Phoenix Health Phase I Counseling Program

When MAT is organized in phases, patients and staff better understand that it is an outcome-oriented treatment approach comprising successive, integrated interventions, with each phase built on another and directly related to the patient’s individual progress.

Our model will consist of 6 phases: The acute phase, Rehabilitative phase, supportive care phase, medical maintenance phase, tapering phase, continuing care phase. Each phase built upon the previous to build a strong foundation for long term recovery.

 

 

Phase I (The Acute Phase) to include the induction of Buprenorphine

• The acute phase is the initial period, ranging from days to months, during which treatment focuses on eliminating use of illicit opioids and abuse of other psychoactive substances while lessening the intensity of the co-occurring disorders and medical, social, legal, family, and other problems associated with addiction. 

• During this phase it is important for the counselor to build a trusting relationship with the patient, let the patient feel as if we are concerned about ALL aspects of their lives and are here to help with any and all of the issues they face. We will do our best to facilitate additional services when needed.

• The following core topics should be addressed during the acute phase of treatment:

  • Alcohol and Drug use

    • Schedule weekly drug and ALCOHOL testing

    • Educate about the effects of alcohol and drug: discourage any use

    • Ensure compliance with scheduled appointments, ongoing dialog with staff

    • Intensify treatment when necessary ie. Additional counseling, group, meetings, one on one, family counseling, etc.

    • Meeting with program physician to ensure adequate dosage of treatment medications

  • Address Medical Concerns

    • Refer patients immediately to proper medical providers

    • Resolution of acute medical crises

  • Infectious Disease Concerns (HIV.AIDS, HEP-C, TB)

    • Vaccinate as appropriate

    • Refer to proper infectious disease clinic

  • Surgical Needs (Skin abscesses etc.)

    • If the needs looks immediate refer to emergency services for immediate debriment of abscess

    • Refer to proper surgical physicians

  •  Co-Occurring Disorders (Mental health)

    • Identify acute co-occurring disorders that may need immediate interventions, acute mental illness crises

  • Psychotic, Anxiety, Mood or personality Disorders, Severe Depression, Suicidal or Homicidal Ideations, Plans, Or Thoughts

    • Identify chronic disorders that may need ongoing (mental illness) therapy

    • May need Trauma Counselor

    • May need immediate psychiatric care depending on the severity of the disorders that are currently untreated 

  • Basic Living Concerns

    • Assess needs, for satisfaction of basic food, clothing, shelter, and safety needs

    • Whom is living in the household, other users example: spouse, siblings

  • Legal and financial concerns

    • Refer patients to appropriate services

    • Legal clinics, attorney referrals

  •   Threats to personal safety

    • Address any domestic violence concerns, living with violent or verbally abusive spouse/family members

    • Develop safety plan if the patient feels he/she is in a situation that may explode and become a crises

  • Inadequate Housing

    • Address the patients housing situation, living in home, apartment, camper, How many adults and children living under one roof

    • Is the patient currently homeless, or couch surfing/moving from one place to another with no permanent stability

    • Are the utilities on, running water, heat, AC, etc.

  • Lack of transportation

    • Does the patient have reliable transportation

    • Patient distance of travel, is there reasons why patient is traveling so far for treatment, are there closer treatment options

    • Is the patient familiar with transportation options? Ie. Medical transportation, bus routes and schedules, ride shares, etc.

  • Childcare needs

    • Identify childcare needs, babysitters, day cares, financial resources to help with childcare

  • Pregnancy

    • If pregnant refer to proper opiate addiction treatment center that specializes in neo natal opiate addiction

    • If not pregnant encourage sobriety prior to any pregnancy

  • Therapeutic relationship

    •  Establish trust, encouragement, empathy and willingness to guide the patient through the MAT program

    • Encourage hard work on the patients end

    • Advocate for the proper dosage with the doctor

    • Encourage regular attendance at counseling session and regular participation

    • Establish the feelings of support for the patient

    • Remain consistent, flexible, and available to minimize wait times (number one reason for loss of patients in MAT is wait times)

    • Positive interaction with treatment providers, office staff, urine collection, management, doctors, etc.

  • Addressing MYTHS about MAT

    • Dispel societal stigma’s

    • Provide treatment incentives and emphasize benefits of treatment

    • Focus on treatment goals

    • EDUCATE patients about MAT and Buprenorphine

    • Educate on the science of addiction and the science on Buprenorphine

    • Build support system

    • Build trust

  • Motivation and readiness for change

    • Commitment to treatment process

    • Encourage patients that they can be successful

    • Advocate for dosing changes if withdrawal/cravings are not subsiding

  • Ambivalent attitudes about substance abuse

    • Address ambivalence

    • Acknowledgement of addiction as a problem with ALL substances including marijuana and alcohol

  • Avoidance of Counseling (NON-COMPLIANCE)

    • First encourage and empower the patient

    • Encourage lifestyle changes to assure proper attendance at counseling

    • Discuss any barriers preventing client from attending, childcare, work, transportation

    • If no appropriate barriers exist, enforce program rules and regulations and lack of compliance will end in discharge

  • Negative relationship with staff members

    • Emphasize treatment benefits

    • Encourage open dialogue and addressing any misunderstandings

  • Negative attitude towards treatment and or consistent non-compliance with program rules and regulations and/or failure to cease using substances

    • Refer to higher level of treatment, inpatient/intensive outpatient