Section 17: Treatment Planning
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Transcript of Section 17: Treatment Planning
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Section 17: Treatment Planning
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Icebreaker
How do you define treatment planning?
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Icebreaker: The Good and the Bad
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The Good and the Bad
Negative Aspects of Treatment Planning
Positive Aspects of Treatment Planning
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Workshop 1: Training objectives (1)
At the end of this workshop, you will be able to:
1. Use ASI information to develop individualised treatment plans
2. Identify characteristics of a programme-driven and an individualised treatment plan
3. Understand how individualised treatment plans help to keep people in treatment and lead to better outcomes Continued
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Workshop 1: Training objectives (2)
At the end of this workshop, you will be able to:
4. Use Master Problem List (provided) to formulate treatment plans and develop:
Problem statements Goals based on problem statements Objectives based on goals Interventions based on objectives
5. Practise writing documentation notes reflecting how treatment plan is progressing (or not progressing)
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What is not included in training
Administering and scoring the ASIAdministering any other standardised
screening / assessment toolTraining on clinical interviewing
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The goal of this training is…
To bring together the assessment and treatment
planning processes
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“Same plan, different names.”
Treatment plans are often. . .
“Meaningless & time consuming.”
“Ignored.”
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The What, Who, When, and How of Treatment Planning
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What is a treatment plan?
A written document that: Identifies the client’s most important goals
for treatment Describes measurable, time-sensitive
steps towards achieving those goals Reflects a verbal agreement between the
counsellor and client
(Source: Center for Substance Abuse Treatment, 2002)
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Who develops the treatment plan?
Client works with treatment providers to identify and agree on treatment goals and identify strategies for achieving them.
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When is the treatment plan developed?
At the time of admission And continually updated and revised
throughout treatment
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How does assessment guide treatment planning? The Addiction Severity Index (ASI), for
example, identifies client needs or problems by using a semi-structured interview format
The ASI guides delivery of services that the client needs
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How does assessment guide treatment planning?
Treatment goals address those problems identified by the assessment
Then, the treatment plan guides the delivery of services needed
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A reliable and valid instrument, widely used both nationally and internationally
Conducted in a semi-structured interview format
Can be effectively integrated into clinical care
(Sources: Cacciola et al., 1999; Carise et al., 2004; Kosten et al., 1987; McLellan et al., 1980; 1985; 1992)
What is the ASI?
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Identifies 7 potential problem areas:1. Medical status2. Employment and support3. Drug use4. Alcohol use5. Legal status6. Family/social status7. Psychiatric status
What is the ASI?
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The ASI is NOT…
A personality test A medical test A projective test such as the Rorschach
Inkblot Test A tool that gives you a diagnosis
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Why use the ASI?
1. Clinical applications
2. Evaluation uses
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Recent developments
Efforts focused on making the ASI more useful for clinical work
(Example: Using ASI for treatment planning)
The Drug Evaluation Network System (DENS) Software uses ASI information to create a clinical narrative
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ASI is now more clinically useful!
New and Improved DENS Software (2005)
Uses ASI information to define possible problem lists and prompt and guide clinician in developing a treatment plan.
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Uses a semi-structured interview to gather information a clinician generally collects during assessment
Shown to be an accurate or valid measure of the nature and severity of client problems
Clinical application
(Sources: Kosten et al., 1987; McLellan et al., 1980; 1985; 1992)
Why use the ASI?
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Prompts clinician to focus session on important problems, goals, and objectives
Basis for reviews of progress during treatment and documentation
Basis for discharge plan
Clinical application
Why use the ASI?
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NIDA Principle 3:“To be effective, treatment must address the individual’s drug use and any associated medical, psychological, social, vocational, and legal problems.”
The ASI assesses all these dimensions.
Clinical application
Why use the ASI?
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Clinical application
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Clinical use of ASI improves rapport“. . . If patients’ problems are accurately assessed, they may feel ‘heard’ by their counsellor, potentially leading to the development of rapport and even a stronger helping alliance.”
(Sources: Barber et al., 1999, 2001; Luborsky et al., 1986, 1996)
Clinical application
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“. . . Patients whose problems are identified at admission, and then receive services that are matched to those problems, stay in treatment longer.”
(Sources: Carise et al., 2004; Hser et al., 1999; Kosten et al., 1987; McLellan et al., 1999)
Clinical application
Using ASI to match services to client problems improves retention.
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For Programme Directors Identifies types of client problems not
addressed through the programme’s treatment services
Quantifies client problems Identifies trends over time
Evaluation uses
Continued
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For Programme DirectorsAssists with level-of-care choicesProvides measure of programme
successDocuments unmet client service needsIncludes data needed for reports to
various stakeholders
Evaluation uses
Continued
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For Programme DirectorsPositions programmes for increased
funding though participation in clinical trials and other research opportunities
Evaluation uses
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For Clinical SupervisorsASI data can be used to
Identify counsellor strengths and training needs
Match clients to counsellor strengths Identify trends in client problems
Evaluation uses