CONTENTS

About This Course

Table of Contents

1. Introduction to the Issues
2. Understanding Alcohol Abuse
3. Understanding Violence Against Women
4. Alcohol and Domestic Violence
5. Alcohol, Sexual Assault, and Rape
6. Prevention and Early Intervention
7. Screening and Assessment
8. Diagnosis and Treatment
9. Legal and Ethical Issues

Supplements
Fact Sheets
Videos
Resources

Silence Hurts
Alcohol Abuse and Violence Against Women

Outpatient Services

Outpatient services usually involve two phases. The first phase is intensive involvement for the first few weeks or months that more closely resembles a day treatment model. This is followed by weekly continuing outpatient care for a longer period (3 to 12 months).

Specialized outpatient programs vary greatly in the intensity of treatment. Partial hospitalization/day treatment programs require patients/clients to attend day-long treatment 5 days per week. Intensive outpatient programs are sometimes hospital based and provide 2 to 3 hours of treatment each day. Finally, traditional low-intensity outpatient care normally involves one group session per week and one individual session per month.

Nonspecialized, nonresidential services are provided by many partial-day treatment programs structured for outpatient care. These include community-based drop-in centers. They are generally less available in rural areas. These facilities are good for:

• People waiting for inpatient or residential care and who require a level of interim care
• People with no family at home on a daily basis
• Retirees who need a structured daily regimen to keep the focus on their addiction

Some of these structured programs can deal with comorbidities in an intensive outpatient setting.

If a woman needs more help and structure than is readily available, an individually tailored, case-managed approach may work well for coordinating outpatient treatment. This would entail:

• Professional assessment of the client's problems and strengths
• Assistance in developing a treatment plan based on known and reasonably available community resources
• Linkage with the identified programs

Usually the client's primary physician and his or her team will be the chief players in ongoing case management.

Providers of primary drug dependence treatment should not overlook the physician, who will prescribe all medications, in their planning. It is important to include the physician in treatment planning and as a player in the recovery network. Without the physician's participation, the entire plan may unravel.

Specialized outpatient treatment generally includes psychiatric consultation and individualized or group psychotherapy. Outpatient programs frequently encourage participants to attend regular meetings of self-help groups. These include Alcoholics Anonymous, Rational Recovery, and Narcotics Anonymous.

Often a proactive case manager helps a person connect with an appropriate group. After a patient's release from the formal and time-limited outpatient substance abuse treatment program, a case manager plays an important aftercare role. He or she coordinates community-based support and monitoring to reinforce gains made during treatment and prevent or minimize the impact of slips.