Assessing Individual Clients Treatment Progress in a Group - Research Paper Example

? Interventions and Assessment s Interventions and Assessment Introduction to Case Study, 200 Corey (2010) points out that substance abuse are on the rise with its often attributed to various underlying problems within a society or the pressure from friends who are already hooked to drug and substance abuse. The most commonly abused substances are cocaine, marijuana and alcohol among other hard drugs. People who are addicted to abusing substances such as marijuana usually need help from experts or counselors to overcome their addiction and live normal lifestyles. The success of a counseling session in most instances depends on the willingness of the client to embrace change and the willingness to progressively alter the addictive behavior for the better. Alice is a twenty three year old lady who is addicted to alcohol, marijuana and cocaine. Due to her addiction, Alice is no longer in a position to take care of her two children, especially after when her husband Lewis was jailed for a drug related offense. The children were enrolled for foster care after an anonymous person reported that Alice had left her children unattended for a long period. Previously, Alice worked in various fast food joints before she was fired because of her unexplained absenteeism from work. Jobless and unable to fend for herself and her children, Alice moved back to her mother’s house but was soon kicked out for stealing her mother’s money. When problems escalated Alice opted for prostitution, putting her life to risk of contracting diseases such as HIV/AIDS, syphilis and other sexually transmitted diseases. When consulted by a counselor, Alice admitted that she needed to change her behavior and way of life to gain custody of her children. Individual Assessment The Importance of Assessing Individual Progress in Group Treatment Group therapy is a session of common therapeutic experience including the presence of other individuals who are going through the same experiences and issues in life. In group therapy the counselor might decide to focus on the various interpersonal relationships that exist between the group members or on the specific concerns that are common to all the group members. In group therapy, maintaining confidentiality is important as well as the respect of each and every member of the group. This will ensure that therapeutic sessions run smoothly and that each member feels comfortable to share their life experiences (Center for Substance Abuse Treatment, 1999). Every member of a group undergoing a group therapy session is allowed to share his or her experiences with friends and family members but it is wrong for such a member to share the information of another member. When a patient joins a group treatment session, he or she sets out goals that are to be achieved at the end of the treatment session. It is true to point out that the assessment of the individual progress in a group treatment is important since it allows an individual to have a clear picture of his or her progress in the treatment. Putting in place goals or a clear picture of the desired outcome usually acts as a motivating factor for patients undergoing group treatment as they remain committed towards the realization of the set goals. Assessing Individual Clients’ Treatment Progress in a Group Sobell and Sobell (2011) assert that improvement in a client’s behavior during group therapy is very important in ensuring that the client records desired progress in the treatment process. There are various strategies in assessing the progress of an individual client undergoing group treatment. One of the main strategies is the assessment of the client’s behavior and their motivation in joining the treatment process. Alice is willing to take part in the treatment procedure by identifying the best group that best suits her. Since she has multiple problems, the best way to assess her progress in the treatment process is through the assessment of her behavior. After enrolling Alice in a therapeutic group, she will be able to recover from her addiction of alcohol and cocaine. Joining the family education group will enable Alice to get emotional support from her mother and to learn the importance of responsible living which entails the good care for her children. Group Formation Stages of Group Formation When forming a group, it is important for the members to understand the rationale for the formation of the group through the development of a proposal that helps all members to set out their goals in consideration of all the issues that relate directly to the members as well as setting up objectives which can be attained by the group members. In doing this, the members will have a clear focus on what they would be working towards achieving. An evaluation process must also be developed for members to assess their progress at specific times. This evaluation criterion should be efficient since it is important for the members to know their progress in the treatment process (Sobell & Sobell 2011). The type of the group formed usually determines the type of people who are going to be admitted into the group since people have different issues that need to be addressed in particular group. The main considerations when forming a group are the size of the group, the nature of the issues facing members to be admitted in the group and whether the group is an open group or a closed group. Alice has a variety of pressing needs that should be addressed quickly to enable her to solve the problems early enough. Alice needs to be admitted in a psycho-education group where she can learn the essence of abstaining from abusing harmful drugs like cocaine. Her family members, especially her mother needs to understand the importance of offering Alice emotional support during this recovery period. After the formation of the group, all the members move to the next stage called the initial stage where the members meet together and know each other better. At this stage, the members get the chance to test the atmosphere and consequently get acquainted by trying to fit into the group. This is enhanced by the process of interaction between the group members thus at some point members will be in a position to disclose their personal issues to other members. The main characteristics of the initial stage are the presence of periods where the members feel awkward as well as being unable to trust the group members. Members usually seek to feel accommodated in the group and leaders should be very careful to cultivate trust among group members. At this stage, the members are undecided on the amount of information that they should