Initial Assessment is the core foundation of any good intensive outpatient rehab program. Out assessments are conducted by our highly trained staff and provide a comprehensive outlook of all areas of a patient’s life. These include their biology, their psychology, social functioning and spiritual health. This assessment also looks to uncover hidden problems areas that might need specific clinical or medical service such as trauma, chronic pain, eating disorders, food addition, sex addiction, or gambling issues. All patients enrolling in our Center will receive a complimentary initial assessment that will outline these specific areas of need for treatment, that will better improve outcomes and level of success.
Addiction evaluation is an additional service that can greatly help in gaining patient collaboration and understanding into their addictive illness. Our addiction evaluations are conducted by Dr. Matthew J. Bruhin (www.matthewbruhin.com), and provide comprehensive, objective measure, psychometric testing. These tests consist of the Addiction Severity Index (ASI), the SASSI-IV, MAST and DAST, as well as other tests that are commonly used in the industry to show how severe one’s addiction is and how it is currently affecting an individual.
After taking these tests, the patient is provided with their scores, a comprehensive write-up of the evaluation, and a thorough treatment plan. This can be very helpful prior to starting the intensive outpatient rehab program, in addition to the Initial Assessment. This evaluation process ensures the patient has a proper understanding of their addiction issues that are occurring, ways to appropriately treat them through evidence-based practice, and to ensure proper collaboration with any family members, employers, or legal persons that might need a more complete and professional understanding of the current situation.
At the Botkiss center for recovery, psychiatric evaluation is an included service of unmatched quality in the industry. Dr. Botkiss, a renowned psychiatrist and dual diagnosis expert in San Diego, and provides hands-on care while developing a treatment plan and medication management plan that works for each patient. Psychiatric evaluation provides Dr. Botkiss’s patients a method of understanding their psychiatric issues that are causing or creating addictive use disorders. Psychiatric evaluation utilizes thorough personal history and considers past medical diagnoses, including chronic pain issues, sleep disorder issues, and mood disorders. By receiving this expert, comprehensive psychiatric evaluation, our patients are primed for success when entering into our intensive outpatient rehab center.
Finally, all patients being admitted into the Botkiss Center for Recovery will undergo an extensive psychiatric evaluation to verify the presence of other forms of mental illness that are often associated with substance abuse. When indicated, psychotropic medication will be offered to treat these associated conditions which may include depression, anxiety, and insomnia. Dr. Botkiss brings to the center over 20 years of clinical experience in treating mental illness in both hospital and outpatient settings using medication and other forms of therapy. He also has access to various intensive outpatient programs (IOP’s) and inpatient treatment at Sharp Mesa Vista Hospital where he previously served as a clinical director at the facility.
Individual counseling -or psychotherapy- is a fundamental and complimentary service offered on our rehab, that is often reported to greatly help people change current addictive behavior. Each patient that enters our treatment program receives at least one individual counseling session per week, or twelve sessions, during the 90 days of intensive outpatient rehab. These sessions can also be increased if needed to two or three times per week for additional cost. Many times, individuals prefer, respond to, or need additional individual sessions. At the Botkiss Center for Recovery, this comprehensive and individualized treatment planning done during the Initial Assesment, allows us to understand your fundamental needs for individual, one on one counseling services. All our counselors at the Botkiss Center for Recovery are highly trained in dual diagnosis and addictive illness treatment. All our clinicians have completed graduate level of education and have many hours of experience in the field. This level of expertise ensures that every individual will receive the best counseling experience in order to be successful
Addiction Group Counseling:
When entering the Botkiss Center for Recovery intensive outpatient rehab program, patients will receive 3 hours of complementary group counseling, 3 evenings a week, for 90 days. Group sessions are collaborative, inclusive, and educational for all our patient’s dual diagnosis needs. Our group therapy and core curriculums include evidence-based treatment models such as cognitive behavioral therapy (CBT), mindfulness, dialectical behavioral therapy (DBT), and motivational interviewing techniques. These specific psychological treatment models have all been extensively researched and found to benefit and provide success to people who currently have addictive issues.
