3. Quality framework 3.1 Assessment and treatment engagement The purpose of assessment is to identify patients’ determine their suitability for treatment and establish a treatment plan. A thorough assessment should precede all treatment and should involve comprehensive drug use, medical and psychosocial history, physical and mental state examination and, as clinically indicated, other appropriate investigations. Good assessment is essential to the continuing care of the patient. Not only can it enable the patient to become engaged in treatment but it can begin a process of change even before a full assessment is complete. The effectiveness of treatment can be expected to be greater if treatment is responsive to an individual’s of change and personal circumstance. Good care planning aims to deliver services that are patient-centred rather than centred on the service provider ().Care plans can facilitate patient access to an integrated selection of services and may prevent patient drop out. Assessment is the first stage of care planning. The primary purpose of assessment is to carry out a functional analysis and determine the best type of response (). However, the initial assessment is also a time when patient and clinician establish a therapeutic relationship. Hence the content and manner of assessment are both important. The general principles of assessment discussed in this section are applicable to all forms of treatment for alcohol and other drug use. The nature of opioid substitution treatment places some additional requirements on assessment of eligibility for this form of treatment. 3.2 Establishing and defining a therapeutic relationship For the prospective patient, the assessment interview is often a time of great vulnerability and expectation. The decision to seek treatment is frequently taken at a time of crisis. Many patients feel ambivalent about treatment, particularly substitution treatment, and entering treatment may be marked by a sense of failure and guilt. It is important for clinicians to demonstrate an accepting, non-judgmental approach to patients, being neither authoritarian nor overly intrusive. Patients are hesitant or reluctant to disclose their drug use or problems. Patients who are report discomfort, shame, fear, distrust, hopelessness, and the desire to continue using drugs as reasons they do not discuss addiction openly with their clinicians. Clinicians need to approach patients who have an addiction in an honest, respectful way, just as they would approach patients with any other medical illness or problem. It is important for clinicians to employ common sense, courtesy and an appropriate level of neutrality in establishing a relationship with patients. It is easy to present the impression of being excessively distant, remote and authoritarian in order to protect
3. Quality framework 3.1 Assessment and treatment engagement The purpose of assessment is to identify patients’ determine their suitability for treatment and establish a treatment plan. A thorough assessment should precede all treatment and should involve comprehensive drug use, medical and psychosocial history, physical and mental state examination and, as clinically indicated, other appropriate investigations. Good assessment is essential to the continuing care of the patient. Not only can it enable the patient to become engaged in treatment but it can begin a process of change even before a full assessment is complete. The effectiveness of treatment can be expected to be greater if treatment is responsive to an individual’s of change and personal circumstance. Good care planning aims to deliver services that are patient-centred rather than centred on the service provider ().Care plans can facilitate patient access to an integrated selection of services and may prevent patient drop out. Assessment is the first stage of care planning. The primary purpose of assessment is to carry out a functional analysis and determine the best type of response (). However, the initial assessment is also a time when patient and clinician establish a therapeutic relationship. Hence the content and manner of assessment are both important. The general principles of assessment discussed in this section are applicable to all forms of treatment for alcohol and other drug use. The nature of opioid substitution treatment places some additional requirements on assessment of eligibility for this form of treatment. 3.2 Establishing and defining a therapeutic relationship For the prospective patient, the assessment interview is often a time of great vulnerability and expectation. The decision to seek treatment is frequently taken at a time of crisis. Many patients feel ambivalent about treatment, particularly substitution treatment, and entering treatment may be marked by a sense of failure and guilt. It is important for clinicians to demonstrate an accepting, non-judgmental approach to patients, being neither authoritarian nor overly intrusive. Patients are hesitant or reluctant to disclose their drug use or problems. Patients who are report discomfort, shame, fear, distrust, hopelessness, and the desire to continue using drugs as reasons they do not discuss addiction openly with their clinicians. Clinicians need to approach patients who have an addiction in an honest, respectful way, just as they would approach patients with any other medical illness or problem. It is important for clinicians to employ common sense, courtesy and an appropriate level of neutrality in establishing a relationship with patients. It is easy to present the impression of being excessively distant, remote and authoritarian in order to protect
endorsed%20MATOD%20guidelines%20accessible%20Apr2014%20(D14-1005149).DOCX