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Competency 3: Treatment Strategies for Working with Clients with an FASD

Adolescents

Treatment Plan Development, Continued

Points to Consider when Developing a Treatment Plan

In developing a treatment plan, the following points might be useful17:

  • Assist the child to adjust to a structured program or environment and to learn how to trust the staff. Youth with an FASD tend to be trusting and need a great deal of structure but may have trouble adapting to changes in routine and to new people.
  • Share the rules early and often. Put them in writing and constantly remind the youth of the rules. Keep the rules simple and avoid punitive measures that most youth with an FASD will not process. If they break a rule, remind them what it is and help strategize ways to help them follow the rule in the future. Ask them what each rule means and how they would follow that rule to get a sense of their understanding.
  • Take a holistic approach, focusing on all aspects of the adolescent’s life, not just the alcohol abuse. Include basic living skills and social skills, such as how to dress, groom, present a positive attitude, and practice good manners. Help the client to develop appropriate goals within the context of her interests and abilities.
  • Provide opportunities to role play or otherwise practice appropriate social behaviors, such as helping others. Areas of focus may include impulse control skills, dealing with difficult situations such as being teased, and problem solving.
  • In an inpatient setting, allow time for the youth to be stabilized and acquire the basic skills to cooperate with others before discussing his or her chemical dependency issues. In an outpatient setting, it may help to develop a rapport with the client and establish trust and communication before addressing chemical dependency.
  • Include refusal skills training. Youth with an FASD will often try to please others and will engage in risky activities to fit in. It is important to help them learn to turn down alcohol.
  • Assign a coach or mentor to meet or talk with them every day in recovery to discuss plans for the day.
  • Include the family in activities, such as parent education about FASD and addiction; and strategies for parenting youth with an FASD and substance use problems, such as avoiding power struggles; and building their child’s self-esteem. Help parents and other family members practice communication skills, such as active listening and using literal language. People with an FASD have trouble understanding slang, metaphors, and other figurative speech. Include family meetings in the treatment plan, with a clear purpose and agenda.
  • Recognize that some family members may have an FASD as well and work with them accordingly.
  • Work with the youth’s school to include appropriate educational arrangements during treatment.
  • Incorporate multiple approaches to learning, such as auditory, visual, and tactile approaches. Avoid written exercises and instead focus on hands-on practice and role playing.
  • Use multisensory strategies, such as drawing, painting, or music, to assist the client in expressing feelings. These strategies take advantage of skills that many youth with an FASD have. They can also help youths to share difficult feelings, such as fear and anger, that may be hard to talk about.
  • Arrange aftercare, and encourage parents to participate in a support group to continue to learn parenting skills and to be encouraged in the recovery process.

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