Substance Use and
Co-Occurring Disorders

The Perseverance Program at Scavetta House is a psychiatrist-led, mental health-focused residential program for patients with substance use disorders and co-occurring mental illness. A true dual diagnosis program, Perseverance offers diagnostic rigor in combination with focused individual, group, and community treatment.  

The goal of the Perseverance program is to help each patient develop an understanding of their psychological and addictive conditions; learn new skills to manage their recovery process; and achieve and maintain sobriety.

Treatment includes focused diagnostic assessments (Evaluative Track only), a range of evidence-based programming including individual, community, and group therapies, medication management, experiential and creative therapies, recovery meetings, and time for meals, exercise, reflection, and recreation. 

Perseverance offers two tracks for patients with different needs.

The Standard Track is suited to individuals with a clear substance use disorder and an understood underlying mental health condition. There is a 30-day minimum stay, and patients join the full schedule of programming upon arrival at Perseverance. 

The Evaluative Track is suited to individuals seeking diagnostic clarity regarding their underlying mental health condition; they may have pursued or repeated treatment options and medications without progress.  The Evaluative Track begins with a focused five-day assessment phase in which comprehensive evaluations are administered, findings analyzed and reported, and a treatment direction established. There is a 35-day minimum stay. 

The Silver Hill Admissions team is experienced in helping patients determine which track is best for them. 

Perseverance is open to patients ages 18+ with a primary diagnosis of substance use disorder, and with a co-occurring mental illness. It is well suited for individuals:

• Stepping down from inpatient care or detoxification
• Having difficulty with outpatient substance-focused treatment
• Unable to maintain sobriety in a less restrictive setting
• Limited in access to local outpatient treatment options
• Ready to reset behaviors and explore core and underlying issues 

Intensive Diagnosis and Treatment with Psychiatrist, Therapists, and Peer Recovery Mentors
Each patient participates in at least four individual sessions per week focused on the core underlying mental health condition or conflict. Weekly sessions include:

• Therapy-based medication management session(s) with program director and addiction psychiatrist, Ryan Wade, MD 
• Psychotherapy sessions with dedicated therapist
• Sessions with peer recovery mentor

The favorable team–patient ratio supports a significant level of focused, individualized attention. The core program team includes Psychiatrist, Therapists, Peer Recovery Mentors, Residential Counselors, plus 24/7 Nursing Support and Interns. See Team Below

Customized Dialectical Behavior Therapy (DBT-S)
The central modality in the program, Dialectical Behavior Therapy for Substance Use (DBT-S), is a tailored adaptation of DBT for substance use treatment. DBT-S is focused on the regulation of intense emotions, development of healthy coping skills, and relapse prevention. The curriculum includes 7+ DBT-S groups each week, with a defined module per week.

Breadth of Evidence-Based Programming
In addition to DBT-S, each patient attends daily Process Group and a range of experiential and creative therapy programs. Patients also participate in community recovery programs, where they benefit from the experience and encouragement of those months, years, and decades into recovery

Before and After Care Continuum
Many patients enter the Perseverance program from the Silver Hill inpatient unit, which has expertise in withdrawal management and detoxification and identifies the optimal time for transfer. Once in the program, the team begins to develop a preliminary discharge plan focused on each patient’s personal goals, family goals, the primary symptoms they are looking to address, and known supports and challenges anticipated at discharge.

Perseverance participants stay in Scavetta House, a residence on Silver Hill’s east campus. Scavetta accommodates 16 patients, in both single and double bedrooms, and shared common areas (see gallery below). There are two treatment tracks (details above); many patients opt for a longer treatment period. 

Some programming takes place within the residence, while meals and other programs are conducted across campus. All Perseverance patients have access to Silver Hill wellness facilities and offerings, including gym, massage therapy, meditation, and more.  

The day begins with an Early Bird Recovery Meeting in the town of New Canaan (optional) followed by breakfast, community meeting and goal planning, and continues with a range of daily programming through the evening, including meals, opportunities to reflect, and downtime. Groups and individual sessions are led by program team members alongside Silver Hill colleagues.  

A typical weekday schedule includes a mix of: 

• Individual Treatment: including Medication Management, Psychotherapy, Peer Recovery Mentorship, plus Family Coordination Meetings.  
• Group Programming: including DBT-S and daily Process Group, plus Psychodrama, Health and Medication Education, Spirituality, Art Therapy, and Meditation/Yoga. 
• Peer Recovery Meetings: including Alcoholics Anonymous, Narcotics Anonymous, Refuge Recovery, and SMART Recovery.  
• Gambling Disorder Counseling and Smartphone Addiction Education and Exposure Planning are available to all Perseverance patients to address these common challenges.  

View a representative weekly schedule here >>

Add-On Services  
The following services are available to all DBT-S patients as needed and are conducted by Silver Hill colleagues with expertise in the respective areas. (Additional fees apply). 

• Cognitive Processing Therapy (CPT): a structured, evidence-based therapy suitable for patients with PTSD or a past history of trauma.  
• Neuropsychological Testing: conducted on campus by members of the Silver Hill Psychology Department
• Family Therapy and Couple Counseling Assessments: Available through Emily Longo, LMFT, Director of Family Therapy and colleagues. 

For many Perseverance patients, the diagnosis, treatment, and experience are profound. The sentiments ‘turning point’ and ‘lifesaving’ are heard again and again. 

Ben Tuff, a former patient at Scavetta House, said receiving a dual diagnosis was startling at first, but once Silver Hill clinicians assured him it was common and a key step toward recovery, he took the necessary steps to address it.

Perseverance, perseverence, persevere

To learn more about this program, refer a patient for admission, or find out if it is right for you or a loved one, please contact Destiny Sammut, Senior Admissions Counselor, at (203) 801-3126 or Silver Hill Hospital general admissions at 1 (866) 542-4455 or complete a contact form here.