Auto news on Youtube Nov 2 2017

Kevin Spacey Will 'Seek Evaluation & Treatment' Following Sexual Abuse Allegations

Well, it looks like Kevin Spacey is taking a break from acting, as he just released a statement through his rep, saying he will seek evaluation and treatment after being accused of sexual harassment.

Kevin Spacey is stepping away from the public spotlight, as the House Of Cards actor just revealed hell be taking the time necessary to seek evaluation and treatment after an actor accused him of making an unwanted sexual advance, according to a statement given to our sister site, Variety. No other information is available at this time, his rep further said.

This news comes just a couple days after actor Anthony Rapp first accused Kevin of sexually harassing him when he was just 14 years old. Kevin also apologized after the news emerged.

I have a lot of respect and admiration for Anthony Rapp as an actor, Kevin wrote on Oct. I am beyond horrified to hear his story. I honestly do not remember the encounter as it would have been over 30 years ago.

But if I did behave then as he describes I owe him the sincerest apology for what would have been deeply inappropriate drunken behavior and I am sorry for the feelings he described having carried with him all these years..

This story has encouraged me to address other things in my life…I have loved and had romantic encounters with men throughout my life, and I choose now to live as a gay man, he continued.

The actor has since been criticized for the way he came out as a gay man.

He was also later accused of groping another young male (not Anthony) at a famous theater in London. Thus, Netflix has halted production on the sixth and final season of House of Cards.

HollywoodLifers, how do YOU feel about Kevin Spacey seeking treatment? Tell us below.

For more infomation >> Kevin Spacey Will 'Seek Evaluation & Treatment' Following Sexual Abuse Allegations - Duration: 2:52.

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How Effectiveness of PRP+ACell Hair Loss Treatment Depends on Customization for Individuals - Duration: 10:53.

Thank you

for your question.

You submitted your question without a photo and you're basically asking, what is the

best type of PRP to treat hair loss? And you state in the substance of your question that

you're reading about things about Acell and PRP and there are variables like the way

it's mixed. What are the questions essentially that you should be asking? Are there certain

methods that should be avoided?

Well, you're certainly asking very relevant questions for this current timeframe. I'll

give you a little bit of background about how I would explain this to you and for patients

who come to our practice. A little bit of background, I'm a Board-certified cosmetic

surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have

been in practice in Manhattan and Long Island for over 20 years. I am also the founder of

TrichoStem™ Hair Regeneration Centers, a system that we developed with PRP and Acellular

matrix that began more than 7 years ago that we developed over the course of this time

and arguably, can be reflective of the largest number of patients treated and a system that

evolved from clinical data derived from treating so many people over this time and looking

at results critically.

So to help you understand the evolution of PRP and Acellular matrix. First of all, for

the longest time, the majority, I would argue that many of my colleagues have been vocal

about this who dismissed PRP, who dismissed Acellular matrix as to help people with hair

loss. And I think certainly, skepticism is important for anything that is particularly

new that is introduced as an option to help people.

The limitation for any hair loss treatment regardless whether it's a pharmaceutical,

whether it's an injection, whether it's surgery is that there is no cure. There is

no cure for hair loss. What we're dealing with hair loss is 95% of the time for men

and women is androgenetic alopecia, male or female pattern hair loss that is genetic.

It's in the DNA. What we have essentially are strategies to manage hair loss.

So when we see our patients at this current time, again deriving information from a lot

of experience and along the way, especially in the early years, a lot of setbacks and

a lot of obstacles that were overcome in developing a system. Now what we do essentially is not

just doing an injection and this is something that's very important to distinguish is

that we take care of patients with hair loss, we're managing hair loss. When we see our

patients, we look at them from the perspective of what is the most optimal strategy to help

them manage the progression of their hair loss particularly if it's genetic pattern

hair loss.

Everyone comes to the table with certain variables: gender, age, age of onset of hair loss, rate

of progression of hair loss, degree of hair loss, previous procedures and therapies for

hair loss, as well as the overall medical context, the hormone levels, anemia, stressors.

When you have so many variables, then one size doesn't fit all.

At the current time, thanks to some publications in the dermatology literature about PRP, there's

become this proliferation of people offering PRP for hair loss, PRP with a specific formula

using Acell for hair loss and what I think is ultimately going to be an awakening for

the colleagues who are offering these procedures as one size fits all or I call it the shotgun

approach is that people with hair loss need management more than just having them come

for an injection every month or every 3 months to try to maintain their hair.

Every patient has a profile and that profile in our practice is used to help predict what

kind of outcome they'll have. And again, we've developed these profiles based on

clinical experience. When we treat our patients, we developed what we call a treatment plan.

