Sunday, December 29, 2013

Managing EAP Clients in Treatment

If you've recently admitted a client to some sort of addiction treatment program, there are few "touch points" you need to keep in mind. Understanding these touch points will allow you to achieve more treatment success with EAP clients and "score more points" with the value of your program for saving lives. It's nice when you can prove in black and white that you're saving lives with your EAP. After admitting a patient to treatment, you can count on resistance raising its ugly head after detox or without about a week of admission. This dynamic is fueled by the patient feeling better, comparing out of the disease, and a desire to drink again with assurance that the client can do it on his own.

Touch points:
  1. Generally these points require updates and motivational assessments from the addiction treatment counselor: Admission, after detox, middle of intermediate care, discharge, starting day of aftercare, completion of aftercare, and any point within the next year where follow-up program discovers that the patient has moved below the four-day-per week participation in Alcoholics Anonymous.
  2. You should be notified 24/7 with regard to the patient's thoughts and ruminations related to leaving AMA (Against Medical Advice)-- both AMA Ideation and actual AMA. When a patient begins talking about leaving against medical advice, a series of intervention steps occurs. Unfortunately most addition treatment program do not understand dynamics of motivation and leverage and therefore each employee from nurse, counselor, volunteer, doctor, or even the janitor  may take a crack at re-motivating the patient to stay. Unfortunately, each of these attempts reinforces the decision to leave. The first person to make an attempt at re-motivating the EAP client should be you. You can communicate leverage from the employer--generally assurance that the employee will be fired if he or she leaves treatment (we are assuming a formal referral to the EAP with a last chance agreement was involved in this sort of admission). If you are called last instead of first, the patient will have already practiced their "pitch" to leave and your job of convincing them to stay will be made more difficult. Use this EAP Handout Tip Sheet for following clients post discharge from your EAP office.