Transcript Treatment Setting and Treatment Planning Chapter 5

Treatment Setting
and Treatment Planning
Chapter 5
Felicia Pressley, LPC
June 8, 2010
Objectives
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Discuss the importance of treatment
planning and treatment setting as
critical elements of substance abuse
programs
Define treatment planning and
treatment settings
Discuss the elements of substance
abuse/dependency treatment plan.
Objectives cont’d
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Become knowledgeable of he External
Reviewers of Treatment Planning.
Be able to describe and discuss the
importance of matching treatment to
needs of the client
Discuss the aspects of treatment planning
and understand treatment planning
Understand treatment setting and be able
to place clients in appropriate settings.
Key Terms
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Detoxification
Dual-diagnosis programs
Goals
Indicators
Intensive outpatient
treatment
Joint Commission on
Accreditation of
Healthcare Organization
Long-term goal
Methods
Minnesota Model
Objective
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Partial Hospitalization
Problem
Recovery/halfway house
Rehabilitation programs
Residential program
Restrictive
Short-term
Signatures
Treatment plan
Treatment setting
Type of plan
Treatment Setting
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Place or environment where substance
abuse treatment services are provided.
The environment of the setting can be
from lest to most restrictive.
Most Common Treatment Settings
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Medical detox and stabilization
Dual-diagnosis hospital inpatient
Free-standing rehabilitation and
residential programs
Partial hospitalization
Temporary recovery or halfway house
Intensive outpatient
Outpatient DUI/DWAI/DUID programs
Medical Detoxification and Stabilization
Services Provided
 Screening for withdrawal symptoms/ or
psychiatric conditions
 On-site medical and psychiatric care that
promotes safe and complete withdrawal
 Staff who structure and nurture the
environment
 Staff who protect client from self-harm or
harm to others
 Staff who educate and counsel clients about
substance abuse and dependency
Dual- Diagnosis Hospital Inpatient
Services provided
 On-site medical and psychiatric care
including 24 hour nursing supervision, and
locked units with limited access to family and
friends
 Personnel with specialize knowledge in dual
diagnosis
 7-,14-, 28-day stays in a protective,
restrictive environment
 Intensive assessment and diagnostic services
 Daily intensive group contact with other
clients
Free-Standing Rehabilitation and
Residential Programs
Services Provided
 Treatment varying from 14 days to a year
 Comprehensive, structured, and intensive
treatment services to transition clients to
sober/ clean independent living
 Development of communal recovering
environment
 Ancillary services available to support
continued recovery; social workers, discharge
planners, and job placement specialist
 Adolescent/youth and adult treatment options
Partial Hospitalization
Services Provided
 Level of care between full
hospitalization/rehabilitation and
intensive outpatient
 Professionally staffed structured
environment providing treatment
services
Temporary recovery or Halfway house
Services Provided
 Minimally structured transitional living
in a recovering environment
 Opportunity to save money to live
independently
 Assistance maintaining a connection
with a recovering community while
dealing with day to day issues.
Intensive Outpatient
Services Provided
 Comprehensive treatment with offsite living while establishing or
maintaining employment
 Graduated treatment services
 Possibly longer-term, intensive
treatment than hospitals and
rehabilitation settings.
Outpatient DUI/DWAI/DUID Programs
Services
 Court Ordered
 Alcohol/Drug Education Program
 Group meetings
 Usually from 12 weeks with 90
minute meetings
Matching treatment to client’s needs
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Ability to pay
Method of payment
Geographic availability of specific services
Current employment, housing and family
condition
Previous treatment experiences
Reliability of assessment information
Availability of space in existing settings
Level of self-care
Current emotional and behavioral rate
Treatment Planning
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Treatment plan for clinician, client
or both?
Why make a treatment plan?
When to make a treatment plan?
YouTube - Residential Inpatient
Drug and Alcohol Addiction ...
Treatment Planning
Understanding the Purpose and
Requirements
 Treatment Plans (TX) are written
documents that detail the problem and
the recovery during treatment episode.
 Develop a TX:
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Problem/ current symptoms
Goals
Objectives and outcomes
Treatment Planning
Planning Development
 Initial treatment (first 24 hours)
 Medical/health
 Emotional barriers
 Interpersonal
 Recognition versus resistance
 Reuse (Relapse)
 Social milieu (gravitates towards unhealthy; drugusing peers)
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Recovery and Home environment (financial
stressors, strained personal relationships)
Treatment Planning Elements
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Type of plan
(initial, master,
updated)
Problems
Indicators
Long-term goals
Short-term goals
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Objectives
Methods
Frequency of
services
Signatures
External Reviewers of Treatment Plans
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Joint Commission on Accreditation of
Health-care Organizations (JCAHO)grants approval to substance abuse
treatment programs and facilities that
provide respectful, ethical assessment,
care, and education to clients and their
families.
Standards for approval:
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Treatment planning, medication use,
nutrition care, rehabilitation care and
services, and special treatment services.
JCAHO guidelines
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Clinical staff:
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Use diagnostic summaries (DSM) to
identify treatment needs
Design intervention tailored to meet those
needs
Develop treatment objectives that are
reasonable, attainable, and written in
measurable and objective terms
Determine patient goals for treatment and
involve patients in developing their own
treatment
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Questions or Comments?