> Competency 5: Continuing Care of Families Affected by FASD > 5. Continuing Care for Clients with an FASD or Possible FASD
Competence 5: Continuing Care of Families Affected by FASD
Continuing Care for Clients with an FASD or Possible FASD
While establishing linkages to services
may be a huge challenge to already overtaxed treatment providers, these linkages are
essential to increase the effectiveness of substance abuse treatment and
recovery services for people with an FASD. A study of people with disabilities
treated by the Anixter Center in Chicago demonstrated that even individuals
with severe and multiple disabilities are successful in treatment and maintain
sobriety if provided with modified treatment and case management services.1 Because
FASD is often undetected, successful outcomes for the treatment center may
increase as providers build linkages and use them to enhance their expertise
and experience in identifying and accommodating FASD (see box for suggestions in the treament of persons with an FASD).
There are no specific guiding principles for treating clients with an FASD. This chart is an example of how principles for a person with Co-Occuring Disorders might be adapted for those with an FASD. These principles were originally identified in the Treament Improvement Protocol Substance Abuse Treatment for Persons With Co-Occurring Disorders (TIP 42).
Suggestions in the Treatment of Clients With an FASD
- Employ a recovery perspective.
Develop a treatment plan that provides for continuity of
care over time. Treatment may occur in different settings
over time (e.g., residential, outpatient) and much of the
recovery process occurs outside of or following treatment
(e.g., through family and community support. It is important
to reinforce long-term participation in these continuous
- Adopt a comprehensive
viewpoint. People with an FASD and alcohol problems generally
have an array of mental health, medical, family, and social
problems. Most need substantial rehabilitation and habilitation
(i.e., initial learning and acquisition of skills). Treatment
should address immediate and long-term needs for housing,
work, health care, and a supportive network.
- Develop a phased approach
to treatment. Many clinicians view clients as progressing
through phases. Generally, three to five phases are identified,
including engagement, stabilization, treatment, and aftercare
or continuing care. These phases are consistent with the
stages of change.
- Address specific real-life
problems early in treatment. Case management may be needed
to help clients find housing or handle legal and family matters.
It may also be helpful to use specialized interventions that
target important areas of client need, such as money management.
Psychosocial rehabilitation, which helps the client develop
the specific skills and approaches she needs to perform her
chosen roles (e.g., student, employee, community member)
also is a useful strategy. Solving such problems often is
important in engaging clients in continuing treatment.
- Plan for the client’s
cognitive and functional impairments. Services for
clients with an FASD must be tailored to individual needs
and functioning. Clients with an FASD usually display cognitive
and other functional impairments that affect their ability
to comprehend information or complete tasks. Interventions
must be compatible with client needs and functioning. Plans
are needed for longer-term interventions and ongoing support,
since people with an FASD have memory problems and difficulty
applying what they learn to different situations.
- Use support systems
to maintain and extend treatment effectiveness. The mutual
self-help movement, the family, the faith community, and
other resources that exist within the client’s community
can play an invaluable role in recovery. In some cultures,
the stigma surrounding FASD and substance use is so great
that the client and even the entire family may be ostracized
by the immediate community. In addition, the behaviors associated
with active substance use may have alienated the client’s
family and community. The addiction professional can help
the client learn about available support systems and how
to use them effectively.
Source: Adapted from Center for Substance Abuse Treatment. 2005. Substance Abuse Treatment for Persons With Co-occurring Disorders.
Treatment Improvement Protocol (TIP) Series 42. DHHS Publication No. (SMA) 05-3992. Rockville, MD: Substance Abuse and Mental Health Services Administration.