In-Patient Addiction Treatment Plan
As the disease of alcohol and substance dependency affects the physical, emotional and social sub-systems, an intervention programme needs to address all the different sub-systems to create an improved level of health. Abstinence on its own will not necessarily lead to a higher level of functioning if an underlying depression or anxiety should still be present. It has already been proven that this is one aspect that could lead to a higher relapse risk. The presence of a dual-diagnosis or co-occurring psychiatric condition, should therefore receive the appropriate medical, psychiatric and psychological attention. It is therefore important that the patient receive information and input on the physical, emotional and social aspects of addiction in order to improve their overall wellbeing. With this background information it therefore shows the importance of a holistic and multi-disciplinary approach in the management of alcohol and substance dependency.
MODALITIES OF TREATMENT:-
Consultations by Medical Practitioner:
- Individual consultations in order to assess detoxification needs and intervention, also overseeing and attending to all other physical aspects of the patient.
- Family sessions may be indicated in order to obtain collateral, or to educate members
In order to diagnose and treat co-occurring psychiatric condition, the patient may be referred to a consultant Psychiatrist. The referring psychiatrist may choose to remain the treating Doctor, in which case the Psychiatrist will also oversee the detoxification process.
- Psycho-education is provided through group consultations. This includes the biopsychosocial aspects of addiction.
- Every patient is assigned to a Psychologist and will receive at least two individual sessions per week
- Group therapy which includes experiential groups
- Family therapy , and Group educational sessions to family members
Social Worker Consultations:
- Individual assessment and intervention sessions
- Family intervention sessions
- Group sessions
- Physiotherapy sessions
- Group education sessions on healthy life style, eg exercise
- Group training sessions in the gym
- Individual sessions upon referral by attending Doctor
Two groups per week are presented to former patients, which is also attended by current in-patients
The Occupational Therapists conduct assessments to evaluate the symptoms and level of functioning of each patient. They also provide very importantly life skills training in group therapy.
A Holistic and multi-disciplinary implementation of programme contents
Week 1: Physical Aspects
During week 1, the focus is on the nature of disease of alcohol and substance dependency where relevant information is given in order to manage this disease to stay in recovery.
Sessions cover the following topics:
- Disease concept
- Physical-, emotional-, and social losses
- Identification, elimination and management of triggers
- Craving management
- Relapse prevention
- Application of lifestyle changes
- Follow-up and aftercare treatment
Week 2: Emotional Aspects
Week 2 focus on the exploration of the emotional aspects related to the addiction and how to work towards an improved emotional functioning.
Sessions cover the following aspects:.
- Childhood and parental influences on emotional functioning
- Understanding personal anger
- The role of unresolved anger in the development of a self-destructive lifestyle (of which substance abuse is an example)
- The relationship between lack of emotional expression and social support regarding the development of an addiction problem
- Co-dependency and how family members are influenced by addiction
Week 3: Life Skills Implementation
Substance abuse often prevents the patient from using effective coping mechanisms and skills. Skills training are therefore required in order to enhance the patients’ ability to stay in recovery.
Topics covered are:
- Communication and conflict management
- Anger management
- Relaxation therapy
- Stress management
- Effective free-time management / ongoing balanced lifestyle
- Ongoing aftercare
- Ongoing applying of lifestyle changes
The multi-disciplinary 3 week in-patient programme aims at stabilising the patient on a physical and emotional level, and to provide life skills training in order to cope with their specific challenges in their home and work environment. The patient now needs to build upon this treatment intervention by committing to a structured after care plan. Monitoring and support from significant others, and ideally from within their working environment and family, play an invaluable role.
Upon discharge an exit interview is scheduled with the relevant parties where the specific aftercare agreements are concluded. This after care plan will stipulate their acknowledgement of the disease concept, the important life style changes and follow-up agreements they need to apply eg.
- Follow-up appointments: Doctor / Psychiatrist / Psychologist
- Identifying and eliminating of high risk triggers
- Stipulating a plan of action for triggers that cannot be eliminated
- Stipulating support group attendance (Claro Clinic has their own support groups on a Monday and Thursday evening, providing ongoing support and education)
- Stipulating regular urine screenings / the taking of ante-buse
- Identifying their support system
- Describing an emergency plan
- Identifying their sponsor