Substance Use Disorders and Treatment Approaches

This assignment delves into the complexities of substance use disorders, examining their prevalence, impact, and effective treatment strategies. It highlights different therapeutic modalities, such as cognitive-behavioral therapy, motivational interviewing, and 12-step programs, emphasizing their applications in addressing various aspects of addiction. The assignment also discusses the importance of personalized treatment plans, considering individual needs, cultural backgrounds, and co-occurring mental health conditions.

1Running head: TREATMENT PLAN
Proposed Substance Abuse Treatment Plan
Name of student:
Name of university:
Author note:

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Table of Contents
Introduction................................................................................................................................3
Level and type of care................................................................................................................3
Referrals for related services......................................................................................................5
Ethical issue...............................................................................................................................7
Diversity issues..........................................................................................................................7
Aftercare and relapse prevention...............................................................................................8
Conclusion..................................................................................................................................9
References................................................................................................................................10

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Introduction
In psychology, a treatment plan for a patient is the comprehensive set of strategies and
tools that are effective in addressing the identifiable strengths of the client, and the deficits
and problems. It is the approach for determining activities and resources as per the needs of
the client for guiding progress and recovery. The present paper outlines a treatment plan the
patient in the case study named Sue. The plan highlights the services needed for complete
recovery of the patient. The paper considers level and type of care, referrals for related
services, ethical issues, diversity issues, and, aftercare and relapse prevention.
Level and type of care
Crisis and urgent care are aimed at providing care to patients suffering from different
issues such as substance abuse so that the specific crisis faced by the client is addressed. The
most common form of the crisis faced by individuals includes danger to self and medical
crisis. Through crisis care, a personalised stabilised plan is to be implemented so that
recovery is achieved for the client and chances of a future crisis situation is reduced. The
client is to be considered for content observation and assessment to gain maximum benefits
(McClure et al., 2015). In the present case, Sue faces the crisis of self-harm. While staying as
an inmate in jail, she had attempted suicide on one instance by stuffing her nose and throat
with clothing. A cellmate had noticed the condition and called the correctional officers, that
faced her. Since Sue struggles with suicidal thoughts, it would be suitable to implement
cognitive behavioural therapy (CBT) as part of the crisis care in accordance to her condition.
Research indicates that CBT, through cognitive restructuring, is effective in alleviating
depression, and this is highly relevant in this case as Sue suffers from stress and depression
owing to the poor quality of life she is leading. The underlying principle of the therapy is that
bringing changes in the way one thinks can be effective in bringing changes in how one feels

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(Vujanovic et al., 2017). By changing the thought process of Sue, the reduction can be
brought about in the suicidal tendency she exhibits.
Taking into consideration the multicomponent nature of the mental health and
physical health issues faced by Sue, it can be recommended that inpatient residential
treatment would be the appropriate level of care for her. Treatment is to be provided in
inpatient sessions that is more common for patients suffering from substance abuse disorder,
like Sue. Facilities having broader behavioural health focus would be ideal for Sue within the
hospital. Long-term residential treatment with the length of stay of six months would be
required since Sue has been suffering from substance abuse disorder for a ltime. The
interventiosn provided in the residential care would help Sue change her behaviour in a
highly structured setting (Berlin et al., 2014). Ethical issues governing inpatient care for Sue
are to be considered in the care approach. Issues such as informed consent, confidentiality of
patient and responsible caring are to be resolved throughout the care process (Passetti et al.,
2016).
The first step in defining the drug treatment plan for Sue would involve stopping her
from using the illicit substance. This process is termed as detoxification or stabilisation
(Galanter et al., 2014). During this process, the client can clear the thought process about the
use of drugs and focus on future treatment plans. The concept is that the client is helped to
recognise the adverse impacts of addiction and to subsequently eliminate drug use. A series
of interventions are to be given to Sue for managing her withdrawal symptoms and acute
intoxication. The process involves three steps- evaluation, stabilisation, and promoting entry
into drug treatment. The evaluation phase would determine the degree of psychological
condition faced by Sue. In the stabilisation process, medications are to be prescribed to Sue
for helping her quit addiction as she has a history of heavy drug use. Once she is stabilised,

