TREATMENT CENTRE

 Principles of treatment  treatment goals - abstinence and harm reduction  Types of treatment  medical treatment  psychological therapy and rehabilitation  self-help programmes  Treatment team TREATMENT

PRINCIPLES OF EFFECTIVE TREATMENT  Comprehensive programme addressing the multiple needs of the client  Repeated assessment to address the changing problems of the client – medical and psychiatric problems  Exclusive programme to address the issues and problems of family members …….

 Individual counseling and group therapy to strengthen motivation  Educational programme to provide insight into the addictive process  Exposure to self-help groups  Long term follow up with emphasis on relapse prevention  Multi - disciplinary team to offer comprehensive care PRINCIPLES OF EFFECTIVE TREATMENT (contd….)

TREATMENT INITIATIVES  Identification and intervention  Medical treatment  Treatment and Rehabilitation  Primary care  Extended care programme  Vocational rehabilitation  Community based treatment programme  Therapeutic community

Identify addiction at the early stage, intervene effectively and motivate him to take help Settings  Schools, colleges  Workplaces  Voluntary agencies  Health care centres, hospitals  Family counselling centres IDENTIFICATION AND INTERVENTION

Methods v Counselling v Involving family and significant others v Making appropriate referrals

How they help v Identification, intervention and motivation v Providing information v Involving family and significant others v Counselling client and family v Making appropriate referrals

MEDICAL TREATMENT Medical care to deal with withdrawal symptoms, co-existing medical / psychiatric problems

Settings General hospitals - different departments  General medicine  Surgery  Gastroentrology  Neurology  Psychiatry Mental health centres and private psychiatrists  Nursing homes MEDICAL TREATMENT

Methods  Medical and nursing care  Assessment  Supportive counselling

How they help  Detoxification to deal with withdrawal symptoms  Assessment and management of medical and psychiatric problems  Dealing with medical emergencies of alcohol poisoning or drug overdose  Handling acute psychiatric break downs or suicidal attempts due to addiction

PSYCHOLOGICAL THERAPY AND REHABILITATION PROGRAMMES Effecting abstinence along with improvement in the quality of life Primary care Settings In-patient / out-patient treatment units Duration 1 – 3 months

Methods used  Assessment  Medical and nursing care  Counselling  Group therapy  Re educative lectures  Family therapy  Involvement of other support persons (employer, friends, clergy)

Life skills training on  Interpersonal skills  Decision making  Problem solving  Strengthening self esteem  Stress management SUPPORTIVE THERAPIES

 Self help programmes  Relapse prevention programme  To recognise high risk situations and emotional triggers that lead to relapse and learn coping methods  Yoga / relaxation techniques

How they help  Enhancing motivation  Providing comprehensive care to lead a drug free life  Effecting positive changes in one's lifestyle  Providing insight into the denial system and personality deficits ……..

 Providing emotional support to the family  Helping the family to develop healthy interpersonal relationship  Ongoing support to prevent relapses How they help (contd…)

EXTENDED TREATMENT PROGRAMMES Intensive programme of a longer duration to provide extended care to relapse prone clients Provide an intermediate step between treatment and independent living Settings  After care centres or half way homes  Residential

Duration 3 – 24 months How they help  Strengthening the social support system  Improving life skills to facilitate reintegration into society  Providing opportunities for vocational skills and employment

VOCATIONAL REHABILITATION Clients are helped to  acquire marketable vocational skills  develop healthy work ethics  find remunerative jobs Settings  in patient / out patient units

COMMUNITY BASED PROGRAMMES Settings  Residential  Community centre / marriage hall / church in villages Duration  One to two weeks Providing treatment in the community where the clients live

How they help  Providing cost effective treatment in the village itself without dislocating the person  Helping the community to create an alcohol free environment

THERAPEUTIC COMMUNITY Emphasis is on  Personal accountability for recovery  Acquiring socially productive lifestyle  Ex-addicts run the centre - Hierarchy of inmates is of great importance and senior members play a major role Settings  Residential programmes

Duration  Six months to two years Methods  Use of self-help group philosophy  Group encounter (confrontation)  Teaching social and vocational skills  Role modeling of senior members

How they help  Developing a drug free life style  Changing negative patterns of behaviour, thinking and feeling that predispose drug use

SELF-HELP PROGRAMMES Settings  Meetings conducted in churches / school premises on an out-patient basis Peer supported groups - Alcoholics Anonymous, Narcotics Anonymous, Gamblers anonymous and Al- Anon

Principles  Spiritual / behavioural framework with 12 steps and 12 traditions  Belief in a higher power  Making a moral inventory of oneself and admitting one's wrong doings  Willingness to make amends to people whom one has harmed  Carrying the message of this fellowship to other suffering persons

How they help  Instill hope about recovery and maintain motivation  Help recovering addicts / their families share their experiences and support one another in a drug free lifestyle  Provide long-term support

TREATMENT TEAM  Physician  Psychiatrist  Nurses  Psychologists / social workers as counsellors  Recovering addicts as counsellors  Community workers  Vocational therapist