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Opioid treatment programs often face unprecedented challenges that require good clinical practice. This is increasingly tied to the need for sophisticated, comprehensive, efficient program operations. Opioid treatment programs with top notch clinical treatment teams can struggle and even fail if staff members are not well trained in the specifics of opioid treatment and/or the organization is not well managed. This training establishes the foundation for opioid treatment clinicians. It provides information on an overview of the opioid treatment system and assists participants in the process of strategic planning.
In the early 1970's Congress recognized that the stigma associated with substance abuse and fear of prosecution deterred people from entering treatment and enacted legislation that gave patients a right to confidentiality. For the three decades since the Federal Confidentiality Regulations (42 CFR Part 2) were issued, confidentiality has been a cornerstone practice for substance abuse treatment programs across the country. This training is designed to explore the why's of confidentiality in substance abuse treatment and is a must for all substance abuse treatment programs' employees.
As we continue our progression towards providing holistic treatment for
those we serve, it is important to keep in mind why it is essential to have
culturally competent service providers at all substance abuse treatment programs.
Culturally competent service providers are aware and respectful of the importance
of the values, beliefs, traditions and customs of the people they serve.
They are also aware of the impact of their own culture on the therapeutic
relationship and take all these factors into account, when planning and developing
services. This training is designed to give each participant an opportunity
to examine their own culture (the box they live in) and to also provide an
enjoyable and insightful experience filled with knowledge about people of
various cultures seeking services at our treatment centers.
Professional & Ethical Responsibilities
Simply stated, ethics refers to standards of behavior that tell us how substance abuse providers ought to act in specific situations. Being ethically appropriate while serving patients has never been as important as it is today. Patients are more sophisticated and are aware of their rights and what is to be expected from treatment providers. This along is usually enough to have clinicians think twice about the behavior they display and how their behavior can profoundly affect their professional career. This training is designed to support clinicians in understanding that any behavior other than a professional behavior may have a negative effect on the therapeutic relationship and the lives of those they serve.
Opioids have been used for thousands of years, and it has long been known that many people who have become dependent on opioids have extreme difficulty permanently ending their use of them. Suffering though the withdrawal is only part of the problem. The real difficulty has always been staying off the drugs once the period of withdrawal is over. Relapse often has nothing to do with lack of willpower or other personality problems. Instead, it appears that people with a long history of opioid problems have experienced changes to the part of their brains that allows a person to feel and function normally. Because of this, treatment for opioid dependency requires a distinctly different approach than mainstream substance abuse treatment. This training will explore the history of opioid dependency, its effect on the brain and required treatment.
The choice of medication used in opioid treatment is based on safety and efficacy, patient preferences and treatment goals. The use of methadone has the longest successful track record in patients addicted to opioids for more than a year and has been shown to control withdrawal symptoms, stabilize physiologic processes, and improve functionality. Treatment with methadone also reduces criminality and noncompliance with HIV/AIDS therapy. This training will provide participants with specific knowledge regarding the effect of opioid dependency and the pharmacology of specific medications used during treatment.
Infectious pathologies are usually qualified as contagious diseases (also called communicable diseases) due to their potentiality of transmission from one person or species to another. Transmission of an infectious disease may occur through one or more of diverse pathways including physical contact with infected individuals. These infecting agents may also be transmitted through liquids, food, body fluids, contaminated objects, airborne inhalation, or through vector-borne spread. This much needed training will provided participants with detailed information about various infectious diseases - prevention strategies and treatments.
Counselors who treat people with substance use disorders do life-changing work on a daily bases. To be successful with this effort, a number of skills and a vast amount of knowledge are necessary. Counselors must be able to identify a variety of helping strategies that can be tailored to meet the needs of each individual patient. Evaluation instruments and interview techniques will be introduced during this training and participants will learn to develop and evaluate patient treatment planning and assessment histories. This evidenced-based training addresses the practical application of major counseling techniques utilized in the field and communication skills necessary to engage the opioid dependent patient from the basic screening process through discharge planning.
The initial screening is the first opportunity for treatment providers to establish an effective therapeutic alliance among staff members, patients, and patients' families. Careful planning for and interaction with new applicants and their families contribute to positive opioid treatment outcomes. This competency-based training will provide participants with the level of knowledge necessary of an effective screening and intake process.
A thorough and comprehensive orientation process is one of the fundamental keys to retaining patients in treatment. This process establishes the foundation for patients and family members to become knowledgeable about rights and responsibilities, grievance and appeal procedures, ways in which input is given, organization rules and financial obligations. During this training, participants will become familiar with the 45 components of an effective orientation, hence optimizing the orientation process for persons served.
