How we determine level of care

It’s important to follow treatment recommendations

Substance abuse treatment, like other forms of treatment, follows a spectrum of care known as the continuum of care. This range marks the most intensive and least intensive services, as well as everything between. Where you fall on that line is called your “level of care.”

Determining someone’s level of care involves a clinical substance abuse evaluation and, from that evaluation, a level of care recommendation for treatment from the clinical supervisor. At Project Courage, we deliver these types of recommendations within 24-48 hours after an evaluation.

After an assessment, we use two different level of care guidelines as well as five risk indicators to make our treatment recommendations. There is a misconception that substance use patterns dictate the needed level of care, but it’s more important to use these guidelines and indicators to make more accurate recommendations.

Level of care criteria

First, we look at the American Society of Addiction Medicine (ASAM) criteria, a set of six dimensions that we explore during an evaluation. As the client goes through personal history, we get a clearer picture of use and life patterns – information that we then use to determine a level of care.

Second, we look at the Level of Care Utilization System (LOCUS) or CALOCUS for adolescents. Based on ratings in the six areas (risk of harm, functional status, co-morbidity, recovery environment, treatment/recovery history, and engagement/recovery status), we generate a score to determine a level of care.

Together, these two criteria methods provide accurate an accurate level of care recommendation.

Risk indicators

In addition to the two sets of criteria, we examine five core indicators to help make our determination.

  1. Family history — Is there a family history of substance abuse? With family history, we consider the role and potential risks of genetics. A family history of substance abuse increases the likelihood of inheriting that trait.
  2. Adverse Experiences — Have there been significant stressors? We consider the number of stressors over the course of the life span – more stressors mean more risk of developing a substance use disorder.
  3. Impaired control—Has the individual tried to cut down or stop and not been successful? Or, desired to cut down or stop use for a prolonged period, but has never taken steps towards change?
  4. Age of initiation—When did the person start using the substance? The younger someone starts, the more increased risk of a substance use disorder diagnosis.
  5. Readiness to change— Does the person feel as though there is a problem? If so, how willing is that person to take action? Careful consideration of the other risk indicators is important as readiness levels can greatly impact treatment.

These risk indicators, in conjunction with the ASAM and LOCUS/CALOCUS criteria, provide a very thorough picture of the using habits and history, allowing us to make a truly informed recommendation.

Project Courage believes in proper placement

We do our very best to provide every person with a thorough look at how we develop a treatment recommendation and have been creative in developing customized treatment plans to provide the best possible service. At Project Courage, we believe strongly in providing a level of care that is appropriate to a person’s needs, even if those needs are beyond our services.

Our adult and adolescent services are:

We are accepting new referrals and would be happy to help assist you and your family in making the next step toward recovery.

By: Courtney Bushnell