SOLUTIONS GRADED A+
✔✔Risk Assessment - ✔✔At both the screening and assessment stages, counselor
must observe client to assess for signs of psychoactive substance toxicity, intoxication
and withdrawal; aggression or danger to others; potential for self-inflicted harm or
suicide; and coexisting mental health problems,
✔✔Treatment Planning - ✔✔An intentional carefully considered road map for treatment
and recovery process. All of the information gathered throughout the assessment
process is analyzed and interpreted in order to make decisions about client placement
and approaches to treatment. Treatment planning is action-oriented and lays out a
logical, goal-oriented strategy for making positive changes in a client's life. Treatment
plans are developed once a diagnosis is confirmed, a placement recommendation has
been made and the client has been admitted into an appropriate level of care. The level
of care is determined based on the diagnosis of the problem and on the client's
strengths and assets.
✔✔Readiness to Change - ✔✔Proschka and Diclemente 1984: Stages of Change
Model. The five stages of change are pre-contemplation, contemplation, preparation,
action and maintenance.
✔✔Case Management - ✔✔A collaborative process. it's primary purpose is to help
individuals identify needed services, select the most appropriate services available in a
given geographical area, facilitate linkage with services and promote continued
retention in services by monitoring the individual's participation, co-ordinate the activities
of multiple services when present and when necessary and advocate for continued
participation (NASW 2012). Objectives include continuity of care, accessibility,
accountability and efficiency. The core agency for a specific geographic area is
responsible for developing contracts with providers for the delivery of specified services
for case-managed clients.
✔✔Memoranda of Understanding (MOU) - ✔✔MOUs are a means to structure a
relationship among agencies. More formal than "social service bartering".
✔✔Counseling - ✔✔A professional relationship that empowers diverse individuals,
families and groups to accomplish mental health, wellness, education and career goals.
✔✔Therapeutic Alliance - ✔✔A key component of successful counseling. Has three
components: (1) The relationship or bond between therapist and client (2)Consensus
between counselor and client regarding the techniques/methods employed in treatment
(3) Consensus between therapist and client regarding the goals of treatment. THE
PRIMARY RESPONSIBILITY FOR DEVELOPING AND MAINTAINING THE
RELATIONSHIP RESTS WITH THE COUNSELOR. It has been found that over 80% of
, the positive outcomes of treatment may be due to the therapeutic relationship (warmth,
empathy, respect for client).
✔✔Building Motivation for Treatment - ✔✔Motivational Interviewing as a style of
interaction to facilitate change, began in SUD treatment in the early 1980's. MI was truly
an innovation in SUD because it created a shift in the underlying philosophy of care and
used a set of specific techniques to engender engagement and empowerment of the
persons seeking help for substance use problems. Earlier style used confrontation as
an intervention.
✔✔Five principles for MI - ✔✔Open-ended questions; Listen reflectively; Summarize;
Affirm; Elicit self-motivational statements.
✔✔The "spirit" of MI is based on 4 key elements: - ✔✔(1)Partnership/Collaboration:
Work in collaboration and avoid the "expert" role. (2)Acceptance/Autonomy:Respecting
the client's autonomy, potentials, strengths and perspectives
(3)Compassion: Keeping the client's best interests in mind.
(4)Evocation: The best ideas come from the client: "You have what you needs and
together we will find it".
✔✔Setting Expectations - ✔✔Educate the client regarding the structure, expectations
and limitations of the counseling process.
✔✔Personal Dimensions that characterize facilitative relationships are: - ✔✔Empathy:
ability to understand how another person sees and interprets and experience,
Genuineness: the ability to be fully oneself and express this to others, Respect,
counselor believes that the client has the ability to make it in life, the right to make his or
her own decisions, Self-Disclosure: the ability to disclose information about oneself
(thoughts and feelings); Warmth: convey care; Immediacy: focus on the :here and now:
relationship with another person; Concreteness: the ability to identify specific problems
and steps necessary to correct them; Cultural Sensitivity: cultural competence requiring
ongoing training and self-evaluation of counselor.
✔✔Active Listening - ✔✔Clear listening. New counselors tend to think while listening
and is not accurately hearing what the person is saying. Important to listen without
judging. Reflecting: summarizing and repeating client's thoughts and feelings in a simple
and clear manner. Asking open-ended questions, requiring clients to explore the
reasons they think, feel and act the way they do. Use effective body language (sit with
legs and arms uncrossed, lean forward and make eye contact. Watch for non-verbal
cues. Listen and watch carefully.
✔✔Process of SUD Treatment: Models of Treatment - ✔✔Medical model: Views
addiction as a chronic and progressive disease. Emphasis on physical causes and
genetic factors. Spiritual Model: Largely because of AA and 12 step fellowships -
Cocaine Anonymous, Narcotics Anonymous and Al-Anon. Spiritual models give less