1. Module 6C Introduction Traditional Settings and Models: Residential Substance Abuse Treatment Programs for Clients with COD

2. Chapter 6 Modules • Module 6A • Essential Programming & General Considerations for Treatment of Clients with COD • Module 6B • Outpatient Substance Abuse Treatment Programs for Clients with COD • Module 6C • Residential Substance Abuse Treatment Programs for Clients with COD

3. 7 Essential Elements &General Considerations • Working in groups • Involving clients in treatment and program design • Family education 1. Screening, assessment, & referral for persons with COD 2. Physical & mental health consultation 3. Prescribing onsite psychiatrist 4. Medication & medication monitoring 5. Psychoeducational classes 6. Double trouble groups (onsite) 7. Dual recovery self-help groups (offsite)

4. In This Module . . . • Residential Substance Abuse Treatment for Clients with COD • Designing • Implementing • Evaluating • Sustaining • Examples of programs

5. Designing Residential Programs for Clients with COD • Intake • Assessment • Engagement • Continuing Care • Discharge Planning

6. TIP Exercise—Design In groups or with partners: 1. Read recommendations on your topic. 2. Think about how these activities are conducted in your programs. 3. Describe what could stay the same and what would need to change in your program to meet the recommendations for COD programs. (8 minutes)

7. Intake Steps 1. Written referral 2. Intake interview 3. Program review 4. Team meeting

8. Assessment Areas • Substance abuse evaluation • Mental health evaluation • Health and medical evaluation • Entitlements • Client status

9. Continuing Care • Goals: • sustaining abstinence • continuing recovery • community living • vocational skills • gainful employment • deeper understanding • increase responsibility • family difficulties • consolidating changes • Key Services: • life skills education • relapse prevention • 12-Step or double trouble groups • case management (especially for housing) • vocational training and employment

10. Discharge Planning • Housing • Case management services • Medication management • Relapse prevention • Positive peer networks • Mutual self help groups • Advocacy involvement

11. Staffing Recommendations • Program director • Secretary • Program supervisor • 10 line staff • Clinical coordinator • Nurse practitioner (half-time) • Entitlements counselor (half-time) • Vocational rehabilitation counselor (half-time) • Consultive arrangements for medical, psychiatric, and psychological input or care

12. Quick TIP Exercise—Training 1. With your partner, look over the questions in Figure 6-3 (pp. 167–168). 2. Substitute the treatment model used in your workplace for each “TC” in the questions. 3. Which questions can you answer easily? 4. Which are you less sure of? (2 minutes)

13. Evaluating Residential Programs for Clients with COD 1. Define operational goals in terms of the client behaviors 2. Decide on study clients and sampling 3. Locate and/or develop instruments 4. Develop plan for data collection 5. Develop plan for analysis and reporting

14. Sustaining Residential Programs for Clients with COD For quality control, the CQI staff uses: • Observation • Key informant interviews • Resident focus groups • Standardized instruments • Staff review

15. Therapeutic Community (TC) • Goals: • Promote abstinence • Decrease antisocial behavior • Effect a global change in lifestyle, including attitudes and values • View: • Drug abuse is a disorder of the whole person, reflecting problems in conduct, attitudes, moods, values, and emotional management • The community is the healing agent