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What this page is, and what Clear Steps is

Clear Steps Recovery is an outpatient addiction treatment provider with two centers, one at 1D Commons Dr, Units 21 & 22 in Londonderry, New Hampshire and one at 392 Chestnut Street, Suite 200 in Needham, Massachusetts. We do not employ interventionists and we do not run interventions. What we do, many times a year, is the part that comes right after one: the phone call, the insurance check, the clinical assessment and the first day of treatment. Families who plan ahead with us before the conversation tend to have a much calmer day, because the answer to "okay, what now?" is already written down.
Below you will find how to recognize that it is time, how a professional intervention is usually structured, how we coordinate with the independent interventionist your family chooses, and what happens hour by hour if your loved one agrees to come in. There is a New Hampshire section for families around Manchester, Derry, Nashua and Salem, and a Massachusetts section for families around Needham, Newton, Wellesley and Boston, because the programs are named differently in each state.

Recognizing the moment

How to recognize that it is time

Most families wait longer than they wish they had, usually because each individual incident could be explained away. Taken together, a pattern is harder to argue with. You do not need every sign on this list. Two or three that keep repeating is enough to make the call.
  • Promises to cut down or stop that have not held, more than once
  • Drinking or using earlier in the day, alone, or in secret, and anger when it is mentioned
  • Money that cannot be accounted for, missed work or school, or a job that is suddenly at risk
  • A DUI, an arrest, an ER visit, a fall, or an overdose reversed with naloxone
  • Withdrawal symptoms in the morning: shaking, sweating, nausea, or drinking to steady the hands
  • Anxiety, depression or sleeplessness that is getting worse alongside the substance use
  • Family life reorganizing itself around the person: hidden bottles, covering stories, children who have learned to stay quiet
One caution before anything else. If your loved one has had withdrawal seizures, years of heavy daily drinking, or heavy benzodiazepine use, stopping suddenly can be medically dangerous. Tell us that on the phone. We do not run detox at either center, so in that case the plan starts with a referral to a partner detox facility, and our outpatient program is the step that follows. In an emergency, call 911.

The process

How a professional intervention works

An intervention is a planned, structured conversation in which the people closest to someone tell them, calmly and specifically, how their drinking or drug use has affected them, and ask them to accept a treatment plan that has already been arranged. It is not an ambush and it is not a debate. Done well, it follows a shape that clinicians and interventionists have refined over decades. The Mayo Clinic describes it in these terms, and most professional interventionists work from a version of the same plan:
  1. 01

    Get help from a professional: An interventionist, an addiction counselor, a social worker or a physician helps the family decide whether an intervention is the right step, who should be in the room, and how to handle a loved one with a history of violence, a serious mental illness or suicidal thinking, where a different approach may be safer.

  2. 02

    Form the team: Usually four to six people the person respects and cannot easily dismiss. People who are likely to lose their temper, or who are struggling with their own use, are asked to help in other ways.

  3. 03

    Gather information and arrange treatment in advance: The team learns about the condition and the treatment options, and lines up a specific program with a specific start date before the meeting. This is where Clear Steps comes in. A vague "you should get help" gives the person room to stall. "Your assessment is at 2 pm today in Londonderry, and we will drive you" does not.

  4. 04

    Write it down and rehearse: Each person prepares what they will say: specific incidents, how those incidents affected them, and what they are asking for. The team rehearses with the professional so that the meeting stays on script when emotions run high.

  5. 05

    Decide on consequences: Each person decides, in advance, what they will change if the offer is refused, and commits to following through. This is the hardest step and the one families most often skip.

  6. 06

    Hold the meeting: The person is brought to the meeting without being told in advance. Each team member speaks. The treatment plan is presented and the person is asked for an immediate answer.

  7. 07

    Follow through: If they say yes, the plan begins that day. If they say no, the consequences begin that day. Either way the family continues its own support, which is why we point every family to our Family Support Program.

Source for the structure above: Mayo Clinic, Intervention: Help a loved one overcome addiction. We are not quoting success rates on purpose. Interventions help many families, and they also fail, and no one can tell you in advance which yours will be.

Our role

How Clear Steps coordinates with the interventionist your family chooses

The interventionist works for your family, not for us. We do not keep a list of preferred interventionists and we do not pay or receive referral fees. When you tell us you are working with one, or planning an intervention on your own, here is what we can do in the days before:
  • Explain the levels of care in your state in plain terms, so the family and the interventionist are describing the same program to your loved one
  • Verify insurance with the carrier ahead of time, with the plan details you have, so there is no coverage surprise on the day
  • Hold a clinical assessment slot at Londonderry or Needham for the planned day and time when scheduling allows, and confirm a backup
  • Tell you what to bring: a photo ID, the insurance card, a list of current medications, and the name of any doctor or program they have seen
  • Arrange a detox referral first if withdrawal is likely to be medically risky, so the handoff from detox to our outpatient program is planned before anyone leaves the meeting
  • Speak with the interventionist directly, with your permission, so the logistics are settled before the meeting starts
  • Be reachable on the admissions line during the meeting itself, because the question that gets asked is almost always a practical one
One thing to know about privacy. Before your loved one is a client, we can talk with you freely about the program and how admission works. Once they are admitted, federal privacy law limits what we can share about their care unless they give written consent, and we will ask them for it, because families who are included tend to be the ones who help most. Our Family Support Program is open to you either way.