Our addiction groups are always conducted by treatment specialists. These individuals have completed graduate level education, are highly trained in working with individuals with substance abuse and dual diagnosis disorders and are hand selected and trained by both Dr. Botkiss and Dr. Bruhin. Our groups are always small, highly confidential, and patients are matched with proper groups to create a cohesive and meaningful therapeutic format. All our groups have no more than eight members at a time. These groups are kept small, so that participation rates are high, and that more clinical applications can be made. By working participating in the group counseling services, our patients at the Botkiss Center for Recovery can gain meaningful sobriety, as well as learn relapse prevention strategies that ensure long-term compliance and psychological change and growth.
Marital & Couple Counseling:
Often those struggling with addiction issues and other mental health disorders, notice increased levels of stress and dysfunction within their primary relationships. The Botkiss center of Recovery honors these relationships and understands the importance of both good marital relationships and partnerships. Therefore, the Botkiss Center for Recovery offers marital and couple counseling as an adjunct to our core groups and individual counseling services. These services are rendered by Dr. Matthew J. Bruhin and his team of therapists (www.matthewbruhin.com)
All new patients will be assessed for any stress or discord within their primary relationships during the Initial Assessment and can be evaluated as to whether marital or couple counseling will improve their experience in the program. These services are then able to be accessed to help further improve the treatment experience, as well as help outcomes in terms of sobriety rate, by allowing home life to return to a normal state of functioning. We are at the Botkiss Center of Recovery want your relationship to be satisfying, with healthy communication, and the support that is required for long-term recovery.
At the Botkiss Center for Recovery, our clinicians are trained to provide family therapy services when indicated. These services are complimentary. Often, when people become addicted to drugs or alcohol, their family unit suffers. Members of the family such as children, parents, and extended loves ones suffer in the process.
Our family therapy services assist families with working through some of the pain, hurt, and isolation that occurs with addictive behavior. Our family therapy services are restorative in nature. They also teach better communication skills and help ensure proper boundaries, while loved ones attend our intensive outpatient rehab program.
Medication Assisted Treatment (MAT):
At the Botkiss Center for Recovery, “cutting edge” treatments for substance abuse will be offered by Dr. Botkiss, including Suboxone and Sublocade for management of opiod addiction as well as various medications for treatment of alcohol addiction including Naltrexone and Vivitrol.
Suboxone is an opiate agonist/antagonist that binds to opiate receptors in the brain to decrease cravings and minimize the risk for relapse. Studies have shown that the use of Suboxone can significantly improve treatment outcomes and help patients with opioid addiction stay connected to a treatment process. Sublocade is an injectable form of the medication which can help with treatment compliance.
Medication assisted treatment (MAT) is also now considered the “state of the art” for use as adjuncts in treating alcohol addiction due to limitations of 12 step programming and other support groups for certain patients. These treatments include naltrexone, campral, antabuse and a relatively new injectable form of naltrexone called Vivitrol.
Transcranial Magnetic Stimulation (TMS):
NeuroStar TMS Therapy is a treatment cleared by the US Food and Drug Administration (FDA) for patients suffering from depression who have not achieved satisfactory improvement from prior antidepressant treatment. TMS stands for “Transcranial Magnetic Stimulation.”
TMS Therapy is a treatment that can be performed in a psychiatrist’s office, under his or her supervision, using a medical device called the NeuroStar TMS Therapy system. NeuroStar TMS Therapy is:
Non-invasive, meaning that it does not involve surgery. It does not require any anesthesia or sedation, as the patient remains awake and alert during the treatment
Non-systemic, meaning that it is not taken by mouth and does not circulate in the blood stream throughout the body.
The typical initial treatment course consists of at least 5 treatments per week over a 4-6 week period, for an average of 20-30 total treatments. Each treatment session lasts approximately 19-40 minutes, depending on what the doctor determines is the correct protocol.
HOW DOES TMS WORK?
Through a magnetic coil, the NeuroStar TMS Therapy system generates highly concentrated, magnetic fields which turn on and off very rapidly. These magnetic fields are the same type and strength as those produced by a magnetic resonance imaging (MRI) machine.
