> Competency 3: Treatment Strategies for Working with Clients with an FASD > 6b. Treatment Plan Development: Points to Consider
Competency 3: Treatment Strategies for Working with Clients with an FASD
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
- 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
- Incorporate multiple approaches to learning, such as auditory, visual, and tactile
approaches. Avoid written exercises and instead focus on hands-on practice and role
- 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.