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Analysis of Dependency Service

  • Colin O'Rourke

Sankalpa Cravings Services

Sankalpa is a Sanskrit expression interpretation idea or notion produced in the heart or mind, a solemn vow or persistence to perform and a desire or definite intention.

History of the agency

The Millennium Carvings program which was set up in 1998 and was recognized and funded by FAS and the neighborhood Drug Task Drive (LDTF). Made to deliver treatment programs for stabilised or ex - drug users in the Finglas/ Cabra area it offered holistic programs exploring specific creativity together with therapeutic treatment programs. Millennium Carvings changed into Sankalpa and continued to make an alternative and healing environment utilising artwork and creativeness. This allows clients participate in their own healing process while addressing some of the sophisticated needs of service users through personal development and group work. The LDTF now ensure Sankalpa adhere to the National Medicine Strategy.

Agency Ethos

'A lasting pathway out of dependency leading towards a culture of recovery in Finglas & Cabra, built by support organizations and service users employed in solidarity'

The characteristic heart underpinning the Sankalpa culture is that of client centered therapeutic environment in an innovative, alternative environment, the emphasis being on community. In creating this community that allows the clients to change intrinsically, the realization being that your client knows what motivates them better than the therapist, change comes from within. It is recognised that the partnership between the customer and the therapist is of best importance when assessing the success of the therapeutic process, and that the cornerstone of recovery is this relationship.

Aims

Sankalpa aim to value the dignity and rights of your client in a just and protected climate while understanding that sole responsibility for just about any addiction is the duty of the client that developed it. In doing this it hopes to enhance intrinsic value in a restorative environment that prices learning with a view to facilitating the healing process. It is presumed that the therapeutic process is helped by creating a space where medication related injury is minimised and where well organised levels of drug services are made available. Best practice and information structured interventions are directed to be utilised as is the support of non treatment of pain. Sankalpa try to promote problem dealing with and critical thinking with their clients while left over honest and wide open minded in their affairs.

Objectives

To meet their seeks Sankalpa deliver quality programs while utilising trained staff who are centered on achieving the required outcomes when you are part of the continuum of clients' restoration and linking and partnering with other organizations to aid in this continuum. Sankalpa support clients by offering CE strategies to aid with moving on to employment and education. They provide licensed further education to clients' showing with dependency issues or stabilised on their medication and assist determined clients in the continuum of restoration by way of the development and implementation of their therapeutic model.

What kind of treatment approach underpins the organization?

The Sankalpa therapeutic model is psychosocial, client centered and evidence based. It utilises organized interventions the aim being to reduce or stabilise the harms associated with illicit medicine use. The healing work is principally done in categories and uses Cognitive Behavior Therapy (CBT), Community Encouragement Approach (CRA), Motivational Interviewing (M. I) and Mindfulness. Someone to one lessons include goal setting, reviews and assessments. It is realized by employees of Sankalpa that access to education and occupation that may recently have been out of reach scheduled to interpersonal deprivation can be the cornerstone of successful recovery.

Components of the treatment approach

Sankalpa views medication dependency as a psychosocial condition implying that internal and interpersonal elements are at play. Non directive humanistic techniques and a perception in a clients potential to intrinsically reduce their own hurting lie in the centre of the Sankalpa system which accepts people because they are without wisdom. The practices hired are with a view to lowering possible adverse health results and social consequences of medication use. Is believed that abstinence although a worthwhile goal is often unworkable and so reducing drug utilization although preferable is not key to the task carried out.

Sankalpa's multidisciplinary way recognises the value of adult education, creative imagination and communal activities and four central services underpin the task that assists in increasing a client's recovery capital.

Explore is a program that works towards building confidence in clients by preparing them for even more education.

Access (a pre-entry to Turning Point) helps clients who wish to stabilise their medicine use.

Turning Point is a four month day program for those who wish to stabilize their medicine use and also to work towards lowering the harms caused by this use.

Connect to the Workplace is a community Employment (CE) design that aspires to introduce medication free clients in to the community and targets training, work positioning and education.

Evaluation of the Company - 10 marks - 275 words

What does the agency prosper?

Sankalpa meet up with the criteria portrayed in their therapeutic model by the creation of the community and fellowship where clients from various levels of recovery will come and be paid attention to non-judgmentally within organizations, someone to one counseling and key work while also benefitting from developing a creative and cultural outlet. Compassion, admiration, dignity, solidarity and empathy are words that explain the task that is carried out.

Staff at Sankalpa receive regular guidance and appraisals which ensures they do not work beyond their competencies and have a knowledge of what's expected of these. Professional development through training/ learning opportunities improves these competencies.

I believe that the culture of any dependency service is greatly affected by the demeanour of the personnel and in Sankalpa the staff appear composed and serene. Clients have a tendency to adjust to this frame of mind.