And part of that treatment plan is the strategy of these injections as to when these injections

are done if more than one injection is done as well as the timeframe in which we will

follow our patients. But routinely, we see our patients every 3-6 months and it's part

of the treatment. There's no additional cost to that. When we see our patients, we

are measuring. We are using microscope photos, we're doing standardized photography and

we spend at least 30 minutes or more every visit after the injection to analyze their

outcomes and results and to give them guidance based on our experience.

And since I've used the word experience a lot, I would say that the thing to ask to

the practitioner is what's their experience. What is the plan in order to see whether or

not their strategy is going to add value to your situation. Again, understanding that

there is no hair loss cure but there are strategies for doing this type of treatment and a way

to optimize the outcomes and prolong essentially the lifespan of the hair that is destined

otherwise to progress downward and disappear.

When we look at what it is that Acellular matrix and PRP and what we call TrichoStem™

Hair Regeneration does, we're reactivating hair that isn't growing. That is by definition

because hair thinning is characterized by the prolongation of the resting phase which

means that there is a significant number of hairs that are just not growing and shortening

of the active growing phase. So, it has been our observation in certain clinical profiles

that the prolongation of the lifespan is actually beneficial because otherwise, the lifespan

of that hair would have been shorter. And the stimulation of growth then means that

there is more hair to the total inventory that is providing best scalp coverage. The

thinning hairs actually become thicker and those thicker hairs contribute to the scalp

coverage. Ultimately, it is maximizing of whatever your inventory is. So the earlier

we treat someone, the better it is. The most challenging patients are the patients who

have very early onset, very aggressive progression or people who have more advanced progression

and are close to the end of their inventory.

Now certainly, there are surprises and there are a lot of people who have more advanced

hair loss that have very impressive results. But nonetheless, I think that when you do

your research, you want to learn about the experience and what is the practice philosophy.

Are they going to be there for you to evaluate? What happens if there is a setback if you

don't get the results that you were hoping for? No medical procedure comes with guarantees

but you try to work with probabilities. That is the practice of medicine is to maximize

probabilities to get the best outcomes. But again, hair loss is managed. And so understanding

that, I think it's important to have that dialogue with the doctor that you are considering

for your treatment.

So I hope that was helpful, I wish you the best of luck and thank you for your question.

For more infomation >> How Effectiveness of PRP+ACell Hair Loss Treatment Depends on Customization for Individuals - Duration: 10:53.

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How Facial Filler Treatment can be Done Soon After a Vampire Facelift® - Duration: 6:39.

Thank you for your question.

You submitted your question without a photo.

You state in your question that you had a Vampire Facelift® 3 days prior or you want

to know if you can get a filler after undergoing Vampire Facelift® 3 days after having this

procedure.

Well, I can certainly share with you a perspective without the benefit of an image or more details.

A little bit of background, I'm a Board-certified cosmetic surgeon and Fellowship-trained oculofacial

plastic and reconstructive surgeon.

I have been in practice in Manhattan and Long Island for over 20 years.

I've been a resource for the Vampire Facelift® network in terms of media who often reach

out at times when they want clarification periodically when Vampire Facelift® gets

press.

And so certainly, I have been available to help people understand what the Vampire Facelift®

is.

This can be useful for your question about having placement on the cheek.

So to begin with, just for the sake of clarification, we have to first define what a Vampire Facelift®

is.

If you had a Vampire Facelift® performed by a Vampire Facelift® provider, then you

had a combination of platelet-rich plasma (PRP) derived from your blood which is a concentration

of the wound healing factors that helps stimulate the skin in a way that makes the skin look

healthier.

That's injected under the skin in different places strategically as well as the use of

hyaluronic acid filler, one syringe or 1 cc placed strategically.

And I would say typically, it's just below the skin level.

So if you're asking about the cheeks, I would say that one major variable to be aware

of and that variable is, how swollen are you 3 days after the procedure?

Majority of the time, with this type of Vampire Facelift® procedure, there isn't a lot of

swelling.

And a lot of times, people like this procedure because of the strategic approach that allows

patients to do this and go back to work the next day.

So if there isn't significant swelling, we have to ask what do you want to do in terms

of the cheeks?

When we think of the cheeks, I'll tell you how I approach this.

Typically, when someone wants cheek volume, it is reflective of the underlying structural

deficit, that's genetic, or loss related to facial aging.

What I do is something called Structural Volumizing.

Structural Volumizing means placing a long lasting filler whether it's a Juvederm Ultra

Plus or Juvederm Voluma and placing it under the muscle above the bones using a minimally

traumatic technique with blunt cannulas.

