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Substance Abuse and Brain Injuries
Substance Use and Abuse After Brain Injury: A Programmer's Guide
Three Versions of Substance Abuse Programming
in Rehab Centers
Version 1.0
Version 2.0
Version 3.0
Chart illustrating the three versions
Version 1.0 - Good programming provides basic education both for persons recovering from brain injury and their families or significant others. In addition, the program provides a general screening for the risk of substance abuse. This screening determines if a referral is indicated. Finally, all staff are trained in the need for a systematic approach to substance abuse prevention and have resolved personal issues involving substance use by survivors. Version 1.0 activities can be incorporated within existing programs without significant change.
Version 2.0- Better programming includes the education, screening and referral elements of Version 1.0, and adds additional capability for in-depth assessment and motivational interviewing. Adding these two features requires special training for staff and time set aside during the treatment programs.
- In-depth assessment. The assessment conducted as part of Version 2.0 programming identifies strengths and needs in relation to substance use, a person’s level of awareness, and the ability of the community environment to support their goals following rehabilitation. This information is used to plan for referrals to community-based resources. If a program provides Version 3.0, this assessment data also serves as the basis for the treatment team intervention.
- Motivational interviewing. Version 2.0 also adds motivational interviewing for the person who will not be receiving additional intervention at the program. This approach is intended to increase the likelihood that persons served will follow through with community-based service providers. Motivational interviews typically can be completed in one or two sessions.
- Referral source linkages. The third element in Version 2.0 is more aggressive identification and evaluation of community-based services. In most cases referral services need special preparation to work successfully with persons who have a brain injury. This bridging between person served and substance abuse treatment resources further facilitates successful referral, enhances continuity of services, and promotes successful recovery.
Version
3.0 - Best programming adds a staff
member trained in chemical dependency treatment. Dedicating staff for
this purpose significantly expands the capability of the program to provide
a holistic approach to substance use issues. A specially trained staff
member has responsibilities for all activities previously described in
Version 2.0, as well as expanding motivational interviewing to include
additional sessions as indicated by the person’s readiness to change.
The treatment team at this level should create a unified treatment plan
based on issues identified during assessment.
Consultation of treatment team members with the chemical dependency professional
is another feature of Version 3.0. A by-product of consultation can be
adaptation of therapies to incorporate substance use issues (e.g., ways
to reinforce messages from the motivational interviewing or strengthen
self-motivation statements). The section addressing a Coordinated Team
Approach (page 40), provides general suggestions of ways to incorporate
prevention and intervention messages in the normal flow of other therapies.
Version 3.0 increases emphasis on developing the referral process and actively following-up with persons served to increase the likelihood of successful follow through with community-based service providers.
Substance Abuse Education Series
Substance Abuse and Brain Injury Toolbox
Utilities for Community Professionals"Lessons from Little Red Riding Hood"