Tag: monitoring

Student Assistance Program

Twenty years of “Real World” Stuff

Student Assistance Program

Two decades ago, a Student Intervention program (IMPACT) was introduced to Idaho educators by the Comprehensive Care/Care Unit Company.  State administrators and School employees participated in training to recognize the needs and the benefits of school Interventions. As a result, some school districts developed programs and policies designed to provide student interventions.  These would occur when Student Attitudes, Attendance, Achievement or Behaviors changed dramatically.  These changes were normally destructive and caused by “something” — to be determined.

Some schools worked with iMResponsible.com to develop processes and policies that provide effective solutions.  Environments were established that allow Interventions to occur as efficiently and smoothly as possible.  20 years later, these schools are still providing effective Interventions for their students.  The results have been addictive. Click on icon below for a one page summary of program ingredients.

Brief Look at SAP Program
Note:  At bottom of this web page -a PDF can be downloaded that contains all of the individual images that are linked/shown on this page.

The iMR Intervention process – rules in – or rules out – Alcohol/Drug issues and provides psychological screening for “dual diagnosis” consideration. Depression, Anxiety, Anger and Cognitive Issues are assessed – which is critical to comprehensive diagnosis of SUD problems.  Current addiction to drugs that are downers or uppers will influence DSM disorder analysis.  If SUD and/or MH issues are diagnosed, appropriate plans are established to improve behaviors.  If these issues are ruled out, other steps can be taken – as appropriate.

Teen Alcohol/Drug Result

 

Teen Psychological
Social/Conduct Disorder / Criminal

      Student and Family issues with Diagnostic Results are virtually eliminated.  They are presented with 15 individual scales that support the results.  Student and Family review results and individual responses to each question.  Objective + Validated results are accepted.

15 Scale Results Chart

Analysis of the results of these Intervention processes have documented: (1) reduced student violations and (2) improved attendance for some of the participants.  Post Intervention results should be consistently analyzed; but, other new “movements” tend to keep administrators’ hot buttons busy with other creations.  Suicide, Opioids, Bullying, Tobacco and Mental Health, etc. issues are but a few of these.

Considering attendance reimbursement realities and administrative costs associated with destructive student actions, a case can be made that Interventions result in a significant positive financial return on investment.

Twenty years of association with school counselors, administrators and education boards has resulted in a personal perspective that indicates: there are too many school balls in the air – all the time.  In Idaho, a standard student attendance day is 4 hours.  Considering the variety of things that can influence these four hours of study, it would seem that a focus on the KISS principal is in order.  This means fewer, simpler processes are needed – not more and more new ones.  This KISS perspective has been molded into our efficient iMR Student Assistance Program.

S A P Elements and Prices

Teachers have the unique ability to observe the personal characteristics of students over a consistent period of time.  When significant changes in behaviors are noticed, it is the result of SOMETHING.  The ability to handle these circumstances in a fluid and objective manner will provide solutions that will save lives.  Saving lives should be up at the top of Educational priorities.

All Interventions are beneficial.  Some change behaviors immediately and others provide a package of evidence that makes future needed changes – more likely.

Other than trying to convince our populace that we should learn lessons from history so as not to repeat them, I can think of no other educational option that will be remembered by all participants and will save lives.

We are hopeful that some school administrators and supporting staff members will take the time to reflect on student improvement options – and – conclude that all gets better when students feel better about themselves.

Check the Ingredients of the iMR Student Assistance Program and incorporate these, easy to manage, solutions into your educational package.  Adopting these live saving processes will not reduce attendance and learning time – they will enhance them.

For a PDF that contains a description of our “Student Assistance Program” and our deliverables, click on this Icon

PDF SAP Program Description

https://www.teamfixes.com/wp-content/uploads/2019/02/Description-of-Intervention-Process-V5-.pdf Complete form below and you will be contacted ASAP!

Rambling through Treatment

Rambling through – Interventions – Treatment – Enabling – Case Management

Don’t expect any profound treatment miracles to expose themselves as I move through this ditty.  I was preparing a 5 Step marketing piece and began to reflect on things that negatively affect behavioral healthcare treatment.  The following things came to mind; but, I was unable to create a smoothly flowing framework.  So bear with me.

