Screening and treating the disabled for addictions

 Screening and treating the disabled for addictions. Potential Clients for Addiction

Abstract

Screening and treating for addictions. A significant proportion of individuals affected by drug addiction are disabled. Disability takes the form of developmental disability leading to intellectual impairments and cognitive malfunctioning and physical disability brought about by spinal cord injuries and traumatic brain injury. Medical conditions also contribute to the prevalence of disabilities. Visual and hearing impairments are also implicated in the assessment, screening and, management of drug addiction and relapse during the recovery process. Disabled patients affected by drug addiction are treated through group and cognitive behavioral therapies. The two approaches compensate for the reduced and impaired functioning of the disabled patient and affected by drug addiction. Policy and legal implications should be addressed during therapy sessions so that patients are fully aware of their privileges and benefits as provided by the social security program for the disabled (Gowing, Ali, Allsop, Marsden, Turf, West, & Witton, 2015).

Screening and treating the disabled for addictions. Potential Clients for Addiction

Introduction

Disability is the impairment in physical, cognitive and psychological functioning. Congenital conditions, conditions that affect the developmental milestones during early development, medical conditions or traumatic injuries are common causes for disabilities. In the United States of America, 53 million people manifest with a form of disability. Research studies have revealed that people affected by disability are three times more likely to be affected by drug and substance addiction than persons with no disability. Out of the total population with disability in the USA, more than half has been diagnosed with substance and drug-related conditions. Disability manifests in various forms. The forms of disability that are discussed in this report are; developmental disabilities are presenting as intellectual and cognitive disabilities, brain traumatic injuries and the associated physical impairments, spinal cord injuries and hearing impairment. Disabilities manifest as impairments that increase the probability of the patient to be involved in drug and substance addiction. Limitations in physical mobility, seclusion within home-care facilities, impaired judgment and cognitive abilities and hearing and visual loss are factors that require special attention in the assessment and management of disabled presenting with drug and substance addiction (Erickson, Lee, & Von Schrader, 2017). The paper discusses interventions from the preventive aspect of managing addiction among the disabled, staffing required, ethical and legal implications while managing the clients, the state and federal benefits offered to patients with disabilities. The paper also discusses the impact of integration of social benefits into the treatment of disabled diagnosed with drug addiction. Finally, the presentation will discuss the reinforcement of the reasons that bar the disabled from drug and substance abuse and which finally leads to substance addiction.

 

Screening and treating addictions
Screening and treating addictions

Screening and treating the disabled for addictions. Potential Clients for Addiction

Screening and treating addictions. Cognitive behavioral therapy is appropriate for the management of persons presenting with intellectual disabilities. Intellectual disabilities result from disruption of the brain’s normal functioning. The specific brain functioning that is affected in intellectual disability includes malfunctioning of executive brain functions such as reasoning, judgment, concentration, decision making, and emotional control. Disability-related conditions that cause intellectual disability include; developmental disorders such as autistic disorders, attention hyperactivity Disorder (ADHD) and disabilities resulting from traumatic brain injury. Generally, persons with disability have reduced cognitive and effective stress coping mechanisms. Cognitive behavioral therapy aims at strengthening the individual’s thinking pattern on drug and substance addiction. Disabled persons are overly taken care of; thus they are given extra protection from social exposure. Intellectual disabilities reduce the affected person’s ability to provide care for themselves even at ages where self-care abilities should be well established and developed. The disabled are therefore not exposed to the environment and to interact and socialize with others. As a result, intellectually disabled persons do not develop effective stress coping mechanisms. Therefore, in the future, when such individuals are exposed to psychological stressors, they do not possess the appropriate mechanisms to counter adapt. One of the ways to deal with psychological stressors is to use drugs and substances among the disabled. Cognitive behavioral therapy for the disabled should contain short-term goals. Liese & Tripp (2018), found out that short-term goals result in the early recognition of warning signs to relapsing into drug and substance addiction over long-term improvement of self-care abilities, compared to long-term goals. Family involvement during cognitive behavioral therapy sessions has been found to have a positive impact on the overall outcomes for the disabled patient. In general population, lack of effective cognitive stress coping mechanisms is associated with an increased prevalence of drug and substance addiction. The cognitive-behavioral model of treatment posits that thinking pattern affects individuals feeling and behavior after that. For instance, among the disabled, thoughts that associate stressful effects and impairments by disability can be dealt; the use of drugs contribute to the increased use of drugs by the disabled (Mulhauser, Weinstock, Ruppert, & Benware, 2018).

Screening and treating the disabled for addictions. Potential Clients for Addiction

Group therapy is another effective treatment approach for managing addiction among the disabled populations. Group therapy is a form of therapy that relies on supportive therapy among the patients affected by the same condition. Group therapy is an effective therapy in managing other psychiatric conditions among the general patient populations. A study by Martinez-Gonzalez, Lopez, & Garcia, (2018), found group therapy to be effective in managing drug and substance abuse among individuals presenting with various forms of disability. However, studies have focused on establishing the effectiveness of particular modifications in group therapy for addictions when dealing with the disabled patient population. Usually, group therapy involves sharing experiences among patients affected by the same condition. Patients in group therapy also share the treatment approaches that they have found to be effective thus; each of the patients can incorporate the form of management approach that has been effective in other similar patient cases. Besides, patients in group therapy offer support for one another in pursuing each of the patient’s goal.

