Top PDF Substance Abuse Treatment Needs, Capacity and Costs

Substance Abuse Treatment Needs, Capacity and Costs

Substance Abuse Treatment Needs, Capacity and Costs

 The prevalence of substance abuse in Wisconsin is an estimated 456,723 adults and adolescents. In both the public and private sectors, the study estimates that during 2004, substance abuse publicly-supported treatment was provided to 34,739 persons under s. 51.42, Wis. Stats. and 13,164 persons received substance abuse services under the Medicaid program. Adding brief and support services such as substance abuse evaluations, transportation, or housing assistance, a total of 63,300 persons received substance abuse-related services under s. 51.42. with reported expenditures of nearly $78,400,000.
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Case Management and Substance Abuse Treatment (Revised)

Case Management and Substance Abuse Treatment (Revised)

interventions to ensure that the client can achieve his goals. The case manager has to work with the client to balance competing interests, and to develop strategies so the client can meet basic survival needs while in treatment. For example, a case manager may have to negotiate between probation and treatment to ensure that the client can attend treatment sessions and meet with his probation officer. Some activities require staging to ensure that they are applied at the right time and in the correct order. Clients who are unemployed and lack employment skills, for instance, should begin job readiness and training activities after they are stabilized in treatment; they will need additional support for seeking and maintaining employment. It is not uncommon for clients to feel they can take on the world once they are stabilized in treatment. If this is the case, the job of the case manager is to encourage clients to go slowly and take on responsibility one step at a time. This can be particularly critical for women anxious to reconnect with their children. The financial and emotional responsibilities are great, and the case manager should work with the woman and child protective services to transition these responsibilities in manageable ways.
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Access to Substance Abuse Treatment in Child Welfare

Access to Substance Abuse Treatment in Child Welfare

Why Recovery Coaches? The potential usefulness of Recovery Coaches is supported by the literature, where there are indications that aggressive case management can increase engagement and retention among families with substance abuse problems (Maluccio & Ainsworth, 2003). Clients that receive support and services responding to identified needs through aggressive case management tend to stay in services longer (Hser et al., 1997), reduce their substance use (Smith &March, 2002), reduce their criminal activities, and improve their functioning in areas where they have received targeted services (McLellan, Frisson, Zanic, Randall, Brill, & O’Brien, 1997). A Title IV-E Waiver demonstration in Delaware focused on a multi-disciplinary treatment team to link clients with substance abuse treatment and on-going assessment, and removes the engagement barriers (Delaware Division of Family Services, 2002). The evaluation found that this approach was effective at decreasing resistance and improving treatment access. Marsh, D’Aunno and Smith (2000) studied the relationship between treatment access and treatment outcome. The authors conclude that those who receive the transportation, outreach, and child-care services were more likely to use the service that, in turn, reduces the substance use. Brindis and colleagues (1997) found that connecting substance abuse treatment with intensive case management services improved treatment engagement and other desirable outcomes.
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Children's needs, parenting capacity : child abuse : parental mental illness, learning disability, substance misuse and domestic violence

Children's needs, parenting capacity : child abuse : parental mental illness, learning disability, substance misuse and domestic violence

The experience of professionals providing specialist services for adults can support assessments of children in need living with parental mental illness, learning disability, substance misuse or domestic violence. Research, however, shows that in such cases collaboration between adults’ and children’s services at the assessment stage rarely happens (Cleaver et al. 2007; Cleaver and Nicholson 2007) and a lack of relevant information may negatively affect the quality of decision making (Bell 2001). An agreed consensus of one another’s roles and responsibilities is essential for agencies to work collaboratively. The evidence provided to the Munro review (2011) found ‘mixed experiences and absence of consensus about how well professionals are understanding one another’s roles and working together’ and argues for ‘thoughtfully designed local agreements between professionals about how best to communicate with each other about their work with a family...’ (Munro 2011, p.28, paragraph 2.23). Although research shows that the development of joint protocols and information- sharing procedures support collaborative working between children’s and adults’ services (Cleaver et al. 2007), a survey of 50 English local authorities found only 12% had clear family-focused policies or joint protocols (Community Care 2009).
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Substance Abuse Treatment and Family Therapy (Revised)

Substance Abuse Treatment and Family Therapy (Revised)

