Treatment Intervention for Clients with AOD - Lab Report Example

TREATMENT INTERVENTION FOR CLIENTS WITH AOD By Student’s Names Code + Course Name Professor’s Name University/College Name City, State Date Introduction Alcohol dependence is a major problem that has bedeviled a number of individuals in Northern Territory (NT) Australia. This state has the highest levels of alcohol consumption in Australia (Jayaraj et al. 2012). Individuals who are experiencing problems related to dependence may approach hospitals or agencies designated for treatment and rehabilitation purposes or may be referred to such agencies by hospitals or tribunal of the Alcohol Mandatory Treatment (AMT). The latter is governed by the AMT Act and it requires that adults who have been incarcerated for public intoxication for at least three times in a span of two months be clinically assessed and referred to appropriate treatment facility (Northern Territory Government Department of Health [NTGDH] 2014). Such clients from AMT services usually suffer withdrawal in the early few days of staying without any alcoholic content in their body and require assistance through this period before proceeding with the rehabilitation program (Haber et al. 2009). There is a substantial number of treatment services available in NT that offer withdrawal and rehabilitation interventions to clients. An example of an agency that offers these services is Banyan House (Forster Foundation for Drug Rehabilitation [FFDR] 2009). Withdrawal and rehabilitation services were offered to the client, Miss X, a 24-year-old female Australian residing in Berrimah, NT. Referral to Banyan House The client was referred to Banyan House by The AMT after more than three cases of been heavily intoxicated within two months and been confined in police's protective custody of. She was only a chronic drinker, but alcoholism had affected her health and social lifestyle considering that she had experienced two miscarriages before and may be expecting children anytime in the near future. Therefore, she places her children at risk of congenital disorders and malformations induced by alcohol such as fetal alcohol spectrum disorder (FASD) (Riley, Infante & Warren 2011). Her family members had recognized the need for containing the problem but had tried in vain to enroll her into a treatment and rehabilitation program. The mandatory referral for treatment determined by AMT tribunal was, therefore, a welcomed relief to the family. Banyan House (Forster Foundation for Drug Rehabilitation [FFDR]) is a Darwin based residential Therapeutic Community (TC) that provides services AOD related services such as residential brief and withdrawal interventions, alcohol and drug assessment, rehabilitation services, counselling and provision of AOD related education and information (FFDR 2009). Treatment Intervention Since the client had just been taken into AMT custody a day earlier, she was still suffering from withdrawal issues that needed care. She was said to be a regular consumer of more than 80gm of alcohol per day predisposing her to hallucinations and severe withdrawal symptoms such as seizure and delirium. She was, therefore, enrolled into the Banyan House withdrawal program. Withdrawal Intervention Among the withdrawal intervention measures, Miss X was provided supportive care. This entailed provision of information to the patient regarding withdrawal from alcohol and her carer, and monitoring and implementing supportive counselling measures by general practitioners, nurses and other health workers. Supportive counselling was focused on reassuring Miss X and how she could cope with her withdrawal symptoms without losing hope (Haber et al. 2009). The client received a lot of fluids at a minimum of 2000 ml per day to keep her body hydrated and replace any lost fluids due to dehydration. Thiamine was supplemented at a dose of 300mg daily for seven days given IV as she was nutritionally depleted (Haber et al. 2009). Pharmacological withdrawal intervention included use of oral diazepam administered at the following doses: 10mg four times a day at days one and two, 10mg three times a day at day three, 10mg twice a day at day four and 10mg once a night at day five (Haber et al. 2009). Adjunct symptoms such as headache and nausea/vomiting were managed using paracetamol and metoclopramide respectively. Rehabilitation Program Among the treatment models used by Banyan House include the Therapeutic Community Model (TCM).TC is treatment model in which the community is used to provide a client a holistic type of care through mutual support and self-help in order to enhance a client’s change in behavior (De Leon 2000, p. 119). Staff that form part of the learning environment in TC include paraprofessionals who have been previous addicts, and others suitable in providing medical and mental health services, family therapy, and educational and vocational trainers (De Leon 2000). TC provides a family and community-based care through enhancing the core features of a positive family and a prosocial environment. It enables clients to actively and practically take part in their recovery process by understanding themselves better, enhance their self-esteem and self-respect, appreciate others and enhance respect for others. A buddy is usually allocated for each new client tasked with ensuring that the client is supported during the early days of adjusting to the community. With time, clients adjust to the community’s routine and habits even taking up micro-leadership roles in work areas within the community. Previous community residents are usually welcomed back to act as role models in activities such as relapse prevention, support and counselling among other social activities (FFDR 