In an ideal world, all our treatment chores would be completed in a timely and effortless manner.  Unfortunately, this is a pipe dream or a conclusion that one would reach after using the wrong kind of drugs.  The gist of today’s message is – “we should minimize the obstacles that prevent “ideal” treatment circumstances”.

Communications, administrative stuff, rules and regulations, emergencies, fatigue, eating, sleep and more – all interfere with flawless goings on.  The 5 Step program design is intended to reduce the impact of these nuisances and provide our Team members with some efficient solutions.

This author believes most individuals want to end each day feeling good about what they accomplished.  They do their best in completing tasks that were presented.  The issues addressed in this article are not intended to be criticisms.  The points made, herein, reflect real world happenings that can affect what we are trying to accomplish.

The other issue that came to mind is: administrative tasks can be a pain in the ass.

Don’t Worry!  I got this under Control!!

For example, I have just completed a fruitful session with an individual and it is important that I document the elements of the session so that my other team members know how we are doing.  I judiciously began my administrative task and an emergency pops out of the woodwork.  Then, ongoing daily tasks prevent me from getting back to my unfinished administrative duties.  These are real world issues and result in less than optimum treatment conditions.  Case management data entries are often done – when possible.  If group activities or external partners are included as treatment elements, getting these case entries into the system may also take some time.

Also, when administrative time is available, the first thing that needs to be completed is the paperwork – to get paid.  Government and Organization processes have been most creative.  They have provided thousands of new code options to make our lives easier and more efficient.

As I compare the data entry tasks for behavioral treatment clients, with regular medical care, I find that the behavioral efforts are more complex and time consuming.  My last two visits with my cardiology team have been 5-10 minutes of silent computer review by the professional and then approximately 5 minutes of a one sided discussion and then a closing silent computer spectacle – that results in a visit summary.

Automating verbal and text input data, using efficient forms, shifting priorities to our clients or patients and simplifying electronic data transfer and integration processes is a start.

Experience with Treatment Processes – (Sensitivity – Empathy)     

Our experience with treatment endeavors has lead us to a bias for AA/NA 12 Step programs.  The principal reason for this focus is that these organizations’ team members believe in individual responsibility and accountability.  Enabling continuing destructive behaviors is not part of their program objectives.

Our experience with counselors and other professional clinicians provides a different set of insights.  To continuously work with a client a degree of sensitivity must be established to provide meaningful dialogue.  Based on human nature, degrees of empathy may also occur.  These relationships will, obviously, be different as we move from clinician to clinician and from client to client.  Perspectives and skills are needed to insure that a tough love atmosphere is part of all treatment programs.

Interventions – Treatment – Enabling

 Helping – can be – Hurtful   

38 years of association with treatment efforts that are related to legal/illegal drug use and dependency have resulted in a few conclusions:

  1. Ignoring that drug dependency is a disease and runs in families’ = kills’ people.
  2. Enabling destructive behaviors is common with family members = kills’ people.
  3. The K.I.S.S. principal needs to be adhered to – or – results will deteriorate.
  4. Keeping it simple means – staying unaffected by alcohol and drugs.
Trauma – DSM-5

Treatment for DSM-5 “trauma – disorders” would be classified as a supplement to the iMResponsible.com programs.  A principal focus of our programs is an effort to stay focused on daily behaviors that need to be changed.  Treatment for trauma disorders is important; however, it is our position that “trauma” treatment results are improved when an individual is sober, stable and working a solid program.

The DSM-5 has defines these trauma disorders as Stressor-Related Disorders :  Anxiety Disorder, Trauma- and Stressor-Related Disorders Acute Stress Disorder, Adjustment Disorder, Posttraumatic Stress Disorder, Reactive Attachment Disorder and Dissociative Identity Disorder.  Physical or medical issues – such as brain trauma, etc., must also be considered.

Interventions

TEAM Interventions conducted to develop righteous and doable treatment plans provide the client with a feeling of group support.  The Intervention also provides the TEAM with an indication that definitive objectives have been established.  “Enabling” behaviors by friends and family are minimized as TEAM objectives are definitive and have been agreed to by all participants.

As an aside, all 5 Step clients do not win.  It has been proven, however, that a TEAM Intervention will assist those who fail to meet treatment contract conditions.  This assistance takes place when the next crisis occurs.  Personal denial is reduced or eliminated and the next try at wellness is enhanced.  20 years of Interventions in Idaho schools has statistically proven that the percent of student violations has reduced since these Intervention practices were initiated.