Family therapists should take care to ensure that the language they use in describing physical and cognitive disabilities is sensitive and appro- priate. As a general rule, one should always put people first, before their disabilities, refer- ring to “people with disabilities” rather than “disabled people.” One should never refer to the disability in place of the person—not “the schizophrenic” but rather “a person with schiz- ophrenia.” A person with a disability should not be called a “patient” or “case,” unless the context refers to a relationship with a doctor. It is key that the therapist learns how well a person understands his or her disability. Some people will have a clear knowledge of the ways in which they are functionally limited, whereas others may deny having any limitations. Similarly, in the area of individual strengths, some people will have received extensive support from family, friends, and professional caregivers to pursue their interests and develop unique talents, but others may have been over- ly sheltered or may have experienced repeated failures. A treatment provider should confer with a disability expert on the delicate topic of how to discuss a client’s disability with him. Providers may be uncomfortable when first confronted with a person with a physical or cognitive disability. That unease can lead them to err in one of two directions: either enabling the person to use his disability to avoid treat- ment or refusing to recognize that a legitimate need for accommodation exists. Accommodation does not mean giving special preferences—it means reducing barriers to equal participation in the program. If a client believes that he or she needs an accommodation, the treatment provider will still need to determine if the request is legitimate or an attempt to manipulate the treatment program. However, a provider’s vigilance in avoiding enabling may predispose him to reject legitimate requests for accommo- dation. If there is any doubt on the part of the provider regarding the legitimacy of the person’s request, he or she should consult a disability expert in order to make this determination. Failure to make good faith efforts at
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Group Therapy Treatment for Substance Abuse (Revised)

Group Therapy Treatment for Substance Abuse (Revised)

• Supervision. A large part of this type of training is ongoing work with groups under the supervision of an experienced therapist. Supervision may be dyadic, that is, supervi- sor and supervisee, but while simple and easy, this setting does not allow opportunities for actual group work. Supervision of group therapists ideally is conducted in a superviso- ry group format. Supervision in a group enables therapists to obtain first-hand expe- rience and helps them better understand what is happening in groups that they will eventually lead. Several other important ben- efits accrue as well. The supervisory group creates a safe place for trainees to reveal themselves and the skills they need to devel- op. It provides support from peers and a chance to learn from their experience. It stimulates dialog around theory and tech- nique and encourages a healthy kind of com- petition. It expands the capacity for empathy (Alonso 1993). Finally, this kind of supervi- sion provides an opportunity for trainees to explore sensitive issues, such as child abuse, sexual abuse, and prostitution. (For more on supervisory groups, see the “Supervision” section later in this chapter.)
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Substance Abuse Treatment: Gone Astray in the Service Array?

Substance Abuse Treatment: Gone Astray in the Service Array?

• How are child welfare/treatment data and outcomes connected to the State level assessment of need for substance abuse treatment and capacity to serve child welfare clients. • How ar[r]

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Policy on reintegration of women with histories of substance abuse: A mixed methods study of predictors of relapse and facilitators of recovery

Policy on reintegration of women with histories of substance abuse: A mixed methods study of predictors of relapse and facilitators of recovery

This study suggests that, for a sample of treatment-seeking women with histories of substance abuse, withholding access to basic needs, positive affiliations, and normal social roles does not reduce the propensity to relapse. Fur- ther, this study suggests support for Braithwaite's [18- 20,22] theory that treating people in stigmatizing and punitive manners may actually increase their propensity to continue with substance-abusing and illegal behaviors. The findings from this study suggest the need to replace punitive policies (e.g., withholding financial assistance) toward women who have histories of substance abuse with policies that allow these women to assume roles of responsibility such as work, education, and parenting. Strategies that support individuals seeking to develop or resume pro-social lives have potential positive implica- tions for both individuals and society. At a minimum, policymakers should consider other factors besides past substance abuse and criminal behaviors when making decisions about how to treat women with histories of sub- stance abuse.
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EXECUTIVE SUMMARY. The Report

EXECUTIVE SUMMARY. The Report

In  this  analysis  we  use  a  Cost‐of‐Illness 19   approach  combined  with  basic  cost  allocation  to  estimate the expenditures attributable to substance abuse for agencies and participants in  the  four domains of  prevention, treatment and recovery, harms reduction, and criminal justice.   It  is  important  to  note  that  the  intent  of  the  costing  work  presented  assumes  a  15%  margin  of  error, which the RSAC members have agreed is adequate to provide baseline information that is  actionable by the Council.   It is recognized that  data sources may cross multiple years and be  inconsistently  available,  thus  the  reported  substance  abuse‐related  costs  are,  at  best,  estimates.   
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Mental Health and Substance Abuse Parity

