What to Expect During Treatment

Your treatment plan, developed after your initial assessment appointment, is the essential document agreed upon by you and your primary counselor to include the identified problems, goals, objectives, target dates and interventions of the treatment process at C2R. You and your primary counselor will review it two weeks thereafter to monitor progress and necessary revisions.

Although early research suggests that online counseling can be an effective approach to treating substance use disorders, it is a newly developed modality without a proven track record. If there are early indications (i.e., within the first 3 weeks of treatment) that treatment does not seem to be effective, please speak to your counselor about alternative treatment approaches including traditional, face-to-face counseling; community-support groups; or residential treatment services.

Your C2R group facilitator will be utilizing the Wellness Self-Management Plus (WSM+) workbook to present you with important topics on recovery. You will be provided with a copy of this workbook upon admission to the program. It is your responsibility to read the assigned lessons and complete the assigned worksheets in a timely fashion.

The WSM+ workbook topics are evidenced- based, research findings which have shown that studying these topics can make a difference in your recovery. The primary goals of the WSM+ program are: learning about mental health and substance use recovery; making the best use of services for substance use, mental health and physical health services; learning how to achieve my goals; decreasing symptoms associated with substance use and mental health problems; learning how to manage daily stress and prevent relapse; staying well by connecting to others; living a healthy lifestyle; and understanding the connection between substance use and mental/physical health.

View the PDF Here.

The primary modality of treatment in C2R is the videoconferenced, group session. These 90-minute sessions typically meet twice weekly in the early phase of treatment and once weekly in the maintenance phase. The early phase groups consist of 3 segments: a review of the previously assigned reading/exercise, a skill-based lecture led by the group facilitator and a check-in with each of the group participants. Participants have the option of giving only their first names or using a user name to protect their identity. All members are able to see the group facilitator and each other in real time.

Group participants complete a sign-in sheet during the group providing the number of consecutive days clean and sober, the number of community support groups attended for the week, a level-of-distress rating, and a self-efficacy rating (daily confidence rating for maintaining abstinence from drugs/alcohol).

Group participants are expected to sign into the group at least 15 minutes prior to the scheduled group time to ensure that there are no technological glitches. (See Technology Breakdowns for more information.)

Revealing the identity of group members and revealing what is said in groups to outside entities is strictly forbidden. Failure to abide by this may be grounds for termination from the program. There is absolutely no recording of group sessions. This will be considered a breach of confidentiality.

Group members are expected to attend all group sessions free from mood-altering substances, to respect each other during group sessions, to refrain from any threatening or offensive language (i.e., sexually, racially, or religiously offensive comments), to dress appropriately if being seen on video, and agree not to allow a non-group member to participate in any way (i.e., listen, watch, read) in the group sessions. (Please be aware that C2R reserves the right to allow clinical supervisors to periodically observe group sessions for quality assurance and clinical supervision.)

Group members are expected to participate in groups while sitting in a private place free of other people or noisy distractions. It is recommended that you purchase and use a headset with a microphone during groups to minimize voices being heard outside of your private area. Please turn off all cell phones, land phones, television sets, and radios during the group time. Please refrain from smoking or eating during group sessions. You are expected to remain in the group for the duration. If you must leave, you are expected to notify the group facilitator.

For any technical difficulties, failures or interruptions during group times, please contact our IT department at support@chat2recovery.com.

Upon signing in to each of your groups through WebEx, you will be asked to complete a written sign-in sheet detailing specific information. The following is an explanation of each of the columns to be completed

User Name/ID# – place your first name or identification number in the box, whichever you prefer.

# Days Clean & Sober – in this box, write the number of consecutive days of maintaining abstinence. If you used substances the same day, you would put a “0” in the box.

# Of Community Support Groups Attended For Week – write in the number of community support groups (i.e., AA meetings, church meetings, etc.) that you have attended in the past week.

