01 / 09
American Society of Addiction Medicine
ASAM Criteria 4th Ed.
Determines the right level of care and when to move up or down.
CATALYST BEHAVIORAL HEALTH CONSULTING, LLC
The Catalyst Continuum.
An operating system for behavioral healthcare — nine evidence-based frameworks, ten levels of care, and one playbook that turns fragmented programs into a coherent recovery journey.
9
Core frameworks
13 additional in the library
10
Levels of care
NARR I–IV + ASAM 1.0–4.0
10
Role playbooks
Reception → Medical
172
Playbook pages
Print-ready master doc
ASAM · NARR · SIMOR4E · CHIME · ROSCFIT · MBCDELIBERATE PRACTICE
PURPOSE
Eliminate the fragmentation between levels of care.
Most behavioral health organizations operate as a collection of programs rather than a continuum. Each level of care runs its own workflows, uses its own language, measures its own outcomes, and hands patients off with a discharge summary and a hope.
The Catalyst Continuum assigns nine core evidence-based frameworks specific jobs in the patient's journey and specific jobs in each staff member's daily work. A patient in Level 3.5 residential care experiences the same identity-supportive language from the BHT running morning group as they do from the case manager coordinating aftercare — and both are looking at the same PHQ-9, GAD-7, and ORS/SRS trend the therapist reviewed that morning.
FRAMEWORK ANCHORS
The nine that anchor everything.
01
ASAM Criteria 4th Edition (2023)
02
NARR Recovery Residence Standards
03
SIMOR
04
4E Cognition
05
CHIME
06
ROSC
07
Feedback-Informed Treatment (FIT)
08
Measurement-Based Care (MBC)
09
Deliberate Practice
Regulatory spine: national standards with Arizona (AHCCCS / ADHS Article 7) and Colorado (BHA) appendices.
THE FRAMEWORK STACK IN ONE SENTENCE
ASAM decides where the patient belongs; NARR governs how the sober-living rung looks; CHIME describes what recovery is; SIMOR explains how it happens socially; 4E extends where it happens; ROSC organizes what surrounds it; MBC and FIT tell us whether it is working; and deliberate practice ensures our clinicians keep getting better at delivering it.
THE FRAMEWORK STACK
Nine frameworks, each with a job.
02 / 09
National Alliance for Recovery Residences
NARR Standards
Defines the four levels of recovery housing and the operational, ethical, and staffing standards for each.
03 / 09
Best et al.
SIMOR
Reframes recovery as a social-identity transition from using-group to recovery-group.
04 / 09
Newen
4E Cognition
Treats mind as a brain-body-environment system, so we intervene in the body and the environment, not only in cognition.
05 / 09
Leamy et al.
CHIME
Names the five recovery processes (Connectedness, Hope, Identity, Meaning, Empowerment) that every intervention should reinforce.
06 / 09
SAMHSA
ROSC
Organizes services and community supports around the patient's chosen recovery pathway, across levels of care.
07 / 09
Miller
Feedback-Informed Treatment (FIT)
Uses ultra-brief outcome (ORS) and alliance (SRS) measures every session to prevent deterioration and dropout.
08 / 09
Fortney
Measurement-Based Care (MBC)
Uses standardized symptom measures (PHQ-9, GAD-7, PCL-5, AUDIT, DAST, WHODAS) to guide treatment decisions.
09 / 09
Ericsson; Rousmaniere; Miller
Deliberate Practice
A structured method of solo and supervised practice targeting specific weak-signal skills.
CONTINUUM AT A GLANCE
Ten levels of care, one operating system.
| Segment | Levels | Setting | Typical LOS |
|---|---|---|---|
| Recovery Housing | NARR I–IV | Peer-run to clinically supported homes | 3–18 months |
| Outpatient | 1.0, 1.5, 1.7 | Office, telehealth | 3–12 months |
| Intensive Outpatient / PHP | 2.1, 2.5, 2.7 | Day-treatment facility | 4–12 weeks |
| Residential | 3.1, 3.3, 3.5 | 24-hour non-medical residential | 30–180 days |
| Medically Monitored / Withdrawal Mgmt | 3.7 (incl. 3.7-WM) | Nurse-staffed, physician-directed | 3–21 days |
| Medically Managed Inpatient | 4.0 (incl. 4.0-WM) | Hospital-level | 3–14 days |
NON-NEGOTIABLES
Regardless of level, role, or state, these are always true.
01
ORS and SRS every session — feedback-informed treatment is the floor, not the ceiling.
02
MBC on admission, weekly, and at every LOC transition (PHQ-9, GAD-7, one substance measure).
03
Person-centered treatment plans in the patient's own language, mapped to CHIME domains.
04
Warm handoffs at every LOC transition — a phone or video call between sending and receiving clinicians.
05
Recovery capital is measured with the ARC or BARC-10 at admission, discharge, and 90 days post.
06
Alumni engagement is a service line, not a marketing tactic.
07
Deliberate practice for every clinician, every month — one skill, one recording, one tweak.
08
Every staff member trained in trauma-informed care and Motivational Interviewing basics.
09
Documentation is a clinical act — notes are written to move the patient forward.
10
Nothing is delivered without a cultural humility and health-equity check.
NEXT STEP
Bring the continuum into your organization.
A 20-minute discovery call maps your current state against the continuum and identifies the right tier. No pitch — a working conversation.
☎ (623) 324-3237 · ✉ info@catalystbhconsulting.com
AUTHORITATIVE REFERENCES
Program development anchored in the frameworks payers and surveyors expect.
- SAMHSATreatment Improvement Protocols (TIPs) library
- ASAMThe ASAM Criteria — levels of care & placement
- Joint CommissionBehavioral Health accreditation standards
- CARFBehavioral health program certification standards
- NIDANational Institute on Drug Abuse — evidence base
- HHS OIGCompliance guidance for BH providers