ASAM Criteria: Paving the Path to Recovery

In the ever-evolving landscape of addiction treatment, staying abreast of the latest advancements and guidelines is paramount to ensuring the highest quality of treatment. The American Society of Addiction Medicine (ASAM) stands at the forefront of this mission, providing comprehensive framework through its Criteria. This set of guidelines has become the gold standard in addiction medicine, shaping the way professionals approach assessment, treatment planning, and ongoing care.

The 6 Dimensions of Care

The ASAM’s Criteria is a dynamic and adaptable tool designed to assist healthcare professionals in providing personalized, patient-centered care for individuals struggling with addiction. The criteria encompass six dimensions, each crucial in capturing the complexity of addiction and guiding comprehensive treatment plans. In December of 2023, ASAM released its 4th Edition, which included updates to these six dimensions. They are:

  1. Intoxication, Withdrawal, and Addiction Medications
  2. Biomedical Conditions
  3. Psychiatric and Cognitive Conditions
  4. Substance Use-Related Risks
  5. Recovery Environment Interactions
  6. Person-Centered Consideration

These dimensions are used to determine which level of care is appropriate for each client. Recommendations for the level of care and treatment plans are crafted through comprehensive patient assessments, which take into account the patient’s biomedical, psychological, and social requirements.

ASAM’s Growing Popularity

The ascendancy of ASAM compliance in the realm of addiction treatment is not merely a passing trend but a paradigm shift that reflects a broader movement toward evidence-based, patient-centered care. As the prevalence of substance use disorders continues to rise, fueled by myriad social, economic, and environmental factors, the need for standardized, effective approaches to addiction treatment has never been more pressing. Against this backdrop, ASAM compliance offers a roadmap to guide both clinicians and patients towards the promise of recovery for several compelling reasons.

Standardization and Quality Assurance:

ASAM compliance establishes a standardized framework for assessing and treating individuals with substance use disorders. By adhering to these Criteria, treatment providers ensure consistency and quality across all aspects of care delivery, from assessment and diagnosis to treatment planning and discharge. This standardization promotes accountability and quality assurance, instilling confidence in patients, families, and referring professionals regarding the effectiveness and reliability of addiction treatment services.

Alignment with Evidence-Based Practices:

ASAM Criteria reflect the latest advancements in addiction medicine and behavioral healthcare. Compliance with their guidelines ensures that treatment providers are utilizing interventions and approaches that have been rigorously researched and validated for their effectiveness in addressing substance use disorders. This alignment with evidence-based practices enhances treatment outcomes and increases the likelihood of successful recovery.

Improved Communication and Collaboration:

When healthcare providers, treatment facilities, and other stakeholders involved in the continuum of care are following the same criteria, this fosters enhanced communication and collaboration. By utilizing a common language and framework for assessment and treatment planning, providers can more coordinate with one another across different levels and settings. This interdisciplinary collaboration ensures that individuals receive comprehensive, holistic care that addresses their unique needs and promotes long-term recovery.

Regulatory Requirements and Accreditation Standards:

Many regulatory agencies and accrediting bodies require compliance with ASAM Criteria as part of their licensing and accreditation standards for addiction treatment facilities. Meeting these requirements demonstrates a commitment to maintaining high standards of care and adherence to best practices in addiction treatment. Compliance with ASAM guidelines can also help treatment facilities navigate the regulatory landscape more effectively and avoid potential legal and financial risks associated with non-compliance.

Enhanced Patient-Centered Care:

These Criteria prioritize a patient-centered approach to addiction treatment, focusing on the individual’s unique needs, strengths, and preferences. By conducting comprehensive assessments and tailoring treatment plans to meet the specific needs of each patient, treatment providers can deliver more personalized and effective care that resonates with the individual’s goals and values. This patient-centered approach fosters greater engagement, empowerment, and satisfaction among those who seek treatment for substance use disorders.