The clients are comprised mainly of men (70%) with 52% of these presenting with heroin related however Sankalpa now realize that service users now present with poly element issues. Sankalpa understand that these medication users experience educational downside therefore unemployment. From a sample group 83% possessed left school early on and 80% were unemployed. The assistance provided address these issues.

Service users have a real words in the development and execution of services at Sankalpa and there is apparent service user participation. Complaints and surveys are seen as a means of improving the service provision and the use of a suggestion box is looked upon favorably. Within my time in Sankalpa an organization was being setup comprised solely of clients to check out various areas of their own recovery (including Sankalpa's role) without any staff involvement.

What will be the challenges facing the company?

As with many addiction services at the moment funding is no more guaranteed and is dependent on the delivery of an excellent service. At present this financing is streamlined from the HSE. The service remains accountable and clear prioritizing good governance.

Clients at Sankalpa always come first and the question is whether they feel they come first, the problem being how habits are attended to, control asserted and ability imbalance suffered without changing this.

Sankalpa are creating a culture primarily by person to person. As the company is known to the public as an 'alternative' company it must be taken into consideration what that means to the general public. In Sankalpa holistic means all areas of the individual is taken into account. Mind, body and spirit.

Harm and risks from the workplace are manipulated by applying health & safety policies and basic safety statements included in the safety management system therefore promoting a culture of safe practices. Sankalpa have detailed policies regulating all aspects of the service provision an example being maintaining that children have the right to be cared for with respect and understanding and be safe all the time. As such these are compliant with children first benchmarks (the national guideline for the security of children. ) If physical, erotic or emotional, disregard is discussed with a staff member it is reported for an onsite child security officer who then takes appropriate action.

At present I am thinking about getting ultimately more experience with group work which was the emphasis of my time with Sankalpa. The teams I was involved in were at various periods of the steering wheel of change (Procheska ref) being either in a place where they were still positively using drugs and desperate to stabilise or were already abstinent or stable on approved medication and making plans to enter employment or education. Each group was comprised of a business lead facilitator and I, and experienced up to eight clients. The culture of the communities was predicated on a shared perception in the opportunity of your life free from drug use. Loose (2001) talks about the importance of folks in addiction having their history heard and sees addiction as the contrary from speech. Within the groups a message board was provided where talk could be properly used and allowed for 'norm transmitting' and 'socialisation' to occur.

The aim of the first group (Turning Point) was to observe how the clients' efforts at becoming or staying stable on their illicit drugs or prescribed medication (be that prescription tablets or methadone) was progressing and develop discrepancies around their ambivalence towards their drug use. The group commenced with a five minute guided meditation that put participants at ease for all of those other session. The facilitator used M. I techniques fluently and shifted through the customers using open finished questions and affirmations while regularly reflecting and summarising with all times resisting the righting reflex. The result of using the M. I got that the clients felt genuinely paid attention to and understood without having to be judged therefore were quite genuine and available within the group. I realised that in comparison, the communities I have already been facilitating outside Sankalpa believe they are employing M. I but are actually missing out on the 'spirit' of M. I. In these earlier categories open-ended questions are being used frequently and facilitators do create an area for clients' to improve intrinsically yet reflecting and summarising were not evident. My very own initiatives at reflections got before been viewed as putting words into clients' mouths.

In the restorative fine art group clients created various items e. g. Mother's Day credit cards. Other than its obvious healing value this group allowed clients become very comfortable with facilitators as it didn't feel just like a formal intervention. This allowed those to be quite open up and honest about their situation while allowing me the time to apply my M. I or Quick Solution Focussed skills. I had been very alert to boundaries when dealing with clients but I don't feel this is detrimental to the relationship although there was an obvious electric power imbalance. Clients tended to presume i got some say in if they had access to treatment or not and my perception of initial conversations was that they seemed rehearsed on the part of the clients, the dialogue possibly used many times in the past with various companies in a bid to aid them on the path to restoration. This quickly moved on to reasons treatment possessed failed before and what they would do different given the chance to return. Change discussion was then evident. Insight into their current situation or the way they now seen their ambivalence appeared to be the main known reasons for their urgency to access treatment centres and perhaps this was as a result of Sankalpa key employees and counsellors developing discrepancies with the widespread M. I style.

The Gain access to Group was composed of clients who have been still actively using drugs but who wanted to become stable and as such clients tended to be less focussed than other organizations and cross converse was more apparent. M. I got used less and course and guidance was presented with but the effect was that the clients stayed enthusiastic about the process. I believe that a direct way with these clients was quite valuable as some were at pre-contemplation/contemplation (Prockeska ref) (maybe action if do it yourself referral as participating without praise) and as such acquired few concerns regarding product use. I did however feel that as direction was given it was possible that clients were stating the 'right' or what they sensed facilitators wanted to hear. Out of this group I've gained a larger confidence in dealing with resistant and ambivalent clients.

