COPE fees are set based on treatment specialties and standard rates for doctoral level clinicians. Although our rates vary depending on the clinician and the specific services you are requesting, generally speaking our individual therapy rates begin at $250. Lower fee slots do occasionally become available. We welcome you to contact us to discuss your specific treatment and financial needs. If we are unable to accommodate you, we are happy to provide you referrals to lower fee mental health centers. For specific group rates or rates on IMPROVE: Outpatient Substance Use Treatment Program, please contact us for more information.

Do you take insurance?

COPE is not affiliated with a particular insurance panel and is considered an out-of-network provider. However, Dr. Rubin is a Lyra provider and can see individuals with Lyra benefits. Please check with your insurance company to inquire into possible out-of-network benefits and rates for reimbursement. Upon request, COPE providers can provide a monthly statement documenting services received that can be used for possible reimbursement from your insurance company and/or healthcare spending accounts. Some questions that may be helpful to ask your insurance company: Do I have mental health benefits? Do I have out-of-network benefits? If so, what are the benefits? How would I obtain reimbursement for an out-of-network provider? How many sessions will be covered per calendar year? What is my deductible and has it been met?

How long does therapy last?

Treatment length varies greatly depending on your specific concerns. However, research has shown that significant improvements can be made within 12 weeks and sometimes less. Some concerns may require longer-term treatment and some individuals choose to continue coming to therapy even after initial treatment gains to maintain skills, prevent backsliding, and manage weekly stressors. Your therapist will work with you closely in the initial sessions to clarify your presenting concerns and an expected treatment duration.

How do I know if therapy will work?

Finding the right therapist mixed with the right treatment can sometimes feel like finding a unicorn for those looking to begin therapy. However, at COPE we try to make this process a reality with a number of talented, specialty trained clinicians who work with you to customize a course of treatment that suits your needs.

What can I expect from the first few therapy sessions?

The initial therapy sessions are a great time for your therapist to get to know you and for you to get to know your therapist. Both are equally important. Your therapist will use this time to ask you a variety of questions in many different domains to understand as much breadth and depth of your life as possible in order to develop a thorough treatment plan. It is important to develop a set of goals that will guide treatment during these initial sessions.

3 Research-Backed Substance Abuse Treatments

Substance use disorder (SUD) is a multifaceted condition characterized by a problematic pattern of substance use. It can range in severity from mild to severe, indicating addiction. However, SUD is a treatable mental health condition, and seeking assistance promptly is crucial if you suspect you or your child may be developing it.

People may experience more than one substance use disorder simultaneously, such as alcohol use disorder and cocaine use disorder. The impact of SUD on health, relationships, and overall quality of life can be substantial and, in some cases, life-threatening. Therefore, early intervention upon recognizing signs of SUD is essential.

The likelihood of developing SUD, termed “addiction liability,” varies among substances and depends on factors like administration method, speed of crossing the blood-brain barrier, onset of effects, and the substance’s capacity to induce tolerance and withdrawal symptoms.

3 Substance Abuse Treatments

Cognitive and Behavioral Therapies

Psychotherapy (talk therapy) can help treat SUD and any other co-occurring mental health conditions. Therapy also teaches healthy coping mechanisms. Healthcare providers may recommend cognitive and behavioral therapies alone or in combination with medications.

Some examples of effective therapies for adults with SUDs include the following:

Cognitive behavioral therapy (CBT): CBT is a structured, goal-oriented type of psychotherapy. A mental health professional helps you look closely at your thoughts and emotions during CBT. You’ll come to understand how your thoughts affect your actions. You can unlearn negative thoughts and behaviors through CBT and learn to adopt healthier thinking patterns and habits. For SUD, CBT also involves encouraging motivation to change and education about treatment and preventing relapse.

Dialectical behavior therapy (DBT): DBT is especially effective for people who have difficulty managing and regulating their emotions. DBT has proven to be effective for treating and managing various mental health conditions, including SUD.

Acceptance and Commitment Therapy (ACT): ACT is grounded in the belief that suffering is intricately linked to our interaction with our thoughts and emotions. Often, in times of distress, individuals attempt to eliminate, evade, or rectify painful thoughts, emotions, or memories. Paradoxically, such efforts frequently contribute to prolonged suffering. ACT is a form of psychotherapy to assist individuals in recognizing thoughts, emotions, and behaviors that hinder them from leading the lives they aspire to. ACT imparts skills for embracing challenging thoughts and emotions, commitment to meaningful actions, and discovering purpose in life.

Contingency management (CM): CM encourages healthy behaviors by offering rewards for desired behaviors. Most commonly, the treatment provides something of monetary value to people with SUD to incentivize them not to use substances. For instance, upon a negative drug test result, you earn a chance to receive a prize or gift card.

Participating in self-help programs, like Narcotics Anonymous, can also play a significant role in SUD treatment. These programs support behavioral modification through self-help and peer support. The underlying principle of these programs is that people with SUD must understand that they have a chronic condition that will never go away. Group therapy supports people with SUD in maintaining self-control and restraint.

Detoxification

In detoxification, you stop taking the substance(s), allowing them to leave your body. Depending on the severity of the SUD, the substance or an alternative may be tapered off to lessen the effects of withdrawal. It’s the first major step of treatment for SUD. You can go through detoxification in both inpatient and outpatient settings.