disclose about themselves. Some common fears that are likely to be experienced by the group members at the forming stage include the worry of being acknowledged or rejected by the group members, fear of being judged by others, and the anxiety of airing one’s problems freely amongst the group members. Alice has a low self esteem and therefore the establishment of trust in the initial stages of the group formation is important. It is difficult for Alice to open up and easily share her issues that are really disturbing her therefore her leader who is able. The group leader or the counselor should be in a position to build trust among the members and encourage the members to be accommodative of other colleagues so that the members can create the atmosphere where they can easily share with other people (Center for Substance Abuse Treatment, 1999). Transitional stages in group treatment In a group, members usually change progressively as the sessions in the group progresses. This is because the members will learn a new thing every day that may cause a change in their addictive behavior. The counselor needs to understand that group development stages are not always fixed because the group members in most cases may show some evidence of going back and forth from the group’s achievements. It is the responsibility of the counselor to evaluate each session as one where the progressive stages of the group development is addressed in each session. Three transitional stages are common in group development. The initial transitional stage involves transition from orientation and the exploration stage to the resistance stage where members move from a stage of distrust of one another to a stage where the members can share information freely amongst themselves (Center for Substance Abuse Treatment, 2005). During this stage, group members look up to the leader or the counselor for safety and confidence during group sessions. Members at this stage would want to know how the leader handles the difficult situations that may arise in the group, especially those conflicts involving group members. Through encouragement and support from other group members, Alice is able to integrate well in to the group that is relevant to her, for example enrolling her in an early recovery group will be beneficial to her since she will be in a position to quickly drop her addiction to cocaine and her continued dependence on alcohol. The second transitional stage is the transition from the resistance stage to the cohesion and productivity stage where members have built trust on their leader and are willing to interact in sharing and solving each other’s problems among the group members. In this transitional stage, members become more supportive of one another and members recover well from their problems. This is the stage when significant progress is registered. During this stage, Alice will be able to share her problems at a more meaningful level and members become closer to one another. If Alice’s mother is willing to be enrolled in a family education group, the relationship between Alice and her mother will be improved since they will have a close relationship. Group members at this stage become more understanding of the leader’s strengths and weaknesses and formulate best ways of interacting with the leader. The last transitional stage is the transition from the cohesion and the productivity stage to the consolidation and termination stage. During this final stage, most of members in the group have found most of the solutions to their problems and are able to terminate the helping group effectively. Members at this level are able to conform to the norms of the society and be able to lead productive lives. The members are able to integrate effectively the practices that they learnt in the group in their daily lives (Corey, et al 2010). Skills That Are Used To Promote Group Formation In a group, members have different views and opinions, which make it necessary for the leader to understand the different needs of each and every individual to promote cohesion and understanding amongst all members. One of the main skills that are important in the promotion of the group formation is the ability of members to respect each and accommodate divergent views. Another important skill is the ability to work through various conflicts that might arise in the day to day sessions rather than remaining silent or going outside the sessions and discussing the issues of the group. Common Problems in Groups The common problem identified with individuals in the case study is that of substance abuse and increased rates of unemployment. For instance, Alice, a young single mother is introduced to marijuana and alcohol by her husband Lewis. After the birth of their second child, Lewis and Alice are introduced to crack cocaine. As a result, she has lost several jobs in fast-food restaurants because she cannot adequately explain the reason for her absence from work. In order to get cash to maintain her drug addiction, Alice engages in sinful acts such as theft and prostitution. To make matters worse, Alice father is abusive and unemployed. He is highly dependent on alcohol, leading to his death as a result of liver cirrhosis. Strategies that Can Manage the Above Problems In order to manage substance abuse problem, it is good for a counselor to make use of group therapy. Group therapy is the preferred mode of substance abuse intervention because of its rewarding benefits. These benefits include reducing isolation rates and allowing members to experience each other’s recovery. All these qualities motivate individuals to yearn for their own complete recovery from addictive or abusive behavior. Furthermore, group therapy helps in handling problems that accompany or are associated with substance abuse such as prostitution, shame, depression and isolation. Despite many groups having therapeutic effects, this treatment improvement protocol (TIP) focus on groups with leaders who have adequate training and are intended to promote substance abuse recovery. Great attention has been diverted to interpersonal process groups. These groups are essential in helping clients to resolve their problems that they have attempted to shun through the use of addictive substances (Flores & Georgi, 2005). For instance, Alice has evaded taking care of her children and facing life’s challenges. As a result, they are confined in foster homes. Group therapy has its own merits and demerits. For instance, if the therapy is applied indiscriminately or by a therapist who is improperly trained or unskilled, it might yield poor outcomes. However, if group therapy is effectively used, it can yield numerous benefits such