2009). The use of staff who are in recovery in TCs is a practical example and message to the clients who are still naïve in the program that the program is successful. The program is continuously welcoming back members who have completed the residential treatment stage Miss. X, therefore, went through the TC program including all the stages that are part of the program. It was a 24 hour seven days a week a program full of planned activities and responsibilities. She progressed through the program acquiring increased responsibilities, privileges and status. Each stage she attained represented an improvement in personal growth and awareness actualized through her attitudes, behavior and values (FFDR 2009). Other Therapeutic Interventions Used Cognitive Behavioral Therapy (CBT). Part of her rehabilitation interventions included the use of CBT. CBT assists a client to identify how their feelings, thoughts and behavior are connected and, consequently, how the client may break these links (McHugh, Hearon & Otto 2010, p. 511). After the initial thorough assessment history taking, Miss. X was scheduled for a twice weekly individual sessions of CBT by the clinician. In addition to the alcohol dependence, it was also ascertained from the interviews done that Miss. X was suffering from depression. A referral was made to a psychiatrist to enable Miss. X be evaluated and assessed for the need of antidepressant medication. Miss. X collaborated with her clinician on the best treatment plan that primarily focused on her unbecoming drinking behavior. There was also a decision made to address her negative behaviors and thoughts that culminated to depression during her substance abuse counselling sessions. Staff members agreed that Miss. X’s successful abstinence from consuming alcohol and identification of feelings, thoughts and behaviors anteceding her drinking and depression would enable her address other issues regarding her lifestyle with time. The first CBT therapy involved doing a functional analysis of Miss. X’s alcohol abuse with a primary focus on feelings, thoughts and behaviors that led to her alcohol abuse. High-risk situations culminating to her drinking behavior were identified. In later sessions, the client was availed information pertaining to the addiction, recovery and relapse process emphasizing on her individual, idiosyncratic drinking habit. She was assisted in developing better, efficient coping skills by concentrating on “self-efficacy enhancement, refusal skills, communication, planning, problem solving, self-regulation, and emotional identification and regulation tasks” in addition to participating in support group meetings (McHugh, Hearon, Otto 2010, pp. 517-520). Later, the client was encouraged to identify how her effort had resulted in her positive changes in behavior with the aim of enabling her understand the significance of her personal effort in the outcome. Her last sessions incorporated her family members, and they were provided with supportive information and recommendations relating to addiction, recovery and relapse they would use in supporting Miss. X’s progressive recovery. In the last 16th CBT session, a relapse prevention plan was developed, her treatment and status were reviewed and assessed and significant positive outcomes were identified including a subjective improvement in her depressive feelings. She was advised to attend follow-up and support group sessions consistently. Pharmacological Therapy. Medicines such as Naltrexone and Acamprosate enhanced reduction of alcohol cravings especially in the early days after withdrawal (Haber et al. 2009). Other medications used included antidepressants used in the management of depression as guided by a psychiatrist. Monitoring and Review of Outcomes After the treatment period lapsed, Banyan House developed an aftercare plan for the client. This was in conjunction with NT Department of Health’s aftercare case workers. This team was tasked with following up and monitoring the client after she returned to her community. Scheduled telephone interviews were used to monitor the client’s progress post-treatment in addition to providing drop-in facilities for the client to visit. The client was encouraged to visit often and provide peer-education and support to other clients who may have been newly initiated on treatment. The client was also designed a self-monitoring program where she would record the events and routines in her life after treatment. After-care plans monitored by case managers linked the client to a continuous community support while at the same time monitoring her progress. Reference List De Leon, G 2000, The therapeutic community: theory, model and Method, Springer Publishing Company, New York. Forster Foundation for Drug Rehabilitation 2009, Banyan House, a residential therapeutic community, viewed 24 October 2014, Haber, P Lintzeris, N Proude, E & Lopatko, O 2009, Quick reference guide to the treatment of alcohol problems. Companion document to the guideline for the treatment of alcohol problem, Commonwealth of Australia, Canberra. Jayaraj, R Thomas, M Thomson, V Griffin, C Mayo, L Whitty, M d'Abbs, P & Nagel, T 2012, High risk alcohol-related trauma among the Aboriginal Torres Strait Islanders in the Northern Territory, Substance Abuse Treatment, Prevention, vol. 7, no. 33, pp. 1-7. McHugh, KR Hearon, BA Otto, MW 2010, Cognitive-behavioral therapy for substance use disorders. Psychiatric Clinics of North America, vol. 33, no. 3, pp. 511-525. Northern Territory Government Department of Health 2014, Alcohol mandatory treatment, viewed 24 October 2014 Riley, EP Infante, MA & Warren, KR 2011, Fetal alcohol spectrum disorders: An overview. Neuropsychology Review, vol. 21, pp. 73-80. Read More