The treatment coil is applied to the head above the left prefrontal cortex. This part of the brain is involved with mood regulation, and therefore is the location where the magnetic fields are focused. These magnetic fields do not directly affect the whole brain; they only reach about 2-3 centimeters into the brain directly beneath the treatment coil. As these magnetic fields move into the brain, they produce very small electrical currents. These electrical currents activate cells within the brain which are thought to release neurotransmitters like serotonin, norepinephrine, and dopamine. Since depression is thought to be the result of an imbalance of these chemicals in the brain, TMS can restore that balance and, thus, relieve depression
Dr. Botkiss was one of the original TMS providers when he opened the Botkiss Center for TMS Therapy here in San Diego almost 10 years ago (www.botkisstms.com). He has had extensive experience with the procedure and is considered one of the experts in the field. The Botkiss Center for Recovery will offer this treatment at an additional fee for patients who also suffer from clinical depression as well as other psychiatric conditions that may include bipolar disorder, PTSD, anxiety and certain other medical and psychiatric conditions.
Ketamine for Depression:
the Botkiss Center for Recovery will have access to the administration of intravenous ketamine as a treatment option for select patients for treatment of severe depression that has been unresponsive to other treatments. This medication is administered under the supervision of a board-certified anesthesiologist in an office setting who works in conjunction with Dr. Botkiss. This is a highly effective treatment which can have an immediate onset of action unlike any other treatment in the field of psychiatry. The treatment is usually administered in a series of six treatments over a 2 to 3-week period of time. For those who respond to the treatment there may be a need for occasional “booster treatments” to help maintain the benefit. Side effects from the treatment are typically well managed and may include mild sedation, some lightheadedness and a “floating sensation “all of which typically subside within 15 to 30 minutes after each treatment. Ketamine is also being used for management of other psychiatric conditions including PTSD, OCD, addiction and for medical conditions including chronic pain (which may require a longer course of treatment). There is also a new form of ketamine (Spravato) that is offered in an intranasal preparation which is in the process of being offered as a treatment alternative as well. Patients who are being treated at the Botkiss Center for Recovery will have access to these treatments for an additional charge through the West Coast Ketamine Center (www.westcoastketaminecenter.com), which is housed in the same location as the primary recovery center.
Alternative Sentencing, Deferred Judgement & Legal Collaboration Services:
At the Botkiss center for recovery, we understand many of our patients are currently being impacted by the criminal justice system. Whether it’s DUI, paraphernalia charges, or other drug or alcohol related legal issues, we are experienced and able to work with your legal team or court system, to help reduce, or completely remove charges, while entering our intensive outpatient rehab program.
The criminal court system is largely impacted in California today. By providing you, the patient, the needed clinical services to demonstrate to courts that whatever issue is currently being dealt with at the legal level will NOT result in recidivism, allows the punitive measures the courts apply to be greatly reduce or eliminated.
Our goal at the Botkiss Center for Recovery is to support your case with any needed forms, letters, or evaluations, to help better prove your case and increase and improve your legal standing. We have comprehensive experience in dealing with criminal attorneys, family attorneys, and civil attorneys in dealing with these matters.
In addition to criminal court cases, family court cases can also be impacted negatively by a patient’s substance abuse problems. Again, we offer comprehensive support services, family therapy, and collaborative resources while working to improve your outcome in family or civil court.
Finally, often patients may have potential legal or employment issues with their employers. The Botkiss Center for Recovery excels in dealing with HR departments in a confidential matter, while working to ensure that you have all legal protections at your disposal. This is in order to take time off, including doctors’ notes, written letters, or collaborative support in working with your HR department or your current employer so that you can get healthy and well.
Comprehensive Drug & Alcohol Testing Services:
At the Botkiss Center for Recovery, we are aware of the need for comprehensive drug and alcohol testing services. These tests lend credibility to our program, as well as ensure that the patients we treat are maintaining their sobriety and moving forward in the proper manner. These drug testing services also provide objective verification for employers, family members, and court ordered compliance measures.
Our lab testing methods are conducted by independent laboratories and can be evaluated at the very highest of standards. It is crucial to have these services as our patients move through the treatment process. By providing the very best in drug and alcohol testing services, the Botkiss Center for Recovery can help provide our patients the structure they need and verification of success that propels them into long-term sobriety.