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Intensive Support for
Those Fighting Addiction

“It’s important to remember,” says Dr. Mona Gupta, “that substance abuse or any other addictive behavior is simply one way in which people seek relief from physical, mental, or emotional pain. Our goal in working with these patients is not only to help them overcome their addiction, but to address the underlying pain.”

Cassie Sicheri (left) and Justin McLendon confer on a treatment schedule for
patients in the Substance Abuse
Intensive Outpatient Program

Over the years, Dr. Gupta has seen and addressed a variety of addiction issues in her Raleigh-based psychiatric practice. “It is an important focus of our practice,” she says. “Consequently, we are aware of, and connected with, all the resources in our area available to these patients and have developed strong referral relationships with many providers.”

As the need has evolved, so has her approach. “The staggering increase in drug use and abuse is truly a national epidemic affecting millions of Americans,” she says. “And it has become increasingly clear to me that there is now a much greater need for support for those struggling with addiction. And our practice is responding to that need. For example, we now offer monthly treatment with Naltrexone—a drug that can help individuals overcoming opiate abuse—as part of a complete treatment program.

“And I am very excited to announce the launching of a new program—Substance Abuse IOP—to help patients dealing with substance abuse and addiction.” IOP, she explains, stands for Intensive Outpatient Program. “This program fills a very real need,” she says, “because it provides a level of support not typically available outside a residential program.”

With practice newcomer, Justin McLendon, and longtime practice veteran, Cassie Sicheri, Dr. Gupta has assembled a team with the professional and emotional qualifications to help program participants succeed in overcoming substance addiction.

Health&Healing: What exactly is Substance IOP?

Meet the Team

While new to the practice and to North Carolina, Justin McLen-don brings 10 years’ experience in mental health and community mental health. His credentials include Licensed Professional Counselor and Licensed Clinical Addictions Specialist. He has an undergraduate degree in psych-ology and a master’s degree in clinical mental health counseling.

As the executive director of Gupta Psychiatry, Cassie Sicheri has been with the practice since its early days. She holds degrees in both psychology and in organiza-tional administration.

JUSTIN: “Intensive outpatient” is the level of care that exists between residential treatment and traditional outpatient treatment. It recognizes that many people dealing with substance abuse issues need a lot of support, but may not need or be able to participate in a residential program.
The program itself includes a combination of group therapy, individual counseling, and family/couples counseling. We use a heavy psychotherapeutic approach in IOP, and we also rely on Dr. Gupta—who will facilitate medication management—to address a patient’s disease with different approaches, as needed.

H&H: How does IOP differ from traditional outpatient care?

JUSTIN: It’s the amount of time—ten hours a week. With more touch points, there’s more accountability. Also, if they start to slip or struggle along the way we can intervene more quickly.

In a typical outpatient situation, a patient may go seven days between sessions with their counselor. For someone struggling with acute substance abuse issues that’s simply, too long.

CASSIE: Nine hours a week is spent in group therapy—a variety of process, psychotherapeutic, and experiential sessions. One hour a week is individual counseling with a licensed therapist—as a minimum. But the program gives us the flexibility to work with individual clients as much or as little as we need to do, case by case.

For example, we could potentially have three individual sessions a week: two with family and one directly with the patient. We want to do whatever is needed to help the person move to where they need to be.

H&H: How does this program deal with the family dynamic?

JUSTIN: Any good substance abuse treatment will incorporate the family. If we don’t do that, we are just simply not giving them the best chance moving forward. Whatever that family dynamic looks like, everybody in that family system has to be on board and incorporated into that healing and that change process.

CASSIE: I think a huge piece of that is educating the family. It’s not uncommon for family members to feel angry or resentful toward the addicted member. They may think he or she is doing drugs out of spite or using substances to hurt them, but there’s so much more to it; and addiction does not work that way.

H&H: Tell us more about the logistics of the program.

JUSTIN: It spans a minimum of two months—60 days—although someone who needs additional support can absolutely extend that.

CASSIE: One of the most important purposes of an intensive outpatient program is to provide significant support without major disruptions in people’s lives. We understand patients need help but still have to go to work and take care of children. So, the program is carefully designed to minimize disruptions.

We schedule group therapy sessions from 5:30 to 8:30 PM two days a week, and from 9:00 to noon on Saturdays. This way, we’re not affecting the average employee’s hours, and allowing time, perhaps, for the spouse to take care of their children. You’re still getting the focused care you need, but it’s not going to fully disrupt your day-to-day activities.

H&H: What about the size and structure of the groups?

CASSIE: The groups tend to be smaller and more personal.

JUSTIN: And there’s a real benefit for patients in such a system, in that they are connected with a variety of people—all bringing and sharing different experiences and different points of view. That model gives each patient a chance to see perspectives and sets of challenges at different times in the recovery process.

H&H: So, how does one get into this program?

JUSTIN: We welcome referrals from many sources: from residential, inpatient treatment facilities, or local hospitals, local therapists, local physicians, primary care, or even internally. We might see people who come from the psychiatry or outpatient counseling practice here.

CASSIE: And please note: You can also self-refer. If today is your day, then give us a call and we’ll take care of you.

JUSTIN: The initial step is to make sure we understand the problem and that we’re recommending the correct level of care. We’ll sit down with the person, find out their history, what’s been going on, what’s the current level of use, and what is the current need. This assessment allows us to identify patients who may need a higher level of care—so we can meet the patient where they are.