Care of Drug Abuse Adolescents with Dual Diagnoses: The Person Clinical Collaboration within a Day Therapy Approach

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Last Updated on May 25, 2021 by

This chapter outlines a day clinical guidelines for adolescent substance users who also have a psychological illness and drug abuse, focusing on the elements of the patient advisor’s interaction with the adolescent user unique to this platform. 

Medical strategies for drug abuse are defined about the specific treatment objectives of empowering adolescent clients to abstain from alcoholism, other drugs, personality behaviours, avoiding drug abuse, supporting juvenile users in learning to identify and accept adequate solid conditions, and appropriate coping mechanisms substance-abuse as a means of controlling these disorders and drug abuse.

Drug abuse therapy for drug abuse focuses on the effects of opioid dependency, quality and structure of the consumer’s ongoing treatment technique. This drug abuse therapy model is a moment perspective that utilizes behavioural modification, 12-step ideology and treatment resources, and self-help involvement. The value of a sophisticated combination of psychodynamic therapeutic approaches with conventional drug abuse methods or 12-steps rehabilitation model techniques is addressed as being vital to a successful working personal relationship with crew cab treated adolescent patients within both group and special therapies. 

Finally, a detailed examination of the client-counsellor relationship’s interpersonal dynamics and the counsellor’s attributes are described and explored as critical to the model’s effectiveness. While genetic and environmental factors play a role in the aetiology and maintenance of alcohol abuse, the various psychological flaws that influence the abuse of mental state drugs in adolescent patients are crucial to the priorities, structure, and function of the Centre for Child and Adolescent Treatment Services (CCATS) Model.

Adolescents who use drugs have unique features such as behavioural issues, ability deficiencies, academic challenges, relationship issues, and psychological problems that childhood development adversities and biological deficiencies have shaped. Developmental research has yielded an inventory of the risks, challenges, and common complications that most often mark the developmental course of adolescents who experience opioid abuse drug abuse.

The authors hypothesize that the majority of the adolescent patients served by the CCATS Model have deficiencies rooted in everyday trauma, such as recurrent sexual abuse and rape, ineffective supervision, in addition to the mitigating factors of learning disabilities, maternal alcohol abuse, and long-standing behavioural and emotional instabilities.

These cumulative authorities or amended act psychiatric deficiencies can be defined as a variety of groups of antisocial traits weaknesses, peer deficits, and depressive symptoms that have been present for a long time and may have been acquired as a child’s attempts to respond to a dysfunctional and dangerous interpersonal relationship (Wood 1988). In this sense, drug abuse is perceived as an effort to achieve social acceptance (Kantian et al. 1990).

1.1 Drug AbuseProgram Description 

The population served consists of adolescents aged 12 to 18 and their families. These patients for treatment are due to lack of hospitalization, school referrals, court referrals, rehabilitation services, and relative’sconsultations. The CCATS Model supports both adolescent patients with a primary psychological illness and those who have a coexisting psychiatric disease, alcohol abuse and dependence disorder.

The following program description focuses on the system’s dual-diagnosis treatment track, though both clinical populations share certain program structure elements. Adolescent clients first undergo therapy four hours a day, five days a week, before transitioning to a three-day-a-week regimen as they plan for removal and follow-up care. The average duration of drug abuse victim stay is 7 to 10 weeks, with differences dictated by the magnitude of the board characteristics, psychiatric disorders, and global evaluation of performance upon intake and admission, as well as during care. The intervention of family members, foster parents, or legal guardians is needed, as it is vital to the success of treatment outcomes.

Adolescent drug abuse clients must be able to acknowledge the program’s structural criteria, which involve regular urine substance screening, random checking for blood alcohol content using a Breathalyzer, participation in at least four to five 12-steps sessions.

Adolescent clients must take a seat in an instructional course, typically a changed day at their own junior or senior high school, including tutorial training. Given the comprehensive extent of behavioural expectations and limitations on the amount of substance consume while in care, applicants for this therapeutic strategy must have at least a moderate level of encouragement toachieve abstinence. The cause for substance abuse is first evaluated during the initial assessment and is then immediately followed on during recovery. 

