Assume You Are Working At An Agency With Both Inpatient And ✓ Solved

Assume You Are Working At An Agency With Both Inpatient And Outpatient

Assume you are working at an agency with both inpatient and outpatient services. Mary is a client of yours in inpatient, so you will be working with her one-on-one at least once a week during inpatient treatment. She will then transfer levels of care—from Level III to Level II.1—according to the American Society of Addiction Medicine (ASAM) criteria. At that point, you will also serve as her counselor in intensive outpatient treatment. Using your knowledge of clinical interventions, consider how to integrate specific counseling interventions—such as Cognitive Behavioral Therapy (CBT), Motivational Interviewing (MI), and Supportive Counseling (SC)—that target triggers into both inpatient and outpatient treatment settings. Her diagnoses include Alcohol Use Disorder, Opiate Use Disorder, and Generalized Anxiety Disorder (GAD).

Inpatient Interventions

During inpatient treatment, the primary focus is on stabilizing Mary's substance use and managing withdrawal symptoms, while addressing her underlying psychological issues. Cognitive Behavioral Therapy (CBT) plays a critical role in this setting by helping Mary recognize and challenge maladaptive thought patterns and behavioral triggers associated with her substance use and anxiety. For example, CBT can assist her in identifying specific triggers—such as emotional stressors or social situations—that precipitate cravings or relapse.

In the inpatient setting, MI is a valuable intervention to enhance Mary’s motivation for change and to resolve ambivalence about her substance use and anxiety management. Through empathetic, non-judgmental conversations, MI can motivate her to set personalized treatment goals and increase her readiness to engage in recovery strategies. This approach can be particularly effective when addressing her ambivalence about abstaining from substances or managing her anxiety without substances.

Supportive Counseling (SC) offers a therapeutic space for Mary to express her feelings and fears related to her diagnoses in a safe environment. SC can reinforce her strengths, provide emotional support, and foster resilience during the challenging early stages of recovery. In inpatient care, integrating SC enhances her sense of safety, helping her develop insight into her triggers and emotional responses.

Overall, inpatient interventions should aim at immediate stabilization, using CBT for trigger identification and response, MI for motivation enhancement, and supportive counseling for emotional support, tailored to her diagnoses of Alcohol Use Disorder, Opiate Use Disorder, and GAD.

Outpatient Interventions

As Mary transitions to outpatient care, the focus shifts toward maintaining abstinence, preventing relapse, and managing anxiety symptoms in her daily environment. CBT remains essential; it can be employed to develop coping skills for real-world triggers, such as interactions with family or exposure to stressors that previously led to substance use. Cognitive restructuring techniques can help her challenge and modify distorted thoughts related to her self-efficacy and anxiety triggers.

Motivational Interviewing continues to be a cornerstone in outpatient care, especially to sustain her motivation for abstinence and manage potential setbacks. MI sessions can help Mary explore her personal reasons for staying sober, address any emerging ambivalence, and reinforce her commitment to recovery goals.

Supportive Counseling, in the outpatient setting, offers ongoing emotional support, helping Mary navigate stressors and anxiety symptoms that may resurface outside of the structured inpatient environment. Through SC, she can process feelings of vulnerability or fear and develop adaptive emotional regulation strategies. This form of counseling also fosters a strong therapeutic alliance, promoting compliance with outpatient treatment plans.

In outpatient care, integrating CBT, MI, and SC enables tailored interventions targeting specific triggers—like social situations, emotional distress, or environmental cues—that could jeopardize her recovery. Combining these approaches supports sustained abstinence, relapse prevention, and effective management of her GAD symptoms.

References

• Center for Substance Abuse Treatment. (2005). Treatment Episode Data Set (TEDS): 2003. U.S. Department of Health and Human Services.
• American Society of Addiction Medicine (ASAM). (2013). The ASAM Criteria: Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions.
• Miller, W. R., & Rollnick, S. (2012). Motivational Interviewing: Helping People Change. Guilford Press.
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