By doing that, we're actually treating an area that is not likely to have been treated

with the Vampire Facelift® procedure.

So the point is that these compartments and spaces can be technically addressed because

of the separation.

If you were to try to add volume in an area where filler was placed already then predictability

and accuracy in correction can be problematic if there's still some swelling.

And generally speaking, we see our patients 2 weeks after any filler treatment to look

at how things look when things have settled down.

So if your physician did not do Structural Volumizing at the time then it is probably

likely that it's completely safe to do that using that strategy.

That being said, I would generally dissuade patients from doing anything so close unless

we're really looking at separate areas.

For example, if someone had their under eye filler placed and they want to do something

for their chin or jawline, well 3 days later is perfectly fine.

These are separate anatomic areas.

But if we're looking at overlapping areas, then usually waiting is better.

A lot of times patients will have urgent deadlines.

So they may come in 3 days later because they have a big event a week from now or they have

something they want to look good for and they're not going to be around because they're traveling.

So we always have to look at every individual situation.

So the take home message here is, essentially, if the area that you want to treat is not

at all affected significantly by the Vampire Facelift® procedure then you can probably,

with reasonable accuracy, have a correction done and improvement and maximize the outcome

of your appearance.

So I hope that was helpful, I wish you the best of luck and thank you for your question.

For more infomation >> How Facial Filler Treatment can be Done Soon After a Vampire Facelift® - Duration: 6:39.

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Kristen Bell Gives Frozen the Rock Star Treatment With Metallica Mash-Up - Duration: 4:57.

Kristen Bell Gives Frozen the Rock Star Treatment With Metallica Mash-Up

Tom Selleck and David Letterman gave an epic performance on Jimmy Kimmel Live Tuesday night. Or should we say, Kristen Bell dressed as Sellecks Magnum, P.I. character and Dave Grohl dressed as Letterman for Halloween, gave an epic performance.

Bell appeared on the late-night show Tuesday, guest hosted by Grohl.  During the interview, Grohl said being there with Bell was kind of the biggest deal to his three daughters.

If I were to jam a song with you, I would become the coolest dad, the Foo Fighters star said. I would jam with you! I would, yes! Are you kidding me? Bell replied.

What do you wanna do? Bell then stood up and started singing a song from her 2013 movie Frozen, Do You Want to Build a Snowman? During her performance, Grohl got up from his seat and started playing the drums.

The performance then turned into a mash-up with Metallicas song Enter Sandman and the result is probably a little surprising and confusing to kids, but pretty awesome at the same time!. Watch the video above to see Bell and Grohls mash-up!.

For more infomation >> Kristen Bell Gives Frozen the Rock Star Treatment With Metallica Mash-Up - Duration: 4:57.

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Life Sustaining Treatment Policy (9 Minutes) - Duration: 8:28.

>> Hello and welcome to this training which will introduce you to the Massachusetts Department

of Developmental Services' new policy regarding life-sustaining treatment.

This training was prepared by the Center for Developmental Disabilities Evaluation and

Research on behalf of DDS.

My name is Jackie Berman and I'm an attorney with DDS.

I'm here to introduce the policy.

At the end of a person's life, there are many decisions to be made about treatment, decisions

designed to preserve dignity, comfort, and quality of life.

The position of DDS is that all individuals have the same rights regarding end-of-life

decision-making including those with intellectual disabilities even if they are under guardianship.

Those who are not capable of making decisions about life-sustaining treatment have access

to options to help them make those decisions.

So what's new in this policy?

While the policy statement is similar to the previous policy, it goes a bit further to

include individuals under guardianship and with health care proxies.

Here's a brief summary of what you can expect.

Some sections have been clarified such as when it's appropriate to consider a Do Not

Resuscitate Order, when to use an Ethics Committee, and when court intervention is required.

The section on guardianship has been expanded and there's a separate training on guardianship.

>> Let's take a closer look at some of the principles found in the Massachusetts Department

of Developmental Services policy on life-sustaining treatment.

Informed choice, goals of care, dignity and comfort, use of hospice, use of Ethics Committees,

long-term life support technology, withholding or withdrawing nutrition and hydration, Do

Not Resuscitate orders, and medical orders for life-sustaining treatment or MOLST.

Decisions about life-sustaining treatment must be made with informed consent.

That means that the person making the decision has the legal authority to do so, that they

have all the relevant information about treatment including risks and benefits, and that the

decision is made freely without coercion.

For someone without a guardian, who is competent, it's advisable to suggest the appointment

of a healthcare agent through a health care proxy.

