Utilization of the Brief Key Treatment Model to the Treatment of Medication Enslavement.


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Section 1: The Place
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Worldwide Congress of Brief, Strategic & Systemic Therapists San Diego, CA – September 12 & 13, 2008 Application of the Brief Strategic Therapy Model to the Treatment of Drug Addiction Christian Moretto, LMSW, MBST Family Therapist, ASAS/WMMG Director of Strategic Therapy & Interventions of NY http://www.strategic-therapyandinterventions.com

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Part 1: The Place & The Study Outpatient Alcohol and Substance Abuse Services outpatient treatment office 1 Supervisor, 1 Intake Coordinator, 1 Psychiatrist, 1 Vocational Specialist, 1 Buprenorphine Treatment Specialist, 3 Addiction Specialists (CASAC - Certified Alcohol and Substance Abuse Counselor) 1 Family Therapist.

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Part 1: The Place & The Study All the clinical mediations have been made after the Brief Strategic Therapy model and conventions created by Giorgio Nardone in Arezzo – Italy. The Study: A preview of vital mediations done on patients giving unending medication misuse and reliance and all related issue and life issues. 74 patients (40 guys and 34 females) with 6 dropouts . Unending clients (by and large over 10 years) From October 2005 to July 2008 Not a controlled study : 30 patients are still in treatment and 44 have been released throughout the years.

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Part 1: The Place & The Study "Life" Problems at Intake

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Part 1: The Place & The Study Mental Health Cluster

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Part 1: The Place & The Study Mental Health Cluster Patients were dealt with in a joint effort with the unit Psychiatrist keeping in mind the end goal to: Stabilize solution regimen. Allude patients to outpatient emotional wellness program. If there should be an occurrence of referral to Outpatient Mental Health Program: Patient gave poor adherence to outside system. Programs demonstrated poor enthusiasm for managing these patients. More often than not, patients finished being dealt with by Psychiatrist and family specialist.

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Part 1: The Place & The Study Substances Abused at admission

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Part 1: The Place & The Study Substances Abused The 3 fundamental zones of reliance and misuse are: liquor, cocaine, and benzodiazepine (Xanax, klonopin, valium, and so forth… ). Numerous methadone centers in NYC are not tolerating patients who are treated with benzodiazepine prescription for a co-happening psychological well-being confusion. Coordinated effort with therapists and doctors (when conceivable and permitted by patient) is of essential significance.

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Part 1: The Place & The Study Profile of a normal patient

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Part 1: The Place & The Study Profile of an Average Patient These information demonstrate the trees yet not the timberland: Poor association with themselves, others and the world, Poor relational abilities, Poor educational encounters and capacity to impart outside of the medication culture ("the road").

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Part 2: The Results Criteria an "Existence" Problems: The 10 bunches: Family, couple, sexual, lodging, salary, work/instruction, legitimate, ACS, Health, Mental Health. Real Improvement: >60% of "life" issues are tackled Among the issues saw at admission or amid treatment more than 60% are understood or close of being settled (patient in preparing, family reunification pending a booked move to a flat, quiet acknowledged in a lodging program contingent upon accessibility, and so on… ). Incomplete Improvement: 60%>Problems solved>30% Among the issues saw at admission or amid treatment more than 30% yet under 60% are comprehended. Treatment Failure or No Significant Improvement: Problems solved<30% Among the issues saw at admission or amid treatment under 30% are illuminated or in procedure of being understood.

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Part 2: The Results Treatment of "Life" Problems: Basic results

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Part 2: The Results Treatment of "Life" Problems: Basic results During treatment, 75% of the patients have encountered a Major or a Partial Improvement of their "life" issues (the10 bunches)

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Part 2: The Results Criteria b-Drug habit Major Improvement: Drug utilization is diminished by >60% Using the patients\' utilization report at admission or toxicology screens before admission to ASAS (benchmark), there is no utilization of medications or utilization is decreased by more than 60% in a time of 3 back to back months as appeared by week by week toxicology screens and patient reports. Fractional Improvement: Drug utilization is diminished by more than 30% yet under 60% Consumption amid treatment is lessened by more than 30% however under 60% on 3 back to back months as appeared by week by week toxicology screens and patient reports. Drug Treatment disappointment or No Significant Improvement: Drug utilization is lessened by under 30% Consumption amid treatment is diminished by under 30% in 3 sequential months as appeared by week by week toxicology screens and patient reports.