Clinical assessment can be defined as an in-depth gathering of data and information, typically conducted at the initiation of treatment, needed to understand an individual's or family's needs as a pre-requisite for developing a plan of care. The interpretive summary involves the integration of data and draws upon the provider's insight and interpretation. This competency-based training is designed to assist clinicians in establishing an effective approach to gathering sufficient culturally appropriate data and weaving that data into understanding.
An individualized treatment plan has been compared to a road map that displays
the path or direction of the journey for each patient receiving opioid treatment.
Therefore, the goal of opioid treatment services can be considered the destination
consistent with their vision of recovery. However, all too often, the journey
is initiated without a clear destination or route. The reason for this may
be that this journey is not always a simple task to orchestrate and/or counselors
are not consistently trained in effective treatment planning. This competency-based
training is designed to assist substance abuse counselors in creating anew
for each patient based upon his/her unique strengths, needs, abilities and
preferences.
Not keeping records is now grounds for malpractice claims. Having no records is both illegal and unprofessional, and is considered a demonstration of poor care. An inadequate record will be seen as evidence of sub-standard care, regardless of the care that was actually provided. This competency- based training is designed to support clinicians in developing a foundation for ethical, legal and professional documentation.
To be considered a professional substance abuse counselor, an individual must have a knowledge base of various counseling theoretical approaches that are evidenced-based and used in substance abuse treatment. Most regulatory reviewers and accrediting bodies also require an explanation of the theoretical approach used during patient treatment. A strong knowledge base of a variety of theoretical approaches often serves as the antidote for successful opioid treatment. This competency-based training will support counselors in learning about or building their knowledge based regarding the various theoretical approaches used in substance abuse treatment.
If you stop and think about it, each of us has been raised in group environments, either through our families, schools, organized activities, or work. These are the environments in which we grow and develop as human beings. Participating in group work is no different. It provides a place where patients come together to share problems or concerns, to better understand their own situation, and to learn from and with each other. Group work can help your patients make significant changes so that they feel better about the quality of their lives. This competency-based training will take you on a journey of discovery about an array of approaches that can be utilized for group work.
Opioid dependent women experience significant barriers to accessing and remaining in treatment. They are also believed to be underrepresented in opioid treatment settings. Because of cultural taboos and stigma, their addiction problems are often not acknowledged by themselves or their families. Pregnant and parenting women addicted to opioids face particular societal condemnations. Engaging and retaining women in opioid treatment requires collaboration between treatment programs and other social agencies. Appropriate interventions can reduce substance use and improve outcome for opioid dependent women. This training will equip treatment providers with the tools necessary to effectively serve their women population.
Though it cannot be said that substance abuse cause domestic violence, the fact remains that substance abuse treatment programs serve substantial numbers of batterers and victims among their patient population and increasingly are compelled to deal with issues related to abuse (Flanzer, 1993). This training will provide the knowledge necessary for counselor to effectively serve this population.
In maintaining a family systems perspective on chemical dependency, it is important to consider how family members communicate and interact with one another in their relationships and how this interaction has been impacted by the active use of chemicals in the home. "A healthy family system functions out of love, care and concern for its members in a manner which creates and maintains order through consistent behavior. Members seek balance when that order is upset by crisis by means of flexible problem solving and decision making skills (Wilson, 1996). This system breaks down when chemical substances are introduced or used by a family. This training will allow participants to experience, through exercises and processes the impact of opioid dependency on family members. Participants will also become skilled in recognizing the various roles family members play in the life of the addicted person.
Opioid treatment programs (OTPs) serve both patients and the community, and affect public health, education and citizen sense of wellbeing. Hence, quality opioid treatment requires good community relations. Prior to the transition in Federal oversight of substance abuse treatment from the U.S. Food and Drug Administration (FDA) to SAMHSA guidelines for opioid treatment programs did not mandate efforts to improve community relations or educate the community. This change in oversight has brought opioid treatment programs into the medical mainstream and has codified SAMHSA's guidelines for OTP accreditation, which recognizes community relations, education and stigma reduction as necessary operational elements. This training will teach participants how to develop a community relations and education plan that extends from its general mission statement and provide tips on how to involve staff and patients.
Effective opioid treatment clinical supervisors are skilled, experienced clinicians. They are knowledgeable about opioid and other chemical dependencies, as well as the various substance used disorders. Their knowledge based also includes research-based assessment, intervention, treatment, and recovery strategies. The specific tasks, responsibilities, and roles of supervisors vary depending on agency mission and general structure. However, some basic competencies are common to a variety of settings and professional disciplines. Clinical supervisors in opioid treatment settings are expected to be familiar with knowledge in the following areas:
The National Opioid Treatment Clinicians Association (NOTCA) was established
in 1999 by the Georgia Methadone Providers Coalition (GMPC) to review and
authenticate clinical competency, by a credentialing process, for opioid
treatment counselors, supervisors and nurses. October 2007, NOTCA was established
as an independent non-profit organization.
