T I P 47 Intensive Outpatient Services Edited
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T I P 47 Intensive Outpatient Services Edited
- 1. Intensive Outpatient Services: Clinical Issues TIP 47 Dr. Dawn-Elise Snipes, PhD, LMHC, CRC, NCC Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
- 31. TREATMENT ENTRY AND ENGAGEMENT Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
- 35. FAMILY-BASED SERVICES Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
- 70. SPECIFIC POPULATIONS Copyright 2008-2012 AllCEUs.com A subsidiary of CDS Ventures, LLC
Notas do Editor
- Multidimensional/Biopsychosocial Recognizes dual disorders as chronic Values case management Blends evidence-based with community based services
- 6–30 contact hours per week Individualized step-up and step-down levels of care A minimum duration of 90 days followed by step-down
- Enhanced services Ambulatory detoxification Childcare Outreach Case Management For more detailed information, see TIP 47, pp. 1–6
- Screening Assessment Treatment planning Treatment engagement Group, individual and family counseling Psychoeducational programming Integration into support groups
- Relapse prevention training Substance use screening and monitoring Vocational and educational services Referral to wrap-around services Mentoring?
- Treatment is available to a wide spectrum of clients Treatment access is straightforward and welcoming (No Wrong Door) Enhance existing motivation Trust is built between the counselor and client Client retention is a priority Individualized assessment and treatment
- Implements a flexible, chronic/episodic care model Monitor abstinence Help clients integrate into support groups If indicated, use medications to manage co-occurring disorders Educate clients and family members about addiction and recovery Include families, employers, and significant others in the treatment process
- Seek out and use evidence-based training and materials Improve program administration For more detailed information, see TIP 47, pp. 7–16
- Bio Housing Health issues Psycho Past/present MH/trauma issues in self/family Past/present SA issues in self/family Past treatment successes/failures Suicide/homicide and family violence Self esteem Coping Skills, strengths and resources
- Social Relationship with peers Occupational Legal Personal and family involvement Financial
- Inconsistent ability for abstract /future thinking Impulsive/short attention span Vulnerable to peer influence Frequent emotional fluctuations Lack of involvement in pro-social activities Pessimistic/fatalistic attitudes
- Level 0.5: Early intervention services Level I: Outpatient services Level II: Intensive outpatient Level III: Residential/inpatient services Level IV: Medically managed intensive inpatient services
- Treatment frequency and intensity is individualized At least 9 hours per week for 90 days Stages Treatment engagement Early recovery
- Goals Initiate a treatment contract Resolve acute crises Engage in a therapeutic alliance Involve clients in preparing a treatment plan Duration — A few days to a few weeks
- Confirm diagnosis, eligibility, and appropriate placement Conduct biopsychosocial assessment Develop treatment plan Provide assessment feedback Explain program rules and expectations Address acute crises Resolve administrative issues Foster therapeutic alliances between client and counselor and group members
- Begin psychoeducational activities Identify sources of social support With client’s permission, initiate family contacts and education
- Assessment and treatment plan are completed Client has completely detoxed Client has adequate attendance and participation
- Goals Abstinence Sustain behavioral changes Identify relapse triggers and develop relapse prevention strategies Identify and begin to resolve personal problems Begin active involvement in a 12-Step or other mutual-help program Duration — 6 weeks to about 3 months
- Help clients follow their plans to sustain abstinence Assist in identifying and developing strategies for relapse triggers Initiate random drug tests and provide rapid feedback of results Help clients and families integrate into mutual-help programs Assist in developing and strengthening positive social support networks Continue appropriate pharmacotherapy, medical and psychiatric treatments
- Sustained abstinence for 30 days or longer Completed treatment plan goals Created and implemented a relapse prevention and continuing care plan Participated regularly in a support group Maintained a sober social support network Resolved medical, psychiatric, housing and personal situations that may trigger relapse
- Step-down/Stage 3 Maintenance Goals Solidify abstinence Use relapse prevention skills Improve emotional functioning Broaden sober social networks Address other problem areas Duration — About 2 months to 1 year
- Help clients practice relapse prevention skills Teach new coping skills Help identify unmet biopsychosocial needs Assist in locating community resources Encourage support groups participation Emphasize the importance of spirituality/altruistic/sober values Provide feedback on random drug test results Continue treatment plan implementation
- Sustained abstinence Improved relationships Improved coping and problem solving skills Obtained drug-free, stable housing Continued participation in a support group Obtained assistance with other problems
- Goals Maintain abstinence and wellness Develop independence from the treatment program Maintain social and support network connections Establish recreational activities Duration —Years, ongoing
- Assist in developing a plan for continuing recovery Acquaint clients with local resources Encourage attendance at alumni or booster sessions Provide biannual checkups Completion criteria — Clients may need community support for the rest of their lives
- Assessment Treatment planning Group and individual counseling Psychoeducation Pharmacotherapy Drug testing/monitoring Case management Community based support groups
- 24-Hour crisis coverage Medical and dental treatment Vocational and employment services Wrap around services
- Pause the presentation and make a list of all of the issues that your clients have to deal
- Childcare Transportation Adult education Housing Food Parenting skills Smoking cessation Postpartum support Relationship/couples counseling HIV/AIDS, Hepatitis screening, education, counseling Domestic violence And more….
- TREATMENT ENTRY AND ENGAGEMENT