Similarly, group therapy relies on the same principles as used by an addiction patient without disabilities. However, group therapy in managing drug and substance abuse among disabled requires some modifications to fit the needs of the disabled. Studies have been conducted to evaluate various forms of therapeutic modifications in group therapy for addiction among patients manifesting with disabled. Group therapy in managing drug and substance addiction among disabled patients involves skills training. During group therapy, the disabled patient undergoes training aimed at equipping the patient with the knowledge to identify high-risk situations that trigger drug use. Patients are guided through group sessions through which patients describe situations, events, and environments which increase risk situations for using drugs.

Screening and treating the disabled for addictions. Potential Clients for Addiction

Further, the patients exchange ways in which each of them has found useful in avoiding such high-risk situations. During group therapy, patients presenting with drug addiction, and disabled discuss the warning signs that they have experienced towards the relapse into drug addiction. The warning signs include cravings for a specific drug or substance, or being in certain peer groups and stressful events. Group therapy among drug addiction patients with a disability should be outpatient and take a shorter time than for treating patients without a disability. The limited time for group therapy allows the patient to have time to carry out activities of daily living since the rate and the extent of performing activities of daily living are impaired in individuals manifesting with disabilities. During group therapy, disabled drug addiction patients are taught on facts concerning the negative and positive effects of drug and substance use. Patients are given time to share various forms of information that they have received elsewhere pertaining the benefits of drug and substance use. The therapist, therefore, assesses the misinformation from patients concerning drug and substance addiction. Disabled individuals have impairment on the ability to judge situations and make appropriate decisions. Visually impaired and individuals with hearing impairments have limited access to information about drug use and its effects. Therefore, during therapy sessions, the therapist has a role of ensuring that their patient receives adequate information on drug addiction (Birchler, Stewart, & O’Farrell, 2018).

Screening and treating the disabled for addictions. Potential Clients for Addiction. 

The motivational interviewing technique has been found to be effective in managing drug and substance addiction among the disabled. Motivational interviewing is a therapeutic skill that aims at stimulating patients to talk about the behavioral change that they want. Motivational interviewing has been effectively used in treating other psychiatric and mental health conditions including drug-related disorders in the general patient population. Disabled patients, for instance, those disabled from the effects of traumatic brain injury, lack insight into the effects of drug and substance use and the appropriate treatment options. Motivational interviewing is utilized as a form of treatment to influence the patient towards behavioral change. Appropriate learning and communication styles are applied for a patient with communications and learning disabilities common among patients with brain injury, visual and hearing impairments.

Screening and treating the disabled for addictions. Potential Clients for Addiction

Specific techniques employed to carry out motivational interviewing are giving direct feedback to the patient, reflecting on the negative impacts of motivational interviewing and provision of examples. The aim of motivational interviewing is to allow the patient to talk about the change that they desire. Talking about the change gives the therapist more information from the assessment session and thus makes the most appropriate decisions on the management approach to using. Increased talking about the change increases the patient’s commitment to change behavior on drug and substance addiction (Magill, Apodaca, Borsari, Gaume, Hoadley, Gordon, & Moyers, 2018).

There are general considerations to make when carrying out treatment for addiction among disabled patients. To begin with, policy-making should be part of the management process for addiction among the disabled. Architectural should put into consideration the physical and mobility challenges that the disabled face. For instance, parking places should have a parking area reserved for the disabled. Additionally, staircase construction should be in such a manner that the disabled who use wheelchairs can use them.

Screening and treating the disabled for addictions. Potential Clients for Addiction

The law contains legal definitions for persons with disability. Therapists providing treatment for the management of addiction among the disabled should familiarize with legal provisions on individual rights and privileges that should be accorded to the disabled presenting with addiction. The therapist should educate patients on the legal framework that provides them with specific rights and privileges. Staff providing care to the drug addiction patient with hearing impairment should receive in-service education on the various forms of communication language for patients with hearing impairments. In cases where the therapist is not competent with sign language, an interpreter is sought. The interpreter should be healthcare professional in order to be aware of the ethical principle of confidentiality of the patient’s health information (Armour, 2018).

Screening and treating addictions. There are several screening tools for addiction among the disabled patient. Notably, drug addiction, screening tools are modified to suit the needs of the disabled patients. There are online assessment and screening tools for drug and substance use. The tools are based on questionnaires which require answer input from the patient. Patient’s score is calculated. The patient is offered appropriate interventions based on the severity of the risk for drug addiction or relapse for the clients on recovery programs. Collectively, assessment and screening tools put into consideration several factors that affect the patient’s vulnerability to drug and substance abuse, including specific age, culture, social, economic status and religious backgrounds (Harris, Sherritt, Grubb, Samuels, Silva, Vernacchio, & Knight, 2018).