Mental Health and Substance Abuse Parity

The Task Force heard from stakeholders about the value of this document and also about the potential usefulness of illustrations or case studies of appropriate implementation of non-quantitative treatment limitations, such as key strategies that demonstrate effective compliance. The Task Force recommends the development of a “Warning Signs 2.0” document to address additional potentially problematic non- quantitative treatment limitations and well as the development of a similar document illustrating appropriate application of comparable non-quantitative treatment limitations and other actions that would reflect best practices in compliance with parity. The Task Force recommends the Departments consider the inclusion of network adequacy issues in the development of these documents, given the considerable feedback it received on this topic throughout its work. Further, the Task Force emphasizes the importance of balancing best practices for compliance with identifying and remediating violations. Increase federal agencies’ capacity to audit health plans for parity compliance. Given current
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Social and Economic Costs of Comorbid Substance Abuse and Mental Disorder

Social and Economic Costs of Comorbid Substance Abuse and Mental Disorder

When we study people in treatment, particularly high rates can be seen. This is probably both because of the increased risk that the substance use poses, and because the two disorders increase the chance of service provision. So, the 6-month prevalence of substance abuse or dependence in an outpatient sample with schizophrenia from Newcastle, NSW in 1998 was 27%, and the lifetime prevalence was 60%. When inpatient samples also focus on high-risk groups, the rates increase even further. In a recent study of inpatients with an early episode of psychosis in Brisbane, 70% of the young people also had a current substance abuse disorder (Kavanagh et al., 1999).
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A national study of the substance abuse treatment workforce $

A national study of the substance abuse treatment workforce $

educational background and experience in the substance abuse treatment field can contribute to a client’s decision making regarding which treatment services will best meet his or her needs. Furthermore, knowledge of a practitioner’s qualifications helps the client to trust the practitioner. For these reasons it is important to make access to this type of data readily available to both the private and public sectors. To determine what is already known about professionals who provide substance abuse treatment services, the authors examined literature that presented staff characteristics (e.g., demographics, required education, years of experience, place of employment) for eight core disciplines that make up the substance abuse treatment field (i.e., counseling, psychiatry (including psychology), psychiatric nursing, social work, guidance counseling, school psychology, marriage and fam- ily therapy, and psychosocial rehabilitation) (Brown, 1996; Lewin Group, 1999; Peterson, et al., 1995, 1998).
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Substance Abuse Treatment and LGBT Cultural Competence

Substance Abuse Treatment and LGBT Cultural Competence

care providers are highlighting the needs of these constituencies to be taken care of in an appropriate and professional manner. However, in so doing, consumers risk not only antigay bias but also the stigma of identifying predis- posing health conditions, such as HIV/AIDS, addictive diseases, and mental disorders, that may alter benefits packages dramatically. Another difficulty is that LGBT-identified persons can be seen as “high-cost-of-care” populations. Although data are not available to support or refute this supposition, several reasons can be suggested for the possibility of increased costs. First, managed care seeks to limit the number of patient visits and shorten the length of visits. As a result, a trustful provider/patient relationship may not develop and, therefore, disclosure of a person’s sexual orientation or sexual identity may not occur. The lack of this vital information may reduce the likelihood that appropriate care is provided in a timely fashion, thereby potentially raising its cost. Finally, some insurance companies have taken steps to reduce the probability of insuring an individual who may someday contract HIV (Li, 1996).
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Choosing the Best Substance Abuse Treatment Facility

Choosing the Best Substance Abuse Treatment Facility

Upon completion of a minimum of 90 days of treatment, a client should move, if possible, into a sober living house to attend to the specifics of an aftercare plan and work. A sober living house with structure, rules, monitoring and random drug testing further strengthens the foundations for long term recovery. Rebuilding life in sobriety is a slow process, new habits need to be learned, a new network of sober people needs to be built, and new perceptions need to be solidified. Most people who complete

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Principles of Adolescent Substance Use Disorder Treatment