The mandatory referral for treatment determined by AMT tribunal was, therefore, a welcomed relief to the family. Banyan House (Forster Foundation for Drug Rehabilitation [FFDR]) is a Darwin based residential Therapeutic Community (TC) that provides services AOD related services such as residential brief and withdrawal interventions, alcohol and drug assessment, rehabilitation services, counselling and provision of AOD related education and information (FFDR 2009). Treatment Intervention Since the client had just been taken into AMT custody a day earlier, she was still suffering from withdrawal issues that needed care.

She was said to be a regular consumer of more than 80gm of alcohol per day predisposing her to hallucinations and severe withdrawal symptoms such as seizure and delirium. She was, therefore, enrolled into the Banyan House withdrawal program. Withdrawal Intervention Among the withdrawal intervention measures, Miss X was provided supportive care. This entailed provision of information to the patient regarding withdrawal from alcohol and her carer, and monitoring and implementing supportive counselling measures by general practitioners, nurses and other health workers.

Supportive counselling was focused on reassuring Miss X and how she could cope with her withdrawal symptoms without losing hope (Haber et al. 2009). The client received a lot of fluids at a minimum of 2000 ml per day to keep her body hydrated and replace any lost fluids due to dehydration. Thiamine was supplemented at a dose of 300mg daily for seven days given IV as she was nutritionally depleted (Haber et al. 2009). Pharmacological withdrawal intervention included use of oral diazepam administered at the following doses: 10mg four times a day at days one and two, 10mg three times a day at day three, 10mg twice a day at day four and 10mg once a night at day five (Haber et al. 2009). Adjunct symptoms such as headache and nausea/vomiting were managed using paracetamol and metoclopramide respectively.

Rehabilitation Program Among the treatment models used by Banyan House include the Therapeutic Community Model (TCM).TC is treatment model in which the community is used to provide a client a holistic type of care through mutual support and self-help in order to enhance a client’s change in behavior (De Leon 2000, p. 119). Staff that form part of the learning environment in TC include paraprofessionals who have been previous addicts, and others suitable in providing medical and mental health services, family therapy, and educational and vocational trainers (De Leon 2000).

TC provides a family and community-based care through enhancing the core features of a positive family and a prosocial environment. It enables clients to actively and practically take part in their recovery process by understanding themselves better, enhance their self-esteem and self-respect, appreciate others and enhance respect for others. A buddy is usually allocated for each new client tasked with ensuring that the client is supported during the early days of adjusting to the community.

With time, clients adjust to the community’s routine and habits even taking up micro-leadership roles in work areas within the community. Previous community residents are usually welcomed back to act as role models in activities such as relapse prevention, support and counselling among other social activities (FFDR 2009). The use of staff who are in recovery in TCs is a practical example and message to the clients who are still naïve in the program that the program is successful. The program is continuously welcoming back members who have completed the residential treatment stage Miss.

X, therefore, went through the TC program including all the stages that are part of the program. It was a 24 hour seven days a week a program full of planned activities and responsibilities. She progressed through the program acquiring increased responsibilities, privileges and status. Each stage she attained represented an improvement in personal growth and awareness actualized through her attitudes, behavior and values (FFDR 2009).

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