·        Treatment plans must be monitored and modified so that they take into account the changing needs of the patient.

·        Medication is used if and when necessary.

·        Dually diagnosed patients must be treated simultaneously for their mental health disorders and their addiction issues.

·        Random drug testing fosters trust and encourages abstinence.

·        Detoxification must be carried out under the constant supervision of a physician. And it is only the beginning of a successful recovery process.

Individual Treatment Planning

Stages of Change Therapy San Diego

APEX Rehab

We work with patients on their road to recovery using a 6-step stages of change model. We realize that change doesn’t happen overnight; it’s a process that includes various steps that build upon each other to create lasting change. Because everyone progresses through these stages at their own rate, we work alongside our patients to provide support, encouragement and motivation every step of the way.

Recovery is premised on the motivation to change. The difference between those who succeed in changing and those who don’t is motivation. As the process of change unfolds, the motivation of the patient goes through transformations. The Stages of Change is a 6-step framework model developed by two psychologists in the mid-nineties. This model outlines the specificities and challenges of every step of the change process and it is widely accepted in addiction treatment.

According to the model, change starts with the individual being too inert or indifferent to change and concludes with the individual who has adopted new behaviors and achieved the desired change. The stages are: pre-contemplation, contemplation, preparation, action, maintenance and termination.

It is important to note that individuals who successfully change typically go through the stages a few times before they complete the cycle without a slip. However, like in Relapse Prevention Therapy, slips are seen as opportunities to learn. They can reveal valuable information and contribute to preventing the patient from committing them again.

It is very common for addicts to enter the treatment while they are at stage one – still disinterested in change. This is the crucial value of this model – therapists have the position of “agents of change”. Before this model was developed, addicts were often denied treatment if the therapists considered they lacked sufficient motivation.

Depending on the stage the patient is in, the therapist adapts the techniques and therapeutic models. For example, for someone who is still strongly ambivalent about change and is in stages one or two, Motivational Interviewing works best. However, if the patient is in stages four or five and is actively seeking change, Cognitive Behavioral Therapy is excellent. In the stage five, maintenance, it’s important to apply Relapse Prevention Therapy.

APEX Rehab is a San Diego alcohol and drug rehab center that staffs world-class therapists who lead the industry with their expertise and innovation. We pride ourselves on the variety of our resources that allows us to build personalized recovery plans that are tailored to the patient’s unique needs and background. We go the extra mile to maximize our patients’ chances for success.

Stages of Change Therapy

Motivational Interviewing Therapy San Diego

APEX Rehab

At APEX Rehab, we believe change is the basis of all recovery. That’s why we create an environment that’s conducive to change, starting with the way in which we work with each patient. We employ motivational interviewing as one step in the change process. This therapeutic approach is designed to explore the patient’s current behavior, help them articulate and understand the reasons they want to make a change, and help them throughout their journey in realizing they have the power to change.

A considerable body of scientific evidence supports the view that motivational interviewing (MI) improves the chances for a successful outcome of the recovery process, even when the patients enter rehab involuntarily. MI is about empathy and synchronizing the session with the client, without imposing anything – it is often said that MI is about meeting the patient where the patient is. Even when patients have low readiness for change, this approach can be the crucial introduction for later therapy.

MI is based on the patient’s strengths and their capacity to change harmful behavioral patterns. It focuses on ambivalence and fear of change as the two main barriers for a full recovery. Ambivalence is the patient’s internal struggle with respect to what they really want – their addiction could have brought them some benefits at some points in life, but at other points they felt that it was a harmful pattern. Ambivalence is at the base of every addiction and it’s not a denial or resistance.

These are the key principles of motivational interviewing in counseling:

·       Ambivalence is a natural component of addictions.

·       The patient and the counselor have to work together and both parties contribute.

·       Sessions characterized by empathy, support and direction provide the best conditions for change.  

Motivational interviewing has demonstrated the following benefits for rehabilitation therapy:

·       More patients choose to follow through the treatment program.

·       More patients participate actively in the treatment.

·       More treatments have successful outcomes.

·       More patients manage to avoid relapse for longer periods after the rehabilitation.

The main goal of motivational interviewing is for the patient to realize the discrepancy between their current situation, their past behavior and their hopes for the future. The counselor guides and supports the patient on the road to realizing how their behavior is different from how they would like to behave. This is done through raising the awareness of the consequences of their past actions and decisions. The therapist supports the patient to realize that the costs of their behavior outweigh any perceived benefits of the addiction.

By using motivational interviewing in alcohol and drug rehab in San Diego, APEX Rehab wishes to enhance the patient’s motivation, i.e. the probability they will start and adhere to the strategies for their change. 

Motivational Interviewing Therapy