Learning Strategies and Preference Clients in Recovery - Research Paper Example

 Learning Strategies and Preference Clients in Recovery EXECUTIVE SUMMARY One of the crucial components of successful recovery is the curative counseling that takes place within drug rehab facilities. Whereas substance abuse surely has a powerful physical element, several abusers effectively detox, just to relapse afterward when disturbing emotional problems recur. The significance of having a facilitator lies in its aptitude to deal with the root causes of abuse that compelled the individuals to start using drugs. All over the course of psychotherapy, substance abusers can explore the psychosomatic part of their addiction. With the help of a competent facilitator, drug abuse counseling cuts to the basic reasons for addiction. DEFINITIONS DARS: it stands for Drug Abuse Recognition System. It includes the newest as well as most consistent detection arrangement, in addition to a methodically researched and technically based guidance and teaching program. Idaho Department of Corrections: The Idaho Department of Correction is in charge of the imprisonment as well as community control of criminals within Idaho. IDOC runs eight jails, four community work places and several trial and parole centres. Clients: Patients, who are recovering from substance abuse problem. CADC: Certified Alcohol and Drug Counselor LSW: Licensed Social Worker Specialty courts: these courts are the divisions working within the legal branch of government that normally deal with a single area of law or have exclusively defined authorities. Methamphetamine: A synthetic drug, utilized unlawfully as a stimulant as well as a prescription medicine to take care of narcolepsy as well as to maintain blood pressure. Marijuana: It is a psychoactive drug, generally smoked, but can be eaten as well. Opioid: It is a chemical substance, with morphine like action within the body Probation: The discharge of a criminal from imprisonment, conditional on a phase of good conduct in supervision. Parole: The momentarily or permanently discharge of a detainee, earlier than the completion of a prison term, on the guarantee of good conduct. Recovery: It is a process of modification by which a person gets self-restraint as well as better physical condition, wellness as well as quality of life. Abstinence: It means limiting oneself from indulging in something TABLE OF CONTENTS 1. INTRODUCTION In state of Idaho, the problem of substance abuse has grown, which increases the number of incarcerated individuals in a correctional institution. The addiction of drugs or alcohol has no barriers and it affects people of all ages, gender, education level, and economics level alike. This situation has increased the need facilitators in the area. The educational level of these facilitators can be a certified alcohol and drug counselor, a licensed social worker, or a licensed counselor. These educators in the addiction field have not received much training on how Adult Learners learn. Many programs in the Recovery field are cognitive based training for students. The facilitators are taught motivational interviewing to determine the client’s readiness for change and to find out which level and recovery program is suitable for the client. Few curriculums address the way Adult Learners learn (Stevens & Smith, 2008). Very few facilitators have a tool to assess what type of learner they are working with and which style of learning should be used with the client. The author is unaware of any training, or core training, being used in the recovery field that assesses the learning style of the client, it appears they are just given the information and expected to learn the information without knowing how the client learns. While there are many recovery programs, very few address the learning preference strategies of the client. There is not clear data on if there is a common type of learning style of client that was addict and in recovery, or type of drug use, period of drug usage, last attended school and gender. There has been an increase of population with addiction issues being sentenced to the department of Idaho Correction. 1.1 Purpose of Research The purpose of this study is to conduct a Needs Assessment to develop a facilitators’ workshop on learning strategies and preference of clients in recovery. The needs assessment will be used as basis to design a curriculum for the workshop. 1.2 Statement of Problem It is necessary for the facilitators to have all the skills and tools necessary to assist their clients in recovery. The learning strategies and cognitive performance provide a window for both the client and facilitator to have an understanding on how the client learns and how the facilitator can meet the needs of the client. This would support the client with a learner-centered instruction and both facilitator and client would have an idea how to enhance the learning ability of client. 1.3 Research Questions 1. What content should be included in the workshop? 2. What tools should be included in the facilitators’ tool kit for Navigators, Problem solvers, Engagers. 3. What assessment measures will be used to measure the success of the workshop? 