Aftercare

CONTINUUM CARE MODEL

Abdullah Baniyameen
baniyameen@aol.com
November 19, 2009

DEVELOPING A CONTINUUM OF CARE PLANNING EFFORT SEEMS TIMELY. THIS HELP FAMILY/SUBJECTS/CLINICIAN TO PRACTICE AND PROVIDE CARE IN MULTI–DIMENSIONAL VENUES. PLANS USUALLY TAILORED TO SUIT THE NEEDS OF BROADER CONTINUUM CARE.

AFTERCARE ISSUES:

To identify and to go through with family members, on issue pertaining to expected aftercare problem. Discuss with groups regarding aftercare expected problems confronting family and list it down:

• Losing interest attending self help group,
• Easily bored, frustration is evident,
• Reactivation of denial, lying,
• Rationalize the use of other substance,
• Chemical,
• Relationship, sex.

۩ Effective continuum care requires a continuous support from family members. Families should well plan ahead to provide continuum care back into family setting.

۩ Organized list of planning accordingly to domain and level of entry. A good model of aftercare plan includes, the good habit principal of daily living.

POINTERS FOR EFFECTIVE CONTINUUM CARE:

• USE OF MUTUAL – HELP PRINCIPLE,
• STRUCTURE,
• RULES,
• RESPONSIBILITIES,
• BEHAVIORAL EXPECTATION,
• ROLE MODELING,
• FEEDBACK MECHANISM,
• THERAPEUTIC LEARNING INTERVENTION.

LEVEL III RECOVERY (MAINTENANCE):

• Acceptance disease.
• Understanding of the Bio – Psycho – Social.
• Appraise valued in put in recovery, through daily structured activity.
• Gradually letting go of self defeating attitudes.Realistic expectation and rational thinking.
• Understanding and managing of high risk situation and previous relapse (ranking). (Intra, inter personal and environmental risk factor).

LEVEL III RECOVERY (RELATIONSHIP):

• To be able to demonstrate, caring, loving self and others.
• Formulate family philosophy.
• Defines roles, boundaries and approaches in new family.
• Rules – do’s – don’t.
• Appreciate differences of opinions, feedback, in a frank and open manner.
• Communicate accurately & listen attentively.
• Ability to express feelings appropriately.

LEVEL III RECOVERY (LIFE SKILLS):

• To be able to breakdown parts of problems.
• To synthesize or put parts of problems together.
• Able to manage money and time wisely.
• Accept responsibilities for own behavior / maintain healthy habits.
• Integrate new found skills into plans for problem solving.
• Identify and deal with feelings constructively.

LEVEL III RECOVERY (SPIRITUALITY):

• MAINTAIN AN APPRECIATE VALUES AND BELIEF SYSTEM,
• DEFINE WHAT’S OK AND NOT OK BEHAVIOR – A CLEAR CONSCIENCE,
• HONESTY,
• RESPONSIBLE CARE & CONCERNS,
• HUMILITY.

SUGGESTED ROLES OF PARENTS:

• Taking charge versus letting go.
• From control to freedom.
• Freedom to Responsibility.
  **As children grow up we must constantly keep redefining our roles as parents.

PARENTAL CALLS FOR RESPONSIBILITY:

• Encourages the children to do so.
• For the kids it means that they must learn that if they want freedom, they must take responsibility for those choices - must learn actions have consequences. When they choose the action, they choosing to accept the consequences…

PARENTAL CONSENSUS ON PRINCIPLES:

• It is absolutely essential that parents agree on these guidelines.
• Primary Goal > is to prepare our children for dealing with the real world.
• The methods we use: must be evaluated on how well that meets the children deepest human needs such as self – esteem, respect, reliance, meaningful relationship with others.

SETTING LIMITS:

WE DON’T LET BABY PUTS IT’S HAND ON A HOT STOVE TO LEARN WHAT HEAT MEANS. TO ADOLESCENT; LIMIT EXISTS TO BE TESTED. HOW SERIOUS IS MY PARENTS IN IMPOSING THE CURFEW OR BANS? HOW FAR I CAN REALLY GO?

CLEAR THROUGH DISCUSSION AND WRITING IT DOWN UNTIL THEY AGREES’ THEY’RE CLEAR. POST IT WHERE IT IS CLEAR WHERE IT IS EASILY REVIEW SUCH AS REFRIGERATOR, BULLETIN BOARD, OR FREQUENT ACCESSIBLE PLACE USED BY ALL.

NO TWO KIDS ARE ALIKE, MUST REFLECT THE CHILD UNIQUE NEEDS AND CAPACITIES, SUCH AS:

• Age. It has to come with maturity & responsibilities in handling them.
• Trust has been earned.
• They must earn our trust; we somehow put ourselves in their hands. Rely on them to do what’s right. They have to show they’re worthy of our trust.
• Trusting and loving them are two different things.
• Loving them is a commitment, it’s a natural part of a family life but they don’t have to earn our love.

ENFORCEMENT OF LIMITS:

• We must model it. We must have some idea what they are doing?
• Or going to class, at least when our kids says that there going to practice after school, we need to know when practice starts and ends and check with the in charge to see whether they attended.
• Check observance or non observance:
  i.e. Billiard, Café, Video Arcade, etc.
• We must follow through with definite consequences when they violates the limits.

SETTING CONSEQUENCES:

• When parents prepare a reasonable, clear set of consequences, that will predictably follow when kids acts inappropriately, kids can learn in a loving supportive, environment a lesson that the world are harsh that actions have consequences.
• When kids learned at home that actions have consequences, they’re more likely to consider what effects those decisions will have on themselves and on those they love.

QUALITY OF EFFECTIVE CONSEQUENCES:

• They’re related to the incident.
• They’re reasonable > that consequences usually exceed the violation.
• They’re timely > the sooner the better.
• Not to elaborate or to complicate.
• They’re enforced calmly, respectfully, without anger.
• Applied consistently - if parent don’t apply it consistently, it fails.

AVOIDANCE IN SETTING CONSEQUENCES:

• Seeking Revenge,
• Punishing Ourselves,
• Rewarding in Appropriate Behavior,
• Making Threats or Promises,
• Shaming,
• Over Emphasizing Consequences.

BUILDING FAMILY UNIT:

• Family Schedule,
• Family Activities,
• Family Events,
• Family Meeting,
• House Utilization Plan,
• House Keeping Duty.

FAMILY SCHEDULE:
SET UP A WEEKLY CALENDAR OUTLINING FAMILY ACTIVITIES.

FAMILY ACTIVITIES:
REGULAR ACTIVITIES, DAILY OR WEEKLY THAT ALL FAMILY MEMBERS ARE EXPECTED TO ATTEND – WORSHIP, DINNER, ETC.

FAMILY EVENTS:
PLAN SPECIAL ACTIVITIES, OUTING TO THE ZOOM, AMUSEMENT PARK, MOVIES, OR VACATIONS ETC.

FAMILY MEETINGS:
HOLD WEEKLY CONTACT TIME TO AIR FEELINGS OR CONCERNS, REVIEW PLANS AND FEEDBACK.

HOME UTILIZATION:
Bath rooms, living room, kitchen when such areas are to be used more frequently, and to develop special rules governing those areas.

HOUSEKEEPING RESPONSIBILITY:
Line up duties and make it clear that everyone is expected to do certain chores without expecting remuneration.

HANDLING MISTAKES AND OWN PROBLEMS:

• PROMPTLY ADMIT OUR MISTAKE,
• ADMIT OUR PROBLEMS,
• AVOID BLAMING OTHERS,
• BE WILLING TO GET HELP.

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