Medication

Medication may be part of your treatment plan. Medications can help modify your brain chemistry to help treat certain SUDs. They can also relieve cravings and withdrawal symptoms.

Medication-assisted treatments are available for:

Opioids: Methadone, buprenorphine and naltrexone are FDA-approved for the treatment of opioid use disorder.
Alcohol: Three FDA-approved drugs include naltrexone, acamprosate and disulfiram.

Research on the Efficacy of Detox and Medication for SUD

This study undertook a secondary analysis of statewide administrative data, specifically the California Outcome Measurement System, gathered from publicly funded drug treatment centers spanning the years 1991-2012. The study focused on individuals seeking detoxification and medication treatment (mainly involving methadone), resulting in a sample of 237,709 unique individuals and 885,971 treatment episodes. Of these, 30.2% (192,252 individuals) pursued detoxification exclusively.

The investigation assessed three key outcomes:

Probability of successful detoxification, defined by staff as completion or early departure with satisfactory progress.
Duration of medication-assisted treatment.
Estimated time-to-treatment subsequent to both successful and unsuccessful detoxification.

The analysis incorporated various controlled variables, including age, gender, ethnicity, primary drug disorder (heroin versus prescribed opioids), frequency of primary drug use, secondary drug use disorder (none; other opioid; stimulant; alcohol or marijuana), education, labor force status, referral source (individual choice or otherwise), treatment episode volume per facility, and county-level unemployment rate.

Key findings include a significant shift in treatment episodes, with detoxification decreasing from 83.7% in 1994 to 40.5% in 2010. Among those who never accessed medication-assisted treatment, the likelihood of successful detoxification diminished with each subsequent attempt.

Noteworthy patterns emerged, indicating that success rates were lowest among younger individuals (under 30) and those of Hispanic descent. Primary users of prescription opioids exhibited an almost 85% higher likelihood of successful detoxification compared to heroin users.

The study also revealed a declining success rate with successive detoxification attempts, with the second attempt being 32% less likely to succeed than the first, the third 44% less likely, the fourth 47% less likely, and the fifth 59% less likely.

The percentage of individuals accessing medication treatment within 14 days post-detoxification was lower for successfully detoxified individuals (51.3%) compared to those who did not achieve successful detoxification (55.3%). Additionally, only 20.2% of the 627,687 detoxification treatment episodes resulted in admission to medication-assisted treatment, and a mere 10.9% were admitted within the crucial 14-day timeframe.

Significance of the Study

This study underscores the involvement of 237,709 distinct individuals in 885,971 treatment episodes across California, shedding light on the recurrent nature of opioid use disorder. It emphasizes the imperative to identify factors influencing successful detoxification and subsequent engagement in medication-assisted treatment through multiple attempts.

Repeated detoxification attempts without subsequent medication linkage were associated with a progressive decline in the likelihood of successful detoxification. This suggests that utilizing detoxification as a standalone treatment may not significantly contribute to the recovery process without concurrent medication-assisted treatment. In terms of medication treatment duration, each subsequent attempt showed an increase in length, and successful detoxification positively influenced the duration of subsequent medication treatment. Consequently, detoxification may enhance future medication treatment efforts by being associated with prolonged engagement in medication-assisted treatment.

Notably, opioid treatment guidelines propose defining success in opioid detoxification based on subsequent linkage to medication, a proposition supported by the findings of this study. This highlights the importance of integrating detoxification with medication-assisted treatment for a more effective and sustained approach to opioid use disorder management.

For individuals and families seeking recovery:

If you or a family member require treatment for alcohol or other drug-related issues, it’s crucial to understand that detoxification alone is not considered a comprehensive treatment for opioid use disorder; rather, it serves as a medical intervention. Following detoxification, a sustained, long-term medication treatment plan is essential. This study reveals that, with each successive attempt at medication-assisted treatment, the duration increases compared to the initial endeavor. It’s imperative to find strategies to initiate and maintain opioid treatment, as prolonged medication treatment correlates with more favorable outcomes.

For treatment professionals and treatment systems:

The data indicates a prolonged stay on agonist treatment with each additional detox episode, emphasizing the necessity of adopting a long-term approach to opioid use disorder recovery and remission. However, shorter durations of medication-assisted treatment are associated with concurrent stimulant use disorder and primary heroin use disorder (as opposed to prescription opioids or a combination of prescription opioids and heroin). This implies that individuals simultaneously using stimulants like cocaine or methamphetamine and those with a heroin use disorder are at a heightened risk of dropping out from agonist treatment. Individuals with these clinical characteristics may require increased attention and support to enhance the likelihood of treatment retention and achieve more successful outcomes.

Contact COPE Psychological Center for Comprehensive Support

For individuals and families seeking recovery or treatment professionals involved in SUD management, COPE Psychological Center offers comprehensive support. Recognizing the multifaceted nature of SUD, COPE provides evidence-based treatments, including cognitive and behavioral therapies and medication-assisted treatments. By understanding the findings of the study, individuals and professionals can make informed decisions, fostering successful and sustained recovery.

Contact COPE Psychological Center today to access personalized and effective interventions, empowering individuals and families on their journey towards recovery. Together, we can navigate the complexities of SUD, promoting healthier lives and positive outcomes.