Enabling

Enabling ones’ destructive behaviors to continue from Intervention – through Treatment is normally a family issue.

 John Southworth has been an Interventionist for several decades and was one of the developers of the 5 Step Intense monitoring solutions.  Last week we met, went to an AA meeting and then had lunch.  John showed me a “no name” copy of a letter he had just received – thanking him for his efforts – with the senders – father.  The letter advised John that the father had died and was found by the family as they visited their vacation home.  John explained that the “father” was participating in an intense treatment and monitoring program that John had recommended.  All was going well.  The client and his wife convinced treatment management that all was going well and they could manage their behaviors in a less intense program.  This new program did not work. The patient died.  John indicated that family enabling is the most consistent anti wellness effort he runs into.

During our discussion, John also indicated that finding treatment facilities that had a treatment priority, higher than the bottom line priority, was becoming more difficult. It seems that business tasks, administrative requirements, regulations, HR matters and finances share time and resources with treatment.

www.southworthassociates.net/

Gotcha’s keep coming up – Even in a well designed Program!

Summary:

The combination of administrative, strategic and relationship conditions associated with each client and clinician affect the results of treatment.  Based on the subjective nature of counseling, it is also difficult to determine when clinical actions are resulting in degrees of dependency or independence.

In our view, anything that interferes with the clients’ acceptance of personal responsibility for treatment tasks is suspect.  The 5 Step program has been designed to emphasis “objective” analysis of treatment elements.  Clients’ become more responsible at case communications and data entry.  TEAM members are provided with forms that enable efficient and effective submission of case information.  Communications via mobile devices are automatically entered into iMR case files.

 Monitoring processes provide quantifiable evidence of how an individuals’ program is working.  These processes also provide an accurate treatment effectiveness score.  This beats the heck out of emergency phone calls just before the reports are due.

One Step at a time!  One Day at a time!  One Life at a time!

I am Responsible!

Team Enabling Tough Love

Key Treatment Elements

Key Treatment Factors – iMResponsible.com – 5 Step Program

Behavioral Case Management

There are many software applications being used to manage behavioral treatment programs.  Most of these programs are focused on entity needs and not on client or individual requirements.  Bureaucratic demands guide software development challenges and results.

There are a few key elements that affect healthcare treatment results. Some are philosophical in nature and beyond the insights and skills of our domestic and international developers and coders.  Real world experience has proven to iMResponsible.com that these solutions are usually supplements or additions to established application programs.

These key factors are: (1) Client must accept responsibility for their behaviors, (2) Diagnosis must be comprehensive, accurate and convincing, (3) Treatment Contracts must be personalized and doable, (4) TEAM tasks must be completed as specified in the plan and (5) case data and communications must be continuously available to the TEAM.

iMR Key Factors  (Note dates on PDF exhibits – iMR has been doing this since 2000.

Step One – Introductory Documents – (Description, Benefits, Requirements and Acceptance.

Key Elements 5 Step

5 Step Implementation

TEAM TREATMENT WORKS

Brief Intro:

This program does not require that you purchase anything!  All tools are provided as needed.  Case management, communication and data entry tasks are completed by each of the treatment TEAM members.  iMR provides web based case management, reports, monitoring alerts and other tools that enable automatic case data entries as authorized.  (e.g. email, phone, phone text, direct entry, etc..)  Program enrollment is based on client and TEAM acceptance of program conditions.

Summary:

This Summary is being published – first – before any factual basis is established. Our busy lives reduce the amount of time we spend reading stuff.

I have been involved with Behavioral Treatment clinics and agencies for four decades. This has included Inpatient, Outpatient and Self treatment processes. Experience with AA/NA has convinced me that long term alcohol/drug abstinence is as successful via these 12 Step meetings as by organized treatment enterprises and government agencies. AA/NA activities are long term and based on real world conditions. Organized treatment is short term and done in unique environments.

Experience with intense monitored treatment programs that are used for critical employees – i.e. medical, airline, transportation, etc.. has proven that these TEAM treatment processes can provide dramatically improved results. They provide the atmosphere and communications needed to improve “real world” treatment results – on a continuous basis. I am convinced that if these “intense” TEAM treatment processes were available to – all individual’s – positive behavioral and substance abuse results would exceed any treatment processes currently used.

