Substance Abuse

Front 1

What are the stages of motivation to change?

Back 1

1. Precontemplation
2. Contemplative
3. Preparation
4. Action
5. Maintenance

Front 2

Precontemplation

Back 2

The individual is not intending to take action in regard to his or her substance abuse problem in the future.
Tasks: try to increase awareness of the need to change; increase concern about the current pattern of behavior.
Goal: serious consideration of change

Front 3

Contemplation

Back 3

The individual examines the current behavior and the potential for change in a risk-reward analysis.
Tasks: analyze the pros and cons of the current behavior and of the costs and benefits of change.

Front 4

Preparation

Back 4

The individual makes a commitment to take action to change and develops a plan for change.
Tasks: increasing commitment and creating a change plan.
Goal: an action plan to be implemented in the near future.

Front 5

Action

Back 5

The individual implements the plan, takes steps to change, and begins new behavior patterns.
Tasks: implementing change; revising plan as needed; sustaining commitment in the face of difficulty.
Goal: successful action for changing behavior and a new pattern of behavior established for a significant period of time (3-6 months).

Front 6

Maintenance

Back 6

The new behavior is sustained for an extended period of time and is incorporated into the lifestyle of the individual.
Tasks: sustaining change over time and integrating the behavior into the person's life.
Goal: long-term, sustained change of the old behavior and establishment of a new pattern of behavior.

Front 7

Levels of Care

Back 7

Level 0.5: Early Intervention
Level 1: Outpatient Treatment
Level 2: Intensive Outpatient/Partial Hospitalization
Level 3: Residential/Inpatient Services
Level 4: Medically Managed Intensive Inpatient Treatment

Front 8

Early Intervention
Level 0.5

Back 8

Designed to explore and address problems or risk factors that are related to substance use and to assist patients in recognizing the harmful consequences of inappropriate substance use.

Front 9

Outpatient Treatment
Level 1

Back 9

Takes place in a non-residential facility or in an office run by addiction professionals.
Patients come in for individual or group therapy sessions, usually fewer than 9 hours per week.

Front 10

Intensive Outpatient/Partial Hospitalization
Level 2

Back 10

Patients come in for individual or group therapy sessions, usually more than 9 hours per week.

Front 11

Intensive Outpatient Treatment
Level 2

Back 11

This is a structured day or evening program of 9 or more hours of programming per week.
The program has the capacity to refer patients for their medical, psychological, or pharmacological needs.

Front 12

Partial Hospitalization
Level 2

Back 12

Includes 20 or more hours of intense programming per week.
This program has ready access to psychiatric, medical, and laboratory services.

Front 13

Residential/Inpatient Services
Level 3

Back 13

Halfway House
Extended care program oriented around long-term management.
Therapeutic community designed to maintain recovery.
Residential facility that provides a 24-hour structured treatment. This program is monitored by a physician and is able to manage the psychiatric, physical, and pharmacological needs of its patients.

Front 14

Medically Managed Intensive Inpatient Treatment
Level 4

Back 14

24-hour program that has the resources of a hospital.
Physicians provide daily medical management.

Front 15

Examples of Goals

Back 15

1. The patient will learn the skills necessary to maintain a sober lifestyle.
2. The patient will learn to express negative feelings to his or her partner.
3. The patient will develop a positive commitment to sobriety.
4. The patient will learn how to tolerate uncomfortable feelings without using chemicals.
5. The patient will learn to share positive feelings with others.
6. The patient will develop the ability to ask for what he or she wants.
7. The patient will develop the ability to use anger appropriately.
8. The patient will learn healthy communication skills.

Front 16

Examples of Objectives

Back 16

The patient will make a list of the essential skills necessary for recovery.
The patient will keep an assertiveness log and will share the log with the counselor each session.
The patient will practice assertiveness skills in interpersonal group.
Verbalize that he or she has a problem, or verbalize an understanding of the problem.
Develop and practice new behaviors that are incompatible with the problem via the AA book.
1. Practice the Twelve Steps of AA.
2. Go to meetings.
3. Learn how to cope with uncomfortable feelings.
4. Develop a relapse prevention plan.

Front 17

Examples of Interventions

Back 17

1. Assign the patient the homework of making a list of 10 times when alcohol use negatively affected his life.
2. Assign the patient to complete a chemical use history exercise and then have him share his answers in group.
3. In a one-to-one counseling session, teach the patient about powerlessness and unmanageability and then have him share what he learned in group.
4. Have the patient share in group five tools he can use to cope with anger effectively.
5. Encourage the patient to share his feelings log in group.
6. Refer the patient to an anger management group and make the first appointment with the patient present.

Front 18

Case Presentation

Back 18

1. Identifying data
2. Present illness
3. Past history
4. Family history
5. Social history
6. Medical history
7. Mental status examination
8. Most likely diagnosis
9. Secondary problems: predisposing factors; psychosocial stressors; stress that precipitated treatment
10. Further assessment you propose
11. Treatment plan
12. Prognosis