Services
1
Definitions of Services
Indirect Services:
The indirect service components of the BOAF Outpatient Clinic consist of such functions as community education, community information, consultation (including program and treatment consultation), training, community development, and referral services.
Direct Services:
The direct service components of the BOAF Outpatient Clinic will include but are not limited to initial psychosocial evaluation, medical services, individual counseling, group therapy, psychiatric services, family treatment, referral for services, and urine screens are chemicals.
Intake Evaluation:
An intake assessment identifies and details the nature and extent of the client’s condition and is essential for the development of an individualized treatment plan.
This service generally includes a psychosocial evaluation, medical history, family history, and alcohol and drug abuse history.
Clinical therapists/counselors are involved in this process along with the medical staff, who writes specific orders for treatment services.
Urine screens are taken also.
Medical Evaluation:
A client interview with the Attending Physician, which include a physical examination, review of health history, and any lab work ordered by the physician.
Individual Counseling:
Sessions with client are conducted by one or more of the following: AODA Counselors, Clinical Therapist, or Psychiatrist, and may include supportive, relationship, insight, Reality therapies, confrontation, values clarification, Gestalt techniques, anger management, etc.
Couples Therapy:
Sessions with client and intimate partner are conducted by one or more of the staff previously listed and includes both married and unmarried partners, however, couples therapy excludes significant family members, children, or siblings.
Family Treatment:
Treatment is applied to the family (all or significant members are considered recipients) as a unit. Family sessions are conducted by one or more of the staff previously listed.
Group Therapy:
Treatment involves the use of group dynamics and interaction that includes group psychotherapy, play therapy, psychodrama, Gestalt, family therapy, group orientation, or group education. Sessions are conducted by one or more of the staff previously listed and not exceed fifteen (15) clients per group and two (2) facilitators.
Psychiatric Evaluation:
The psycho diagnostic process includes a medical history (where appropriate and warranted) and a mental status exam, which notes the attitudes, behavior, estimate of intellectual functioning, memory, orientation, and inventory of the client’s assets in a descriptive and interpretive narrative with impressions and recommendations.
The interview will be conducted and report written by the Medical Director, or through referral by the Medical Director.
Psychiatric Consultation:
The psycho diagnostic consultation focuses on one aspect of a client’s functioning and includes a short note in the client’s chart discussing the psychiatrist’s impressions. This consultation will be conducted by the Medical Director.
Medication Management:
This is a monthly check-up by either the Attending Physician or Medical Director to monitor any clients receiving medication while in outpatient and/or day treatment services at the Clinic.
Medical Consultation:
This is a medical check-up requested by either a client or the primary counselor for a medical review by the Attending Physician.
Crisis Intervention:
This consists of emergency treatment services on an individual, marital, or family basis to help stabilize the client(s) and provide immediate support. The process is considered to be of short duration and have a narrow and immediate focus.
Referral:
In the event that a client requires inpatient care for either AODA (Alcohol and Other Drug Abuse) or psychiatric problems, referrals will be made to either Aurora Medical Center, Kenosha WI., or St. Mary’s Medical Center, Racine WI. For clients that require psychiatric or psychological services on an inpatient basis, the Medical Director will arrange referrals to Sinai Samaritan, St. Michael’s, or the Milwaukee County Mental Health Center, which also provide day hospitalization services.
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Programs/Goals/Objectives
Adult Treatment Program
Purpose:
To provide flexible individualized outpatient treatment that is an intensive, supportive, and confrontive interpersonal experience through the delivery of specialized individual and group therapy to the adult and adolescent alcohol and drug dependent client.
To assist the client in maintaining freedom from alcohol and other drugs while establishing an abstinent, functional, and productive lifestyle.
To provide referral to the appropriate treatment provider if it becomes apparent in the estimation of the clinical team that the client can not attain stated goals through the programs offered.
Goals and Objectives:
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To support a personal commitment to be alcohol and drug free,
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To encourage and motivate clients to take charge of their own lives and maintain an alcohol and drug free lifestyle,
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To provide positive social and community involvement and experiences that enable participation in all aspects of life without alcohol or other drugs,
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To encourage involvement with AA/NA/CA and self-help groups. To have Faith-based program speaker engagements in local schools.
These goals are met through the provision of weekly individual, group, couples, and/or family sessions as determined by the therapist and client.
