Treatment 101 Substance Abuse Basics West Coast Consulting Wanda King

Objectives You will be able to: Define key treatment terms Describe the basic framework for a continuum of care Develop questions to ask your treatment provider

What Is Treatment Treatment is all of the interventions intended to short-circuit the addiction process and to introduce the individual to effective recovery

12 Core Competencies Screening Process by which a client is determined appropriate and eligible for admission to a program Client Intake Process of collecting client information at the beginning of treatment that is used in assessment of a client for treatment Client Orientation Individual or group sessions to familiarize clients with program service expectations and goals

12 Core Competencies Client Assessment Confirms the presence of a problem and helps illuminate other problems connected with the substance abuse disorder. Is used to develop and appropriate set of interventions Treatment Planning Defining areas of strengths and needs establishing long and short term goals and developing an appropriate plan for reaching these goals

12 Core Competencies Individual Counseling One to one counseling with the client and/or with clients family Group Counseling Process involving clients for the purpose of exploring client issues with other clients Family Counseling Process of exploring the dynamics of the family system

12 Core Competencies Case Management activities which bring services, agencies, resources or people together and work toward the achievement of established goals. Crisis Intervention services which respond to a client with alcohol or other drug issues during acute emotional and/or physical distress

12 Core Components Client Education Seminars or workshops which have the major goal of increasing the clients’ knowledge and patterns of problem behavior Referral Identifying strengths and needs of the client that cannot be met by the counselor or agency and assisting the client to use the support systems and community resources available

12 Core Components Record Keeping charting the results of the assessment and treatment plan: writing reports, progress notes, discharge summaries and other client-related data Consultation discussing with counselors and other professionals the client’s treatment to assure comprehensive, quality care for the client

Comprehensive Assessment How do you determine level of addiction? How to you determine level of care? What is included in a comprehensive assessment?

Levels of Use Experimental Use Social Use Substance Abuse Addiction Dependency Components of Dependency Psychological Physical

Continuum of Care Assessment Case Management OutpatientIntensive Outpatient Inpatient Residential Medical Model Group Home Detox Sober Living Home Based Family Comprehensive Assessment Determine Level of Use Determine Level of Care

Treatment Modalities Outpatient Non-intensive 9 or less Intensive 9 – 20 Day treatment – spend day can be education focused if youth

Treatment Modalities continued Inpatient/residential Medically monitored intensive inpatient Residential Therapeutic Communities Group homes/transitional living Detoxification Self-help

Principles for Effective Treatment 1. No single treatment is appropriate for all individuals? True: matching treatment services to individual problems and needs is critical to success 2. It is not important for treatment to be available immediately? False: Because people may be uncertain about entering it is important to take advantage of opportunities when they are.

Principles for Effective Treatment 3. Effective treatment addresses only AOD use? False: to be effective treatment must address drug use and any other associated problems. 4. Treatment plans must be updated on a regular basis? True: participants may require varying services and treatment components during the course of treatment

Principles for Effective Treatment 5. The length of treatment does not impact treatment effectiveness? False: appropriate time in treatment depends on individual problems and needs. 6. Medications are an important element of treatment for many patients. True: methadone is effective in helping individuals addicted to opiates. For participants with mental disorders medications can be critical

Principles for Effective Treatment 7. Drug using or addicted individuals should deal with co-existing mental disorders first? False: because addictive disorders and mental disorders often occur in the same individual clients presenting for either condition should be assessed and treated for both. 8. Detox by itself can change long-term drug use? False: medical detox safely manages symptoms of withdrawal but is rarely sufficient to help addicts achieve long-term abstinence.

Principles for Effective Treatment 9. Treatment does not need to be voluntary to be effective? True: coerced and voluntary treatment has about the same success outcome rates 10. Recovery from addiction can be long-term and frequently requires multiple treatment episodes? True: as with other chronic illnesses, relapses to drug use can occur during or after successful treatment episodes. Addicts may require prolonged treatment and multiple treatment episodes to achieve long-term abstinence

Adolescent Treatment in Juvenile Drug Court Elements associated with effectiveness Assessment and treatment matching Ability to engage and retain Comprehensive integrated approach Qualifications of staff Aftercare and relapse prevention Gender/culturally appropriate Family involvement Developmental appropriateness

Interventions Associated with No or Minimal Change Passive referrals Educational units alone Probation services as usual Non-standardized outpatient treatment

Interventions Associated with Deterioration Treatment in groups that include one or more highly deviant individuals Treatment of adolescents in adult units and/or with adult model and materials

Relapse What is relapse A process in which an individual who has abstained from use for a period of time begins to think about using, then uses What is relapse prevention A set of strategies to train AOD users to cope more effectively and overcome triggers in their environment

Relapse Anticipate relapse Natural part of recover Should not be confused with program failure Prevention should start in the beginning Prepare for relapse Occurs in first 3 – 12 months Program cannot predict # of times Determine how program will respond Distinguish between relapse and ongoing use Teach participants about triggers

Relapse Warning Signs Unscheduled absences from sessions Changes in attitude and mood Change in level of engagement Physical changes – weight, sleep, health Change in performance in school or job Family report of changes in home interactions

Expressive and Experiential Therapies Music Therapy – using music to achieve treatment goals Art Therapy Journaling Autobiography

Question to Providers Take 5 minutes and work with group to develop questions you have for your treatment provider.