 

When a treatment facility embraces the standardized framework of ASAM Criteria, they are offered a multitude of benefits. Their outcomes are improved, treatment plans are enhanced, the allocation of resources is optimized, and the decision-making of their patients becomes empowered. This is not merely a set of rules and regulations, but a path that holds transformative potential for the lives of individuals and communities affected by addiction. It represents a convergence of best practices, regulatory standards, and patient-centered principles that pave the way towards interdisciplinary cooperation and mutual support. By aligning with ASAM’s guidelines, treatment providers can enhance the quality, effectiveness, and accessibility of addiction treatment services, ultimately improving outcomes and promoting recovery for their clients.

 

If you and your organization are looking to come into alignment with ASAM’s Criteria, we can help! Accreditation Guru offers assistance by providing crosswalks of your policies and procedures to ASAM, reviewing clinical records for accurate documentation of ASAM Criteria clinical processes, and more. Click here to schedule a free Zoom consultation with us so we can further discuss your unique needs.

How Accreditation Supports Recovery Principles

The national accrediting bodies have been among the moving forces in the integration of the recovery model into the care, treatment and services for people with mental health and/or substance use disorders. Recovery principles can now be seen throughout behavioral health standards of accrediting bodies as well as the outlined expectations that an organization will demonstrate conformance/compliance to these standards. And, the integration makes sense – this model not only complements the more traditional model of medication and “talk” therapies, but also expands the focus to include the person’s own goals and strengths and empowers them to be actively involved in the process.

The US Substance Abuse and Mental Health Administration (SAMHSA) has also integrated the recovery model in their publications, requirements for certified community-based behavioral health clinics, training materials, and grants. To that end – they’ve developed the Working Definition of Recovery. Several of the guiding principles shown here are addressed in the accrediting bodies’ standards.

Accrediting bodies’ implementation of such a model involves workforce training so that staff can fully understand and embody the organization’s philosophy, thus permeating service delivery to positively impact the recovery of the people served.  In addition, the accreditation survey process itself supports the recovery principles. Surveyor(s) not only review written documents, but also observe interactions amongst staff at all levels and persons served and share their observations with the organization. This external survey can confirm, enhance, and strengthen the organization’s intent and commitment to recovery principles

While accreditation as a whole supports the recovery model, below are specific examples of ways in which accreditation and the recovery model intersect:

Person-Driven – An individualized plan of care, treatment, and services based on the needs, strengths and abilities, preferences/expectations and goals of each person being provided care, treatment or services is a core accreditation requirement. “Boiler plate” plans that repeat over and over the same information for each person served will result in survey findings (unsatisfactory conformance/noncompliance with standards) and the need for correction to achieve full accreditation. Furthermore, it’s an expectation that an accredited organization actively involve the person served in identifying their needs and preferences for aftercare and, as much as possible, making choices about where, type, and by whom.

Holistic – The needs of the person in relation to various life domains, such as physical health and housing, are addressed in case management/care coordination standards (assessment of the person’s needs and assistance in meeting these identified life domain needs). Since access to routine and needed physical health care can be a challenge for those who need it, the accrediting bodies offer options for the integration/coordination of physical health care. Health Home standards have been established to facilitate successful integration of physical health care with an organization’s traditional behavioral health programs.

Culture and Respect – Accreditation standards emphasize that the person served encounters respect in all aspects of their care, treatment, or service experience and this is reflected in the organization’s policies, procedures, rules, and expectations as well as the rights and responsibilities of the person served. Standards clearly emphasize that service delivery is provided by staff in an atmosphere of respect and understanding and sensitivity to cultural values, beliefs, and preferences.

Trauma – The approach of the accrediting bodies to trauma centers around their screening and assessment, planning and delivery of services, and workforce training standards. Standards require a screening and assessment process to identify people whose lived experiences either currently and/or in the past may have included trauma(s). Also, organizations need to demonstrate that the impact of trauma on the person served is considered in the planning and delivery of care, treatment, or services.

Peer Support – Peer support services are an important component of the recovery model. These services are part of the plan of care, treatment, or services, and are provided by trained individuals who share similar lived experiences with mental health and substance use challenges. Accrediting bodies not only recognize the utilization of this type of service by mental health and substance use treatment providers, but also have developed standards addressing the integration of these services into the planning of care with the active involvement of the person served.