Inspiration can emerge from inside or outside, but the adolescent customer’s anxiety is thought to be the source. This frustration can manifest as feelings of self-dissatisfaction, depression, anxiety, or fear of reprisals. Evidence of the presence and degree of this distress is actively sought during the intake/assessment interview. The counselling team makes a concerted effort to maintain or raise this anxiety during rehabilitation, gradually working with the adolescent client to help shift their pain from physical to mental, and from prison time to wellbeing.

Since the CCATS Model only uses behavioural enhancement mechanisms and “timeout” in a no-restricted situation for rule violations, adolescent patients with a record of harassment behaviours must be able to maintain these patterns in a quite stressful position.

1.2 What are the Approach’s Goals and Objectives For Drug Abuse?

Drug abuse and substance addiction are known as critical conditions, treated accordingly. This therapeutic focus on the primacy of drug abuse disorders derives from the finding that adolescents regularly involved in daily use of rhythm drugs have considerable trouble addressing any other recovery target and, in reality, often display uninhibited expression of violent urges and acting-out behaviours. 

Thus, although individualized and unique to each person, the progression of treatment objectives starts with the adolescent’s encouragement for avoidance from alcoholism and a reduction in, and finally cessation of, use of rhythm drugs. Secondary care targets are individualized, but they may be classified as unique to the prevalent mental disorder comorbid with substance consumed. For instance, an adolescent patient with a major depressive illness may have therapeutic objectives that include symptom reduction and the absence of acute symptoms of depression. 

An adolescent with conduct disorder who is also consuming drugs can be encouraged to follow treatment goals such as stopping the harassment behaviour and finding appropriate and effective coping strategies to posing behaviours. In addition, the project focused on the successful management of pervasive peer habits.Stealing, deception, school delinquency, oppositional and rebellious conduct, sexual promiscuity, excessive physical threat, and social participation with adolescents associated with drug use are all examples of common behaviours found in this population. 

The rehabilitation methodology encourages a logical, egalitarian, educational focus on the effect of personality or peer behaviour on the desires and hobbies of conflict within interpersonal relationships, as well as intrapsychic suicidal thoughts. Recognizing the centrality of the parent’s efficient development, clinical outcomes often include any observable behavioural change in parenting style, varying from reducing or eliminating extreme dispute inside the household to referring family to care outside the programme system for psychological or opioid mental disorder, which is seen as counterproductive.Finally, under this approach, additional recovery targets are decided by the adolescent patients themselves. 

  • Pursuing educational and career ambitions are indications of self-selected treatment objectives.
  • Investigating transferential phenomena.
  • Investigating psychological conflicts.
  • Seeking divine guidance in a 12-steps program.
  • Analysing new or previously pursued leisure practices or desires.

The recognition and implementation of a serially monogamous or “recovering” culture through the positive impact of the care subculture and referral’s positive behavioural culture to meetings such as AA and NA is key to achieving the majority of the significant treatment objectives within this model.

1.3 What is the Logical Reason for Drug Abuse Action?

The theoretical reasoning behind Complex Comprehensive Treatment Model is that drug abuse is an overdetermined occurrence sustained as an activity (despite substantial negative consequences) due to its adaptive nature as a peer depersonalization disorder and debilitating mental responses (Buckstein et al. 1992; Fairbairn 1981; Kantian 1978). All other model components are affected by the adolescent drug abuse customer’s particular central issues caused by loss, trauma, mental illness, and integrated experience deficiencies as a result of this primary aetiology conclusion.

Drug abuse therapy begins by assisting the client in recognizing the nature of the problems and the resulting irrational thought. Following that, the person is motivated to achieve and sustain abstinence and acquire the requisite strategic mind-set and insight meditation to succeed in rehabilitation for the rest of his or her life.

