Day One at SunCloud Health?
Day one in treatment starts with checking in with the same therapist who did your intake so as to give you a familiar face when you arrive. We will review the day’s schedule, assign you a “buddy” for the first few days, and introduce you to your primary therapist who has been assigned to you. We will review your insurance benefits if we have not done so already, discuss our expectations of you, your expectations with us and generally just make sure you are comfortable and settling in. The first day can sometimes feel overwhelming or a bit clunky. This is normal! We will do everything we can to make sure you are comfortable, that you know where to go and when and that you begin to acclimate in a way that feels safe for you.
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Is SunCloud Health a good fit for you? Our comprehensive admission process is just the beginning.
We live in a world defined by immediacy. People know what they want and they want it “right now.” This necessity for quick answers and rapid results has metastasized into the field of behavioral health, which often results in the following scenario.
A person recognizes that some sort of therapy or treatment is needed. Understandably and in part because of the lack of standardized outcome measurements, this individual is not sophisticated as to what quality of care actually means or what type of treatment is required. Enter, the ever over-utilized internet search. A program that seems right is located and a phone call is made. Typically, in this short conversation, benefits are verified and an in-person appointment is scheduled.
At this 30-to-60 minute intake meeting, a self-history is provided to a therapist. Recognizing that a commitment to treatment can be fleeting, and without consulting anyone outside of that room, a qualitative and quantitative recommendation is often made by the therapist right then and there. The person can enter the program as early as the very next day.
Naturally, the pending patient is delighted—the entire process was quick and fairly painless. Unfortunately, this lack of information gathering is inadequate and can prove deleterious to the person in need.
Consider this question: in what other area of medicine is a diagnosis and course of treatment made immediately and unilaterally without additional clinical information such as labs or tests and made solely on self-reported information?
The answer is simple: there is none—it doesn’t exist.
Comprehensive care is a term frequently bandied about in the mental health and addiction community. At Sun Cloud Health, we believe complete care doesn’t start at the day of admission, but at the very first phone call. Every step we take is intentional, well thought out and in the best interest of the individual. We move quickly and prudently. We don’t cut corners despite the fact that we know we are “competing” against many who do. After all this is medicine and the Hippocratic oath presides.
We take our responsibility at all levels throughout treatment, including at the admission process, incredibly seriously. We know our version of Care isn’t for everyone. We admit less than 50% of the people who do an intake assessment with us. Approximately 10% decide they aren’t interested and choose another program, approximately 10% we ultimately refer to another program (mostly to a higher level of care, because they need more than what we can safely provide) and nearly 30% of people who come to us for an intake are either not willing to or can’t agree to the conditions we recommend as part of admission.
For instance, some may want to continue to smoke marijuana and only work on their eating disorder, some may want to continue to take Xanex despite being extremely depressed, some may want to continue to take their Adderall despite a long history with addiction, some may want to work on their alcohol addiction but remain at 95 lbs with a BMI of 15 and some simply don’t appreciate the connection between underlying trauma and their self destructive behaviors. There are places that will support patients in “carving out” what they do and do not want to work on while in treatment, and many of these facilities are indeed quite good at treating a specific diagnosis. For better or for worse, we are not one of these. We are a place to consider if one is interested in working on “all of it”, understanding the connectivity between various self destructive behaviors and underlying trauma. We want people to heal from their pain and embark on a journey of long term sustainable recovery. Of course we want to help everyone and save every life that we can. However our chance of doing so is significantly reduced when people are not willing or able to commit fully to all aspects of our integrative and highly sophisticated version of treatment. The evaluation process is extremely important in this regard. Long term sustainable recovery for those who are a good fit starts the day we get the first call.
Our call center is staffed with skilled professionals willing to spend the time required to determine if our program is the right fit for the individual. Because our treatment model is sophisticated and integrative, our staff wants everyone to realize that we treat addictions and disorders simultaneously. As such, we want to admit people who genuinely understand and desire our care. With that said, we respect and understand the presence of dissonance. Committing to treatment can be challenging, even frightening.
Our level of care is not always suitable; if not, we try to provide referrals and other resources. Although we view this initial interaction as an incredibly valuable aspect of the admission process, there is no cost attached.
The next step is a 1.5-2 hour bio psycho social evaluation. We regard this diagnostic tool as other professionals might view an X-Ray or CT. This is a critical component of the intake process since self-reported histories are inherently biased; we need accurate and detailed information to ensure that our version of care is correct.
We then ask permission to gather “collateral information.” This could be from an outside therapist, primary care doctor, current or past psychiatrist, or a previous treatment program. We may unearth something as seemingly minor as a bad reaction to a particular medication that the person simply failed to mention. We may request a conversation with a family member to assess the home environment. It is important to determine safety, access to drugs and alcohol, etc. If the individual has been depressed and experiencing suicidal ideation, the family needs to know the seriousness of the problem, especially if the person is living at home during treatment.
Collecting outside information such as whether there are weapons in the home or if the individual has a history involving violence or aggression toward themselves or others is vital. Not surprisingly, these types of details are rarely volunteered by the person, and yet can be a game-changer in terms of treatment.
Information such as this gives us a more accurate and comprehensive picture of the person. Additionally, a history of previous interventions as well as what worked and what did not, is highly beneficial.
We may ask for the results of recent blood work or an EKG. Labs give us an “under the hood” look to assess the extent to which the body has been impacted by the person’s behavior. For example, extreme drug abuse or an eating disorder can adversely affect cardiac function. We need to know if the heart has been weakened or impaired. When indicated, we perform a UTOX screen and weigh people (blindly).
There are those who claim this attention to detail is either excessive or a waste of time. We do not and never will. Again, imagine an orthopedic surgeon encountering a new patient. Before picking up a scalpel, the doctor conducts a physical, takes a history, and orders films. Why? Because the doctor cannot see inside that person’s body, and neither can we. We can hope a heart is healthy, we can even try to believe that a person was not high during the evaluation, or we can know it definitively through empirical evidence.
Completing the process can take a couple of days. This may prove frustrating, especially when other programs will admit quickly. But understand, we do what we do because we don’t know how to do it any other way. The decision to admit someone into our program is only made with a high level of fact-based confidence.
Addictions and disorders evolve and intensify over a period of many months, often years. Waiting a short time to access the correct care can be seen as a barrier to treatment; or it can be viewed as good medicine—the necessary steps to ensure people get the quality, comprehensive care they need and deserve.
VIDEO: IS SUNCLOUD HEALTH A GOOD FIT FOR YOU? CHECK OUT OUR ADMISSION PROCESS TO LEARN MORE.
Dr. Kimberly Dennis, MD, Medical Director, CEO and Co-founder at SunCloud Health explains the admission process at SunCloud Health, along with details on who is right and who may be referred elsewhere for treatment.