Therapist's Guide to Clinical Intervention - Sigmund Freud

shaping of a new identity integrating the culmination of where the individual has been and
where he/she is. This foundation of integrating experience one day at a time is what will take
the individual to tomorrow.
SUBSTANCE ABUSE AND/OR DEPENDENCE
Goals 1. Complete assessment with appropriate referrals
2. Encourage abstinence
3. Break through denial
4. Support cognitive restructuring
5. Improve behavioral self-control
6. Develop refusal skills
7. Improve social skills
8. Improve communication skills
9. Improve coping skills
10. Improve problem-solving skills
11. Improve self-esteem
12. Support and educate family
Treatment Focus 1. Thorough Assessment for Referral and Treatment
and Objectives A. Evaluate substance use (how much, how often, substances of choice, family history,
patterns of use, prior treatment, level of impairment in major life areas, inability to
control use, etc.)
B. Refer for general physical examination and consultation with primary care
physician. Refer for specific assessment of physiological impairment if warranted
by history.
C. Referrals (assuming detox is not an issue or is completed)
1. If unable to remain in recovery, refer to residential program
2. Outpatient chemical dependency program
3. 12-step meetings or other supportive groups and programs
D. Evaluate cognitive deficit
1. Establish baseline assess of fund of knowledge, take into consideration level of
education and level of development
2. Identify strengths and weaknesses
E. Inadequate nutrition
1. Facilitate identification of prior eating patterns
2. Develop and establish eating three balanced meals a day
2. Abstinence
A. Individual has made a commitment to abstain from substance use
B. Individual is participating in an outpatient program
C. Individual has worked with therapist to develop own program for abstinence
recovery
3. Denial
A. Convey an attitude that is not rejecting or judgmental
B. Confront denial with reality of use and education to correct misconceptions
C. Identify the relationship between substance use and personal problems
D. Do not accept or ignore the use of other defense mechanisms to avoid reality
38 i. Treatment Planning: Goals, Objectives, and Interventions