For someone without a guardian and whose ability to make informed decisions is questioned,

a clinical team assessment should be considered.

Note that under Massachusetts' law, even a court appointed guardian does not have the

legal authority to make a decision regarding all life-sustaining treatments.

This may require expanded authority from the probate court.

In such a case, the DDS attorney, along with a guardian, will petition the court to expand

the authority of the guardian.

This process of court expanding authority of a guardian to consent to highly invasive

medical treatment is called Substituted Judgment.

When, in the opinion of the medical providers, the burdens of attempting to cure or prolong

life outweigh the benefits for the individual, then treatment can shift to comfort care.

Comfort care may include both palliative care and hospice.

Palliative care focuses on patient comfort rather than recovery.

When getting better is no longer an option, hospice care emphasizes comfort measures and

end-of-life counseling to provide emotional, social, and spiritual support to the person

who is dying, as well as to their family and caregivers.

To preserve the dignity and comfort of the individual, pain relief and comfort measures

will be provided, even if treatment for the underlying illness has stopped.

If death from a terminal condition is expected within six months, then the person is eligible

for hospice services.

Hospice services can be provided at home, in a long-term care facility, and even a day

program.

Hospice is a treatment option if no other treatment is viable.

While anyone can request hospice, a physician must order it.

When there's a disagreement about the decision to accept or refuse life-sustaining treatment

or whether or not implement a DNR Order, it may be useful to consult with an Ethics Committee

to insure that the person's human rights and dignity have been fully considered.

An Ethics Committee may include clinicians whose expertise is relevant to the person's

condition and an ethicist.

However, where court approval of a decision is required, the ultimate decision making

responsibility cannot be shifted away from the court to a committee or panel.

A decision as to whether or not a Substituted Judgment is required must be made in consultation

with the DDS Regional Attorney.

When there's some reasonable expectation of a cure or remission of an illness, then life

support measures should be taken.

Stopping life support would be considered if the burdens outweigh the benefits.

It's generally expected that artificial nutrition and hydration such as through intravenous

fluid or a feeding tube would be given.

Any decision to withhold or withdraw nutrition or hydration is reviewed on a case by case

basis.

A legally competent person, in collaboration with his or her qualified healthcare provider,

can consent to a DNR order.

If the person is incapable of giving consent, then the consent to a DNR order may be given

by a properly activated health care agent or by an involved family member whether or not

they are the legal guardian.

Consultation with the DDS Regional Attorney is required to determine the legal authority

of the guardian or health care agent.

In order for a DNR order to be considered, one or more of the following conditions must exist:

Life threatening illness or injury, chronic progressive disease, dementia, serious

chronic health condition that requires or will require advanced medical intervention,

any advanced debilitating disease.

Any end-of-life or DNR order must be reviewed at least once a year at the ISP to determine

the continued appropriateness of the order.

MOLST stands for medical orders for life-sustaining treatment.

The MOLST must be signed by the competent individual and that person's physician, physician

assistant, or nurse practitioner.

If not competent, the person's loving family member, whether guardian or not, may sign

the DNR section only.

In all other cases, the guardian must have expanded authority to sign.

Likewise, the person's designated health care agent may sign if a physician has activated

the health care proxy.

The DDS Regional Attorney should be consulted anytime a guardian signs a MOLST or DNR order

or if there are any questions about a guardian or agent's legal authority to sign on a person's

behalf.

A MOLST differs from an Advanced Directive, such as Five Wishes, in that it can only be

signed when the person has a serious illness or condition or is near the end of life.

It must be based on the person's current medical condition.

Once the order is signed, it is put into effect immediately.

If a health care agent signs it, it must be consistent with the authority as specified

in the health care proxy.

This is one webinar in a series on end-of-life planning with and for individuals with intellectual

disability.

These trainings and other related trainings are also available on our website or the DDS

website.

Thank you.

For more infomation >> Life Sustaining Treatment Policy (9 Minutes) - Duration: 8:28.

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Osteo eCourses - Learn Osteopathy Assessment and Treatment - Duration: 0:56.

Hi, I'm Aviva Cohen registered osteopathic practitioner with over seven years experience learning from the best,

JP Barral, John Upledger, Bruno Chikly and Suzanne Scurlock-Durana.

World leading innovators leading the way to the healthcare of the future.

Welcome to my Osteo eCourses. Join me

teaching as I treat.

Follow this guided journey.

Beginning with assessment right through to releasing a restriction.

That's what I need!

Pow!!!

Learn as I treat. It'll change your life for good.

For more infomation >> Osteo eCourses - Learn Osteopathy Assessment and Treatment - Duration: 0:56.