Within this context, susceptibility to the formation and management of prohibition is regarded as normal, inevitable, and essential to extent of adsorption behavioural change. The method of action of this model entails delivering creativity psychotherapy and a progressively informed view of an adolescent patient’s reluctance to accept situational or more behaviourally oriented counselling assistance, as well as exploring the triggers of that patient’s reluctance. Additionally, the clinical alliance with care providers is used to support adolescent clients in effectively acknowledging, recognising, and incorporating elements of their unwillingness to change and growth through abstinence implementation. In this chapter, various emotional and psychological structure approaches are described in detail to aid in this process.

1.4 Change Agent For Drug Abuse  

While these factors influence and coordinate the drug abuse therapy, the emphasis seems to be on the adolescent patient’s willingness to embrace and use the treatment’s management, treatment, instruction, and strengthening components. Any priority put by the adolescent drug abuse patient on comparing the causes of change to sources other than himself or herself is properly considered and analysed.

Counsellors establish an atmosphere in which the adolescent client builds self-esteem by increasingly accepting personality and intranet-related programs of influence in deciding to use the treatment centre’s social and psychological support structures.  The individual in the drug abuse program is the driver of transformation in this drug therapy model. The client must assume responsibility for carrying out a rehabilitation program. While rehabilitation is primarily the client’s responsibility, they are encouraged to seek help from others such as counsellors, treatment staff, sponsors, cannabis or healing peers, and family members.

Adolescent drug abuse patients are treated as responsible for their actions and, eventually, for the behavioural changes required to establish and sustain an abstinent or “rehabilitation” lifestyle in this model.  Although the staff’s empathic guidance and uneasiness recognize that initial behaviour adjustment is daunting and traumatic at times, the adolescent client is nevertheless regarded as self-regulating and capable of tolerating the challenge inherent in change by using adequate social reinforcement and diversion strategies. The adolescent client is often advised to consider abrogation of duty outside of himself or herself as fundamental to the current problems.

1.5 Drug Abuse Definition, Multifactorial Factors

A definition of the conceptual framework of drug abuse and dependency and their connection to living in harmony with medical conditions is crucial to understanding this treatment approach.In this approach, adolescent drug use is viewed as a social norm. Drug dependency and alcoholism, on the other hand, are perceived as manifestations of mental illnesses and an attempt to peer mental responses such as depression, anger, anxiety, agitation, and depressive symptoms. According to this model, the onset of drug abuse disorders in adolescents is accompanied by depressive disorders and psychological symptoms (Christie et al. 1988; Daykin et al. 1987; Newcomb et al. 1986).

The model of drug abuse disorders as a psychotherapeutic condition (Engel 1980) is a useful development that incorporates all known etiological aspects. Adolescent patients are exposed to this model in academically focused treatment groups. It is readily understood and instinctively accepted as an organising system of thought for further investigating an adolescent’s engagement with toxins, users’ behaviour, relationships, and community impact on use habits.

In short, drug abuse and pharmaceuticaldrug abuse are viewed as manifestations of fundamental psychological and social disorders that may also be strongly conditioned by evolutionary, parental, and socioeconomic factors, resulting in a relatively culturally homogeneous pattern of symptoms and behaviours once behaviourally established. This trend varies according to variability, degree of substance usage, and intensity of substance abuse, but it involves behavioural regression, character dysfunction mental fascination with drug use—and habits correlated with drug acquisition and use. According to this model, in some situations, alcoholism and pharmaceutical drug abuse are interpreted as actions by the individual to peer excessive influence in the absence of appropriate coping strategies.

2. Drug Abuse In Opposition to Other Therapeutic Approaches 

As previously mentioned, the effective surgical format differs and requires a variety of types of care. Both modalities share the counsellor’s need for psychodynamic understanding of resistance and empathic analysis of ambivalence regarding abstinence and treatment. This technique is most similar to motivational interviewing methods (Miller and Rollick 1991) and Prochaska and DiClemente’s transtheoretical approach (1984). 

Clinical techniques from these approaches, such as evoking uneasiness, rationalising, giving guidance, and emotionally intelligent feedback, and using an instructional but non-confrontational approach, are used as effective therapeutic tools during the assessment, execution, and successful treatment processes.

