One of the entrance doors at the Scripps Mansion at Guest House: none come too early; none return too late

Evidenced-based care (EBC) is based upon three principles: (1) care that is researched and evidences effective outcomes, (2) care that uses clinical expertise to identify each patient’s condition, diagnosis, risks and benefits associated with the intervention and (3) care that incorporates client preferences and values. Research indicates the care practices are derived from the systematic collection of data through observation and experiment and the formulation of questions and testing of hypotheses.

Best practice (BP) is a method or technique that has been generally accepted as superior to any alternatives because it produces results that are superior to those achieved by other means. BP does not always rise to the level of evidenced-based practice with researched outcomes but often becomes a standard way of implementing care because of the outcomes.

At Guest House our experience has been that EBC and BP should be complimentary. This means that we incorporate multiple EBC and BP in our delivery of clinical, non-medical care. What follows is an explanation of four examples.

12-Step Facilitation (TSF) is a core EBC practice that informs the delivery of care at Guest House. TSF is grounded in the belief that addiction is a spiritual and medical disease. For individuals with mental health issues, TSF can be used as a way of looking at life – a philosophy of life. TSF prioritizes active participation as a means to recognize the course of the illness and its process of recovery. Beneficial for clients diagnosed with an addictive illness is involvement with the fellowship of Alcoholics Anonymous (and related community-based 12-step self-help meetings). Sustained sobriety is a result of step work and participants establishing and building relationships with others in recovery. It is through this involvement people recognize their addiction, experience a reprieve from the compulsion and participate in the journey of recovery.

Motivational Interviewing (MI) is an EBC counseling style used at Guest House that guides the clinical staff to become a helper in the change process and express acceptance of our clients. It is a way for our therapists to interact with the clients in a manner that helps to recognize and resolve their questions, concerns and ambivalence which often become barriers to realizing their personal goals.

A small group meeting space in one of the treatment centers

Disease of Addiction is a best practice resource adopted at Guest House that helps our clients who have a diagnosis of addictive illness to better understand their addiction. Many people assume that addiction is not a disease but a weakness of character. This misconception contributes to the stigma of addiction and unfairly minimizes the challenge of overcoming chemical dependence. Advances in neuroscience and imaging technology have rapidly evolved our understanding of addiction and demonstrated a great deal of support for what is often referred to as the brain disease model of addiction. This model considers genetic and environmental factors that cause physical changes to the brain and is the basis for many existing and emerging concepts, including (but not limited to) genetic predisposition to addiction, behavioral addictions, psychopharmacological treatment interventions and cross-addiction.

Eye Movement Desensitization Reprocessing (EMDR) is a best practice integrative psychotherapy used at Guest House that focuses on healing trauma. Trauma is often a result of past disturbing experiences that continue to cause distress because the memory was not adequately processed. These unprocessed memories are understood to contain the emotions, thoughts, beliefs and physical sensations that occurred at the time of the event. When the memories are triggered, it is the stored disturbing elements re-experienced that cause the symptoms of PTSD and/or other disorders. EMDR focuses directly on the memory and is intended to change the way that the memory is stored in the brain, thus reducing and eliminating the problematic symptoms.

Guest House has selected these EBC and BP options because in our experience they are complimentary and provide our clients the best opportunity to recognize the trap associated to their condition, to engage treatment and to initiate recovery.

Guest House prides itself on providing current, quality care based on each individual client. For more information about services offered, please visit GuestHouse.org or contact Jeff Henrich, president and CEO, at jhenrich@guesthouse.org or 248-393-8913.

Written by Tom Ghena, Lead Therapist, Men’s Program