Level of Care Options: Finding the Right Level of CARE
At CARE Counseling, we are an outpatient clinic that exclusively provides outpatient services. We love to do therapy and do it well.
As an outpatient clinic, we often partner with other referral partners. When a client comes to CARE with presenting concerns that cannot be met in an outpatient setting, a higher level of care is often the solution.
There are many things that are taken into consideration including risk of harm, functional impairment in important life areas, co-occurring conditions such as substance use or psychosis, the recovery environment, response to treatment, and engagement in services.
When it comes to levels of care, I like to think of service level intensity ratings with a range [0-6] from none/ minimal as part of recovery maintenance at Level 0-1 and low to intensive outpatient support at Level 2-3. These are typical level of needs for a client at CARE. It is at an outpatient intensive level  that multiple supports in addition to therapy are often recommended such as psychiatry, case management, or specialized therapy options. Some clients may receive therapy twice a week until additional supports are in place to help stabilize mental health.
The Child and Adolescent Service Intensity Instrument (CASII) is an assessment tool that helps determine the appropriate level of care for children. An adult equivalent is the Level of Care Utilization System LOCUS.
Recommendations beyond an intensive outpatient level [4+] include medically monitored non-residential or residential treatment options such an intensive integrated care or a facility equipped to provide psychiatric monitoring.
A step-down approach is recommended when completing a high level of treatment. Rather than jumping from a Level 5 to a 2, accessing supports that are somewhere in the middle and then stepping down to an outpatient setting helps ensure that gains in functioning and safety stabilization are maintained.
Accessing services at the recommended level of care is so important.
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