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her recovery process can be initiated. The emphasis would then be on drug treatment plan of
the facility in an inpatient setting.
Agonist intervention would be the effective evidence-best option for the medical
treatment of Sue. In agonist therapy, the healthcare profession is to prescribe the patient
agonist drug that works by attaching themselves to the same receptors as the addicted
substance (Marsden et al., 2017). In the present case, the drug sued by Sue is cocaine. Such
therapy would help her in relieving painful withdrawal as well as continuous cravings. The
patient would, therefore, be allowed to focus on long-term therapy. One example of such a
drug is Amphetamine.
Referrals for related services
In addition to the treatment that has been outlined above, there is a necessity to
allocate resources and services that would be helpful in providing wraparound and
comprehensive services. Community-based service provider working with substance abuse
patients is to be contacted that promotes access to a continuum of quality substance abuse
prevention and recovery support services. The service would aim at implementing
contingency management that provides an incentive for reinforcing positive behaviour like
remaining absent from substance use. The service would also help with motivational
enhancement therapy that helps patients like Sue to enhance motivation and adhere to
particular plans for engaging in the recovery process. Counselling can be provided for
reduction of substance abuse and an increase of skill building. In this regard, it is to be
mentioned that individual counselling would be beneficial in contrast to group counselling
(Loizou & Stogiannidou, 2016).
Further, it would be advisable to refer Sue for Psychoeducation that aims to educate
individuals suffering from substance abuse disorders. According to Velasquez et al., (2015)

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psychoeducation can be used in conjunction with other approaches such as cognitive
behavioural therapy. It has been already mentioned in the present case that CBT would be
appropriate for Sue. The underlying principle of this effort would be to provide Sue with the
adequate knowledge required for better understanding of her condition. She would be thereby
enabled and empowered to cope up with her issues. For sue, the issues face are
multidimensional, including substance abuse, economic crisis, strangled relationship with
husband and prostitution. Psychoeducation would involve evidence-based research that can
address all of these mentioned aspects.
Medication treatment for substance use disorder is known as Medication-Assisted
Treatment (MAT) in which medication is used together with behavioural therapies and
counselling. Medication would reduce the symptoms associated with substance use
withdrawal. The commonly used medications that can be used for Sue are Buprenorphine and
Methadone. Therapy with these drugs reduces the effects of the substance used and helps in
reducing cravings (Brady et al., 2015). Further, Sue might be referred to a Neuropsychologist
who would be responsible for studying the psychological processes of the client and her
corresponding behaviour. The objective would be to understand how the thinking process in
the brain guides the actions of the client. Treatment approaches can be after that taken
accordingly. Lastly, a Psychiatrist is to be referred to so that Sue can be helped to cope up
with the emotional issues she is facing. As she faces an economic crisis and also unstable
social relationships, it would be necessary to provide her with emotional support and care.
Encouragement and motivation would be the driving factors for bringing her back into
normal life (Butcher et al. 2015).

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Ethical issue
A comprehensive set of guidelines governing the treatment of substance abuse
patients is to be followed for ensuring that ethical principles are abided by. For successful
treatment of Sue in an ethical manner, the ethical issues that are to be considered are
confidentiality, the duty of care, and respecting client self-determination (McDougall, 2015).
It is the obligation of the service user to disclose any information related to Sue’s mental and
physical health condition to any third party unless deemed necessary. If the confidentiality of
the patient’s information is not protected, the relationship between the patient and care giver
would get diminished, thereby negatively influencing patient care outcomes. There is a
necessity to create a trusting environment for achieving success in treating Sue. The duty of
care relates to the responsibility of abiding by the legal and professional obligations set in
place for treatment of substance abuse patients. Further, if there is a lack of motivation and
denial in due course of treatment, it would be unethical to terminate treatment. Further, there
is a need to respect the preferences of the patient and acknowledge her perspectives. All
discrepancies arising between the client’s viewpoint and that of the care giver are to be
handled tactfully nd best resolution is to be provided.
Diversity issues
Sue is an immigrant who came to the US from Haiti with her children after an
earthquake in her country. Though she can speak English, she is more fluent in Haitian
French. She has Catholic religious review. Coming to her educational status, she was the only
one in her family to complete high school though she had initially dropped out her school.
Race, gender and education level have been linked with psychosocial concerns relevant to
treatment of patients with substance abuse problem. As opined by Rowan et al. (2014) the
ethnic and cultural background of a client is of much significance in treatment of substance
abuse patients since the perceptions and believes of the patients have a remarkable impact on

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the clinical experience. Coping style, treatment setting, and social support related to
substance use disorders are influenced by the cultural background of the client.
In the present case, there is a need to understand the beliefs and perceptions of Sue in
relation to a treatment process that has resulted from the Catholic beliefs. Catholic Church
has been opposing substance abuse, and looking into history one would find that the different
Catholic organisations have taken part in outreach activities in this regard. It would be
therefore beneficial to influence Sue’s determination and motivation level to quit substance
use based on Catholic principles. In addition, the fact that Sue is an immigrant would also
serve as an influencing factor in her treatment. While delivering care to the patient, it would
be essential to be sensitive towards her vulnerability to suffer depression. The interrelation
between immigration and substance abuse, as linked with resettlement, adjustment and
acculturation are to be considered in the present situation (Lehman & Dixon 2016).
Aftercare and relapse prevention
Effective treatment for substance abuse needs ongoing support, and aftercare and
relapse prevention measures are to be taken to facilitate this process. The primary goal is to
enable drug discontinuation and promote long-term recovery (Bear et al., 2017). In the
context of substance abuse treatment, the term aftercare refers to the programs that follow
either out-patient treatment regime or residential care regime for supporting complete
rehabilitation. Relapse is the common result of drug addiction, and replace prevwntion
systems aim at diminishing chances of such responses to the treatment. In case of Sue, it
would be advantageous to provide aftercare through the structured form of sober living house
care. Such living settings provide a drug-free and safe environment for the patients to
embrace. The professionals would be able to identify the possible triggers and avoid high-risk
circumstances that can demoralise the patient into the use of drugs. Further, the patient would