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For stroke patients, experts highlight importance of rapid treatment - Duration: 1:22.

For more infomation >> For stroke patients, experts highlight importance of rapid treatment - Duration: 1:22.

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PicoSure Tattoo Removal Treatment: Andy, Before & After - Duration: 1:53.

For more infomation >> PicoSure Tattoo Removal Treatment: Andy, Before & After - Duration: 1:53.

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Relieve Arthritis in Your Hands with These 4 Natural Remedies Treatment for Arthritis - Duration: 3:05.

Relieve Arthritis in Your Hands with These 4 Natural Remedies

These natural remedies can be a great complement to relieve arthritis in your hands, but they

can't replace medication prescribed by your doctor.

1.

Castor oil Castor oil has the ability to reduce pain

and inflammation caused by arthritis.

It contains a substance known as ricinoleic acid, which acts as an anti-inflammatory and

pain-reliever when it comes to problems like this.

What do I need?

2 tablespoons of castor oil (30 g) How do I use it?

Heat a few tablespoons of castor oil, and once it reaches a temperature safe for your

skin, smooth it over your hands.

Repeat twice a day, every day.

2.

Fenugreek seeds

Fenugreek seeds contain fatty acids and essential amino acids that act as anti-inflammatories.

These properties mean it can help with pain from arthritis of the hands while helping

to prevent fluid retention.

They also contain antioxidants which help eliminate waste that your body doesn�t need,

as it supports lymphatic functions in your body.

Ingredients

1 teaspoon of fenugreek seeds (5 g) 1 cup of water (200 ml)

How do I use them?

Soak a teaspoon of fenugreek seeds in a cup of water and let sit overnight.

The next morning, strain and consume the seeds.

Repeat the treatment for at least two months.

3.

Epsom salts Epsom salts have the ability to reduce inflammation

and stiffness, making them a great option for arthritis.

Topical application relaxes your muscles and joints, helping reduce pain.

Ingredients

1 cup of Epsom salts (200 g) Hot water (as needed)

How do I use it?

Add the cup of Epsom salts to a container with hot water and soak your hands for 20

minutes.

Repeat the treatment at least 3 times a week.

4.

Apple cider vinegar

Apple cider vinegar contains organic acids that help regular blood pH, stimulating balance

in your body�s inflammatory processes.

The active substances in it, such as acetic acid, reduces pain the hands and stimulates

your circulation.

Ingredients

1 tablespoon of apple cider vinegar (10 ml) 1 cup of water (200 ml)

How do I use it?

Dilute a tablespoon of apple cider vinegar in a cup of warm water and drink on an empty

stomach, without any other food.

Optionally, you can add the vinegar to a container with hot water and soak your hands for 20

minutes.

Use every day.

For more infomation >> Relieve Arthritis in Your Hands with These 4 Natural Remedies Treatment for Arthritis - Duration: 3:05.

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Introducing and Demonstrating the NIAAA Alcohol Treatment Navigator - Duration: 19:18.

MODERATOR: Welcome to the webcast introducing and

demonstrating the new NIAAA Alcohol Treatment Navigator.

Speakers will be Dr. George Koob,

director of the National Institute

on Alcohol Abuse and Alcoholism,

and Dr. Lori Ducharme, lead developer of the Navigator.

They will provide an overview

and a walkthrough of the Navigator tool.

Note that this webcast is being recorded.

We will now start the presentation.

DR. KOOB: Hello, I am George Koob,

the director of the National Institute

on Alcohol Abuse and Alcoholism,

and I would like to thank you for joining us today,

as we launch the new NIAAA Alcohol Treatment Navigator.

As we have recently completed National Recovery Month,

I am happy to introduce you to this exciting and important

new online resource. Our webcast will answer several questions:

What is NIAAA Alcohol Treatment Navigator?

Why did NIAAA develop the Navigator?

How is the Navigator different from other resources?

And, how can individuals, their families, and health

professionals use the Navigator to find alcohol treatment?

The Navigator is a tool designed to help people recognize

and find quality care for alcohol use disorders.

That is, care that is professionally led treatment

grounded in decades of clinical and health services research.

We developed the Navigator to address

the alcohol treatment gap.

In any given year, more than 15 million adults in

the United States meet the diagnostic criterion

for an alcohol use disorder,

but less than 10% of them receive treatment.

Meanwhile, many of those in treatment

may not receive the care that best fits their needs.

There are many reasons why people don't receive

any alcohol treatment --

or the right treatment -- for their needs.

For example, they don't know

all the treatment options that are available.

They don't know where to look.

Their doctors don't know where to refer them.

