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Addictions Treatment Planning for Effectiveness

Addictions Treatment Planning for Effectiveness

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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”.