The day they say yes

What happens the same day if your loved one agrees

Momentum matters. When a person says yes, the family's job is to get them to us before the yes fades, and our job is to make the next few hours simple. Here is the sequence at either center:
  1. 01

    The call, or the confirmation: If you planned ahead with us, a family member calls to confirm the assessment slot. If you did not, call (603) 769-8981 anyway. The line is answered 24 hours a day and same-day assessments are available in many cases.

  2. 02

    Insurance check: Admissions verifies the plan with the carrier, or confirms the check already done, and explains any deductible or copay before anything is scheduled. If there is no insurance, we talk through what is available.

  3. 03

    The clinical assessment: A licensed clinician meets with your loved one at Londonderry or Needham, talks through what is going on, screens for withdrawal risk and for anxiety, depression or trauma, and matches them to the right level of care using the ASAM criteria. Dr. Richard Marasa, MD, our Medical Director, oversees the medical evaluation and any medication decisions.

  4. 04

    Detox first, if it is needed: If the assessment finds that withdrawal needs medical supervision, we arrange a bed at a partner detox facility and plan the step back into our program for the day they are discharged. We do not provide detox on site, and we will say so plainly rather than let anyone assume otherwise.

  5. 05

    The start date: For most people the answer is a start in Day Treatment, an intensive program or evening groups within days, at the center closer to home. You leave with a schedule, a point of contact and the date of the first family support session.

If your loved one says no, call us anyway. We will help you understand what the refusal usually means, how to hold the boundaries you set, and how to keep the door open. About half the value of an intervention is what the family learns about itself, and that part does not depend on the answer.

New Hampshire

Intervention help around Manchester, Derry, Nashua and Salem, NH

New Hampshire families most often reach us from Manchester, Derry, Londonderry, Nashua, Salem, Windham, Hudson and Bedford. Our center at 1D Commons Dr, Units 21 & 22 in Londonderry sits just off Route 102 at I-93 Exit 4, about 15 minutes from Manchester, 10 from Derry and 20 from Nashua or Salem, with free on-site parking. That matters on intervention day, because the drive from the living room to the assessment is short enough that nobody has time to change their mind.
The levels of care your loved one may be matched to in New Hampshire are Partial Hospitalization (PHP), our most structured day program, the Intensive Outpatient Program (IOP), Evening IOP on Monday through Thursday from 6 to 9 pm for people who need to keep working, standard outpatient care, and medication-assisted treatment with Suboxone, buprenorphine, naltrexone or Vivitrol under Dr. Marasa's oversight. If detox comes first, we arrange it with a partner facility or through The Doorway NH (dial 211), the state's free entry point, which a family member can also call.

Insurance and cost in New Hampshire

Our Londonderry program works with Ambetter Health, AmeriHealth, Anthem Blue Cross Blue Shield, Harvard Pilgrim, NH Healthy Families, Point32Health, TRICARE, Tufts Health Plan, VA Community Care and WellSense Health Plan, and with New Hampshire Medicaid through Granite Advantage plans. We are not in network with Medicare at this time. Call and we will verify the exact plan before the intervention so the cost question is answered before it is asked. See insurance in New Hampshire.

Family support in Londonderry

Our New Hampshire family support group meets every third Wednesday of the month from 6:00 to 7:15 PM at the Londonderry center. It is free for family members of anyone enrolled with us, and it is where many families do the work that an intervention starts. Details are on the Family Support Program page, and the Manchester, Nashua and Salem pages cover the drive from each town.

Massachusetts

Intervention help around Needham, Newton, Wellesley and Boston, MA

Massachusetts families reach our Needham center at 392 Chestnut Street, Suite 200, just off Route 128/I-95 and a short walk from the Needham Heights commuter rail stop. It is about 30 minutes from downtown Boston, 10 from Newton, 6 from Wellesley, 8 from Dedham and 15 from Waltham, with free on-site parking. In Massachusetts our programs are called Day Treatment, full clinical days on weekdays, and Evening Treatment on Monday through Thursday from 6 to 9 pm, with a standard Outpatient Program as the step down and medication-assisted treatment in Needham when it fits. Your loved one's insurance plan may call Day Treatment a partial hospitalization program. A mental health track runs alongside for the anxiety, depression or trauma that is so often underneath the drinking or using.

Insurance and cost in Massachusetts

Our Needham program works with Harvard Pilgrim, Mass General Brigham Health Plan, Tufts Health Plan, Point32Health, Optum, UnitedHealthcare, TRICARE and VA Community Care, and more. MassHealth covers substance use treatment through its plans, and coverage at Needham depends on the specific MassHealth plan, so call and we will confirm before the conversation. We are not in network with Medicare at this time. See insurance in Massachusetts.

Detox in Massachusetts comes first when it is needed

We do not run detox in Needham. When the assessment says withdrawal needs medical supervision, we arrange it with a partner facility and plan the step into Day Treatment or Evening Treatment for the day of discharge. Our detox referral page explains how that handoff works, and the Needham center page covers directions from Boston and the surrounding towns.

For you

The family needs support too

Families who have lived with addiction describe sleepless nights, close calls and a slow loss of trust. That does not resolve on the day your loved one starts treatment. Our Family Support Program teaches how addiction works, how to set boundaries that help rather than harm, how to spot the warning signs of relapse, and where to turn for your own support. Family involvement is encouraged from the first week of treatment at both centers.