Drug and Alcohol Clinic with Inpatient Detox Growth Through Learning and Change via Action

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Overview of the Programme & Modular Treatment Process

The Lampton Intensive
Programme

The Lampton Intensive Programme is an individually tailored residential treatment programme providing respite and treatment for the problem drinker or drug user away from their usual work or family environment.

In this unique programme Cognitive Behavioural Therapy, recognised as one of the most effective interventions for drug or alcohol dependence, is enhanced by activity-based personal development and a range of adjunctive therapies in a four-week Intensive Programme.

Access to the Intensive Programme is normally by self- referral, GP referral or by an employer. Following a telephone assessment the patient will be offered an admission date normally within three days. On arrival, a medical and social assessment will provide the basis for an agreed personal care programme.

Each patient works to a personalized and dynamic programme built around ongoing assessment of their needs and progress. The programme elements include:

• One to one key working sessions to monitor progress, provide individual counselling and support and enable ongoing development of their personal relapse prevention plan

• The Journal Group providing the opportunity for patients to share and discuss their thoughts around each day's experiences and insights. Within the group patients provide both feedback and support to each other around the shared goal of recovery.

• Written assignments which are completed by all patients around a range of topics such as Guilt and Shame, Powerlessness, Unmanageability, Gratitude. These assignments require patients to focus on particular aspects of the addiction and recovery process and, by writing, re-enforce the learning acquired.

• Relapse prevention - a crucial element in the recovery process. All patients will find themselves, both during and after treatment, in situations where the pressure

• to drink or use drugs is increased. By exploring past relapses, identifying the triggers to use and the thinking which enabled them to happen (permissive beliefs), each patient builds up a personal Relapse Prevention Plan.

• Life story construction and analysis providing the individual with a map of how they reached their present situation. Through increased understanding of relationships, attitudes, decisions and behaviours patients are able to begin building the foundations for an effective future.

• Positive relaxation. Crucial to recovery from substance abuse is the ability to relax and to participate in positive leisure pursuits as an alternative to chemical relaxation. Patients participate in a range of activities including gymnasium, swimming and outdoor activities and are offered relaxation training, reiki and yoga.

Module One
Foundation Treatment

This module, run by our Medical Director, currently provides a detoxification programme from opiate based drugs, alcohol and benzodiazepines in our purpose built Detoxification ward which is staffed 24 hours a day by a team of RGN and RMN qualified nurses.

The core aim of the Foundation Programme is to provide clients with the most comfortable, effective and safe route towards becoming substance free or stabilized on prescribed psychoactive medication where this is appropriate.

Upon arrival, a thorough assessment is conducted by our Doctor and nursing team. This assessment fully explores the patient's physical and mental health, their level of dependence and their past experience of detoxification and rehabilitation (if any). A detailed treatment plan is then agreed with the client which details proposals for medication and the anticipated duration of treatment.

For those dependant on opiates, we favour using methadone, then subutex, as this is the best way to avoid opiate withdrawal symptoms. Some clients may be detoxified using Subutex alone, but whatever is decided we offer supportive symptomatic treatment too.

Some opiate dependent clients may wish not to use opiates for detoxification. Where this is a safe option we would always try to support them in their personal goal since this is the first step on the road to a drug- free life.

Withdrawing from alcohol dependence can be every bit as uncomfortable as dealing with opiate dependence. For those who are dependant on alcohol we use a robust benzodiazepine detox, including additional vitamin prescribing to deal with some of the effects of long term drinking.

Withdrawing people from benzodiazepine dependence has long been recognised to be particularly challenging due to the complex pharmacology involved and the need to withdraw patients over a longer period than that commonly required for alcohol or opiates. For this patient group we often find ourselves dealing both with the effects of a carefully- phased reduction of the drug and with the side effects of the drugs which have been taken over the preceding years. Our response to this is to ensure that we deal with the benzodiazepine whilst ensuring that we are sensitive and responsive to the levels of physical and psychological discomfort which some patients experience.

The challenges of detoxification become more complex as more drugs enter a patient's history and obviously, for those clients who are poly-substance users, we design a treatment regime that addresses all of their detoxification needs concurrently.

Whilst being treated on the detoxification unit, clients have opportunities to receive acupuncture, reiki and other alternative therapies. They are encouraged to take part in activities and groups when they are ready to do so, but emphasis is given to care planning and making sure that the patient is consciously engaged in the process of change. Clients are reviewed regularly by the Doctor and have the opportunity to see our own GP to address any further medical issues.