Or, they don't know how to tell

if a provider is offering good-quality treatment --

what we call "evidence-based care."

Often, people call NIAAA looking for a recommendation

or a referral, because they don't know where else to turn.

In fact, during my tenure as director of NIAAA,

I've received numerous calls from colleagues

and the general public asking for advice

on finding good alcohol treatment providers --

in or near their communities -- for their family and friends.

Those calls inspired us to develop the Navigator,

which makes this complicated process easier

by telling people what they need to know

and what they need to do to recognize and find quality care.

Now, as a federal research agency,

NIAAA cannot endorse or recommend

any particular health care provider or program.

Instead, we have created a resource that explains the steps

to take in searching for an alcohol treatment provider

anywhere in the US.

That strategy is at the heart of the Navigator.

Drawing on nearly two years of development --

with input from patients, their families, treatment providers,

and leading alcohol researchers -- the Navigator

offers an easy-to-use and comprehensive resource

that can inform the search for good-quality treatment.

It includes

an overview of alcohol use disorder,

a description of different kinds of treatment options,

step-by-step instructions for searching

several existing directories of treatment providers,

10 questions to ask and answers to listen for

when interviewing a provider,

five signs of quality to look for,

and a downloadable toolkit

to help organize and simplify the search process.

With the Navigator,

individual adults will be better able

to find treatment options that meet their unique needs.

Family members will feel empowered

to help an adult loved one

who may be struggling with alcohol use disorder.

And primary care physicians and other health providers

will have a tool to share with patients

who may need a referral to alcohol treatment.

We believe that the NIAAA Alcohol Treatment Navigator

will be a game-changer for people

looking for quality treatment for alcohol use disorders.

We hope you will visit the site and go through it,

and share it widely.

And we plan to refine and update the Navigator regularly,

so, please give us your feedback.

It is available at AlcoholTreatment.niaaa.nih.gov.

Again, AlcoholTreatment.niaaa.nih.gov.

I will now ask Dr. Lori Ducharme,

NIAAA's program director for health services research,

and the lead developer of the Alcohol Treatment Navigator,

to explain more about it and show you how it works.

DR. DUCHARME: Thank you, Dr. Koob.

I'm Lori Ducharme, program director

for health services research at NIAAA.

As a researcher who has been studying addiction treatment

programs for more than 20 years,

I can tell you from experience why

the Alcohol Treatment Navigator

is such a unique and important resource.

Alcohol treatment can be very hard to find.

Knowing where to look for treatment is difficult,

mainly because the treatment system

isn't really a system at all.

It's an uncoordinated set of services that exist

in independent settings and silos,

with different funding streams,

that, for the most part, are still not well-integrated

into general health care.

That makes it really hard for people

to find the kind of care that they need, when they need it.

The Navigator is designed to take the mystery and frustration

out of the search process.

Existing online resources are limited,

and there really aren't any sites that bring

all of the information together in one place

to tell you what you need to know,

and what you need to do, to find treatment.

The Navigator does that.

When searching online,

it can be hard to identify good-quality treatment

when you see it.

What are some signs of quality that you should look for?

The Navigator helps with that.

Another issue is that there are a lot of stereotypes

about alcohol treatment.

People often think their only choices are either

a mutual help group or long-term residential rehab.

And while those options certainly work for some people,

they are not a good fit for everyone.

In fact, a theme of the Navigator

is that different people need different options.

What worked for your friend or neighbor

might not be the best fit for you. And that's okay.

We need to help people understand the whole range

of professional treatment options that are available,

and how to find one that meets

your unique needs and preferences.

For all of these reasons, searching for alcohol treatment

can be confusing and overwhelming. We understand.

In the process of developing the Navigator,

we talked to many patients and families

who had been through this process.

And they shared with us their experience and frustrations,

the mistakes they made,

what they know now that they wish they had known sooner,

and information they still have trouble finding.

We're grateful that so many people

were willing to share these experiences with us.

We got input from patients and families

at every step of developing the Navigator

to make sure that our advice made sense, was easy to follow,

and helped them feel more empowered

to make these decisions about seeking treatment.

And, of course, we also involved researchers

and treatment providers in the development of the Navigator

to make sure it reflected the latest research

and was grounded in the reality of today's health care system.

One more thing. We chose the name Navigator deliberately.

The Navigator is not a locator --

although it will give you some tips

on how to search specific provider directories.

Rather, the Navigator offers a comprehensive strategy

to help people search for evidence-based alcohol treatment

that's delivered by skilled health professionals,

and help them choose among the many options

that are out there to find one that best fits their situation.