Adolescent clients’ deceptive, abusive, rapacious, or drug-using habits are specifically challenged, as in the Minnesota Model; nevertheless, this limit setting helps give the client the connection to affect needed for actual improvement to occur by disrupting the defined cycle of affect projection and acting out. The psychologist uses complex analysis of resistance, transmutation, and acting-out episodes, similar to conventional psychodynamic models for drug abuse program, but in the sense of a therapeutic strategy that is very directive and strict in establishing boundaries with the drug abuse adolescent client.

Taking inspiration from the theoretical framework and clinical techniques of the Motivational Interviewing Model, psychodynamic interpretation of violence and acting out is applied only in the context of a very well individual relationship between client and counsellor. This customer collaboration is viewed as the central, coherent process by which all implementation plans are established and implemented.

The CCATS Model’s overall intellectual and clinical framework is an eclectic formulation incorporating compatible techniques from stage change, psychodynamic, and conventional Minnesota Model, or 12-step recovery method techniques.

2.2 The Most Distinctive Therapeutic Approaches For Drug Abuse

The model differs from an aggressive, chemically synthesized drug abuse model in which a patient’s hesitation or uneasiness is framed as a lack of willingness to surrender or as a sign of reluctance or wilfulness. Under the integrated model, wariness is regarded as normal and predictable, and it is an important component of beginning prohibition and preserving mental stability.

The counsellor’s use of emotionally intelligent, reality-focused guidance is seen as assisting the adolescent client’s self-exploration and, eventually, self-motivation for behaviour improvement. This treatment method differs from a conventional psychodynamic model. The counsellor avoids an aggressive, directive approach and focuses primarily on underlying complexities and emotional vulnerabilities beneath drug abuse, excluding overt interrogation and exploration of the effects of drug usage.

3. Drug Abuse Format

Person, community, and parenting counselling educationally focused drug abuse groups; psychological obstacle (e.g., mountain biking, high rock climbing gym, rock climbing); creative arts cognitive therapy; main objective groups; peer assessment groups; personnel response groups; relaxation techniques; and pharmacotherapy (when appropriate) all work together to support the program’s structural framework. There is also considerable use of behaviour management strategies in drug abuse format, such as the use of a level status and opportunity scheme, as well as the comprehensive use of facilitate strategies, such as the acknowledgment of adolescent patients’ substance abuse anniversaries and the use of a ticket system of sticker awards.

The treatment format for drug abuse victims also includes public education promotion as well as the production and teaching of management skills. Delegating responsibility to senior members of the recovery community for introduction of rehabilitation format, protocols, and the use of 12-steps supporting groups, as well as teaching appropriate alternative coping mechanisms to drug use and other acting-out behaviours through peer disclosure of life findings in group and informal settings, are examples of techniques. The drug abuse counsellors work as advisors for this phase, but the responsibility for these tasks is delegated to the adolescent clients themselves.

The CCATS Drug Abuse Model is Contrasted to Other Ones.

The use of 12-step service organizations by drug abuse adolescent clients is controlled by forming regular rehabilitation goals related to conducting conferences, associating with different “clean” peers, and receiving an AA/NA or CA supporter. Finally, bibliotherapy is an essential component of the program’s structural format. 

These drug therapy manuals created for personal and social counselling were intended to be components of a more extensive recovery program. When paired with excretion, individual and group drug abuse therapy, initial clinical and psychiatric evaluations, and continuing involvement in a self-help program, may form a comprehensive treatment plan. These procedures, however, can be used in combination with drug therapy, other offering training programs (such as homeopathy), family or couples counselling, or skilled psychotherapy.

Adolescent drug abuse customers will be given articles, posters, and a professional therapy workbook containing lesson plans and didactic materials on lifestyle change, the psychotherapeutic model of dependence, the consciousness theory, the effects of AOD on the body and mind, effective anger management and expression, and other drug abuse treatment topics. Completing any of these prescribed learning activity, as well as daily participation at 12-step meetings, are vital criteria for achieving an improvement in the client’s status system level (along with individualised treatment goals).

