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Addictions Treatment Planning for Effectiveness

Addictions Treatment Planning for Effectiveness. CSD 5970. Issues to Consider. Safety Withdrawal Potential Suicidality Medical Issues (Immediate) Domestic Violence Risk Behaviors. Issues to Consider. Basic Needs Food Clothing Shelter Transportation Medical Care. Issues to Consider.

Samuel
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Addictions Treatment Planning for Effectiveness

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  1. Addictions TreatmentPlanning for Effectiveness CSD 5970

  2. Issues to Consider • Safety • Withdrawal Potential • Suicidality • Medical Issues (Immediate) • Domestic Violence • Risk Behaviors

  3. Issues to Consider • Basic Needs • Food • Clothing • Shelter • Transportation • Medical Care

  4. Issues to Consider • Engagement • Motivation (external & internal) • Contingencies • Stage of Change • Stage of Engagement • Treatment history (successes and “failures”)

  5. Issues to Consider • Diagnoses • Identified Problems • Client’s Perception of Problems & Goals • Environment • Support System • Strengths & Resilience

  6. Treatment Planning • Licensure Guidelines • Initial plan approved by a physician • Written & Individualized • Gender & culturally appropriate • Within 24 hours, Level IV • Within 7 days, Level III & Level II • Within 14 days, Level I

  7. Treatment Planning • Problem list • Goals (a statement to guide resolution or reduction of the problem) • Objectives (observable & measurable) • Methods (Services) • intensity, duration, frequency, referrals for client, family & significant other

  8. Toolbox • Community resources • Shelters • Food pantries • Government aid programs • Domestic violence programs • Psychiatric services • Medical clinics • Family service providers, etc

  9. Toolbox • Education & Information • Drug information • Disease process • Family issues • Resources • Treatment options

  10. Toolbox • Skill Building • Problem solving skills • Anger management • Relaxation • Recreation & hobbies • Relapse prevention

  11. Toolbox • Support • 12-step recovery groups (AA,NA,CA) • Online AA • Women for Sobriety • Rational Recovery • Church (Structured addiction groups)

  12. Toolbox • Insight & Clinical resources • Structured groups (step groups, skill-building groups) • Process groups • Specialized groups based on gender, sexual orientation, age, or education

  13. Toolbox • Insight & clinical resources • 12-step facilitation • Cognitive-behavioral counseling • Motivational interviewing • Gestalt therapy • Narrative therapy • Strength-based counseling • Therapeutic recreation

  14. Toolbox • Misc. Tools • Journaling • Drug & alcohol testing • Contingencies (recovery birth dates, celebrations)

  15. Guidelines • “What do you want”? treatment plans. • Guides our efforts until the next revision. • Incorporate additional information into psycho-social history & revised plans • Creative & affirming • Strength-based • The client owns their treatment plan!

  16. Exercise • Robert • 48 year old African-American male, warehouse worker • Divorced, lives alone in a house he owns • Referred by EAP after on the job accident • Multiple treatment episodes including 3 residential treatment admissions. • Drinks 8-24 beers daily, no drug history • Alcohol dependence • 2 DUIs, 3 illegal transportation, 1 battery charge • “I really want to want to stop, but I don’t”. “I have to keep my job and work or I will lose my house”.

  17. Exercise • Evelyn • 25 year old Caucasian female, unemployed & homeless • Referred by homeless shelter • Intermittently works as sex worker or “mules” for a dealer. • Heroin & Cocaine “sometimes uses needles”. • No treatment history • Heroin dependence • “I have to get off the streets or I am going to die. I have to find another way to live but I am trapped”.

  18. Exercise • Nate • 19 year old Native-American male • Student, lives in dormatory • Referred by college after 2 mandatory alcohol ed classes. Faces expulsion hearings in 60 days. • Alcohol, Marijuana, Ecstasy • Alcohol & Marijuana abuse • “Do what you have to do, collect your money from my insurance, and leave me to my own devices – I will be fine/ Just get the damned Dean off my back”.

  19. Exercise • Sylvia • 14 year old Caucasian female student • Referred by father who stayed during the session. • Alcohol and occasionally Inhalants • Alcohol abuse • No previous treatment history – history of acting out in school and poor academic performance. • “Father, give her whatever she needs, I will pay for it”. Sylvia, “I will do whatever you say, I didn’t mean to cause all of these problems”.

  20. Exercise • Jerry • 50 year old African-American male • Self-referred – Self-employed musician • Divorces, lives with girlfriend • Extensive drug history including hallucinogens, marijuana, alcohol, cocaine. Multiple treatment episodes and periods of abstinence the longest about 2 years. • Heroin dependence • “I am tired, I can’t live that life anymore. I want to quit”.

  21. Exercise Helen • 26 year old Chinese-American female • Single, lives alone in rented home • Referred by physician • Employed as electrical engineer • Cocaine & rarely alcohol • Cocaine dependence • “I can’t let my employer find out. My career would be over. I am expecting a 30 million dollar research grant in a few months”.

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