Through a combination of education,

step-by-step instructions,

resources, and tools, the Navigator is designed to help

point the way to evidence-based alcohol treatment.

Let me show you what it looks like.

This is the home page for the new

NIAAA Alcohol Treatment Navigator.

I'll start here to orient you to the site,

and then we'll go through and highlight some of its contents.

So, the Navigator is all about helping you find your way --

for yourself or an adult loved one -- to alcohol treatment.

The site is organized around two primary sections.

One is informational -- what you need to know

about alcohol treatment.

The other is the road map --

a strategy for searching and finding treatment options.

Let's start with the first section,

"What to know about alcohol treatment."

So, this section covers four topics.

They provide some background and context

to understand why your search for treatment and

the options you need may be different than someone else's.

In "What is alcohol use disorder?", we explain

the signs and symptoms of alcohol use disorder,

and we emphasize that it is a medical condition,

often chronic in nature, that should be assessed

and treated by a trained health professional.

In "What types of treatments are available?", we describe

a variety of professional treatment options,

including licensed professional therapists,

outpatient and inpatient treatment programs,

and physicians who specialize in addiction treatment.

In the section "Why do different people need different options?"

we explain what goes into a clinical assessment,

and how a health professional will use that information

to shape a treatment plan.

That's what determines the type and intensity

of treatment to consider.

And then, finally, we provide some information about

treatment costs, how to find out about insurance coverage,

and we emphasize that the most expensive option

is not necessarily the best.

Again, it depends on your specific needs.

So, let's just click briefly into the

"What is alcohol use disorder?" page.

Here you can see that these pages

are all brief and easy to read,

with links if you are interested in more detail.

And, there are navigation buttons, both on the side

and at the bottom of the page,

so that it's very easy to move through the site.

So, that's the what to know section of the site.

Now, let's go up here to the top navigation bar,

and we'll click over to the section

on how to find alcohol treatment.

Now, this section is really the heart of the Navigator.

This is where we give you a strategy, some tools, and

some step-by-step instructions for searching for treatment.

We know this can be overwhelming,

so we really want to take the stress out of this process

by breaking it down into smaller steps.

There are three parts to this.

First, we'll give you some signs of quality to look for.

Not all treatment programs are the same,

and this will help you differentiate between them.

Next, we'll show you how to find professional treatment

providers, and how to decide if they're a good fit for you.

And finally, once you've come up with a short list of potential

options, we'll give you a tool to help you choose among them.

So first, let's look at what we call

"five signs of higher-quality care."

How can you tell whether a treatment provider

offers good-quality treatment?

This is about helping people become

better consumers of health care information.

It's really important to look beyond the television ads,

and glossy brochures, and websites that promise a cure.

Those can be rather seductive messages

when you are desperate to find help.

But it's important to take a step back

and really look at what a provider is offering.

We looked at both the accumulation

of years of health services research,

as well as the current state of the treatment field

and the consensus of experts.

And from that, we selected five signs of quality that can

be applied to the whole variety of treatment providers

and span the continuum of services from initial assessment

through treatment and long-term recovery.

The five signs that we suggest people look for are,

first, credentials --

the specific licenses, certifications,

education, and training that are associated

with expertise in alcohol treatment.

Second, you want a provider who will conduct

a comprehensive assessment.

That means they don't only focus on the person's

alcohol and substance use issues,

but the whole variety of medical, mental health,

and other issues, including their housing situation,

employment, and social support networks.

Third, it's important that a provider involve the patient

in developing a customized and responsive treatment plan.

This reinforces the idea that there should not be

a one-size-fits-all approach to treatment.

And the treatment plan should be updated

as the patient progresses through treatment

and as their needs and goals change.

Fourth, we talk about the importance of

finding a provider that uses

evidence-based therapies in treatment, including

both behavioral therapies or counseling techniques,

as well as considering the use

of FDA-approved medications, when appropriate.

And finally, we recommend finding a provider

who either offers or will help develop a plan

for long-term continuing recovery support,

reinforcing the idea that alcohol use disorder

should not be addressed as an acute illness,

but rather in a chronic or continuing-care framework.

Each of these expands to provide the kinds of details

I've been describing.

So, for example, here is what

the credentials item looks like when it's expanded.

For each type of provider, we give you the specific

credentials, degrees, licenses, and letters to look for.

OK? So, five signs of quality to look for,

written in a way that's easy for people to understand.

Now, certainly there are more than five indicators of quality,

and these are not a guarantee of success,

but they should help you assess your options.

Now I'll show you the search section.

Here, we orient you to three different types

of professional treatment providers --

licensed professional therapists,

accredited treatment programs,

and board-certified addiction doctors.