I was also engaged with ASSIST (The Liquor, Smoking and Compound Verification Test). ASSIST is a testing tool reinforced by the globe Health Organistaion (W. H. O) that I completed with clients to gain a knowledge of the history of their medicine use and determine a risk factor for every substance reviewed. ASSIST focuses mainly on the 90 days before the diagnosis and a short intervention or discussion was then completed with the client. Linking current medication use with the potential risks involved can help inspire clients to improve. When concluding ASSIST really the only issue I had formed was when clients were still positively using drugs and each question that required an individual word answer was included with a tale. I felt I had developed to shut clients down after each question to get it completed. I start to see the value of this as a tool if it could be came back to and repeated at a later time allowing the worker gauge improvements in a customer.

Identify a learning goal consequently of this interaction

I was primarily nervous and worried about what I found in every group and I found when I was not involving myself that I had not been as tuned in to the conversation as I could be. With this arrived a feeling which i was a part of the group rather than a facilitator that was something I needed to push previous. I was also aware that I used to be worrying that I would interrupt the other facilitator, my thinking being that they probably acquired something more highly relevant to say. The main of this I believe to be in how debriefing in my groups in the past have been rolled out. I am now understanding how to accept criticism of how I am in groups and previously found it as a rejection of types, either defending and explaining my words or justifying them for some reason. I did so not find this in Sankalpa where I thought any responses was coming from a place where I possibly could learn. For instance it was taken to my attention during debriefing which i have been offering my opinion by my facial gestures together or by my sitting position on the couch which I completely accepted and arrived to comprehend.

In these groupings I did so enjoy expanding discrepancies and interacting with ambivalence and I found that over time the presenting issues tended to follow a pattern. Consequently I assume that in the foreseeable future I will hear the same ambivalences often and I can respond consequently.

I believe that clients sensed that I've strolled the same avenue before and although this was never discussed it appeared to be an unspoken given and the one which I am quite more comfortable with. I've become aware that although the task is all for the clients benefit it is as also about me finding interpretation in my history. If my past is to benefit me for some reason today it is within understanding just what a client is certainly going through and offering a different level of empathy than anyone who has not walked this route. In expressing that self-disclosure never sensed necessary.

My amount of time in Sankalpa when not in a group setting offered me the required time to reflect on my own attitudes and reactions to what came up up in group, the realisation being that speaking less and going out of a client with their own silence alternatively than wanting to rescue or end sentences on their behalf is more beneficial. It also made me aware that I must remain neutral and calm all the time in groups regardless of my own emotions.

I was asked to be leading facilitator in a psycho education group this issue being 'Self-esteem'. I transformed this down so when I actually co-facilitated the same group the topic subject made me appreciate the very reasons I converted it down were rooted in my own self esteem. Personally i think I would have grown more robust by allowing myself to check out through on something that put me outside my comfort zone and allowing myself to make errors that I possibly could learn from.

I discovered that from my present work both in a single to 1 and group i am becoming a little too M. I focussed and so missing out on a huge explorative piece possessing a propensity to plan my next words so carefully which i am not fully hearing the actual service user is saying. (Abram, 2013) says that wanting to 'say the perfect thing' is an enormous obstacle to empathising.

Cohesion was built within communities peers and a community was made available to clients that was not based exclusively on drug abuse rather in ways to handle issues encompassing their medicine use.

By going to Sankalpa clients were addressing the influences of boredom, isolation and loneliness that they could have been experiencing in their lives.

All self-disclosure was confidential. Owning the actual fact that you have an issue with habit and voicing that in the front of folks can be daunting but it can make someone agree to and face up to their problems.

The socio-emotional tendencies displayed by the group tended to be positive, the feelings was light hearted, the group was cohesive, morale was high and everything members showed an interest in the wellbeing of the group. Getting and staying clean and aiding others do in the same way were the primary task of the group.

I commenced to feel quite consumed with stress at one point during my positioning because I felt I had not been doing enough of what was expected of me but during guidance a better understanding of my role was explained which put my mind at slumber. This empowered me to start to see the value of guidance I a means I hadn't seen before. I feel that in future I'll get this understanding earlier with whatever agency I work with.

I found my experience in Sankalpa to be very rewarding, specifically being permitted to observe how different facilitators work and how it may be possible to defend myself against what I consider to be the more favorable aspects of each style and that which sits best with my very own personality.

Abram, T. (2013, September 27). Barriers to Empathy. Retrieved from Michegan Point out University or college: http://msue. anr. msu. edu/information/barriers_to_empathy

Loose, R. (2001). The main topic of Addiction:Psychoanalysis and the Supervision of Entertainment. London / New York: Karnac Books.

6) Taking care of staff and ourselves.

Assisting clients with the continuum of rehabilitation by way of relationship with other businesses and services

Rate of Governance code.

The Division of Social Security fund employees involved with CE schemes and finance the CE techniques of clients.

Motivational Interviewing (M. I) and creating a culture

(ref)

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