2. NEEDS ASSESSMENT OF CLIENTS IN RECOVERY Needs assessment is a methodical technique for evaluating the health concerns facing a population, leading to approved priorities as well as resource allotment that will develop health and decrease inequities. The Idaho management is determined and focuses on guaranteeing that there is suitable capacity within pertinent drug, improvement, and reintegration facilities. Such an assessment will have to take complete information on the gender, traditions, and other varied wants of the aimed population in addition to any unmet requirements from this point of view. The assessment will as well have to be carried out in reference to the prerequisites of the national regulation on carrying out an equality impact evaluation. The use of needs assessment is to check, as thoroughly as feasible, what the comparative requirements and problems are within different groupings and situations, and take authentic as well as fair decisions on how needs might be fulfilled most efficiently within accessible resources (Fisher & Harrison, 2010). When a person is stressed with drug abuse, soberness can appear to be an impracticable objective. However, improvement is never out of reach, regardless of how bleak the situation appears. Change is feasible with the correct cure as well as support, and by dealing with the major cause of drug abuse. It is facilitator’s responsibility to ensure that the patient should not lose hope, even if he has tried and failed earlier. The path to healing generally involves bumps, difficulties, and delays. For many individuals, struggling with drug abuse, the major as well as most difficult step toward improvement is the very first one: choosing to make a change. It is common for clients to feel inconsistent regarding quitting the drug of choice, even when after understanding that it is creating troubles in the life. Change is never simple and requires the client to change a lot many things, such as (1) the way he manages stress, (2) his activities in spare time, and (3) the way he sees himself. Once the drug abuser made the decision to challenge his addiction, he should check the treatment choices he have. Throughout the recovery process, the facilitator should keep reminding the client about the following important things: There is no particular cure that helps every person. When taking into consideration a plan, one should remember that everyone’s requirements are different. Substance abuse treatment should be adapted to your exclusive setbacks as well as circumstances. It is significant that facilitator selects a program that feels correct. Treatment should handle more than just the substance abuse. Addiction influences patient’s entire life, together with relations, profession, physical condition, and psychosomatic health. Treatment success relies on adopting a fresh life style as well as dealing with the causes that compelled the patient for drug abuse. It may have been due to a failure to control pressure, in which case the client will need to discover healthy methods to deal with demanding situations. Dedication as well as follow-through is one of the very important needs of the client. Drug abuse cure is not a fast and simple procedure. Usually, the longer, and more strong the drug abuse, the longer, and more severe the cure client will need. However, in spite of the healing plan’s duration, continuing follow-up care is key to healing. There are a number of places where a person can look for help. Not everyone needs medically controlled detox or a comprehensive period in rehab. The level of care one needs is according to the age, substance abuse record, and other medicinal or psychiatric situation. Besides general practitioners and psychologists, various “clergy members, social workers, and counselors offer addiction treatment services” (Herdman, 2008). As one seeks help for drug abuse, it is as well essential to get cure for any other medicinal or psychosomatic concerns the person is facing. The most exceptional prospect of improvement is by means of integrated cure for both the substance abuse problem as well as the mental health issue. This implies having joint psychological health and abuse treatment from the same facilitator. The facilitator should inform the client that he could not deal with substance abuse problems alone. No matter what treatment approach is chosen, it is necessary to have a firm support system. The more helpful influences client has in his life, the better his chances for revival. Getting better from drug addiction is not simple, but it becomes a little less difficult to deal with when there is a proper facilitator to guide the clients. Moreover, having the support of acquaintances and relatives is a priceless asset during recovery. A sober social network is another important need of the person recovering from substance abuse. It is essential to have companions who will support the recovery. The patient can attend a class; join a place of worship or a community group, or going to events within the community. Situations like constant worry, being alone, aggravation, resentment, embarrassment, apprehension, and depression will stay in the life even when the person is no longer taking drugs to cover them up. However, he will be in a better place to finally handle them and look for the help he need. 3. NEED OF FACILITATOR’S WORKSHOP Facilitators treat clients with alcohol and drug addictions. They work within residential cure centers as well as in outpatient management centers and private clinics. They offer an extensive range of services to the clients. These facilitators usually involve themselves in treatment arrangement with clients. They may advise individual and group therapy, “family counseling, educational programs, medical care, psychiatric care and self-help groups like Alcoholics Anonymous or Narcotics Anonymous” (Ford Books & McHenry, 2009). A key role of facilitators is the provision of counseling facilities. They generally offer both individual as well as group counseling sittings and may