TRAINING AND COUNSELING IN SUBSTANCE USE TREATMENT Flashcards
CASAC is an acronym for…
Certified alcohol and substance abuse counselor
ROSC is an acronym for…
Recovery Oriented System of Care
ROSC includes…
- Recovery centers in community - Recovery activities and websites - Housing - Peer support - Mutual support - Faith based groups - Medical care, HIV services - Mental health care - Transportation
Treatment issues in managed care
-Federal Affordable Care Act - lower short term costs - Limited sessions - Restricting provider availability - Dictation of type of therapy received - ROSC
Strengths and limitation in counseling and treatment
-Former substance users as
recovery counselors
-Counselors who have
never been users
Ethical and competent counseling
Therapeutic relationship
-> boundary violation
issues NAADAC
(code of ethics)
-> characteristics (warmth
unconditional positive
regard, empathy, belief
that individuals strive
toward self actualization )
Multiculturalism
->openness and awareness
Role of substance abuse counselors
Assessment Treatment planning Client orientation Case consultation Confidentiality Counseling Crisis intervention Discharge planning Follow up activities Referral Client advocacy Personal and professional growth
Professional Expectations: (1) Training, Practice and Ethics (M) P (M) E (M) R (MN) H (MN) E (MN) E (MN) D
(Must) Practice objectivity and
integrity
(Must) Embrace to protect the
privacy of patient
(Must) Respect integrity and
protect welfare and
group with whom the
counselor is working
(Must not) Harass or behave in
a manner that
can be demeaning
or harassing
(Must not) engage in any
relationship with
patient or
(Must not) Engage in sexual
activity with patient
or significant other
(Must not) Discriminate in work
related activitiesSuccessful Treatment:
Reduction or elimination of substance abuse
Removal of access to illegal and dangerous drugs
Understanding of underlying co-occurring mental health issues
Development of healthy stress-management techniques
Connection with support networks to encourage ongoing sobriety
Environments for Substance Use Treatment / Interventions:
Long-term Residential Treatment
24 hour care in non-hospital-based setting
Therapeutic communities (TCs) – 6 to 12 month stays, focus on “resocialization”
Short-term Residential Treatment
Brief, intensive, 12-step model approach in 3 to 6 week in-patient program.
Transition to outpatient care is crucial to success
Outpatient Treatment
Group counseling is often major component, some designed to treat comorbid conditions
Less intensive/ more functional?
Individualized Drug Counseling
Integrated model/approach: attended to other aspects of functioning (e.g., education, employment, etc).
Group Counseling
Applied in numerous setting, recent efforts to standardize and improve accessibility
Working within the Criminal Justice System
parity
the state or condition of being equal, especially regarding status or pay
Laws, Policies & Regulations
Mental Health Parity and Addiction Equity Act of 2008
Requires insurance groups to offer coverage for mental health or substance use disorders benefits comparable to general medical coverage.
Deductibles, copays, out-of-pocket maximums, treatment limitations, etc., for mental health or substance use disorders must be no more restrictive than other medical care
Health Insurance Portability and Accountability Act (HIPAA) of 1996
Federal law for protecting confidentiality and security of healthcare information
Privacy Authorization Form. Authorization for Use or Disclosure of Protected Health Information (Required by the Health Insurance Portability and Accountability Act —- 45 CFR Parts 160 and 164)
42—CFR (SAMHSA): Confidentiality of Drug & Alcohol Abuse Patient Records
Disclosure Authorization:
Protect Record Content: Identity, diagnosis, prognosis, treatment
Disclosed only for expressed purposes and must be within consent by patient
Disclosure Exceptions:
Can legally disclose without consent if/when:
To medical personnel to the extent necessary/ to meet a bona fide medical emergency
To qualified personnel for the purpose of conducting scientific research, management audits, financial audits, or program evaluation, but such personnel may not identify, directly or indirectly, any individual patient in any report of such research, audit, or evaluation, or otherwise disclose patient identities in any manner.
Court ordered with “good cause”
Prognosis
the likely course of a disease or ailment (an illness, typically a minor one)
“the disease has a poor prognosis”
What does decision making include
Personal values
->Interconnectedness with
code of ethics and
professional guidelines
->Second nature approach to
decision making
->Informed and reflective
decision making
Client's best interest
-> Beneficence (good doing)
->Nonmaleficence
Transparency in decision making
-> consultation/ supervision
-> Review of the code of ethics
-> Referral
->Communication with client
Perceptions of formal training and practice
->Reliance on the code of ethics
-> Disconnect between training and reality
Transparency in Decision-Making:
Consultation/Supervision
Review Code of Ethics SAMHSA, OASAS, Agency specific?
Referral Internal vs. External? Why or why not?
Client Communication
Perceptions of Formal Training & Practice:
Reliance on Code of Ethics
Disconnect between Training & Reality
Vicarious
countertransference
experiencing in the imagination through the feelings or actions of another person
countertransference
the emotional reaction of the anaylst to the subject’s transference
Provision
The action of providing or supplying something for use
ob·jec·tive
of a person or their judgment) not influenced by personal feelings or opinions in considering and representing facts.
“historians try to be objective and impartial”
yeild
provide
Tricyclic antidepressants
increase levels of norepinephrine and serotonin, two neurotransmitters, and block the action of acetylcholine, another neurotransmitter. Scientists believe that by restoring the balance in these neurotransmitters in the brain that tricyclic antidepressants alleviate depression
norepinephrine
a hormone that is released by the adrenal medulla and by the sympathetic nerves and functions as a neurotransmitter . Also used as medicine or drig to raise blood pressure
Acetylcholine
Neurotransmitter throughout the nervous system (check that it’s really a neurotransmitter)
Comorbid
simultaneous presence of two chronic diseases or condition in a patient
transient
impermanent, lasting for only a short amount of time
ellicit
evoke a response from someone
module
individual parts that can construct a more complex thing as a whole
verbatim
in exactly the same words as used originally
Professional expectations (PART 2) SCAR
(M) Strive to inform the public,
of the effects of
alcoholism and substance
abuse
(M) Cooperate with
investigations/proceedings
requirements of OASAS
(M) Acknowledge the limits of
present knowledge in public
statements concerning
alcoholism/substance abuse
(M) Respect
colleagues/professionals