Current Level of Distress Rating (1-10)– This box asks you to rate your current level of distress using a number from 1 to 10 with 1 being no distress to 10 representing severe distress

Current Self Efficacy Rating (1-10) – self-efficacy is defined as your current level of confidence to maintain sobriety or abstinence from your problem substance(s). A rating of 1 suggests no confidence to maintain abstinence whereas a rating of 10 suggests full confidence.

I Have Completed Today’s Assignment – you will be assigned readings and written exercises prior to each group session. Have you completed the assignment – Yes or No?

• Be honest in group including recent substance use
• Treat fellow group members with respect
• Speak one at a time
• What is said in group, stays in group
• Be drug/alcohol free for group sessions
• Stay on topic

• Complete readings and written assignments prior to group sessions
• Attend groups regularly and on time
• Sign-in 15 minutes before scheduled group time
• Honestly complete sign-in sheet (to be discussed)
• Participate in a private area free from distraction (turn off phones, radios, t.v., etc.)
• Actively participate in sessions
• When possible, use a headset with an attached microphone
• Remain in group for the entire duration
• If you must step out, inform your group facilitator
• Absolutely no recording of group sessions
• Non-group members are not allowed to participate in any way (e.g., listening, watching, or reading)
• Refrain from smoking and eating during group sessions

Periodic, 30-minute sessions, held by either videoconferencing (e.g., Skype), telephone, or face to face, are arranged directly between you and your primary counselor. These sessions are held in order to monitor your treatment progress, explore obstacles to treatment goals and objectives, revise your treatment plan, assess the need for a higher level of care, determine if other services are recommended (e.g., couples counseling, psychotherapy, etc.) and to arrange for discharge. Typically, you are scheduled to meet with your counselor every two weeks (3 times) during the 6-week program. However, other factors may determine a varying frequency of these sessions.

An essential factor in your successful treatment experience is simply showing up. The act itself confirms to oneself a commitment to change. C2R has the expectation of a consistent show rate to all of your scheduled appointments during your 6-week program and beyond. If you cannot make an appointment, we do expect you to contact your primary counselor ahead of time by either phone or e-mail to report your planned absence.

Because videoconferencing is still such a new and developing medium, we expect you to arrive to your scheduled group sessions, at least, 15 minutes early to ensure a successful connection. By checking in early, you leave some time to contact our IT department in case of difficulties with your connection. If you will be late for scheduled sessions, please notify your counselor, when possible, in advance.

C2R is a completely voluntary program. Honesty to yourself, your group, and to your counselor is an essential ingredient for achieving a successful result. No one expects perfection, so neither should you. If you have setbacks, if your cravings feel uncontrollable, if you’re losing hope, please speak up. Everyone can relate and many can help you. You have taken a big step in asking for help, so let others help you when you need it.

One of the limitations of online counseling is the possibility of misunderstandings occurring while using text-based modalities such as e-mail or internet chats due to a lack of verbal and non-verbal cues. Without these cues, such as voice inflected in anger or despair, seeing a smile indicating that a statement was made in jest, a statement not understood to be sarcastic, or not seeing someone crying, information may be misconstrued. Even with videoconferencing, given its limited bandwidth, misunderstandings may develop while information and verbal and non-verbal cues are lost in transmission. Consequently, both the client and the counselor must make an extra effort to be clear in communicating what is actually being stated.

During the time that you are enrolled in C2R, we ask that you refrain from all mood-altering substances not prescribed by a physician. It is important that you develop new coping skills that don’t involve the use of substances. Often, people replace their drug of choice with other substances leading to the development of new dependencies. Also, it is not respectful to your group peers to be using substances that they are trying so hard to abstain from themselves. If you begin taking any new medication, including over-the-counter medications, please inform your primary counselor.

Due to their potential for abuse, the following prescribed medications are discouraged:

• Opioid-based painkillers (e.g., codeine, Vicodin, Percocet, Percodan, Oxycontin, etc.)
• Benzodiazepines (e.g., Valium, Xanax, Klonopin, Ativan, etc.)
• Sleep Medications (e.g., Ambien, Sonata)