Approximately 42 percent of our clients with a mental health diagnosis have a co-occurring substance use disorder. Recovery from either a mental illness or a substance use disorder can be difficult to achieve, but for those who may be dealing with co-occurring diagnoses, Recovery can be a bit more challenging. Further, it may take time to determine which came first. A client may present with significant mental health issues, but after building trust and working with the client, staff might learn that a substance use disorder exacerbated the mental health issue. Because mental illness and substance use affect each other, identifying and addressing each is critical to recovery.
The recent American Society of Addiction Medicine (ASAM) training provided opportunities for attendees to learn about the ASAM criteria and how to use them to better support clients in reaching recovery.
Just as there is no “one size fits all” shirt, there is no 30-day, 90-day, 180-day, etc. program that fits the needs of all people in recovery The ASAM recognizes this fact and emphasizes the idea that Recovery is a process that is individual rather than program driven.
The ASAM model uses the individual’s treatment plan to guide treatment vs. the program dictating treatment. Through the Treatment Plan, services are driven by the need of the client, his or her strengths, any collaborative services, outside referrals, intensity or level of treatment along with goals and objectives. The needs of each client drive the treatment and not the availability or duration of the program. We know that programs are not “one size fits all” but provide a general number of groups and individual encounters. The clinician and client work as partners in identifying the goals and objectives for the client.
The treatment plan is the tool for both the client and clinician. The client is the expert on personal needs, strengths, goals and objectives. The clinician provides support and education on how each service in the treatment plan directly correlates to the goals of the client. The clinician determines the progress made by the client and this is noted in Progress Notes. When the individual has met the agreed upon goals and objectives, successful completion and termination of services is indicated. So the really distinctive feature of the ASAM is that services are completed when goals and objectives are met rather than the client has completed a particular number of services. Recovery is not “doing time”, it is a journey whereby the clinician acts as the guide, helping coach the client toward achieving his/her own goals and objectives. This approach makes the recovery journey more collaborative and beneficial for the client.
By Carol Shertzer, ACSW