as providing peer support thus allowing an individual to abstain from abuse of drugs. In addition, group therapy makes an individual to feel as part of a society rather than being isolated. The main problem that might result from substance abuse as highlighted by the case study are such as removing of children from custody and placing them in foster care due to negligence of their parents, dependency by addicts on cocaine and other hard drugs and taking of alcohol. These problems further lead individuals to exposure to illegal activities in order to make ends meet. Extremely affected victims may suffer a host of other problems such as lack of permanent residence, loss of employment, inadequate support system, strained relationships with family members and friends, possibility of depressive disorders and frequent drop out from substance abuse treatments. Group Intervention Strategies The most effective way of handling groups engaged in substance abuse is by motivating them. Motivation is what an individual does and it involves problem recognition and identifying solutions to the problem. After identifying the solutions, the affected persons should stick with the change strategy (Miller. 1995). People keep asking themselves a list of endless questions such as what is meant by motivation. Why do people have the urge to change? Can motivation help individuals modify their substance addictive behavior? For the last fifteen years, clinical attention and considerable studies have diverted their attention on ways that can effectively motivate individuals who use drugs to continue, initiate and consider substance abuse treatment. In addition, studies have focused on the best approaches to enabling drug abusers to manage, reduce or halt their excessive utilization of drugs, marijuana and alcohol. Studies indicate that addicts can achieve the desired behavior change on their own by enrolling in a formal rehabilitation program. These programs are such as the Intensive Outpatient Program. However, entry into this program is a process that is both critical and complex not only to the client but also to the program itself. The motivation of the clients to change ranges from anticipation to absolute resistance. The intake process of intensive outpatient treatment program determines whether the patient will go through the admission procedures swiftly, identify his or her preferred interventions and engage or take part in the treatment. In substance abuse treatment, clients’ early attrition is an extremely pervasive problem. To address the problem, the following admission process is recommended: Individuals involved in the client’s attrition should asses the readiness of the patient to change. In addition, appropriate strategies should be applied to motivate the client. This aims at encouraging the client to enter and engage in treatment. At the beginning of the program, a collaborative relationship should be established between the client and the clinician. Clinicians need to identify and overcome obstacles that might kill the morale of the client from participating in the treatment. For purposes of supporting the effective recovery of the patient, clinicians should match the clients to treatment settings that are less restrictive and intensive. Clinicians or health practitioners need to develop variable intensity individualized interventions. Furthermore, a duration that satisfies the needs of each client should be determined rather than enrolling a client into a predefined program. The above mentioned group strategies should be applied in the case of Alice to meet both her short-term and long term goals. Her goals after treatment are to have a permanent resident, abstain from alcohol and cocaine use, become fully employed and regain custody of her children. The approaches are applied in order to enhance motivation. Motivation increases a client’s will to engage in treatment, yielding positive treatment outcomes. The resulting outcomes include decreased consumption, abstinence, adjustment, seeking socially and successful treatment referrals. Motivation is all that Alice needs in order to rebuild her life once again. Conclusion Most people suffering from substance abuse do not access adequate support from their immediate environments. However, those who are exposed to group therapy significantly improve in their daily lives. Generally, positive patient outcomes are only achieved when a client is provided with appropriate treatment. The treatments are meant to handle life problems such as lack of employment and assertiveness and also communication problems. Various interventions can be utilized to handle substance abuse. For example, the use of electronic media campaigns and other strategies such as market controls and use of coercive measures such as tobacco bans and age control. The media apart from warning against addictive habits can also be used to educate the public on effects of hard and soft drugs use. Apart from restriction and coercion, elements of promotion including providing stimuli, opportunities and encouraging people to change can also be used to curb substance abuse. The principal outcome of any intervention strategy is to equip the general population with adequate knowledge in order to protect them from substance abuse (Wakefield et al., 2010) References Center for Substance Abuse Treatment. (1999). Enhancing motivation for change in substance abuse disorder treatment. Treatment Improvement Protocol (TIP) Series 35. DHHS Publication No. (SMA) 08-4212. Rockville, MD: Substance Abuse & Mental Health Services Administration. Retrieved August 3, 2012 from http://ncadistore.samhsa.gov/catalog/ProductDetails.aspx?ProductID=15543 Center for Substance Abuse Treatment. (2005). Substance abuse treatment: Group therapy. Treatment Improvement Protocol (TIP) Series 41. DHHS Publication No. (SMA) 05-3991. Rockville, MD: Substance Abuse & Mental Health Services Administration. Retrieved August 3, 2012 from http://ncadistore.samhsa.gov/catalog/productDetails.aspx?ProductID=16899 Corey, G (2010). Groups: Process and practice. Belmont, CA: Brooks/Cole. Flores, P.J., & Georgi, J.M. (2008). Substance Abuse Treatment: Group Therapy. Retrieved August 4, 2012, from, http://www.ncbi.nlm.nih.gov/books/NBK64220/pdf/TOC.pdf Miller, S. (1995). Conceptualizing motivation and change. Retrieved August 4, 2012, from, http://www.ncbi.nlm.nih.gov/books/NBK64972/#A61655 Sobell, L. C., & Sobell, M. B. (2011). Group therapy for substance use disorders: A motivational cognitive-behavioral approach. New York: Guilford. Wakefield, M.A., Loken, B., & Hornik, R.C. (2010). Use of mass media campaigns to change health behavior. Lancet, 376, 1261-71 Read More