as well give marriage counseling or family counseling as and when considered necessary. Counseling sittings originally concentrates on calming down the client but then may explore earlier sufferings and the causes because of which the client turned to substance abuse. Counseling sessions as well offer constant support as clients attempt to retain their soberness. They also inform clients regarding substance abuse and the recovery procedure. Issues incorporate the “dynamics of addiction, health risks caused by alcohol and drug use and abuse, stress management, coping skills, problem solving skills, communication skills, healthy relationships and relapse prevention” (Connors et al, 2004). A number of treatment plans also offer guidance regarding issues like nourishment and work out; however, dieticians and exercise physiologists may teach those sessions rather than substance abuse counselors. Alcohol and drug addiction influences the complete family unit and the majority of treatment plans deal with that. Facilitators may inform family members regarding substance abuse and refer them to other plans or examinations as considered necessary. They may as well offer marriage counseling as well as family counseling to assist clients in restoring damaged family links. Individuals with substance abuse issue may need a number of other services, together with medicinal care, psychological care, vocational exercise, or support, monetary aid, lodging support, childcare, as well as transportation. Substance abuse counselors have to be acquainted with community resources as well as to work personally with other organizations or contractors to ensure their clients get all the aid they require. Substance abuse and behavioral disorder counselors work with clients both “one-on-one and in group sessions” (Myers & Salt, 2007). Several include the standards of 12-step plans, “such as Alcoholics Anonymous, to guide their practice” (Myers & Salt, 2007). They train clients how to manage anxiety and life’s setbacks in ways that assist them in getting well. In addition, they facilitate clients to recreate professional contact and, if needed, restore their job. They as well facilitate clients to develop their individual relations and look for ways to talk about their addiction or other trouble with relatives and acquaintances. A number of facilitators work with other physical as well as psychological health experts, for instance, psychiatric consultants, social workers, general practitioners, and nurses. A few work in facilities that provide work for various types of healthcare as well as psychological health experts. Within these settings, “treatment professionals work in teams to develop treatment plans and coordinate care for patients” (Velasquez et al, 2001). A number of psychotherapists work with clients who have been asked by a judge to get cure for substance abuse. Others work with particular category of people, for instance, youngsters, veterans, or individuals with physical disabilities. Various specialize in disaster involvement; these facilitators intervene when a person is causing danger to his or others’ lives. “Other facilitators specialize in non-crisis interventions, which encourage a person with addictions or other problems to get help. Non-crisis interventions often are performed at the request of friends and family” (Lewis et al, 2010). Many facilitators get training to work as a private practitioner, where they work single-handedly or with a set of psychotherapists or other experts. These facilitators deal with their practice as a business. This incorporates working with clients as well as insurance companies to get fee for their services. Besides, they market their practice to get fresh clients. 4. LEARNING APPROACHES FOR CLIENTS IN RECOVERY Substance abuse can be handled with the treatment that is adapted to individual requirements of clients. They can be trained to control their circumstances and lead a normal and healthy life. Behavioral therapies such as psychoanalysis, psychiatric help, support groups, or family therapy are also very helpful. Medicines are useful in curbing the withdrawal condition as well as drug addiction. Additionally, recent research works reveal that management of substance abuse via methadone by a satisfactory dosage level combined with behavioral therapy decreases mortality rates and scores of other health related issues (Juhnke, 2002). Many patients have need of other examinations like medical and mental health services along with HIV prevention. Clients, who get the treatment for more than three months, generally have improved results as compared to those who stay for shorter time. Giving long-term self-discipline to the client is the major focus of every substance abuse treatment; however, the immediate objective is to cut down drug use, boost the client’s competence, and ease the medicinal as well as communal setbacks arise from substance abuse. There are numerous drug abuse management plans. Shorter ones spans over six months and consist of residential cure, medicinal therapy, and drug-free outpatient treatment. Longer ones consist of methadone management and residential curative treatment. Clients are given an oral dose of methadone hydrochloride or levo-alpha-acetyl methadol (LAAM), sufficient to block the consequences of heroin and get a steady, non-euphoric condition without any physiological craving for drugs (Pita, 2004). After achieving this steady mental and physical condition, the client is capable of disengaging from drug searching as well as from other connected illegal activities. Moreover, with proper counseling and communal