A personal intervention substance abuse treatment approach: Substance abuse treatment in a least restrictive residential model

Abstract

The following paper will detail demographic information about alcohol and substance abuse issues in the acquired brain injury (ABI) population. Included in such a review will be a systematic presentation of the current data on the incidence of such issues as well as a comprehensive treatment model with outcome data provided. Pre- and post-test measures of separate functional outcome areas were employed to assess the effects of the treatment package. The paper will document the core elements of a substance abuse treatment programme that is based upon community inclusion and positive, proactive treatment methods in facilitating decreases in substance abuse behaviour. The programme employed a host of individual and group session protocols specifically targeted at education and self-monitoring of behaviour in order to facilitate more effective self-control of addictive behaviours. The positive outcomes achieved by the participants involved in the study provide clinical justification for a proactive behavioural approach to substance abuse in the ABI population.

Outcomes of post-acute rehabilitation for persons with brain injury

“…An observational prepost study design was used due to the obvious practical and ethical concerns of withholding or delaying treatment required for a randomized control design. In addition, in a previous study [28], repeated pre-treatment measures demonstrated a stable baseline across two assessment periods. Participants in the previous study demonstrated similar levels of severity, age, gender and time post-injury and there is no reason to assume a significant difference in the population between studies, As in previous studies [27,28] the FAOM was used to determine change from admission to discharge in areas of residential status, level of supervision, community integration, self-managed behaviours, level of awareness and vocational or productive activity.…”

“…A more recent study by McMorrow et al [27] outlined specific treatment components of pro-active behavioural treatment to promote rehabilitation gains and demonstrated durable outcomes in level of independence, community participation, behavioural self-management, level of awareness and vocational status at 1-year follow-up, as measured by the Functional Area Outcome Menu (FAOM) in a small groups design. Hensold et al [28] demonstrated significant treatment effects utilizing the same personal intervention approach to persons with significant substance and behavioural issues also using the FAOM outcome tool.…”

The prevalence of cognitive impairment in a rural in-patient substance misuse treatment programme

“…This finding has significant implications for the delivery of psycho-social drug and alcohol treatment as around half of the treatment population may experience difficulty understanding, remembering and applying information about drug and alcohol misuse to their own situation. Further, it is likely that this same group of people will experience barriers to participating in the daily routines of residential treatment and complying with directions from staff (Hensold et al, 2006;Mantell, 2010). It is not surprising that level of education and cognitive impairment are related.…”

“…These factors indicate that people with cognitive impairment are likely to experience difficulty engaging with and participating in substance misuse treatment that is predominantly based on cognitive and behavioural change activities. Further, some of the behaviours described as common features of cognitive impairment, such as poor self-monitoring and self-regulation and dependence/lack of initiative are seen in some treatment modalities to be causes and consequences of addiction thereby ascribing moralistic explanations to behaviours that may be due to an impairment (Goddard, 2003;Hensold et al, 2006).…”

“…Meyers & Smith, 1997;Wild, 2006). Cognitive impairment is one factor known to affect people's ability to participate in treatment because of the range of cognitive, behavioural and emotional problems such impairment can cause (Hensold, Guercio, Grubbs, Upton, & Faw, 2006).…”