Documente Academic
Documente Profesional
Documente Cultură
Development of Program
Two and one-half years ago when I began work at one of Harlem
Valley's Day Treatment programs I set out to answer the latter
question. Through working with the patients themselves and by
implementing a program within an existing psychiatric setting I
began to find answers to that question. The answers that were
discovered proved worthy of comprising a comprehensive
treatment and proved to be applicable across separate treatment
sites and multiple program formats. The first group, which began
in December 1984, grew to eleven groups across six treatment
sites, and includes clinics, day treatment, continuing treatment and
residential program settings. Programs had to take place in our
own treatment sites and utilize existing staff, without additional
funds or special staffing. This led to the development of a
treatment and group leadership approach that did not require
extensive training in the area of substance abuse and alcoholism.
Few mental health professionals would argue with the fact that
heavy confrontation, intense emotional jolting, and discouragement
of the use of medication are detrimental approaches to the
treatment of a chronically mentally ill person. Yet efforts to treat
these patients have consisted mainly, of referring them to agencies
that treat primary substance abusers who do not have a chronic
disorder, where in many cases the above treatment methods and
strategies are employed. It is no wonder that there is a great deal of
resistance from these patients to following through with these
referrals, as well as refusal by these agencies to take responsibility
for an ongoing psychiatric disorder.
Overview of Program
A brief alcohol and drug screening tool is presently in use for all
intakes at Harlem Valley. The questions include clinical intuition
as well as historical information, so that the patient in the denial
phase of his or her problem does not have the problem go unnoted.
Where positive signs of substance use problems are identified,
liaisons at the facility are notified of this, so that they may follow
the case until a decision is made about referring the patient to the
substance use treatment group. If a patient is referred he or she is
interviewed by the group leader(s). This interview is really the
beginning of the treatment process and is a method of establishing
a purpose for the patient's participation in the group, be it to view
educational materials or to work on an acknowledged problem.
The interview focuses on the patient's potential contribution to the
group as well as what is expected of a participant.
Administrative Support