services, become a useful part of his or her society. Outpatient drug-free therapy does not use medicines; instead, it uses various customized plans for clients who visit a hospital on normal breaks. The majority of the plans are related to personal or group psychoanalysis. Clients opting for these plans are abusers of drugs apart from opiates or are opiate abusers for whom maintenance treatment is not suggested, for instance, individuals who have steady, well-integrated lives and merely a short record of drug abuse. Therapeutic communities (TCs) are extensively controlled programs, during which clients live at habitation center, for around 6 months to one year. These clients have a long history of drug dependence, criminal activities as well as impaired social functioning. The main objective of therapeutic communities is to provide a drug-free and crime-free lifestyle to patients recovering from substance abuse. The ‘Minnesota Model’ of drug abuse management supports short-range residential plans, known as substance dependency divisions. These plans spans over three to six weeks of initial inpatient treatment and after that, an extensive outpatient cure by 12-step self-help groups, like ‘Narcotics Anonymous’ or ‘Cocaine Anonymous’. Private chemical addiction plans for substance abuse started during the mid of 1980s with indemnified alcohol and cocaine abusers as their main clients. However, in the present day more programs are shifting their services to publicly funded clients (Conyers, 2010). Methadone maintenance programs are generally more flourishing at retaining clients with opiate addiction in comparison with therapeutic communities, which sequentially are more flourishing than outpatient programs that offer psychiatric therapy as well as counseling. Within different methadone courses, those that offer higher doses of methadone, have improved preservation level. In addition, those that offer additional services, for instance, psychotherapy, rehabilitation, as well as medicinal care, together with methadone usually get improved outcomes as compared to those programs that offer nominal services. Drug management plans within detention centers can do well in stopping patients to go back to illegitimate activities, generally if they are involved in some community-supported programs that go on with cure even when the client is out of the detention center. Numerous programs have cut down their fees by a considerable amount to make it economical as well as easily accessible. For instance, the Idaho Model, an current study on management of drug abusers in detention centers, reveals that prison based therapy, alongside a curative community setting, minimizes the chances of rearrest by 70 percent and also lessens the risk of going back to substance abuse by 45 percent. The client undergoes the behavioral management procedure in the supervision of a facilitator within a protected and controlled setting. After attending a series of behavioral strategies, he learns to amend the belief as well as actions concerning drug abuse to get a more positive standard of living. Behavioral management can be done on an outpatient as well as on inpatient basis. Outpatient behavioral management asks the clients to register with the facilitator and visit on a regular basis so they can be examined. It is not necessary that he live at the rehab centre; however, he should have a sober person present at his place of his recovery. 5. KIRKPATRICK’S FOUR LEVEL MODEL FOR NEEDS ASSESSMENT The Kirkpatrick Model was invented by Donald Kirkpatrick and has been in practice as an assessment model from the late 1950's. The Kirkpatrick model assumes that there are four levels of outcomes that could result from interference, and hence an evaluation could concentrate on any or every of these four levels. According to Kirkpatrick, with the purpose of assessing training programs, four measurements must be taken. Its major function is to simplify the meaning of assessment, and provide instructions on the way to get started and progress. Learner's understanding of the intervention, either helpful or unhelpful, knowledge and expertise acquired by the learners; any development to the learner's behavior; and impact on the society must be calculated and assessed. Level Target Evaluation Goal Reaction Training Preliminary support by learners Learning Learner in intervention Learning took place in consequence of intervention Behavior Learner within a broader school perspective Learning had an effect on activities, or, performance in a broader perspective Results Societal Level The intervention had the preferred outcomes within the society Table 1: Four levels of Kirkpatrick Model (Kirkpatrick, 1998). In accordance with the four levels of Kirkpatrick's model for assessing training success, evaluation should always start with level one, and subsequently, as time and funds permits, move consecutively through the remaining levels of assessment. 