TEAM treatment means that a TEAM* is active and supports diagnosis, treatment plans, treatment tasks and other real world circumstances. (*TEAM = Medical, Clinical, Vocation, Family, Social, Legal and supporting processes)

Historical and Current Treatment Efforts

This nation is inundated with programs that claim they improve drug induced destructive behaviors.  Unfortunately, Federal statistics over the last 5 decades verify that these processes aren’t working. Why is this?

  1. The results of drug assessments do not convince the individuals involved that they are actually responsible for their past behaviors and the results of these behaviors.
  2. Treatment plans include a package of activities that are:

►designed to protect the designer against liability issues

►not designed by a treatment TEAM and the client

►not accepted as doable by the client

  1. Treatment tasks are not definitively monitored, published and updated as needed.
  2. Treatment TEAM members are not defined. Treatment participant roles are not formalized.

Note: A growing number of Professionals are managing treatment programs that use drug management as a component.  These professionals are, in fact, assuming responsibility for the client’s welfare.  They are also assuming responsibility for the results of any treatment programs where drugs are a key component.  Recent issues pertaining to the conflicts between ASAM Treatment criteria and DSM-V elements are related to treatment perceptions.  Substance Abuse and Addiction are classified by some as a Disease and by others as Destructive behaviors – that can be fixed with drugs.  This is not a Common Sense playground.

Personal

With 39 years of recovery, this is what, my final Inpatient Treatment did for me!
1. Kept me from using alcohol/drugs for a period of time
2. Provided an atmosphere that helped develop some new thought processes
3. Convinced me of the benefits of 12 Step Programs
4. Provided me with some educational facts
5. Provided me with a post treatment contact that was a 12 Step participant and willing to work with me as I participated in real world activities. Dan was a Sponsor and TEAM member.

Step #5 is the reason I have 39+ years of sobriety. AA/NA participation is still going on and provides a positive impact on my attitudes and life.

Miscellaneous

My four decades of healthcare experience has created a skeptical perspective of programs that have been designed by treatment entities, agencies and universities. Many propose that behaviors and chemical imbalances can be a reason for dependency, addiction and disease. Most are designed because the one before it hasn’t worked. Nationally, trillions have been spent, hundreds of agencies have been created, thousand of grants used and hundreds of programs introduced and then phased out. During these efforts, the principles of the 12 Step programs that have successfully turned millions of lives around have been ignored or discounted. AA/NA traditions prevent actions that could minimize the possibility of individual improvements, such as: building treatment organizations. Objectives are different.

Many clinicians are ‘recovering’ individuals themselves and are dedicated to providing effective services to their clients.
Most clinics, who employ these clinicians, are concerned with continuing their operations and this requires balancing treatment deliverables with cash flow. Eventually, the focus must be on cash flow and treatment deliverables and effectiveness become secondary. Regulations and audits guide general deliverables; however, bed and group counts are the principal measurement of success.

Common sense would suggest that the diagnosis of an individual’s psychological, social and criminal behaviors would be negatively affected if they are using drugs. (e.g. Alcohol is a depressant, Amphetamines can result in paranoia and stress, etc.) Question: how valid are these diagnosis if the client is using? Shouldn’t substance abuse issues be addressed before behavioral diagnosis processes are begun?

The use of opiates, illegal drugs and medical prescriptions have created withdrawal needs that must be provided by Inpatient treatment and, in some cases, include the use of alternative drugs to ease withdrawal symptoms.  These processes have shifted professional treatment focuses from becoming abstinent from drug use to using appropriate drugs to fulfill individual needs. Individuals that are using these “new generation drugs” are not suitable for the iMResponsible.com TEAM treatment program until they are drug free.

Personal experience with drug recommendations made by physicians has led me to believe that significant study should occur before any drug is used.  I have not taken any prescription that did not have undesirable side effects.  Some are long lasting.  The song that is sung = “the benefits outweigh the negative side effects”.  Common sense is also useful in these circumstances.

TEAM – Key Elements

The attached PDF includes a description of all of the 5 Step Intensive Treatment Elements. 

iMR Program Program Implementation 2017 V1

These Treatment Processes have been used effectively with “Critical Employees” during the last 15 years.

For more info – contact david@imresponsible.com