COPE: A Case Study

The need for a substance abuse recovery home in Starke County, Indiana is a need that is unmistakable in the county based on the hefty number of individuals that suffer from substance abuse and dependency in the county which is clearly displayed by the recent number of crimes that are related to or involve illicit and prescription drugs. In attempt to meet this need and create an opportunity for individuals suffering from substance abuse and dependency to receive local substance abuse treatment in a recovery home the proposal will be presented to several stakeholders within the Starke County community. The term stakeholder “refers to those people who are affected, or could be affected, by the service” (Canadian Career Development Foundation, n.d.) that is being proposed. The proposal for the creation of a substance abuse recovery home will be presented to five key stakeholders including Ms. Becky Anspach the director of Community Services of Starke County, Starke County Community Corrections director of operations Mr. Robert Hinojosa, Ms. Dee Lynch the director of the Indiana Department of Child Services of Starke County, Porter Starke Services facilitator of intensive outpatient program treatment (IOP), and Ms. Rhonda Adcock the director of Starke County CASA.

The role of the social worker in this setting is to perform duties as an informed clinician based on evidence based practice to provide individualized case management to all clients. The social worker will complete a comprehensive intake assessment which includes demographics of the client, address presenting problem, and a risk assessment. Client’s also receive mental health screenings and individual and group counseling to gain new coping skills and address any triggers to prevent relapse utilizing interventions as CBT and Motivational Interviewing. The social worker will discuss limits of confidentiality and a signed informed consent from the client to receive services.

Strengths and Weaknesses for Integrated Treatment In a perfect world, integrated treatment approaches for all clients is a thorough, thoughtful, and positive approach to the overall recovery of the individual, especially for those with co-occurring disorders. Currently, through my professional work as a drug and alcohol case manager, both site and field-based, I see the strengths as a collaborative and integrated approach to treatment for these individuals, including a variety of programs and professionals, ranging from drug and alcohol treatment providers, mental health counselors, psychiatrists, and certified recovery and peer specialists. Van Wormer and Davis (2018) highlighted the evidence-based Assertive Community Treatment (ACT) approach

Today, there is a substantial population of Hmong living in America that still suffer from the negative effects of this traumatic history. In order to provide effective community-based treatment for Hmong clients, a counselor should be able to meet specific challenges presented by mental health and addiction issues peculiar to this population and be willing to provide advocacy through community resources.

Melanie is a 16-year-old Caucasian female who struggles with issues related to emotional dysregulation, leading to impulsive and potentially unsafe behaviors. Prior to her arrival, Melanie struggled with symptoms of anxiety and depression, emotional dysregulation, subsequently leading to impulsive and potentially unsafe behaviors at home, school and in the community. She struggled to accept limits at home and school and reacted with loud and destructive outbursts. Melanie was consistently running away from school and programs, due to increased impulsivity and difficulty comprehending situations, demonstrating poor judgment and poor decision-making skills. Melanie’s current goals are to learn about and develop appropriate interpersonal relationships, identify and practice effective coping skills, and work on developing a healthy and positive identity.

Cathy is a 52- year old female who was brought to outpatient services at the Community Service Boards (CSB) due to personal concerns of her sister, Beth. The client has been living with her sister for four months, after she left her fiancée who was emotionally and verbally abusive toward her. Beth brought her sister to the CSB because Cathy has been cutting herself, which is a longstanding pattern for her. Additionally, in the past week, Cathy has made suicidal ideations. Cathy admits to using more Xanax then her psychiatrist prescribed; as well as, her daily use of marijuana. Beth, the client’s sister, stated her use of marijuana has alienated her from her children and family. The client also states she struggles with boredom on most days.

Sovereign Health is a residential rehabilitation, for-profit company for substance abuse, mental health disorder, and dual diagnosis. The agency has a total of nine locations in Arizona, California, Florida, Texas and Utah. The Los Angeles location will be assessed in this paper. Sovereign Health’s mission is, “to help people gain control over their health and various illness that may threaten it” (Sovereign Health, n.d.).

Carolinas Healthcare System (CHS) is an organization that provides patient-centered care in every patient interaction. The department of Patient Experience, previously known as Patient Engagement, formed six years ago with only five employees. Since then, the department

There were higher levels of satisfaction with service availability (Cook et al., 2008). At the beginning of the program participants mental health characteristics were collected using Functional Assessment Rating Scale (FARS). At the end of the program participants had “no problem” with substance abuse, harming oneself or others and depression (Spaulding & Lacasse, 2015). Many of the participants achieved their recovery goals and rated higher in satisfaction in meeting basic needs, clinical recovery (e.g. accessing psychiatry), physical wellness, social recovery (e.g. group membership) and existential recovery (self-sufficiency) (Croft & Parish, 2008).

While this systemic division of roles can be said to increase efficiency of the department, it is not without its faults. One of these liabilities entails the billing of Medicaid. Care coordinators are tasked with performing one “billable” service per client per month. This is an action care coordinators takes on behalf of clients that is then billed to Medicaid, allowing NADAP to sustain itself financially. Since care coordinators have large caseloads and therefore many billable services to achieve each month, clients are, at times, not receiving the care they need. Instead, the clients are often receiving the care that allows the care coordinators to check off the billable service box, not always considering the care only as it pertains to the client. Furthermore, since the care coordination program relies on Medicaid for financial support, it focuses attention to the billing of services as opposed to the services itself. Care coordinators’ performances are evaluated based on the successful completion of all the clients’ core services, and not on the success of their clients’ wellness goals per say. Consequently, the organization hires care

Stage C is the counselor encouraging the client to learn new techniques to get through their issues. During this part of the phase, we have identified previous and current coping attempts. “It is appropriate for a counselor to be challenging and persistent in getting clients to think of ways they could begin to cope better.” “This approach helps clients get in touch with their problem-solving abilities” (Kanel 70). Allow the client to come up with their way of coping with their problems.

Biologically the patient has been coping with chronic pain, degeneration, and weight issues for the last 35 years. He was active for a portion of his life, but lacks the motivation to engage in activities he once enjoyed. Psychologically the client’s emotions range from reported guilt and anger to worthlessness and hopelessness. He is overwhelmed by chronic pain and reports increased symptoms of depression. Mr. Franks is socially isolated from all but his wife. Veteran’s groups and volunteer activities are functions he once attended, but no longer does. The client mentions attending church in the past, but he makes no mention of where he is at spiritually.

Hardiness/resilience is a personality characteristic originally identified by Suzanne Kobasa (1979) and redefined in further studies by Kobasa, Maddi, and Kahn (1982), and many others, as cited in (Schafer, 2000; Morris & Maisto, 2005). It was established in these studies, that participants who displayed the

Stephanie Contreras works as the Finance Director at COPE. She leads a team of interns that have a background in finance. She is in charge of creating and ensuring that the fundraising plan is followed and that COPE generates enough financial support (Srinivas, 2015, para. 14). She provides financial reports to the Executive Director to prove that COPE has the ability to be sustainable. She insures COPE receives funding from donors and the government and also makes sure that money is used to support COPE’s mission (Srinivas, 2015, para. 14). Ms. Contreras also contacts potential donors and also maintains the websites that are used to fundraise money for COPE. The finance director is in charge of implementing fundraising strategies to offset the costs of running COPE and does regular audits

(Hamar, Coberley, Pope, & Rula, 2013). Some individuals will respond and be able to find ways that are healthy avenues to deal with any life stressor simple by listening to a counselor who is able to talk about coping skills.