The accrediting bodies require written plans, policies, or procedures promoting these recovery principles to form a framework for implementation and a communication to staff and people served of the philosophy, beliefs, and values of an organization.

For more information on the recovery model and/or how accreditation can benefit your organization, visit AccreditationGuru.com.

 

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.

Telehealth – One Size May Not Fit All!

As the COVID-19 pandemic has evolved, technology-based service delivery – “Telehealth” (aka Teletherapy or Telemedicine) has quickly become a necessary mode of service delivery for behavioral health providers. One study reports that using telehealth for substance use disorder care has increased 1,400% during COVID. The tremendous uptick over such a short time necessitated a “learn as you deliver” approach for many providers. Now, eighteen months into the pandemic, providers are trying to transition into a new normal and evaluating whether they should offer online, in-person, or hybrid services. Lessons learned from the quick adoption of telehealth for behavioral health care indicate “one mode does not fit all”.

What will be the best mode of service delivery in the future?

In terms of patient satisfaction, it may be a mix. A Vista Research Group study indicates that patients receiving both face-to-face and telehealth treatment consistently rated their satisfaction more highly than those receiving only in-person care. “I see a tremendous variance in staff and clients’ perceptions, experiences, and value assessment of behavioral health telehealth service deliver,” says David G. Branding, PhD, CEO, JAMHI Health and Wellness, Inc.

Yet Behavioral Health Business reports that a market research study polled individuals receiving tele-behavioral health services and showed the majority – 84% – wanting to continue. Reasons for continuing virtual services include the convenience, lack of need to travel, and more comfortable surroundings at home. Carol Smith, one of Accreditation Guru’s CARF accreditation experts, says, “The organizations that I am working with report increased accessibility for their clients due to services being delivered virtually.”

But not everyone has equal access to, or comfort with, telehealth technology, per a RAND corporation study. “While the increased use of telehealth was widespread, some groups of Americans reported using the services less often than others,” said Dr. Shira H. Fischer, lead author and a physician researcher at RAND, a nonprofit research organization.  “If telehealth use is going to remain high, we need to ensure quality of access, particularly for behavioral health care where education, age, and gender were all associated with levels of use.”

Indeed, behavioral health providers are hearing mixed reactions to continuing telehealth. As Colorado Behavioral Healthcare providers transition back to in-person service delivery, they are receiving mixed feedback. “Some staff and clients want to continue with virtual services, while other staff and clients want face-to-face services,” says Doyle Forrestal, Chief Executive Officer of Colorado Behavioral Healthcare Council

As organizations adapt service delivery modes to changing environmental conditions, critical factors to consider are efficacy, client satisfaction, and accessibility. Dave Branding reminds agencies that no matter what mode(s) of service delivery are used, services must always be person-centered.

Accreditation Guru can provide knowledgeable, experienced, and efficient consulting for ay behavioral health organization on the path to (re)accreditation, regardless of your chosen service delivery.

We’d love to hear from you! Reach out to us for more information.

Sources

  1. LexisNexis Risk Solutions, 2021 Mental Health Report Validates Surge in Mental Health Telehealth Visits During pandemic, healthcaredive.com (May 20, 2021).
  2. Conti, Joanna, Why Were Patients Dissatisfied with Telehealth-Only Addiction Treatment? vista-research-group.com (July 22, 2021).
  3. Coward, Kyle, 84% of Americans Want to Continue Getting Mental Health Care Via Telehealth Post Pandemic, BHbusiness.com (July 8, 2021).
  4. Fischer, Shira H., MD, Use of Telehealth Jumped as Pandemic Shutdown Begun, Use is Highest for Mental Health Services, Rand.org (January 11, 2021).

For more information or questions about the contents of this article, please write or call Jennifer Flowers @ Jennifer@AccreditationGuru.com / 212.209.0240.   This post contains original content and was written for Accreditation Guru, Inc. Use of this copy is permitted with credit and reference within the same body of copy to Accreditation Guru, Inc.