Screening and treating the disabled for addictions. Potential Clients for Addiction

Conclusion

Screening and treating addictions. In conclusion, disabilities exist in different forms as determined by etiology. Each form of disability presents with a unique challenge to the patient. Disabilities affect the functioning of the patient presenting with various forms of disability. Significantly, disability affects an individual’s ability towards self-care. Also, disability affects the patient’s cognitive functioning. Children born with developmental disorders manifesting with disability are given more protection than children who are not disabled. Therefore, disabled children lack exposure to various stressors. Failure to expose children to social stressors slows down the process of developing a stress coping mechanism, either cognitive or effective. The adverse effect on cognitive and affective stress coping mechanisms reduces the ability of the individual to deal with various stressors in life, thus resolve to take drugs leading to drug addiction.

Screening and treating the disabled for addictions. Potential Clients for Addiction

Discrimination and stigmatization against some disabilities present as additional psychological and emotional stress to disabled. Therefore, this increases the number of stressors that trigger drug use and finally addition among the disabled patient. Impaired judgment and decision making increase the probability that an intellectually disabled person will make an inappropriate decision about drugs addiction. Disabled persons, therefore, may engage in drug abuse leading to addiction for the wrong reasons, commonly expecting positive effects of drug addiction.

Additionally, disabled persons are prone to negative peer influence since their judgment, and decision-making functioning is affected. However, disability sometimes contributes towards reduced rates of addiction among the affected persons. Specifically, traumatic brain injury patients avoid taking alcohol to avoid sustaining more injuries under the influence of drugs and substances and the effect of alcohol to slow down the rate of healing of traumatic brain injury. The treatment of addiction among the disabled is achieved through cognitive behavioral therapy, group therapy and motivational interviewing. The treatment modalities are meant to address the uniqueness of drug and substance addiction among the disabled.

Screening and treating the disabled for addictions. Potential Clients for Addiction

Screening and treating addictions. Cognitive behavioral therapy addresses the reduction in the cognitive and effective coping mechanism. The treatment modality aims to strengthen the affects patient is coping skills to psychological and emotional stress. In other words, cognitive and behavioral therapy for drug addiction among the disabled compensates for the lost ability to make decision and judgment. Group therapy utilizes t traditional concepts and ideas for any group therapy involving any psychiatric patients. However, the approach is modified in order to address the specific needs of disabled patients presenting with drug addiction. The treatment of drug addiction requires familiarization of the relevant policies and legal frameworks about t treatment of drug addiction among the disabled patients. Motivational interviewing promotes the patient to speak about their willingness to change, therefore preparing them to achieve the change in behavior that they desire.

Screening and treating the disabled for addictions. Potential Clients for Addiction

References

Armour, P. (2018). The Role of Information in Disability Insurance Application: An Analysis of the Social Security Statement Phase-In. American Economic Journal: Economic Policy, 10(3), 1-41.

Birchler, G. R., Fals-Stewart, W., & O’Farrell, T. J. (2018). Couple therapy for alcoholism and drug abuse. Clinical handbook of couple therapy, 4, 523-544.

Erickson, W., Lee, C., & Von Schrader, S. (2017). Disability statistics from the American Community Survey (ACS). Ithaca, NY: Cornell University Yang-Tan Institute (YTI).

Gowing, L. R., Ali, R. L., Allsop, S., Marsden, J., Turf, E. E., West, R., & Witton, J. (2015). Global statistics on addictive behaviours: 2014 status report. Addiction, 110(6), 904-919.

Harris, S. K., Sherritt, L., Grubb, L., Samuels, R., Silva, T., Vernacchio, L., … & Knight, J. R. (2018). Practical Tools to Support Adolescent Substance Abuse Prevention in Primary Care: A Multi-Site Randomized Controlled Trial of Computer-Facilitated Screening and Provider Brief Advice in the Medical Office. Journal of Adolescent Health, 62(2), S13.

Liese, B. S., & Tripp, J. C. (2018). Advances in Cognitive-Behavioral Therapy for Substance Use Disorders and Addictive Behaviors. Science and Practice in Cognitive Therapy: Foundations, Mechanisms, and Applications, 298.

Magill, M., Apodaca, T. R., Borsari, B., Gaume, J., Hoadley, A., Gordon, R. E., … & Moyers, T. (2018). A meta-analysis of motivational interviewing process: Technical, relational, and conditional process models of change. Journal of consulting and clinical psychology, 86(2), 140.

Martinez-Gonzalez, J. M., Vilar-Lopez, R., & Verdejo-Garcia, A. (2018). Long-term effectiveness of group cognitive-behavioral therapy for alcoholism: Impact of dual diagnosis on treatment outcome. CLINICA Y SALUD, 29(1), 1-8.

Mulhauser, K., Weinstock, J., Ruppert, P., & Benware, J. (2018). Changes in Neuropsychological Status during the Initial Phase of Abstinence in Alcohol Use Disorder: Neurocognitive Impairment and Implications for Clinical Care. Substance use & misuse, 53(6), 881-890.

 

 

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