Keeping Patients Engaged: the VAHA Experience

Persons presenting for the treatment of addictions need a “VAHA!” experience. If they don’t get it, they may not return for the next appointment or fail to engage in residential treatment.

What is a “VAHA” experience? It consists of the four things that someone considering treatment typically needs to actively engage in treatment. The components are as follows:

V – Validation. The person gets validation that a condition or conditions identified is/are in need of treatment. The message may be “You are wise in seeking treatment because you have condition X or conditions X and Y that require professional help.” The understanding that the condition can be not just detrimental, but possible possibly fatal may serve to validate the action to seek treatment.

A – Assurance. The individual needs assurance that the condition(s) can be treated. The individual also needs assurance that having the condition is not a moral issue nor personal failure, but is at least a partially medically based condition for which there are appropriate treatments. This may involve brief education on the nature of the condition(s).

H – Hope. The individual needs to hear that the condition(s) can be treated successfully. The message is that following the treatment protocol to be developed specifically for the person is based on successful treatment of other people with similar conditions. The objective is to provide the individual with hope and motivation that a successful outcome is probable if a treatment plan is adhered to.

A – Acceptable Action Plan. The individual will want to have some understanding of what is required of him/her and that the action plan is acceptable. This involves the mantra of “meeting the persons where they are.” The action plan (a.k.a. treatment plan) must make sense to the prospective patients if they are to effectively and actively engage in treatment.

In the area of outpatient mental health, the modal number of visits is one. That means that people scheduling a visit to a mental health professional are likely to not come back after the first session. The same might be true for substance use disorders. If there is no clearly articulated reason to engage, hope that the problem is resolvable, or meaningful strategy understandable to the patient for dealing with the presenting complaint, why come back?

A successful intake with engagement is likely to involve a VAHA experience whether the components are clearly recognized or articulated by the intake staff. For some programs, the outreach worker may accomplish at least part of the VAHA. In any case, implementation of these concepts can help staff facilitate engagement.

Photo by Austin Kehmeier on Unsplash