Module Two

The Treatment for Change Programme is a primary rehabilitation programme available to patients who have completed or who do not require detoxification. Highly structured, the programme is based on a typical working week with scheduled work 9.00a.m - 5.00p.m. Monday to Friday, a high tariff activity on Saturday or Sunday, and structured free-time between.

The core programme elements are written into an agreed personalised care plan for each patient but will include:

One to one key working sessions to monitor progress, provide individual counselling and support and enable ongoing development of their personal relapse prevention plan

The Journal Group providing the opportunity for patients to share and discuss their thoughts around each day's experiences and insights. Within the group patients provide both feedback and support to each other around the shared goal of recovery.

Written assignments which are completed by all patients around a range of topics such as Guilt and Shame, Powerlessness, Unmanageability, Gratitude. These assignments require patients to focus on particular aspects of the addiction and recovery process and, by writing, re-enforce the learning acquired.

Relapse prevention - a crucial element in the recovery process. All patients will find themselves, both during and after treatment, in situations where the pressure

to drink or use drugs is increased. By exploring past relapses, identifying the triggers to use and the thinking which enabled them to happen (permissive beliefs), each patient builds up a personal Relapse Prevention Plan.

Life story construction and analysis providing the individual with a map of how they reached their present situation. Through increased understanding of relationships, attitudes, decisions and behaviours patients are able to begin building the foundations for an effective future.

Positive relaxation. Crucial to recovery from substance abuse is the ability to relax and to participate in positive leisure pursuits as an alternative to chemical relaxation. Patients participate in a range of activities including gymnasium, swimming and outdoor activities and are offered relaxation training, reiki and yoga.

By focusing on the whole person, and ensuring continuity of support following completion of the residential programme, people are returned to their home community drug and alcohol free, with enhanced self-awareness, new coping skills, and confident in knowing that crisis support and advice is only a phone call away.

Module Three

Re-integration Programme (12 weeks)

Moving from the protected environment of a rehabilitation centre back to the community is particularly daunting for patients seeking to maintain a drug or alcohol free existence. The Re-integration Programme introduces patients to increasing levels of independence and freedom within which they can experience the pressures to relapse in the community and review these triggers in the safety of the unit with their peers and counsellors.

Some more vulnerable clients completing Module Two still experience considerable uncertainty regarding their ability to cope with fully independent living. For these clients, Module Three offers the chance to continue to live within the safety of Lampton Court and to extend their participation in the cognitive behavioural elements of the programme.

Whilst in Module Three all clients are required to attend one Journal Group, a weekend experiential learning session and to participate in the relapse prevention group and a re-entry-focussed "Moving-On" group.

The reduced participation in structured therapy allows clients two days per week in which to develop and pursue their own personal development curriculum. This curriculum will normally include:

• Training, through our connection with North Devon College

• Accommodation search and acquisition

• Job seeking including application skills development and training needs assessment.

• Voluntary work to experience positive contribution to the community

• Other appropriate self-development intitiatives. Positive relaxation.

In addition to these self- defined activities the general topics at the core of the Re- integration Programme can be defined as those which equip the programme graduate to face independent living confidently and without relapsing or resorting to previous maladaptive coping behaviours.

In support of the core programme participants continue to access a range of complimentary therapies including Reiki, Tai Chi and Auricular Acupuncture

Activity Therapy Programme
A unique and exciting feature of the Lampton Programme

Activity Therapy is an experiential process requiring participation in active individual and team challenges. These concrete experiences enable clients to explore and test-out in a very real way some of the theories and personal insights acquired in group and one to one sessions. Requiring teamwork, planning communication and focus to succeed, this hands-on approach builds self-esteem, motivation, communication, trust, self awareness and physical wellbeing.

For many clients the activities are new, adventurous and exciting and produce a natural euphoria or high. Typically, one client commented after surfing for the first time, that the feeling was similar to the rush he experienced from heroin, but without the pain. Such learning is vital in enabling clients to be confident in their ability to find relaxation without intoxication. Thus, as well as contextualising learning, giving fun and new experiences AT seeks to develop an enjoyment of the outdoors and provide first-hand experience of low cost activities to pursue on returning to the community. Each resident will participate in a selection of activities typically drawn from the following lists. Naturally, the availability of any particular activity will always be subject to climatic conditions, an assessment of individual risk including physical capacity, and the stage at which the resident joins the programme.

• Trust building exercises Caving

• Kayaking Climbing Horse riding Abseiling Surfing Power kiting Mountain Biking Problem solving

• High ropes course

• Orienteering on Dartmoor

• Coasteering

• Yachting

All Activities are subject to availability, the weather and climatic conditions.