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Part 2: The Results Drug Treatment: Basic results

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Part 2: The Results Drug Treatment: Basic results There is no equalization in medication enslavement treatment: it\'s all great or all terrible. These patients have Manichean practices and treatment results are additionally Manichean. 66% of the patients encountered a noteworthy or an incomplete change with respect to their utilization of medications.

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Part 2: The Results Combination of treatment results on "Life" Problems and Drug Consumption

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Part 2: The Results Combination of the treatment results on "Life" Problems and Drug Consumption A natural and evidently clear result begins to rise: 1-there is no "life" change with medication utilization ; or 2-t here is no adjustment in medication utilization without "life" change". Which one starts things out? Lets investigate in more detail the 2 extremes of this diagram: 1-Patients with significant upgrades in both their "life" issues and their medication utilization. 2-Patients with no critical changes in both territories.

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Part 2: The Results Among the 54% with effective Drug treatment (N=37)

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Part 2: The Results Among the 54% fruitful Drug treatment (N=37) Total Abstinence If patients could keep up an equalization utilization of medications they would not have encountered the need to come to treatment. As Saint Thomas Aquinas composed "Complete forbearance is less demanding than immaculate balance". Long winded Consumption The rate of change of "life" issues is just a large portion of that of the individuals who are totally abstinent. Notwithstanding devouring medications in a verbose and direct way has a noteworthy negative effect on life (for these patients who are unending clients).

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Part 2: The Results Among the 34% having No Significant Improvement in Drug Consumption (N=23)

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Part 2: The Results Among the 34% having a No Significant Improvement in Drug Consumption (N=23) The effect of medication utilization on life is the same for the two populaces (negligible change and no adjustment in medication utilization). All in all, medication addicts treated in this project (perpetual clients) are unequipped for balance They are the champions of playing at the teeter-totter (endless loop) frantically by : getting away life issues through medications; and intensifying their life issues by utilizing drugs which will lead them to significantly more steady or critical medication utilization.

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Part 2: The Results Conclusions: The two limits of the range are working in a dissymmetrical route: At the start of treatment If one is just lessening his medication utilization a tiny bit, one won\'t encounter critical changes throughout his life when contrasted with one who is utilizing drugs obviously. To make preparations of progress in these patients (endless clients) a huge exertion should be made toward the start of the treatment. Towards restraint: Even on the off chance that one is expending drugs sporadically, one won\'t encountering the full consequences forever change. All out restraint is key for this populace ( they are not equipped for balance )

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Part 2: The Results Why drug dependence treatment is so troublesome and selfish jerk to treat ? Most extreme endeavors are required at the beginnings but is not promptly compensating, These endeavors should be sought after until complete forbearance is acquired so as to experience full life change. In the event that the endeavors are not sought after until the end, odds of returning to the beginning stage are not immaterial. What starts things out? "life" issues or medication enslavement? This inquiry is unimportant as: they meet up and fill each other at one purpose of the voyage, them two are to be tended to amid treatment in a sort of sound and adjust teeter-totter amusement , and taking after an individual perception: patients have no issue when they are utilizing drugs, amid that minute everything is OK, it\'s the point at which they return to life that issues resume… Therefore, it would be a mix-up treating one and only perspective (medication) at once.

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Part 3: Perceptive Reactive System & Attempted Solutions Life\'s Basic guideline: keep a smooth equalization

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Part 3: Perceptive Reactive System & Attempted Solutions What are the issues by and large exhibited by patients? 1-Others: accomplice, relatives, the children, the specialists, post trial agents, police, society… and 2-The world, the way it ought to give: them immediate and easy rewards and products. They are living in Utopia. 3-Themselves: The way they ought to be. In light of my clinical experience, the issues are : utilization of medications, the 10 bunches in the "life" Problems zone, absence of relational abilities and capacity to identify with others and the world in an adaptable, common and key route, powerlessness to postpone compensates and to search for results, absence of critical thinking aptitudes, their dreams on self, others and the world,

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Part 3: Perceptive Reactive System & Attempted Solutions Perceptive-Reactive S

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