In addition, random urine screens may be performed to encourage the resolve of the client in remaining free of alcohol and other drugs.
Primary Treatment Program:
The Primary Treatment Program will consist of two stages:
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Stage 1, group therapy two times per week, 2 ½ hours per group for six weeks. Of the 30 hours in Stage 1, 12 hours will be education and 18 hours will be group therapy.
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Stage 2, group therapy one time per week, 1 ½ hours per group for 12 weeks.
The Program can be individualized in the following ways. Upon assessment, the client could be placed in any part of the programming.
For example, a client who had already received the educational portion could come to the Stage 1 group therapy only or Stage 2 depending on the individualized need for support. A client who needs more intensive services and support could be involved in weekly individual sessions as well as group. Clients may be discharged after completing either stage of the program, if the primary therapist was of the opinion of the client was not dependent or had received maximum benefits.
The educational portion will consist of twelve topics, eight core and four discretional.
The eight mandatory topics are:
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Disease concept
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AA/NA/CA and the 12 Steps
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Progress nature of alcohol and drug abuse/dependence
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Relapse
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Family dysfunction
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Pharmacology
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Grief work
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Feelings and defenses
The other optional topics include relationships, wellness, shame, guilt and addiction, and spirituality.
The core and optional curriculum is based upon Terence Gorski’s work as stated in “Passages Through Recovery” and “Staying Sober”.
Continuing Treatment Services:
Upon discharge from primary outpatient treatment, clients may be referred for Continuing Treatment by the clinical team. Continuing treatment consists of open ended ongoing group sessions that incorporate ongoing education and group therapy. The sessions are scheduled once per week for 1 ½ hours and run on a 16 week’ cycle. The groups focus on life challenges the recovering individual encounters on a daily basis in the family, social, or work areas. All clients are encouraged to participate in AA/NA/CA. While in continuing treatment, clients may also become involved in individual, couples, or family counseling. Clients may be directly referred to continuing treatment as part of the admission process to the Outpatient Clinic.
Day Treatment Program:
The Outpatient Day Treatment Program (DTP) is designed to confront a more chronic degree of substance abuse and dependence than primary outpatient treatment.
The Day Treatment track is for clients who do not require inpatient treatment, but will benefit from a more structured regimen than is traditionally available in the outpatient area. Typically, DTP clients have extreme dysfunction in one or more life areas (frequently legal), but may also suffer from social isolation, chronic unemployment, physical problems or severe family disruption. This particular client group has traditionally done poorly in outpatient treatment because of need for more structured programming rather than medical intervention.
Program Description:
The Day Treatment Program involves primary treatment for alcohol and drug dependent individuals that consist of an intensive, daily structured program provided by an interdisciplinary clinical team.
The two stage programming may be concentrated in a six week period of spread out up to twelve weeks.
The program provides a didactic sequence, daily group therapy, individual, couples, and family counseling, AA/NA/CA orientation, recreation/socialization, vocational counseling, and psychiatric consultation.
3
Outpatient Clinical Service
Client Bill Of Rights – Outpatient Clinic
The BOAF Outpatient Clinic supports the following rights of clients:
When clients receive services for mental health, alcoholism, drug abuse, or a developmental disability, as either an inpatient or outpatient, the following rights are guaranteed under Wisconsin State Statute Section 51.61.
Treatment and Related Rights:
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To be free from having unreasonable and arbitrary decisions made about you.
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To receive prompt and adequate treatment for your condition.
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To refuse any medication and treatment.
(This decision may result in discharge.)
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To be free from unnecessary or excessive medication.
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To give informed consent to treatment.
Communication and Privacy Rights:
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To refuse to be filmed or taped without your prior consent.
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To a humane treatment environment.
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To be free from any type of experimental research.
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To have your treatment records and conversations concerning your treatment kept confidential.
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To have access to your treatment record after discharge (or during treatment, with the approval of the Clinic Director) and to have access at all times to records of medications you take or any treatment you receive for physical health reasons.
Client Right to File a Grievance:
If you feel that your rights have been violated, you as the client have the right to file grievance with the BOAF has a grievance procedure through which you may file your complaint. Grievances must be filed in writing within 45 days of the incident or issue. Clinic staff will supply you with a copy of the Grievance Procedure upon request. You as the client may at the end of the grievance process, or at any time during it, choose to take the matter to court. However, if you choose to initiate court proceedings, the internal BOAF grievance procedure will end.