Principles of Adolescent Substance Use Disorder Treatment

R esearch evidence supports the effectiveness of various substance abuse treatment approaches for adolescents. Examples of specific evidence-based approaches are described below, including behavioral and family-based interventions as well as medications. Each approach is designed to address specific aspects of adolescent drug use and its consequences for the individual, family, and society. In order for any intervention to be effective, the clinician providing it needs to be trained and well- supervised to ensure that he or she adheres to the instructions and guidance described in treatment manuals. Most of these treatments have been tested over short periods of 12–16 weeks, but for some adolescents, longer treatments may be warranted; such a decision is made on a case-by-case basis. The provider should use clinical judgment to select the evidence-based approach that seems best suited to the patient and his or her family. *
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Principles of Substance Abuse Prevention for Early Childhood

Principles of Substance Abuse Prevention for Early Childhood

original research. Unfortunately, this question has not been adequately addressed through research. Minor changes to original program materials to make the people, contexts, and examples more relevant to a specific group have been found to have little effect on intervention outcomes. Generally speaking, significant changes to the intervention structure and content are not recommended, as there is limited evidence on how these types of changes will affect outcomes. When a target population or context differs markedly from those targeted in available science-based interventions, a new intervention tailored to meet that population’s specific needs (e.g., cultural or contextual needs) may need to be designed. An example of one such program, Family Spirit (described in “Research-Based Early Intervention Substance Abuse Prevention Programs”) intervenes with very young poor mothers on American Indian reservations (Barlow et al., 2006).
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Krista Rhoades Decision Support Services Oklahoma Department of Mental Health and Substance Abuse Services

Krista Rhoades Decision Support Services Oklahoma Department of Mental Health and Substance Abuse Services

z TEDS data is supposed to be submitted to TEDS data is supposed to be submitted to SAMHSA’s Center for Substance Abuse SAMHSA’s Center for Substance Abuse Treatment (CSAT) by all st[r]

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Behavioral Health Issues Among Afghanistan and Iraq U.S. War Veterans

Behavioral Health Issues Among Afghanistan and Iraq U.S. War Veterans

Locating Substance Abuse Treatment and Mental Health Services Providers.. Resources[r]

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Narrating the journey of sustained recovery from substance use disorder

Narrating the journey of sustained recovery from substance use disorder

Participant recruitment was done by means of purposive sampling through the researchers’ professional (formal) and personal (informal) networks and the internet. The researchers firstly identified the various treatment and post-treatment support structures within the Gauteng area. These included a 12-Step based treatment centre, a faith-based treatment centre, a non-profit community centre, Alcoholics Anonymous fellowship, Narcotics An- onymous fellowship and two faith-based support groups. Gatekeepers from the identified treatment centres and mutual aid support groups were then contacted and meetings arranged to discuss the aim of the research and to obtain the help of the gatekeepers in identifying participants. Inclusion criteria set out at the beginning of the research were to involve participants who were in sustained recovery for three years or longer, over the age of 18, resident in the Gauteng area of Pretoria and Jo- hannesburg, South Africa, and able to speak English. Po- tential participants were either contacted telephonically or in some instances the field worker attended support groups and presented the prospective research to the group. Participants were given the opportunity to accept or decline participation and those that agreed to partici- pate, signed consent forms. No compensation was awarded/offered to any of the participants.
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Medical marijuana users in substance abuse treatment

Medical marijuana users in substance abuse treatment

In relation to social outcomes, one client went from not looking for employment to “not in the labor force.” Though one client went from looking for employment to not looking for employment and one moved from full time employment to part time employment, the mean number of days worked in the last 30 days went up from 4.0 to 5.5. Other notable changes include enroll- ment in school and enrollment in job training for dis- tinct clients. No criminal justice involvement (arrests, jail, or prison) was reported in the 30 days before dis- charge. This is worth mentioning when considering that one client was in prison in the 30 days before admission and another client had been arrested and spent time in jail in the 30 days before treatment. One client who had visited an emergency room in the 30 days prior to admission did not return in the 30 days prior to dis- charge. Similarly, one client who had been hospitalized in the 30 days prior to admission was not re-hospita- lized in the 30 days prior to discharge. In total, the number of clients reporting medical problems in the last 30 days dropped from 37.5% (n = 3) to 12.5% (n = 1) amongst those completing treatment. The three that had indicated medical problems in the 30 days before admission went from a mean of 4.375 days with medical problems to zero. One person discontinued use of psy- chiatric medication. Reiman [19] reported that many
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