6.0 Introduction: Treatment Planning, Coordination of Services, Referrals, Community Resources, Client Advocacy, and Aftercare

TAP 21: ADDICTION COUNSELING COMPETENCIES

The Knowledge, Skills, and Attitudes of Professional Practice

          So we are back to the TAP 21. Let's take a look at where we've been so we have a clearer idea of the path we are taking now.  Much of what you have learned so far have been related to understanding addiction and learning how to screen and assess clients for substance use disorders. 

The student learning objectives targeted with this unit are: 

  1. Describe the interdisciplinary approach to addictions treatment and discuss its value;
  2. Describe the components of a treatment plan; problem-solving models and processes;
  3. Evaluate a case history of a presenting client to include screening, assessment and treatment planning, aftercare and follow-up.

Screening & Assessment (Where we've been)

  • Determine the client’s readiness for treatment and change as well as the needs of others involved in the current situation.
  • Review the treatment options that are appropriate for the client’s needs, characteristics, goals, and financial resources.
  • Apply accepted criteria for a diagnosis of substance use disorders in making treatment recommendations.
  • Construct with the client and appropriate others an initial action plan based on client needs, client preferences, and resources available.
  • Based on the initial action plan, take specific steps to initiate an admission or referral and ensure followthrough.
  • Select and use a comprehensive assessment process that is sensitive to age, gender, racial and ethnic culture, and disabilities that includes but is not limited to:

History of alcohol and drug use
Physical health, mental health, and addiction treatment histories
Family issues
Work history and career issues
History of criminality
Psychological, emotional, and worldview concerns
Current status of physical health, mental health, and substance use
Spiritual concerns of the client
Education and basic life skills
Socioeconomic characteristics, lifestyle, and current legal status
Use of community resources
Treatment readiness
Level of cognitive and behavioral functioning.

Treatment Planning (Where we're headed)

  • Analyze and interpret the data to determine treatment recommendations.

Level of Care (LOC) assessment is defined as a face-to-face interview with the individual to ascertain treatment needs based on the degree and severity of alcohol and other drug use/abuse through the development of a comprehensive confidential personal history, including significant medical, emotional, social, occupational, educational, and family information.

  • Use relevant assessment information to guide the treatment planning process.
  • Develop with the client a mutually acceptable treatment plan and method for monitoring and evaluating progress.
  • Provide the client and significant others with clarification and additional information as needed.
  • Examine treatment options in collaboration with the client and significant others.
  • Consider the readiness of the client and significant others to participate in treatment.
  • Prioritize the client’s needs in the order they will be addressed in treatment.
  • Formulate mutually agreed-on and measurable treatment goals and objectives.
  • Identify appropriate strategies for each treatment goal.
  • Coordinate treatment activities and community resources in a manner consistent with the client’s diagnosis and existing placement criteria.

Coordination of Services is a collaborative process that includes the following activities: engagement, evaluation of needs, establishing linkages, arranging access to services ensuring enrollment in the appropriate health care coverage, advocacy, monitoring, and other activities to address client needs throughout the course of treatment. Coordination of Services includes communication, information sharing, and collaboration, and occurs regularly with case management and/or provider staff serving the client within and between agencies in the community.

Referral Process

          This is the process of facilitating the client’s use of available support systems and community resources to meet needs identified in clinical evaluation or treatment planning. It involves the following skills:

  • Establish and maintain relationships with civic groups, agencies, other professionals, governmental entities, and the community at large to ensure appropriate referrals, identify service gaps, expand community resources, and help address unmet needs.
  • Continuously assess and evaluate referral resources to determine their appropriateness.
  • Differentiate between situations in which it is most appropriate for the client to self-refer to a resource and situations requiring counselor referral.
  • Arrange referrals to other professionals, agencies, community programs, or appropriate resources to meet the client’s needs.
  • Explain in clear and specific language the necessity for and process of referral to increase the likelihood of client understanding and followthrough.
  • Exchange relevant information with the agency or professional to whom the referral is being made in a manner consistent with confidentiality rules and regulations and generally accepted professional standards of care.
  • Evaluate the outcome of the referral.

Service Coordination

          This is the administrative, clinical, and evaluative activities that bring the client, treatment services, community agencies, and other resources together to focus on issues and needs identified in the treatment plan. Service coordination, which includes case management and client advocacy, establishes a framework of action to enable the client to achieve specified goals. It involves collaboration with the client and significant others, coordination of treatment and referral services, liaison activities with community resources and managed care systems, client advocacy, and ongoing evaluation of treatment progress and client needs.

  • Initiate collaboration with the referral source.
  • Obtain, review, and interpret all relevant screening, assessment, and initial treatment planning information.
  • Confirm the client’s eligibility for admission and continued readiness for treatment and change.
  • Complete necessary administrative procedures for admission to treatment.
  • Coordinate all treatment activities with services provided to the client by other resources.
  • Apply confidentiality rules and regulations appropriately
  • Maintain ongoing contact with the client and involved significant others to ensure adherence to the treatment plan.
  • Understand and recognize stages of change and other signs of treatment progress.
  • Assess treatment and recovery progress, and, in consultation with the client and significant others, make appropriate changes to the treatment plan to ensure progress toward treatment goals.
  • Describe and document the treatment process, progress, and outcome.
  • Conduct continuing care, relapse prevention, and discharge planning with the client and involved significant others.