In addition to group therapy or support groups, vicarious learning can be promoted by asking clients to name anyone they know who has successfully confronted a problem related to drugs or alcohol. Different types of services are regulated differently; therefore, the expectations for treatment plans can vary. Clients who are contemplating change can spend long periods of time evaluating themselves, their environments, and their options. More often, clients trying to change disordered substance use struggle with uncertainty about the strength of their convictions or the extent of their abilities to follow through with the options they have selected for responding to problems. A more fruitful strategy with clients who do not totally comply with the abstinence expectation is to maintain interaction as long within agreed timeframes and therapeutic boundaries as the client is willing and able to talk appropriately about what is interfering with compliance and how abstinence the day of the session can be realistically enforced in the future. Her therapist can better prepare her to confront these situations in a manner that prevents relapse by talking about and recording the particular events that Viola anticipates will be most stressful. An action plan specifies criteria of change, often in terms of behaviors that demonstrate a difference from prior habits.
The goals of closing on good terms are to arrange another session, to leave the client feeling successful, and to instill confidence that will enable the client to follow through on what was agreed upon Counseling tips: Tailor your closure to the client and the particular circumstance of this brief intervention; interpret any client resistance in a positive light leading to progress. It is not unusual for clients to express at least some reluctance to engage in a more public form of therapy or self-help, but for clients who are willing to at least experiment, the therapist can emphasize the value of comparing experiences with others who are blazing their own paths to the goal of improving their own circumstances. It is often constructive for the therapist to offer the client some explanation of how therapy works and how change occurs. In addition to talking about relapse promoting factors in individual sessions, clients can also be invited to explore related experiences in a group therapy context. The therapist often distinguishes between expectation of client effort and insistence on outcome.
Addressing Therapeutic Confidentiality and its Limits Early in therapy, clients are educated about confidentiality in the therapy relationship. Related vocational counseling applications are discussed more extensively in Chapter 9 of Glidden-Tracey 2005. To the extent that the therapist has used psychoeducation to inform and discuss these potential outcomes with the client ahead of time, the procedures, if necessary, are less likely to elicit resistance from the client who knows about them. The client who is using substances, perhaps despite agreements to the contrary, but who has not agreed to regularly report any substance use to the therapist, may be inclined to deny the behavior or otherwise falsify information to protect from detection with unknown consequences. Methods and timeframes of particular relevance to treatment of substance use disorders will be considered in greater depth in the following sections on psychoeducation and relapse prevention planning. You should consider this factor if you are interested in learning some Examples of Substance Abuse Treatment Plans.
Chris reported that he is ready to begin enforcing his new parenting system. Followup sessions were held with both groups at 1 week, 3 months, and 6 months. I will refer them to your page so they can benefit from this information as well especially when it comes to setting goals and objectives. Screen At each visit, ask about alcohol use How many drinks per week? Wilk and colleagues examined evidence from 12 controlled clinical trials that randomized nearly 4,000 heavy drinkers to brief intervention or no intervention. Even light or moderate use of some substances can result in health problems or, in the case of illicit substances, legal problems. Treatment planning continues as long as the client keeps returning for therapy sessions and can also help clients engage in change efforts beyond therapy. As soon as substance use concerns emerge as a focus in therapy, clear expectations should be communicated about reporting substance use.
This is fine since every treatment plan is as individual as the client treated, but it should be noted why the item does not apply. By systematically exploring the reasons for and against drinking, you can help her tip the scale in favor of change. Not giving in to urges by taking them as a challenge is the positive answer to negativity. Treatment providers who work in settings other than substance abuse treatment must be flexible when assessing, planning, and carrying out brief interventions. . Each of these topics in turn will be addressed in this section in terms of what the therapist needs to know about the topic itself and what the therapist needs to consider in educating the client about each topic.
The treatment plan Juanita and her therapist generated together can be viewed in Table 4. They note that research also supports the efficacy of these therapies for other psychological problems, important considering the high comorbidity of substance use disorders with other mental health concerns. Nathan, for another example, sold drugs for years before his most recent arrest, his new wife, and his renewed faith all convinced him to clean up his act. Using open questions that avoid presumptive wording is more likely to elicit relevant content from the client. Initial withdrawal of a heavily used substance is often associated with intense physical craving, but the experience of craving a favorite substance can continue or recur long after the substance has been completely flushed from bodily tissues.
Center for Substance Abuse Treatment. The therapist asked if he was worried that Karen might not want to go if she was aware of his plan, but Paul expressed certainty that she would be interested in helping him. Stages of change are being examined in brief interventions with hazardous and harmful substance users as well, as a means of tailoring interventions to the individual's current stage of change Hodgson and Rollnick, 1992;. Watch for defensiveness or other resistance, and avoid pushing too hard. Frequently the client gets anxious about the conflicting pulls. Therapist expressions of empathy are crucial for creating therapeutic conditions in which treatment plans can be made and implemented.
While some substance-induced alterations of baseline functions are certainly experienced as desirable, the excessive use of psychoactive substances also invites consequences of impaired cognition, affect and behavior that can be stressful and even dangerous. A small successful application of a brief motivational intervention within a substance abuse treatment setting administered approximately 1 hour of motivational interviewing for problem drinkers adapted from to seriously opiate-dependent clients recently admitted to a methadone maintenance clinic. The therapist suggests taking some time to decide on other places to study, and on how Juanita can resist inclinations or invitations to go to the coffee house. Others, like Nathan, are able to articulate clear goals, but have little understanding of how to formulate a workable plan to move from where they are to where they want to be. If the client remains unwilling to commit to abstaining from substance use on the day session, the therapist has the option of raising the topic of possible referral to more intensive treatment. The therapist often wants to be explicit that one goal is to provide clients with a broader base of general drug and alcohol information that will assist the client in making better informed choices about consuming or using them. Even if the client expresses ambivalence, intoxication further clouds immediate inclinations to think about their own contributions to current difficulties.