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be helped with her coping skills required for ensuring long-term recovery. Relapse prevention
can be achieved by employing mindful strategies. These strategies, such as meditation, hold
immense potential to be effective in case of Sue since she has been suffering from stress, and
research highlights that such strategies are effective for stress reduction.
Conclusion
The case study of Sue presented a multidimensional view of the patient treatment
process in relation to substance abuse. Acknowledging the condition of the patient, the need
of delivering crisis and urgent care on an immediate basis is felt since she has a suicidal
tendency. It can be recommended that inpatient residential treatment would be the
appropriate level of care for her. Referral is to be done to the community-based service
provider as the next stage in the care process. Psychoeducation and medication treatment plan
are equally important in the care process for Sue. Core ethical and diversity issues are to be
considered throughout the care process. With an effective aftercare and relapse prevention
plan, it can be hoped that success would be achieved as desired patient outcomes would be
evident at the end.

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References
Bear, U. R., Beals, J., Novins, D. K., & Manson, S. M. (2017). Alcohol detoxification
completion, acceptance of referral to substance abuse treatment, and entry into
substance abuse treatment among Alaska Native people. Addictive behaviors, 65, 25-
32.
Berlin, L. J., Shanahan, M., & Appleyard Carmody, K. (2014). Promoting supportive
parenting in new mothers with substance‐use problems: A pilot randomized trial of
residential treatment plus an attachment‐based parenting program. Infant mental
health journal, 35(1), 81-85.
Brady, K. T., McCauley, J. L., & Back, S. E. (2015). Prescription opioid misuse, abuse, and
treatment in the United States: an update. American Journal of Psychiatry, 173(1), 18-
26.
Butcher, J. N., Hooley, J. M., & Mineka, S. M. (2015). Abnormal psychology. Pearson
Higher Ed, 66-89.
Galanter, M., Kleber, H. D., & Brady, K. (Eds.). (2014). The American Psychiatric
Publishing textbook of substance abuse treatment. American Psychiatric Pub, 17-41.
Lehman, A. F., & Dixon, L. (Eds.). (2016). Double jeopardy: Chronic mental illness and
substance use disorders. Routledge, 27-54.
Loizou, D., & Stogiannidou, A. (2016). Substance Abuse Prevention Among Greek
Emerging Adults: Evaluation of a Psycho-Educational Counselling
Intervention. European Journal of Counselling Psychology, 5(1), 18-42.

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Marsden, J., Stillwell, G., Hellier, J., Brown, A. M., Byford, S., Kelleher, M., ... &
Mitcheson, L. (2017). Effectiveness of adjunctive, personalised psychosocial
intervention for non-response to opioid agonist treatment: Study protocol for a
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McClure, J. R., Criqui, M. H., Macera, C. A., Ji, M., Nievergelt, C. M., & Zisook, S. (2015).
Prevalence of suicidal ideation and other suicide warning signs in veterans attending
an urgent care psychiatric clinic. Comprehensive psychiatry, 60, 149-155.
McDougall, W. (2015). An introduction to social psychology. Psychology Press, 115-137.
Passetti, L. L., Godley, M. D., & Kaminer, Y. (2016). Continuing care for adolescents in
treatment for substance use disorders. Child and Adolescent Psychiatric
Clinics, 25(4), 669-684.
Rowan, M., Poole, N., Shea, B., Gone, J. P., Mykota, D., Farag, M., ... & Dell, C. (2014).
Cultural interventions to treat addictions in Indigenous populations: findings from a
scoping study. Substance abuse treatment, prevention, and policy, 9(1), 34.
Velasquez, M. M., Crouch, C., Stephens, N. S., & DiClemente, C. C. (2015). Group
treatment for substance abuse: A stages-of-change therapy manual. Guilford
Publications, 134-178.
Vujanovic, A. A., Meyer, T. D., Heads, A. M., Stotts, A. L., Villarreal, Y. R., & Schmitz, J.
M. (2017). Cognitive-behavioral therapies for depression and substance use disorders:
an overview of traditional, third-wave, and transdiagnostic approaches. The American
journal of drug and alcohol abuse, 43(4), 402-415.