Audit of Substance Abuse Treatment Facilities in ... - SA HealthInfo

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3.6.2. Provision of assessment servicesWhen assessment services were considered, more than 80.0% of facilities complete achemical history for each new client (Figure 14). Overall, 81.3% of facilities complete abio-psychosocial history for each client. In contrast, just over half of the facilities(56.3%) conduct psychological evaluations and 12.5% of facilities assess clients forpsychiatric disorders (Figure 14).By province, 6 (85.7%) facilities in Free State, 2 (100.0%) in Limpopo, 3 (100.0%) inMpumalanga, 2 (100.0%) in North West and 1 (50.0%) in Northern Cape complete achemical history for each new client. In terms of completing a bio-psychosocial historyfor each client, 6 (85.7%) facilities in Free State, 1 (50.0%) in Limpopo, 3 (100.0%) inMpumalanga, 2 (100.0%) in North West and 1 (50.0%) in Northern Cape do so.Psychological evaluations are conducted in 3 of the provinces, namely 6 (85.7%) of thefacilities in Free State, 1 (50.0%) in Limpopo and 2 (100.0%) in North West. In contrast,psychiatric assessments are only conducted by 2 facilities in Free State (28.6%).Figure 14. Proportion of treatment facilities providing assessment services (%).10080604020088815613Chemical history Bio-psychosocial history Psychological evaluation Psychiatric assessmentsOverall3.6.3. Substance abuse counselling servicesAll of the facilities (100.0%) report providing one-to-one/individual substance abusecounselling services, substance abuse counselling services in a group format as well aslife skills development services (Figure 15). A smaller proportion of facilities providepsychoeducational lectures (87.5%) and offer mental health-related counselling services(68.8%). When specific substance abuse treatment modalities used by facilities duringsubstance abuse counselling were considered, we found that 37.5% of facilities report44
using 12-step approaches, 75.0% report using contingency management, 93.8% reportusing motivational interviewing techniques, and 50.0% report using cognitivebehavioural therapy (CBT) techniques (Figure 15). A small proportion of facilities (6.3%)offer alternative therapies (such as aromatherapy), provide self-help/support groups(37.5%) (for example Narcotics Anonymous [NA] and Alcoholics Anonymous [AA]) andprovide occupational therapy (31.3%).Figure 15.Proportion of treatment facilities providing substance abuse counsellingservices (%).Occupational therapy31Self-help/support groups38Alternative therapies6Life skills100Mental health counselling69Psychoeducational lectures88Contingency management7512-step counselling38Motivational interviewing94CBT counselling50Group counsellingIndividual counselling1001000 20 40 60 80 100 120OverallOverall, equal proportions of facilities (37.5%) use 12-step approaches and provide selfhelp/supportgroups; however, the distribution of these facilities across provinces is notthe same (Table 9). Facilities in 2 provinces report using 12-step approaches, namely FreeState (71.4%) and Mpumalanga (33.3%) whereas self-help/support groups are availablein Free State (57.1%) and Limpopo (100.0%). Facilities in Free State, Limpopo andMpumalanga provide mental health-related counselling services. Compared to facilitiesin other provinces, alternative therapies and occupational therapy are only available in theFree State. Facilities in Limpopo and Northern Cape do not provide CBT counselling.45
Page 1 and 2: Alcohol & Drug Abuse Research UnitM
Page 3 and 4: 3.1.2 Treatment facility profile by
Page 5 and 6: 4.3 Targeting barriers to treatment
Page 7 and 8: EXECUTIVE SUMMARYA cross-sectional
Page 9 and 10: services to historically underserve
Page 11 and 12: use, reductions in criminal activit
Page 13 and 14: Despite high levels of substance ab
Page 15 and 16: Despite the apparent availability o
Page 17 and 18: treatment services provided. At pre
Page 19 and 20: use disorders whose physical and em
Page 21 and 22: delivery, treatment retention, and
Page 23 and 24: audit substance abuse treatment fac
Page 25 and 26: 2.8.3. Further data considerations
Page 27 and 28: Figure 1. Inpatient intensity of ca
Page 29 and 30: Since there is a large overlap betw
Page 31 and 32: the total client population (χ = 4
Page 33 and 34: Figure 7.Comparison of race profile
Page 35 and 36: services per month ranges from 13 t
Page 37 and 38: 3.4.1. Characteristics of staff at
Page 39 and 40: supervision. In contrast, a much sm
Page 41 and 42: In terms of client record-keeping,
Page 43: Core findings:• Compared to the p
Page 47 and 48: Figure 16. Proportion of treatment
Page 49 and 50: 3.7. ADDRESSING BARRIERS TO TREATME
Page 51 and 52: Table 11. Proportion of facilities
Page 55 and 56: Figure 20.Proportion of substance a
Page 61 and 62: 3.9.2. Monitoring of clients’ pro
Page 65 and 66: PART 4: DISCUSSION OF KEY FINDINGSW
Page 67 and 68: previous audits of specialist subst
Page 69 and 70: small proportion of South African d
Page 71 and 72: high levels of substance use among
Page 73 and 74: these barriers appears to significa
Page 75 and 76: appropriate services for Black/Afri
Page 77 and 78: clients progress post-treatment, an
Page 79 and 80: • The number of state facilities
Page 81 and 82: • Another way of ensuring (indire
Page 83 and 84: • The age appropriateness of serv
Page 85 and 86: REFERENCESAllard, S.W., Tolman, R.M
Page 87 and 88: Myers, B., & Fakier, N. (2007). Rep
Page 89: Zule, W.A., Lam, W.K., & Wechsberg,

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