5.1. Level 1 - Reaction On reaction level, learners are inquired to remark anonymously, generally in the shape of feedback forms, on the competence of the intervention, the approach, as well as the apparent significance. The objective at this step is only to recognize obvious setbacks in the intervention. Level one assessment will give a sign of the capacity of the intervention to retain the learner's attention, the importance, amount, and suitability of interactive training in addition to the learners' perceived value of the involvement. If learners have an optimistic response to the program in its execution, it is more expected that optimistic results will be attained. Level one is possibly the most commonly utilized measurement since it is the easiest to measure. “The most commonly used method of level one evaluation is the so-called smiley sheets completed by learners after the completion of the program” (Kirkpatrick, 1998). In their most basic form, they assess how well learners liked the training. This type of assessment reveals important information if the questions raised are more difficult together with the significance of the program goals, the capability to maintain interest, “the amount and appropriateness of any interactive exercises and the perceived value of the information conveyed by the intervention” (Kirkpatrick, 1998). This level is not problem solving for the intervention's achievement as it does not actually calculate what new abilities the learners have gained or what they have learned and can shift to a broader perspective. This has made a number of evaluators to downplay its worth. Nonetheless, it appears that the awareness, concentration, and inspiration of the learners are decisive to the success of any program. 5.2. Level 2 - Learning The point to which learners modify their mind-sets, develop understanding and enhance expertise after taking part in the intervention are varying measures on level two. The learning evaluation needs a post-testing to find out what abilities were learnt in the intervention. The post-test is applicable only when merged with pre-testing, so that the researcher can distinguish between current understanding and information learnt throughout the program. On level two, there is generally a significant link between a known learning need and the assessment. Evaluation of learning is not completely restricted to level two, and can be done at any point during the workshop to measure its success, using a number of evaluation methods. Pre- and post measures are mostly employed to find out the retention of information, together with observational statistics and discussions. Measurement on level two might signify that an intervention's teaching techniques are useful or useless. 5.3. Level 3 - Behavior It is believed that the third level of assessment signifies the most accurate evaluation of a facilitator's success. Nonetheless, measuring on this level is generally tricky as it is often impractical to expect when the alteration in activities will take place. This calls for significant decisions with respect to when, how and how often to assess. Level three evaluates the point to which behavioral alteration, or the capacity to “transfer learnt information into action” (Kirkpatrick & Kirkpatrick, 2006), has taken place as a result of program participation. Evaluation can be carried out formally (by testing) or informally (by inspection). The measurement of behavior is essential since the major use of the involvement is to develop results through via behavioral modification - in this case abilities, understanding, activities, and mind-set. Level-three assessment tries to answer the following issue: “Are the newly acquired skills, knowledge, and attitudes being used or transferred in the learner's everyday environment” (Kirkpatrick & Kirkpatrick, 2006)? Clients normally score fine on post-tests; however, the actual issue is whether any of the new information and talents are “retained and transferred back” (Kirkpatrick & Kirkpatrick, 2006) into a broader perspective. Level three assessments try to answer whether or not client's behavior really alters because of new learning. Level three assessments are generally carries out at prearranged intervals. Kirkpatrick advised that a post-test be done between three to six months following the intervention. By letting a little time to pass, clients have the chance to apply new expertise and retention rates can be verified. 5.4. Level 4 - Results Level four moves away from the effect on single client and focuses on community as a whole. Level four assessments consider the clients' capability to apply learned expertise to new and different circumstances. It is defined as assessment being stretched further than the impact on the clients. The concentration widens the effect of the intervention on the whole community - in other words, on the way training controlled the entire perspective. For instance, what alterations took place within the wider community as a result of the intervention? Training success is calculated at this level - whether the training is effective and providing value on a community level in Idaho - and evaluates impacts together with legal act, competence, confidence, joint effort and decreased inaccuracies. Gathering as well as analyzing information on level four is usually considered as quite tricky, lengthy, and expensive. As facilitator move from level one to level four, the procedure turns out to be more complicated even though it appears to offer information on “increasing significant value” (Barbazette, 2005). It is recommended that every level should be utilized by the facilitators to give a ‘cross set of data’ for assessing a training program. 6. RESEARCH DESIGN This study will use a quantitative, descriptive research approach. Quantitative research methods are based on the collections and statistical analysis of numerical data research methods. The ATLAS is used for the client to identify their specific learning preference. Conti and Kolody (1999) designed the ATLAS (Assessing the Learning Strategies of Adults). The quantitative approach was designed to investigate if there is a correlation between, drug or alcohol addiction, and the learner’s preference to learn. A needs assessment is conducted to emphasize discrepancies between the current approach to treatment and the learner based approach to learning. In this research, information was gathered from survey using the quantitative and ATLAS among Client’s in the Idaho correctional system in the 5th district. 