For a program that depends on screening and assessment to succeed, there should be a clear view of the treatment objectives and limitations. There should also be well-established links with the substance abuse treatment facilities based at the community level to enable proper response to the client needs and promote access to additional services required in the program. There is dire need to look at the essential features of ensuring proper treatment to clients with COD in different medical settings including acute care (Van & Davis, 2018). The service provider only offers the services that the client is willing to accept.
The screening and assessment tools to be applied in the case for Janis include the literature to sensitize her on the disorders, case management to address the housing and other needs and refer the client to detoxification when necessary. The triad should also work on engaging the client by ensuring a positive experience which will encourage her to visit again. The triad should also make follow-ups on the client in the hospital and corporate with the inpatient and outpatient medical staff to ensure continuous care since it is a crucial step in the process. The providers of primary care update the triad on every visit by the client to allow the counselors to create a working relationship trust with the clients promoting engagement in mental health or substance abuse care (Van & Davis, 2018). Immediately after meeting with the client, the triad informs the medical providers about the clinical disposition and the treatment plan. Such sessions provide a chance for cross-disciplinary learning.
The accessing services may include the use of the CORE Clinic which provides interventions based on crisis counseling, single session treatment, temporary mental health services and counseling based on treatment to substance abuse, and appropriate psychoeducation. Due to the diversification of the COD, the treatment referrals at the CORE center are different including treatment of residential substance abuse treatment to acute psychiatric hospitalization, and stable operations links with treatment communities (Van & Davis, 2018). In situations whereby the client requires intensive care, the triad will be compelled to offer critical triage function towards the treatment of the larger substance abuse and communities providing mental health services.
The substance abuse treatment may be integrated with the mental health services within an existing medical setting to provide anew care model for Janis. The changes may be perceived as unnecessary by the existing systems and operating culture. The same manner in which the providers establish the readiness for change or treatment from the client, the administrators are obliged to establish the readiness for change in the organization before the implementation of the strategy for integrated care (Van & Davis, 2018). The establishment should take into account factors like room to accommodate the additional staff, the establishment of an organizational reporting structure which is clear and ensure adequate time for the providers to partner with other disciplines. The assessment team will brief the planners. During the development of a plan, the administration seeks inputs from all the stakeholders including the clients. It is usually a prerequisite necessary in the development or provision of services. Such information could be obtained from focus groups, data from the archives, and interviews conducted by providers.
In the development of the plan, the administration will also need to define the role of every primary care, treatment for substance abuse, and providers of mental treatment. There should also be a clear specification of the expected results for mental health and the services on treatment for substance abuse. Both the mechanisms of formal and informal mechanisms should be outlined and piloted before the services are implemented fully. During the development and implementation of the program, the administration should not overlook the differences between the medical and social service cultures (Van & Davis, 2018). A room should be allowed for the relationship and team building. The last step is to ensure that there is continued monitoring and flexibility in developing the model.
Janis could apply several steps in the management of her addiction and mental problems. She should begin with the Double Trouble Recovery (DTR). The mechanism offers twelve steps which are linked to the usual implementation of the original twelve steps. An example is that the addiction problem should be converted to COD, and she is changed to step twelve accordingly. The Dual Disorder Anonymous requires the organization to follow a similar format to DTR. Similar to the rest of the dual recovery fellowships, the organization offers a meeting format which is applied by the members of the groups who chair the meetings (Van & Davis, 2018). The Dual Recovery Anonymous is whereby the organization offers twelve steps which are an adapted and developed version of the traditional twelve steps almost the same as those applied by the DTR and Dual Disorders Anonymous. The words “assets” and “liabilities” are applied in place of the usual term “character defects.” To add on, the method involves affirmations into three of the usual twelve steps. The organization has to offer a format for the suggested meeting which is similar to the rest of the dual fellowships to be applied by the members of the groups who chair the meetings.
The Dual Diagnosis Anonymous is whereby the institution offers a hybrid approach which applies five extra steps in addition to the twelve usual steps. The five steps vary from the steps of the dual recovery groups in emphasizing the potential requirement for medical management, clinical interventions, and therapy. The organization will also offer a meeting format to be applied by the group members who have the responsibility of chairing the fellowships. The dual recovery fellowships are based on membership instead of service delivery programs for consumers. The fellowships work as autonomous networks ensuring system support which is parallel to the usual psychological or clinical services (Van & Davis, 2018). The meetings are organized by individuals who are responsible, empowered, and assist each other in chairing the meetings for newcomers and fellow members. The meetings are not controlled by professional counselors unless the leader happens to be one, and the members do not receive any payment for leading the meeting. The fellowships could sometimes promote informal working relationships with the professional service providers and consumer organizations.
In maintaining the principles and traditions of the twelve steps, the dual recovery twelve-step fellowships do not offer specified clinical or counseling sessions, psychiatric symptom classes, and any related services which may be similar to case management. The dual recovery fellowships ensure a primary intention of the members assisting each other to obtain and maintain dual recovery, avoid lapses like in the case of Janis, and transfer the recovery message to other individuals who have gone through dual disorders (Van & Davis, 2018). The twelve step members who chair the meetings in turns are usually a member of the whole fellowship.
Van Wormer K. & Davis, D.R. (2018). Addiction Treatment: A strengths perspective. (4th ed.). Boston, MA Cengage Learning.
Diagnostic and Statistical Manual of Mental Disorders. (5th ed). Arlington, VA American Psychiatric Publishing, Inc. ISBN: 9780890425558