Drug Abuse Methods of Treatment

  • Particular emphasis on personality dynamics, insight-oriented therapy, Education, and peer support.
  • Access to 12-step programs.
  • Self-importance psychotherapy.
  • Urine substance testing, Medical care.
  • Schooling support.
  • Referral 12-step programs with encouragement for participation.
  • Urine drug tests Defiantness. 

It is described in the manipulation that transmission to psychiatrist and AA is interpreted; addressed, clarified, interpreted, challenged. When challenged, the client is viewed as being unable to commit or sustaindrug abuse if therapy fails. Understanding of cognitive and affective and behavioural dynamics, which leads to symptom alleviation. Prohibition from AOD; insight into one’s own and others’ dynamics; stress reduction; 12-step responsibility, Avoidance from AOD; participation in and devotion to the 12-step program.

The drug abuse counsellor ought not to be harsh in his or her evaluation of the consumer’s addictive habits. If the client did not have andrug abuse, they wouldn’t even need substance therapy, so punishing the client for showing these symptoms is futile. Also, since clients often experience feelings of regret and remorse due to their addictive habits, they must be encouraged to talk openly about substance use as well as addictive behaviours, as well as to be respectful of each client’s story to help overcome those feelings.

It is also important for the drug abuse counsellor to value the clients. The drug abuse counsellor should never be late for an appointment, and he or she should never handle or behave disrespectfully towards clients. The counsellor should refrain from sharing too much personal information. Although primary standard can allow the drug abuse customers open up or inspire the client by serving as a style icon, excessive self-disclosure detracts from the customer’s rehabilitation.

If the drug abuse counsellor is inclined to use self-disclosure, a fair rule to follow is to first have a clear goal or purpose for the therapy, and then decide whether he or she is using self-disclosure at this time. Eventually, the drug abuse counsellor should be aware of whether a client’s concerns are the product of their issues and, as a result, prevent from responding to the consumer based on their existing complexities. For instance, imagine a recovered counsellor believes it is critical to break ties with addicted associates, but a particular client who has an alcoholic partner or girlfriend is unable to do so. In any case, the counsellor must respond independently and effectively to the customer’s point of view, rather than strictly adhering to the notion that cutting communication from all abusers is the only route out.

Relationship Between a Client and a Counsellor In Drug Abuse

The counsellor’s job is to offer direction and guidance while also keeping the person accountable through non-judgmental conflict. In a perfect world, the recovery person sees the counsellor as an ally and mentor who can help them stay sober. The client has the confidence to say as much as the counsellor. The counsellor should plan the session, present direction and guidance, and listen carefully. The counsellor must recognize the difference between being proactive and empowering the client to direct his or her own actions.

In some instances, the drug abuse advisor must be directive. The counsellor creates a process structure that involves providing input on the most current urine drug screens, the client’s progress in treatment, and managing any instances of use or close use. Based on what the patient seems to need, the counsellor defines and presents the appropriate subject for discussion. Besides, the counsellor may specifically encourage the drug abuse patient to modify such habits, such as attending three meetings a week. 

However, in this drug abuse counselling approach, the patient is often encouraged to be conscience. For instance, within the context of a particular topic, like coping with psychological distress, the patient will pressurise or negotiate the direction they wish to take, and the counsellor will respond to the customer’s choice. When a person would be unable to change an alcohol dependence, such as being in a dangerous situation, the proper counsellor solutionfor drug abuse is to consider where the patient is and explore how the patient will do better the next time the problem occurs.

Thus, healing-up from drug abuse is ultimately seen as the patient’s duty, and the counsellor wishes to promote peer movements toward recovery. On the other hand, the psychologist can prevent gestures towarddrug abuse in a variety of ways, many of which are a guideline.

In general, including friends, relatives, and even good family in drug abuse treatment via family sessions may help with rehabilitation. Encouraging family participation can encourage the addict to build a more robust, and more competent support network. It can minimise the family’s positive or co-dependent behaviours, which can stymie the addict’s recovery; and it helps the counsellor of drug abuse victim to intervene in any troubling family situations that otherwise might lead to a rebound of drug abuse.