6.1. Population and Sampling The participants included in this research will include male and female clients who are currently on Parole or Probation with the department of Idaho. All the clients were in some form of recovery treatment at the time they volunteered to take the survey. The survey was voluntary and no names or information was given out. The paper was numbered at the top right. 6.2. Data Collection Instrument The researcher and ATLAS designed the data collection instrument for this study. 1. What is the gender of the client: does gender have a learning preference among this population? 2. What is the client’s current age: Does the client’s current age have anything to do with their learning preference? 3. How many years have they been involved with addiction? Does the length of using an illicit drug reflect a certain type of learning strategies? 4. What is their drug of choice? Does a different drug of choice have a common learning preference of the client? 5. How old was the client when they first used illicit drugs or alcohol. Does using illicit drugs or alcohol reflect a certain learning preference? 6. Are their barriers in the client’s ability to learn? This allows the client to identify issues when trying to learn new things. 7. Last grade the client attended. Is there a pattern client’s preference of learning in recovery related to the last grade the client attended in school? 7. LIMITATIONS OF THE STUDY Limitations are restricted to clients that have been incarcerated or on Parole or Probation. There are fewer women in the correction system to take the survey. The population of clients is from the Magic Valley area assigned to the 5th district court system. The research includes both quantitative and qualitative approaches. Some qualitative research was used in questioning the client on what barriers they experienced in learning new activities. The facilitators are Certified Alcohol and Drug Counselors, Licensed Social Workers and Drug Alcohol Rehabilitation Specialist. Moreover, there is a pattern to the type of learning strategies and preference for facilitators. 8. DELIMITATIONS OF THE STUDY The researcher imposed restriction sending the survey to clients who are currently in the Idaho corrections system. There are clients in the specialty courts, and private clients who were not asked to do the survey. The research chose not to include clients currently on misdemeanor probation. The research chose to remain Quantitative in the approach of the research, more than qualitative approach due to restriction of time. The clients, who participated, did so on their own free will and were from the age of 18 to 71 years old. 9. RESULTS AND DISCUSSION The results obtained from the questionnaire showed that the substance abuse is most common in people aged between 36 to 55 years; 43 percent of respondents were from this age group. The least number of substance abusers - only 5 percent - were from the age group of 55 years and older. The majority of these respondents were involved in drug abuse for around 12 years before they asked for any sort of help. Out of the respondents who were 25 to 35 years of age, around 65 percent were mentioned that they used alcohol and / or methamphetamines due to the easy accessibility and lack of restrictions for buying. Marijuana is the second largely abused drug in Idaho after methamphetamines. It is not just exported into the state, but is as well cultivated on the public terrain within Idaho. ‘Prescription drug abuse’ as well as ‘pharmaceutical drug addiction’ are also the important issues faced by Idaho society. Public is increasingly using sedative pain relievers such as Oxycontin, anxiety relievers, stimulants, and medicines like ‘Hydrocodone’ and ‘Benzodiazepines’ for substance abuse. These addicts use prescription medicines to satisfy their addictive needs, as these drugs can easily be bought and are cost less as compared to the street drugs. Facilitators of drug management for substance abusers have been successful in removing or decreasing drug use. Clients who completed a drug management program, went to some rehab facility, or were employed were more likely to discontinue using drugs. The initial contact stage of engagement by a drug treatment facilitator is critical to developing faith and assurance with the intention of starting a treatment program. As clients can often become apprehensive, threatened by facilitators, who are insulting regarding their using drugs, the best approach to be sympathetic and supportive in helping them handle issues linked to their personal lives or their psychological health. It is crucial that the facilitator works within the boundaries of the accessible training resources, and that will need flexibility. The beliefs and cultural expressions of Idaho’s population represent an important resource for training for community-based activities. To facilitate training process successfully, the substance abuse counselor should be: well-informed as well as skilful play a major part throughout the training period correspond in simple and clear language with clients apply appropriate and suitable learning strategies include real life experiences in training employ training techniques that are helpful REFERENCES Barbazette, J. (2005). The Trainer's Journey to Competence: Tools, Assessments, and Models. Pfeiffer. 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