due tomorrow

Treatment Plan

Claudia Rangel

University of Phoenix

CCMH/551 – Individual Counseling

December 1, 2015

Mrs. Felicia Martin

Treatment Plan

A treatment plan basically refers to the actual road map that shall be used by the patient in all through their treatment journey. A good treatment plan should be able to follow the individual patient inevitably for the next 5 years in which the relapse rates will be able to drop to around zero. A treatment plan is built primarily around the problems that the patient is currently going through. The patients, who undergo a cocaine use disorder such as Selena in this particular scenario, do not in any way require treatment in an inpatient setting. This is majorly because withdrawal syndromes are not essentially medically complex. There are several studies that exist that have indicated that most of the patients can indeed, be effectively treated for the cocaine abuse in an intensive outpatient program.

Problem Selection and Assessment

The major problems in this scenario are majorly two. The first problem is that of isolation and consequent depression. We are able to see that Selena comes from a broken family which she has no contact with and in addition to this she does not have any real friends. This can also be deduced from the fact that she is 31 years old and has been divorced twice with no children. Another problem that she faces is that of cocaine usage. This can be seen based on the fact that she attempted group therapy and is currently trying to limit their consumption of the drug.

Goals of the treatment

Some of the goals in this scenario will involve: motivating the patient to change, assessing the patient’s overall safety and clinical status and establishing and also maintaining a much needed therapeutic alliance with the patient. Another goal would be to be able to manage the patient’s intoxication and also withdrawal states and consequentially developing a system for the patient’s adherence to the specific treatment plan. Additionally, another objective of the entire program is seeking to prevent the relapse of the patient while educating the patient about the importance of abstinence and the dangers of substance abuse. Another objective is to reduce the morbidity and the sequelae of the substance use disorders.

Intervention

In the treatment of the acute cocaine intoxication, there has been the subject of quite a lot of systemic investigation. Generally speaking there does not exist any one specific antidote for cocaine treatment. In fact, cocaine treatment is quite typically supportive and furthermore, it is aimed at treating the symptoms such as delusions or autonomic hyperactivity. Cocaine intoxication in addition can serve to produce, hypertension, vasospasm, myocardial infraction, seizures, cardiac arrhythmias amongst others(Zweig & Leahy, 2012). Although these beta blocker labetalol have been cited as being the most helpful, in reducing this cocaine toxicity, the animal studies and some clinical experience has served to suggest that the use of factors such as adrenergic blockers and dopaminergic antagonists should be in a state of careful monitoring while attempting to treat acute cocaine intoxication. This indeed could prove to be quite important in achieving the goal of managing Selena’s intoxication.

On the aspect of medication, for many of the patients, the pharmacological treatment is not quite ordinarily indicated as the initial resolution to the treatment of cocaine dependence. This is basically due to the fact that currently, there has been no medication that has been found to possess the requisite clear cut efficiency in relation to this aspect. However, it is important to note that in a large number of studies; it has been shown that there exists a large amount of promising results in relation to the pharmacotherapy agents and the patients who have a more severe form of cocaine dependence. In addition to this, it has proved to be quite effective especially for the patients who have not been responding effectively to the psychosocial treatment that they have been subjected too (Leahy & Holland, 2000). This essentially will be in line with the goal of preventing a relapse to the patient.

Studies on drugs such as desipramine, have been able to bring forth rather inconsistent results. Some studies have revealed that there is a benefit of the medication, while I sharp contrast, other studies has been able to reveal that there has been no response on the patients. An additional study has also been undertaken, comparing desiprmaine, with placebo and ended up showing improvement with desiprimine inthe short term (i.e. 6 weeks) but not a 12 weeks or a 12 month period(Leahy & Holland, 2000).

Psychological treatment

For the treatment of cocaine dependence, the use of Cognitive-behavioral therapies (CBT) can prove to be quite indispensable in offering a wider range of greater therapeutic benefits than the much lesser intensive approaches that have been evaluated in several control conditions. It has proven to be just as effective as the manual- guided disease model approaches and can thus be associated with the further decreases in the cocaine use even after the subjects end up leaving the treatment. In addition to this, the CBT seems to be having a particularly positive effect as compared with the other more severe cocaine users and/or those who possess a comorbid disorder.

Although the use of self-help groups have not been proven to be the best alternative to professional treatment, a greater participation in AA, Cocaine Anonymous, or any other 12 step self-help group has been able to predict less cocaine usage, at a much more subsequent follow up point. This will be serve in attaining the goal of motivating Selena to change and leave the use of cocaine.

These manual guided and professionally delivered treatments are essentially based on 12 step principles and the patients treated using such approaches are greatly encouraged to seek to attend the AA or Cocaine Anonymous meetings and consequently become involved in the traditional fellowship activities that take place. Moreover, they also maintain journals of their self-help group attendance and consequent participation. These therapies which include TSF and individual drug counseling have been able to demonstrate the efficacy that is involved in the treatment of the cocaine use disorders (Zweig & Leahy, 2012).

The effectiveness that is associated with the 12 step oriented individual drug counselling was demonstrated in the NIDA Collaborative Cocaine Treatment Study. In this study it was demonstrated that cocaine use was significantly reduced in relation to the baseline after a rather intensive treatment program with the use of group drug counselling, cognitive therapy and group drug counselling. The greatest reductions in cocaine use in this study were eventually noted to be with the 12 step oriented standard group counselling which also seems to be comparable in terms of efficacy to the relapse prevention aftercare (Zweig & Leahy, 2012).

Justification

The stipulated treatment will prove to be quite an effective instrument in combating this vice of cocaine addiction. The strategies and goals will be able to counter the various challenges that Selena is undergoing which drive her to cocaine use. In addition the 12 step group sessions will aid to make the group therapy sessions more effective for her and will also aid her to gain new friends and associates which will enable her to get rid of her current friends who do drugs. Due to the fact that she is a bit isolated and depressed, these newly formed friendships in these group therapy meetings, will give her a new found strength that she is not undergoing the problem alone. The use of medication will prove helpful in reducing her cravings for the drug, especially in the 12 step group therapy meetings.

References

Leahy, R., & Holland, S. (2000). Treatment plans and interventions for depression and anxiety disorders. New York: Guilford.

Zweig, R., & Leahy, R. (2012). Treatment plans and interventions for bulimia and binge-eating disorder. New York: Guilford Press.