At the bottom of this page, we link into a step-by-step

search strategy for each of the those

three provider types.

In each of those sections, we link out to an existing,

publicly available national directory of professional

treatment providers and show you how to search it.

It's important to point out that there is no

one central curated list of treatment providers

across the United States.

This would all be much easier if there were.

But that's exactly the reason why we built the Navigator.

Because it can be very difficult

to understand and find all your options otherwise.

Now, I'm not going to click through all of these pages,

but I do want to show you how this is organized,

so you can see the general strategy involved.

So, let's first look at addiction therapists.

Each of these three sections are organized in the same way.

First, we tell you what you'll be searching.

In this case, it's the Psychology Today directory.

Then, we briefly describe what these providers do.

We alert you to any quality indicators

that may be relevant as you're searching.

And then we lead you through the search itself.

A point we strongly emphasize is that

you should not be making any treatment decisions

based only on what you find in these directories.

It's really important to call up a provider first,

and ask questions to learn more about them,

about their approach to treating alcohol use disorder,

and to see whether they would be a good fit for you.

To help with that, we provide a list of 10 questions

to ask a therapist before your first visit.

You can preview those questions here.

So, let's click on question 2, here.

And, what you'll see is not just the question itself,

but also an explanation for

why we suggest you ask the question,

and what answers to listen for.

And, the idea is, as you interview a provider,

two things will happen.

It will start to shape your opinion about them

and whether they might be a good fit for you.

And their answers will tie back to those five signs of quality

that we talked about earlier.

So, those are questions you'll want to be prepared to ask.

Now, as for searching,

we provide a link out to the Psychology Today directory,

which is here.

Again, this is not an NIAAA resource.

You'll be searching their website directly.

And then, to help you make sense of your search results,

we also have a downloadable set of search tips.

These will show you, click by click,

how to use that directory and how to narrow down your results.

And then we provide similar advice

for searching for specialty treatment programs.

Again, same structure.

What do these providers do?

Signs of quality.

Ten questions to ask and answers to listen for.

And, here we have a simplified search tool

that will pull from the national inventory

of specialty addiction treatment programs

that is maintained by our sister agency, the

US Substance Abuse and Mental Health Services Administration.

And the third of the three sections.

Here we talk about addiction doctors as an option.

Again, what they do.

Signs of quality.

Questions to ask.

Tips for searching.

And in this case, we link out to two existing directories,

one that lists doctors who are

board-certified in addiction medicine,

and the other for doctors

who are board-certified in addiction psychiatry.

OK? So, the search section of the Navigator is very dense,

but we've really tried to break it down into

smaller, more manageable steps with lots of clear instructions.

If you do all that searching, you'll hopefully end up

with a short list of providers in your area,

and you can narrow down that list by calling

and asking questions about their treatment approach.

But then, how do you make a decision?

So, we also created a companion toolkit for the Navigator.

And among other things,

it includes a treatment options chart

that you can download and save.

It looks like this.

Now, this may not be necessary for everyone, but

this may help you organize your notes and compare

apples to apples across the providers you've talked to.

If you've called and interviewed these providers

using the questions that we suggested,

you should then be able to fill out this chart.

These last five columns, here on the right, map onto

those five signs of quality that we mentioned earlier.

And from there, the idea would be that, all else being equal,

people would prioritize those providers

that have more indicators of quality, assuming that they are

a good match for your specific needs and circumstances.

I'll come back to the home page to show you one more section

of the Navigator, and that's this section

on support through the process.

When we did early focus groups with patients

and their families, they encouraged us

to include a section like this,

because these were things they really wished they had known.

So, we talk about how to start the conversation

with a loved one who may need treatment.

We talk about managing expectations around treatment --

how long it may last, and what to expect.

Understanding relapse -- that it's a common part

of the recovery process and does not mean that the patient

has failed, or that treatment didn't work,

and what should happen next.

Long-term recovery support resources --

again, reinforcing that addiction is not something

we address as an acute episode,

but a condition that will require long-term support.

And finally, support for you.

If you are using the Navigator to search for treatment

on behalf of a loved one, how can you be helpful,

and what kinds of help and support are available for you.

So, that was a very quick overview of NIAAA's

Alcohol Treatment Navigator.

I just want to restate how grateful we are

to all of the families and providers and scientists

who provided input into this website.

We hope that it helps inform people

about all of their options.

That treatment is not one size fits all.

That there are some signs of quality to look for,

and that can increase the chances

of finding evidence-based care.

And, that the Navigator's tools can help people search for,

interview, and make informed choices

about treatment options that will meet their needs.