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S            Substance abuse treatment has historically been organized around single episodes of care with the expectation that when    

               patients finished the treatment they would need very little followup care. Thus the systems of care have been organized around

               an episodic relationship in which a person seeks treatment, receives an assessment and treatment, and  leaves the episode of

               treatment or is discharged and assumed "cured"; relapse has been viewed as failure of the patient not failure of the treatment.


Acute Care Model Characteristics:


  • The intervention is focused on symptom elimination for a single primary problem.
  • Professional experts direct and dominate the assessment, treatment planning, and service delivery decision-making. 
  • Indirect focus on changing the social recovery environment
  • Passive referrals to address co-occurring problem
  • Minimal or no post-discharge monitoring or "check-up"
  • Evaluation of outcomes over relatively short periods of time (6-12 months) with the expectation that improvements should continue after treatment


Chronic Care Model Characteristics:

  • Network of formal and informal services developed and mobilized to sustain long-term recovery for individuals and families impacted by the disease
  • The role of the health care professional is to empower the patient to take charge of their own recovery instead of relying on the "expert professional"
  • Require significant changes in lifestyle and behavior on the part of the patient to maximize their benefit.
  • Wellness is the goal and long-term recovery is viewed as self-sustainable.
  • Screening patients for early evidence of problems.
  • Negotiating access to additional formal care and addressing potential barriers to it.
  • Proactively tracking patients and providing regular “checkups,”
  • Emphasizing early formal re-intervention when problems do arising




Below are links to several Articles describing and discussing Recovery Oriented Systems of Care: